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Infectious diseases pose threat for patients with Addison’s disease
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13th European Congress of Endocrinology
Patients with Addison’s disease are at increased risk for infection, and infectious diseases are likely to provoke adrenal crisis in this population, according to two new studies.
Stefanie Hahner, MD, of the University of Würzburg in Germany, and colleagues conducted a prospective study to evaluate incidence and causes of general morbidity and hospitalization among patients with Addison’s disease. The researchers included 472 patients in the study.
Their analysis revealed an incidence of 7.6 events of adrenal crisis per 100 patient-years. Sixty-two patients had an adrenal crisis during the 2-year study period, with almost two-thirds of those requiring hospitalization and 9.5% requiring treatment in intensive care. Two patients died of adrenal crisis during the study.
“The number of adrenal crises was higher than we expected from previous studies,” Hahner said in a press release. “Infectious disease provoked 39% of the crises, with psychological stress also causing problems.” Neglected cortisone intake, strong pain, heat and other factors were also implicated.
In addition, although 95% of patients had emergency cards explaining their disease, only 28% possessed emergency injection sets.
“[These data] show that these crises are largely caused by infectious diseases and stress, but also that patients need to be better prepared to respond to the crises when they arise and that infectious disease has to be treated early and aggressively in this patient group,” Hahner said.
In a second study, Lisanne Smans, MD, of the University of Utrecht in the Netherlands, and colleagues also found that infectious events and hospitalization for infections are more common in patients with Addison’s disease. Their study compared outcomes of 390 patients with Addison’s disease who were simultaneously using glucocorticoids and mineralocorticoids with 1,933 control patients. The overall incidence of infectious episodes was 59.2 per 100 person-years. According to the researchers’ data, the risk for infection was 1.5 times higher for patients with Addison’s disease. The rate of hospital admission was also higher in this group compared with controls (3.8 cases per 100 person-years vs. 0.8 cases per 100 person-years).
“We need to raise awareness among doctors and patients of the risk of infections in Addison’s patients compared to the general population,” Smans said in the release. “We now want to move on to see whether influenza vaccinations can help this patient group.”
For more information:
- Hahner S. Oral Communication Session 1.5.
- Smans L. Oral Communication Session 1.6. Both presented at: 13th European Congress of Endocrinology; Apr. 30-May 4, 2011; Rotterdam, the Netherlands.
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