Endocrine Abstracts

Objective: Adrenal insufficiency is the clinical manifestation of deficient production or action of glucocorticoids, with or without mineralocorticoids deficiency and adrenal androgens. The mortality of untreated adrenal insufficiency reaches up to 80% in 2 years. Moreover, the symptom is non-specific like malaise, dizziness. Therefore, history taking, prompt diagnosis and management are more important. The diagnostic investigation, although well established, can be challenging, especially in patients with secondary or tertiary adrenal insufficiency. However, information about the prevalence and characteristics of adrenal insufficiency in Korea is lack. Therefore, we reviewed the characteristic of patients of adrenal insufficiency.

Methods: We reviewed medical records of patients who visited Keimying University Dongsan Medical Center for 4 months and conducted a test such as rapid ACTH stimulation test and insulin tolerance test.

Results: In 267 participants enrolled, most common reason (38.9%) to conduct a test was that patients complained suspicious symptoms related with adrenal insufficiency and the second reason (29.6%) was for diagnosis the cause of hyponatremia. Among them, 37.4% patients was diagnosed as adrenal insufficiency. 70% was female and mean age was 65.23 years old. Basal cortisol level was 3.93±3.81 and it was significantly lower than normal patients (P=0.000). Common symptoms are anorexia, nausea, dehydration, and arthralgia. 67% patients had history of steroid medication and 53% of patients took steroid within 3 months.

Conclusion: A lot of patients who diagnosed adrenal insufficiency are related with steroid medication. History taking about long-term use of steroid is necessary for early detection. Basal cortisol level could not be diagnosis but provide an useful clue for diagnosis of adrenal insufficiency. In addition, when we use steroid, we are more cautious about development adrenal insufficiency. We need further study to evaluate the prevalence and characteristics in a large population.