Endocrine Abstracts

Objective: Evaluate the prevalence of adrenal insufficiency (AI) in Southern Province of Seville that comprises around 400.000 people.

Materials and methods: Retrospective descriptive study that includes patients diagnosed with primary (PAI) and secondary (SAI) adrenal insufficiency that are followed up at Virgen de Valme University Hospital.

Results: Out of the 125 patients with AI, 51 patients (40,8%) had PAI and 74 patients had SAI (59.2%). PAI was diagnosed in 30 men (59%) and 21 women (41%). Age at diagnosis was 32 ± 21 years. The most common cause was of autoimmune origin (51%), followed by adrenalectomy (31%), congenital adrenal hyperplasia (16%), and tuberculosis (2%). Among patients with autoimmune origin of PAI, 15 (58%) had at least one associated autoimmune disease, most commonly Hashimoto’s thyroiditis (80%), type 1 DM (27%), pernicious anemia (13%), celiac disease (7%), Grave’s disease (7%), Goodpasture’s syndrome (7%), and psoriasis (7%). As for adrenalectomy, the cause of surgery were pheochromocytoma (37.5%), Cushing’s syndrome (37.5%), and metastasis (25%). Regarding treatment, the mean dose of hydrocortisone was 23.2 ± 7.9 mg and of fludrocortisone 0,08 ± 0.5 mg. SAI was diagnosed in 41 men (55%) and 33 women (45%). Age at diagnosis was 48 ± 21 years. The main etiology was non-functioning pituitary macroadenoma (25.7%), followed by craniopharyngioma (10.8%), functioning pituitary adenoma (8.1%), Sheehan syndrome (6.8%), pituitary apoplexy (6.8%), empty sella turcica (6.8%), traumatic head injury (5.4%), immunotherapy (4.1%), hypophysitis (4.1%), exogenous corticosteroids (4.1%), radiotherapy (2.7%), idiopathic panhypopituitarism (2.7%), pituitary hypoplasia (2.7%), pituitary carcinoma (1.4%), and other causes (8.1%). The mean hydrocortisone dose for treatment was 18.8 ± 5.3 mg.

Conclusions: In our study population, it was observed that AI occurs more frequently in men. SAI is more common and occurs almost 15 years after PAI, with the dose of hydrocortisone being almost 5 mg less than in PAI. The most common cause of SAI was non-functioning pituitary macroadenoma, while in the case of PAI, it was of autoimmune origin and most commonly associated with Hashimoto’s thyroiditis.