Endocrine Abstracts

IntroductionWorldwide, 100 million people have been diagnosed with COVID-19. Patients with adrenal insufficiency (AI) are assumed, on the basis of expert opinion, to be at higher risk of infection.AimTo determine the patient reported incidence and potential risk factors of infection with COVID-19, for patients diagnosed with AI.MethodA 42 item questionnaire (inclu...

Introduction: Patients with Addison’s disease are burdened by substantial comorbidity and likely require a large package of care. There is a proportion of South African patients who can afford private health-care, comparable to health-care offered in a developed country. We hypothesised that comprehensive package of care costs for Addison’s disease is relatively high.Methods: We identifed 131 patients with Addison’s disease within a privat...

Introduction: Male hypogonadism may complicate Addison’s disease (AD), but the prevalence of testosterone deficiency in adult males with primary hypoadrenalism is unknown.Methods: Male patients older than 18 years of age enrolled in the South African AD national registry were screened for biochemical testosterone deficiency (early morning basal testosterone <9.9 nmol/l). Testing was also performed to see if these subjects were more susceptible t...

Objectives: Addison’s disease diagnostic and management challenges in Africa are not well documented. We aimed to identify the specific needs of patients with established Addison’s disease, across Africa.Methods: An online survey of a large pool of medical practitioners was undertaken. The questionnaire covered patient demographics, aetiology, therapy and limitations of diagnosis and treatment.Results: Of the 36,203 recip...

Background: The burden and management of Addison’s disease (AD) in Africa have not been well documented. We aimed to identify specific disease characteristics, patient demographics and patterns of clinical management in established AD in Africa, hypothesizing that deficiencies in diagnosis and management exist.Methods: An on-line survey of a large pool of medical practitioners’ experience from Africa and Middle East, relating to AD was conduc...

Background: Data examining HLA associations in Addison’s disease (AD) from South Africa (SA) are limited. We wished to determine the HLA in South African AD patients either positive or negative for 21 hydroxylase autoantibodies (21 OH-AA) and matched healthy controls, hypothesising that certain HLA alleles could predominate, but there may be differences from Western countries.Methods: SA patients (n=73) were enrolled as part of a nationwide...

Background: Large populations of HIV and tuberculosis occur in South Africa and, amongst these patients, Addison’s disease is probably underdiagnosed. Preliminary data in 60 HIV-positive patients with a CD4 count less than 100 cells/mm3 showed that the overall prevalence of hypoadrenalism was 6.7%, with 1 patient having primary hypoadrenalism and 3 patients having central hypoadrenalism. This report describes the prevalence of hypoadrenalism and its association...

Background: Salivary cortisol, as measured using electro-chemiluminescence has been used to monitor patients with Addison’s disease (AD) on hydrocortisone replacement. Salivary cortisone has been suggested as an alternative to salivary cortisol, as it may accurately reflect plasma free cortisol. We wished to examine the pharmacokinetics of these analytes in patients and controls.Methods: We measured salivary cortisol and salivary cortisone by liquid...

Background: Addison’s disease is probably under-diagnosed in South Africa, given that the prevalence is considerably lower than reported in Western countries (Chabre O 2017); this is important as patients may be dying from a highly treatable condition. In addition, large populations of HIV and tuberculosis infected patients in South Africa may have some symptoms erroneously attributed to these conditions, rather than Addison’s disease. We determined the prevalence an...