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DOI: 10.1055/s-2007-973077
© J. A. Barth Verlag in Georg Thieme Verlag KG · Stuttgart · New York
Long-lasting Subclinical Addison's Disease
Publication History
received 28.09.2006
first decision 12.12.2006
accepted 27.02.2007
Publication Date:
12 September 2007 (online)
Abstract
Objective: To report a patient with autoimmune adrenal disease and increased ACTH with longstanding hyperpigmentation as an isolated symptom.
Methods: A 49-year-old woman requested a diagnostic work-up for hyperpigmentation initiated 9 years before, associated with increased ACTH. She was receiving replacement therapy for autoimmune hypothyroidism. Basal and dynamic tests of glucocorticoid axis, basal investigation of mineralocorticoid axis and measurement of organ specific autoantibodies were performed.
Results: Plasma ACTH (143 pmol/l; normal <13.2 pmol/l) and antibodies against 21-hydroxylase (115 UI/ml; normal <1) were remarkably high, thyroid peroxidase and parietal cell antibodies were positive at low titter and all additional tests were normal.
Conclusion: Autoimmune adrenal disease can have a very long preclinical period even with high concomitant ACTH and specific antibody titers.
Key words
hormones - antibodies - autoimmunity
References
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Correspondence
S. TorrejónMD
Servei d'Endocrinologia i Nutrició
Hospital de la Santa Creu I Sant Pau
Sant Antoni M Claret 167
Fax: +34/93/556 57 27
Email: storrejon@gmail.com