Deirdre Green
Deirdre Green
Academic Department of Endocrinology, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin
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Rosemary Dineen
Rosemary Dineen
Academic Department of Endocrinology, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin
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Michael W O’Reilly
Michael W O’Reilly
Academic Department of Endocrinology, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin
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Mark Sherlock
Mark Sherlock
Academic Department of Endocrinology, Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin
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Introduction Adrenal insufficiency (AI) is characterised by inadequate adrenal corticosteroid hormone production and is classified as primary, secondary or tertiary ( 1 ). Primary adrenal insufficiency (PAI) is caused by pathological processes
Margret J Einarsdottir
Margret J Einarsdottir
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Penelope Trimpou
Penelope Trimpou
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Gudmundur Johannsson
Gudmundur Johannsson
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Oskar Ragnarsson
Oskar Ragnarsson
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Introduction Oral glucocorticoid (GC) treatment can lead to adrenal insufficiency by suppressing the hypothalamic–pituitary–adrenal axis. This can result in life-threatening adrenal crisis if the patient does not receive an increased GC dose
Natacha Driessens
Natacha Driessens
Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, Department of Endocrinology, Route de Lennik, Brussels, Belgium
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Madhu Prasai
Madhu Prasai
Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, Department of Endocrinology, Route de Lennik, Brussels, Belgium
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Orsalia Alexopoulou
Orsalia Alexopoulou
Department of Endocrinology, Cliniques Universitaires Saint Luc, Brussels, Belgium
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Christophe De Block
Christophe De Block
Department of Endocrinology-Diabetology-Metabolism, Universitair Ziekenhuis Antwerpen & University of Antwerp, Drie Eikenstraat, Edegem, Belgium
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Eva Van Caenegem
Eva Van Caenegem
Department of Endocrinology, Academisch Ziekenhuis Sint-Jan Brugge – Oostende AV, Ruddershove, Brugge, Belgium
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Guy T’Sjoen
Guy T’Sjoen
Department of Endocrinology, Ghent Universitary Hospital, C. Heymanslaan, Gent, Belgium
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Frank Nobels
Frank Nobels
Department of Endocrinology, Onze-Lieve Vrouw Ziekenhuis, Moorselbaan, Aalst, Belgium
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Christophe Ghys
Christophe Ghys
Department of Endocrinology, Universitair Ziekenhuis Brussel, Laarbeeklaan, Brussels, Belgium
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Laurent Vroonen
Laurent Vroonen
Department of Endocrinology, Cliniques Universitaires de Liège, Avenue de l’hôpital, Liège, Belgium
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Corinne Jonas
Corinne Jonas
Department of Endocrinology, CHU UCL Namur - Godinne, Avenue Docteur Gaston Thérasse, Yvoir, Belgium
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Bernard Corvilain
Bernard Corvilain
Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), CUB Hôpital Erasme, Department of Endocrinology, Route de Lennik, Brussels, Belgium
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Dominique Maiter
Dominique Maiter
Department of Endocrinology, Cliniques Universitaires Saint Luc, Brussels, Belgium
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Introduction Primary adrenal insufficiency (PAI) is a rare disease, most commonly of auto-immune origin. There is a global variation in prevalence from 80 to 145 per million in Europe, with the highest case numbers reported in Scandinavian
Angelica Sharma
Angelica Sharma
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Katharine Lazarus
Katharine Lazarus
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Deborah Papadopoulou
Deborah Papadopoulou
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Hemanth Prabhudev
Hemanth Prabhudev
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Tricia Tan
Tricia Tan
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Karim Meeran
Karim Meeran
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Sirazum Choudhury
Sirazum Choudhury
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Introduction Patients with adrenal insufficiency (AI) have premature morbidity and mortality ( 1 ). Mildly elevated levels of glucocorticoids or non-circadian timing of therapy may contribute towards cardiovascular disease and increased
V Guarnotta
V Guarnotta
Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
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C Di Stefano
C Di Stefano
Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
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A Santoro
A Santoro
Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
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A Ciresi
A Ciresi
Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
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A Coppola
A Coppola
Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
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C Giordano
C Giordano
Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy
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Introduction Adrenal insufficiency (AI) is characterized by high morbidity and mortality, likely due to inappropriate glucocorticoid (GC) treatment and no physiological daily exposure. Indeed, conventional GC treatment, with hydrocortisone (HC
Amit Kumar
Amit Kumar
Department of Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India
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Maria Ghosh
Maria Ghosh
Department of Biochemistry, Christian Medical College and Hospital, Ludhiana, Punjab, India
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Jubbin Jagan Jacob
Jubbin Jagan Jacob
Department of Endocrinology, Christian Medical College and Hospital, Ludhiana, Punjab, India
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principal cause of euvolemic hyponatremia (EuVHNa). Although SIAD has a specific diagnostic criteria, it remains a diagnosis of exclusion and needs the absence of secondary adrenal insufficiency (AI) and hypothyroidism as an essential criterion for the
Johan G Beun
Johan G Beun
AdrenalNET, The Netherlands
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Pia Burman
Pia Burman
Department of Endocrinology, Skåne University Hospital, Lund University, Sweden
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Olle Kämpe
Olle Kämpe
Department of Medicine (Solna), Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
Department of Endocrinology, Diabetes and Metabolism, Karolinska University Hospital, Stockholm, Sweden
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Department of Endocrinology, Diabetes and Metabolism, Karolinska University Hospital, Stockholm, Sweden
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Eystein S Husebye
Eystein S Husebye
Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Stephanie Hahner
Stephanie Hahner
Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Germany
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Jette Kristensen
Jette Kristensen
Addison Foreningen i Danmark, Denmark
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Alida Noordzij
Alida Noordzij
AdrenalNET, The Netherlands
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Per Dahlqvist
Per Dahlqvist
Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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The number of individuals in Europe with primary and secondary adrenal insufficiency (AI) is estimated to be 20–50 per 100,000 ( 1 ). AI is characterised by a deficit in synthesis and release of cortisol, with symptoms including tiredness
Salem A Beshyah
Salem A Beshyah
Department of Medicine, Dubai Medical College, Dubai, United Arab Emirates
Diabetes and Endocrine Clinic, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
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Diabetes and Endocrine Clinic, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
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Khawla F Ali
Khawla F Ali
Department of Medicine, Royal College of Surgeons in Ireland Medical University of Bahrain, Adliya, Bahrain
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Hussein F Saadi
Hussein F Saadi
Department of Endocrinology, Medical Subspecialties Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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attracted the most attention with the largest volume of literature ( 5 ). Nevertheless, significant deficiencies remain in guidance toward the management of other endocrinological disorders during Ramadan ( 6 ). Adrenal insufficiency (AI) represents a
Marcus Quinkler
Marcus Quinkler
Endocrinology in Charlottenburg, Berlin, Germany
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Bertil Ekman
Bertil Ekman
Departments of Endocrinology and Medical and Health Sciences, Linköping University, Linköping, Sweden
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Claudio Marelli
Claudio Marelli
Shire International GmbH, Zug, Switzerland
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Sharif Uddin
Sharif Uddin
Shire, Lexington, Massachusetts, USA
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Pierre Zelissen
Pierre Zelissen
Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, the Netherlands
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Robert D Murray
Robert D Murray
Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds, UK
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on behalf of the EU-AIR Investigators
on behalf of the EU-AIR Investigators
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cortisone, resulting in higher systemic availability of the active 11β-hydroxy form, prednisolone ( 12 ). Prednisolone is used in some patients with adrenal insufficiency (AI) as hormone replacement therapy. Advocates of prednisolone highlight that it
Kathrin Zopf
Kathrin Zopf
Department of Endocrinology, Diabetes and Nutrition, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Kathrin R Frey
Kathrin R Frey
Department of Medicine I, Endocrine and Diabetes Unit, University Hospital, University of Würzburg, Würzburg, Germany
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Tina Kienitz
Tina Kienitz
Department of Endocrinology, Diabetes and Nutrition, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Manfred Ventz
Manfred Ventz
Department of Endocrinology, Diabetes and Nutrition, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Britta Bauer
Britta Bauer
Endocrinology in Charlottenburg, Berlin, Germany
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Marcus Quinkler
Marcus Quinkler
Endocrinology in Charlottenburg, Berlin, Germany
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GR functionality. In patients with bronchial asthma, the Bcl I polymorphism seems to at least partially explain the development of a severe form of asthma associated with resistance to glucocorticoids ( 10 ). Patients with adrenal insufficiency
