Choroba addisona – Rokowania, prognozy i postęp choroby

Choroba addisona
Rokowania, prognozy i postęp choroby

Choroba Addisona charakteryzuje się generalnie korzystnym rokowaniem dzięki dostępności terapii zastępczej kortykosteroidami, umożliwiającej pacjentom prowadzenie aktywnego życia i osiąganie prawidłowej długości życia. Niemniej jednak, dożywotnia terapia hormonalna jest niezbędna, a rokowanie zależy od etiologii, czasu rozpoznania, wdrożenia leczenia oraz obecności chorób współistniejących. Standaryzowany współczynnik śmiertelności (SMR) wynosi 1,15 (95% CI 0,96-1,35), z istotnie podwyższonym SMR 1,50 u pacjentów diagnozowanych przed 40. rokiem życia, szczególnie u mężczyzn (2,03). Średni wiek zgonu jest obniżony o 3,2 lata u kobiet (75,7 lat) i 11,2 lat u mężczyzn (64,8 lat). Największym zagrożeniem jest przełom nadnerczowy, a także choroby sercowo-naczyniowe, nowotwory i infekcje, które znacząco wpływają na śmiertelność. Współistnienie cukrzycy typu 1 lub 2 zwiększa ryzyko zgonu (28% vs 10%, RR 3,89). Długotrwała terapia glikokortykosteroidami i mineralokortykosteroidami niesie ryzyko powikłań metabolicznych, takich jak otyłość, cukrzyca typu 2, osteoporoza i nadciśnienie tętnicze.

Prognoza choroby Addisona (Choroba addisona) – rokowanie

Wskaźniki śmiertelności i oczekiwana długość życia
Czynniki wpływające na rokowanie
Powikłania wpływające na rokowanie
Osteoporoza jako powikłanie długoterminowej terapii
Choroba Addisona a COVID-19
Jakość życia
Kluczowe zalecenia dla poprawy rokowania
Kolejne rozdziały

Prognoza choroby Addisona (Choroba addisona) – rokowanie

Prognoza w chorobie Addisona jest generalnie korzystna. Dzięki dostępności terapii zastępczej kortykosteroidami oraz postępom w diagnostyce większość pacjentów może prowadzić normalny, aktywny tryb życia z niewielkimi ograniczeniami, osiągając normalną długość życia.¹²³ Należy jednak podkreślić, że osoby z chorobą Addisona wymagają dożywotniej terapii zastępczej hormonalnej, a rokowanie zależy od kilku kluczowych czynników: etiologii choroby, czasu rozpoznania i wdrożenia leczenia oraz współistniejących chorób.⁴

Wskaźniki śmiertelności i oczekiwana długość życia

Badania dotyczące śmiertelności w chorobie Addisona wykazują różne wyniki. Dawniej uważano, że oczekiwana długość życia pacjentów jest normalna. Nowsze badania wskazują jednak na podwyższone ryzyko przedwczesnej śmierci, szczególnie w określonych grupach pacjentów.⁵

Ogólny standaryzowany współczynnik śmiertelności (SMR) wynosi 1,15 (95% przedział ufności 0,96-1,35), przy czym jest podobny u kobiet (1,18) i mężczyzn (1,10). Jednak u pacjentów zdiagnozowanych przed 40. rokiem życia SMR jest istotnie podwyższony do 1,50, z najwyższą wartością u mężczyzn (2,03).⁶ Średnia wieku w chwili zgonu dla kobiet (75,7 lat) i mężczyzn (64,8 lat) jest odpowiednio o 3,2 i 11,2 lata niższa od szacowanej oczekiwanej długości życia.⁷⁸

Szacuje się, że osoby doświadczające powikłań lub ciężkiej niewydolności nadnerczy mogą tracić od 3 do 11 lat życia.⁹ Dodatkowo, ryzyko zgonu jest ponad 2-krotnie wyższe u pacjentów z chorobą Addisona, nawet po rozpoznaniu i wdrożeniu leczenia.¹⁰

Czynniki wpływające na rokowanie

Na rokowanie w chorobie Addisona wpływa szereg czynników, które należy uwzględnić w opiece nad pacjentem:

Wczesne rozpoznanie choroby – opóźnienie w diagnozie znacząco pogarsza rokowanie¹¹¹²
Adekwatna terapia zastępcza glikokortykosteroidami i mineralokortykosteroidami¹³
Unikanie przełomu nadnerczowego – głównego zagrożenia dla życia pacjenta¹⁴¹⁵
Właściwa edukacja pacjenta dotycząca zasad postępowania w czasie choroby (sick day rules)¹⁶
Wiek pacjenta w momencie diagnozy – osoby zdiagnozowane przed 40. rokiem życia mają podwyższone ryzyko przedwczesnego zgonu¹⁷

Powikłania wpływające na rokowanie

Choroba Addisona może prowadzić do szeregu powikłań wpływających na długoterminowe rokowanie:

Przełom nadnerczowy

Przełom nadnerczowy stanowi największe zagrożenie dla pacjentów z chorobą Addisona. Jest to stan zagrażający życiu, który może wystąpić w sytuacjach stresu, infekcji lub przy nieadekwatnej terapii zastępczej. Nieleczony przełom nadnerczowy może prowadzić do zgonu.¹⁸¹⁹ Przełom może zostać wywołany de novo, np. przez krwotok do nadnerczy, lub być następstwem ostrego zdarzenia nałożonego na przewlekłą lub nieadekwatnie leczoną niewydolność kory nadnerczy.²⁰

Choroby współistniejące

Za wyższy współczynnik śmiertelności u pacjentów z chorobą Addisona odpowiadają głównie choroby sercowo-naczyniowe, nowotwory złośliwe oraz choroby zakaźne.²¹ Do 50% pacjentów z chorobą Addisona rozwija inne schorzenia autoimmunologiczne, co może dodatkowo komplikować przebieg choroby i pogarszać rokowanie.²²

Szczególnie niekorzystne rokowanie obserwuje się u pacjentów z cukrzycą typu 1 lub 2 współistniejącą z chorobą Addisona. Badanie przeprowadzone przez Chantzichristos i wsp. wykazało, że śmiertelność w tej grupie pacjentów wynosi 28% w porównaniu do 10% u pacjentów z samą cukrzycą (przy medianie okresu obserwacji 5,9 lat). Względne ryzyko zgonu było 3,89 razy wyższe u pacjentów z chorobą Addisona w porównaniu z grupą kontrolną.²³

Powikłania związane z terapią

Długotrwała terapia glikokortykosteroidami i mineralokortykosteroidami wiąże się z ryzykiem powikłań, które mogą wpływać na rokowanie:

Nadmierne dawki glikokortykosteroidów (hydrokortyzonu) mogą prowadzić do otyłości, cukrzycy typu 2 i osteoporozy²⁴
Nadmierne dawki fludrokortyzonu mogą powodować nadciśnienie tętnicze²⁵
Terapia glikokortykosteroidami w chorobie Addisona może indukować utratę masy kostnej, zwiększając ryzyko osteoporozy²⁶

Osteoporoza jako powikłanie długoterminowej terapii

Choroba Addisona wiąże się z wysokim ryzykiem zmniejszenia gęstości mineralnej kości (BMD) i rozwoju osteoporozy, szczególnie przy długotrwałej terapii kortykosteroidami.²⁷ Badania wykazały, że:

Pacjenci, u których rozwinęła się osteoporoza, byli znacząco starsi niż ci z prawidłową gęstością mineralną kości (p = 0,018)²⁸
Menopauza stanowi istotny czynnik predykcyjny wystąpienia osteoporozy (p = 0,006)²⁹
Osteoporoza występuje znacząco częściej u kobiet (p = 0,046)³⁰

W związku z powyższym, dawki glikokortykosteroidów powinny być dostosowane do najniższej tolerowanej dawki, a regularne pomiary gęstości mineralnej kości mogą być przydatne w identyfikacji pacjentów zagrożonych rozwojem osteoporozy.³¹

Choroba Addisona a COVID-19

Europejskie wieloośrodkowe badanie ankietowe wykazało, że pacjenci z zaburzeniami czynności nadnerczy, w tym z chorobą Addisona, przechodzą zakażenie COVID-19 stosunkowo dobrze, pod warunkiem odpowiedniego dostosowania dawek leków. Spośród 64 pacjentów z zaburzeniami czynności nadnerczy i zakażeniem COVID-19, 59 (92%) zgłosiło całkowitą remisję choroby, 4 pacjentów (6%) zgłosiło utrzymującą się chorobę, a 1 pacjent (2%) miał śmiertelny przebieg zakażenia.³² Badanie to podkreśla znaczenie edukacji pacjenta na temat zasad postępowania w czasie choroby.³³

Jakość życia

Mimo generalnie dobrego rokowania, pacjenci z chorobą Addisona zgłaszają niższą samoocenę jakości życia w porównaniu do populacji ogólnej.³⁴ Wielu pacjentów musi nauczyć się radzić sobie z nawracającym zmęczeniem, a dodatkowo mogą występować choroby współistniejące, takie jak cukrzyca czy niedoczynność tarczycy (hipotyroza).³⁵

Kluczowe zalecenia dla poprawy rokowania

Dla optymalizacji rokowania w chorobie Addisona zaleca się:

Ścisłe monitorowanie dawek leków w celu zapobiegania przedawkowaniu lub niedostatecznemu leczeniu³⁶
Regularne kontrole medyczne i dostosowywanie terapii w zależności od stanu pacjenta³⁷
Dokładną edukację pacjenta na temat choroby, objawów przełomu nadnerczowego i zasad postępowania w sytuacjach stresowych³⁸
Szybkie wdrażanie odpowiedniego leczenia przy pierwszych objawach pogorszenia stanu zdrowia lub zakażenia³⁹
Regularne monitorowanie gęstości mineralnej kości w celu wczesnego wykrywania osteoporozy⁴⁰
Optymalne leczenie chorób współistniejących, szczególnie cukrzycy i chorób autoimmunologicznych⁴¹

Podsumowując, choroba Addisona pozostaje potencjalnie śmiertelnym schorzeniem, szczególnie w przypadku przełomu nadnerczowego, zakażeń oraz nagłych zgonów u pacjentów zdiagnozowanych w młodym wieku. Jednakże przy właściwym leczeniu i monitorowaniu, rokowanie dla większości pacjentów jest bardzo dobre.⁴² Chorzy wymagają dożywotniej terapii zastępczej hormonalnej oraz regularnej oceny lekarskiej w celu optymalizacji dawkowania leków i zapobiegania powikłaniom związanym zarówno z samą chorobą, jak i jej leczeniem.⁴³⁴⁴

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Materiały źródłowe

#1 Addison’s Disease: What It Is, Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
The prognosis for Addisons disease is generally good. Although people who have Addisons disease will need to take medicine for the rest of their lives, they can live normal, healthy lives. […] The dosages of these medications, however, need to be closely monitored to prevent over- or under-treatment. Over-treatment with glucocorticoids (hydrocortisone) may result in obesity, Type 2 diabetes and osteoporosis. Over-treatment with fludrocortisone can cause high blood pressure (hypertension). […] Up to 50% of people with Addisons disease develop another autoimmune condition.
#2 Addison’s Disease – Endocrinology Advisor
https://www.endocrinologyadvisor.com/ddi/addisons-disease/
The availability of corticosteroid replacement therapy and advances in diagnostic testing have improved the prognosis of patients with Addisons disease. The prognosis depends on the etiology, the time frame in which Addisons disease is diagnosed and treated, and any challenges that arise from comorbid conditions. Because in its early stages Addison disease is generally characterized by nonspecific signs and symptoms, the correct diagnosis is often overlooked or delayed. The symptoms of Addisons disease often progress very slowly, which means the disease might not be identified until a severe or acute stressor transforms the condition into a life-threatening adrenal crisis. Patients with Addison disease have lower self-reported quality of life and increased mortality. […] Addisons disease is not typically thought to be life threatening. But there is evidence that traumatic brain injury can lead to deficiency in the secretion of corticotropin, resulting in adrenal insufficiency (Addisons disease) and life-threatening hyponatremia and hypotension. Given the slow progression of the symptoms of Addisons disease, the disease may not be identified until a severe or acute stressor causes a life-threatening adrenal crisis.
#3
https://www.nhs.uk/conditions/addisons-disease/
With treatment, symptoms of Addison’s disease can largely be controlled. Most people with the condition have a normal lifespan and are able to live an active life with few limitations. […] But many people with Addison’s disease also find they must learn to manage bouts of fatigue, and there may be associated health conditions, such as diabetes or an underactive thyroid (hypothyroidism).
#4 Addison’s Disease – Endocrinology Advisor
https://www.endocrinologyadvisor.com/ddi/addisons-disease/
The availability of corticosteroid replacement therapy and advances in diagnostic testing have improved the prognosis of patients with Addisons disease. The prognosis depends on the etiology, the time frame in which Addisons disease is diagnosed and treated, and any challenges that arise from comorbid conditions. Because in its early stages Addison disease is generally characterized by nonspecific signs and symptoms, the correct diagnosis is often overlooked or delayed. The symptoms of Addisons disease often progress very slowly, which means the disease might not be identified until a severe or acute stressor transforms the condition into a life-threatening adrenal crisis. Patients with Addison disease have lower self-reported quality of life and increased mortality. […] Addisons disease is not typically thought to be life threatening. But there is evidence that traumatic brain injury can lead to deficiency in the secretion of corticotropin, resulting in adrenal insufficiency (Addisons disease) and life-threatening hyponatremia and hypotension. Given the slow progression of the symptoms of Addisons disease, the disease may not be identified until a severe or acute stressor causes a life-threatening adrenal crisis.
#5 Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death – PubMed
https://pubmed.ncbi.nlm.nih.gov/19011006/
Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death. […] Until recently, life expectancy in Addison’s disease patients was considered normal. […] Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). […] Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). […] The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. […] Addison’s disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison’s disease.
#6 Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death – PubMed
https://pubmed.ncbi.nlm.nih.gov/19011006/
Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death. […] Until recently, life expectancy in Addison’s disease patients was considered normal. […] Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). […] Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). […] The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. […] Addison’s disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison’s disease.
#7 Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death – PubMed
https://pubmed.ncbi.nlm.nih.gov/19011006/
Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death. […] Until recently, life expectancy in Addison’s disease patients was considered normal. […] Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). […] Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). […] The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. […] Addison’s disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison’s disease.
#8 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Hormonal disruptions experienced by people with Addison disease can cause many health concerns and may shorten lifespan. Effective treatment can improve your outlook. […] This article will review what effect Addison disease has on the body, and how the problems that arise from this disease can reduce your overall life expectancy. […] Beyond an adrenal crisis, Addison disease can also shorten your lifespan by damaging your immune system and other basic systems in the body. […] With appropriate management and avoidance of adrenal crisis, many people with Addison disease can live a long life, without a significantly shorter lifespan. […] This outlook, however, depends on proper treatment, following your treatment regimen carefully, and avoiding adrenal crisis events. […] Some older research shows that people who do experience complications or have severe adrenal insufficiency may lose between 3 and 11 years of life.
#9 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Hormonal disruptions experienced by people with Addison disease can cause many health concerns and may shorten lifespan. Effective treatment can improve your outlook. […] This article will review what effect Addison disease has on the body, and how the problems that arise from this disease can reduce your overall life expectancy. […] Beyond an adrenal crisis, Addison disease can also shorten your lifespan by damaging your immune system and other basic systems in the body. […] With appropriate management and avoidance of adrenal crisis, many people with Addison disease can live a long life, without a significantly shorter lifespan. […] This outlook, however, depends on proper treatment, following your treatment regimen carefully, and avoiding adrenal crisis events. […] Some older research shows that people who do experience complications or have severe adrenal insufficiency may lose between 3 and 11 years of life.
#10 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#11 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#12 Addison’s Disease – Endocrinology Advisor
https://www.endocrinologyadvisor.com/ddi/addisons-disease/
The availability of corticosteroid replacement therapy and advances in diagnostic testing have improved the prognosis of patients with Addisons disease. The prognosis depends on the etiology, the time frame in which Addisons disease is diagnosed and treated, and any challenges that arise from comorbid conditions. Because in its early stages Addison disease is generally characterized by nonspecific signs and symptoms, the correct diagnosis is often overlooked or delayed. The symptoms of Addisons disease often progress very slowly, which means the disease might not be identified until a severe or acute stressor transforms the condition into a life-threatening adrenal crisis. Patients with Addison disease have lower self-reported quality of life and increased mortality. […] Addisons disease is not typically thought to be life threatening. But there is evidence that traumatic brain injury can lead to deficiency in the secretion of corticotropin, resulting in adrenal insufficiency (Addisons disease) and life-threatening hyponatremia and hypotension. Given the slow progression of the symptoms of Addisons disease, the disease may not be identified until a severe or acute stressor causes a life-threatening adrenal crisis.
#13 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#14 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Hormonal disruptions experienced by people with Addison disease can cause many health concerns and may shorten lifespan. Effective treatment can improve your outlook. […] This article will review what effect Addison disease has on the body, and how the problems that arise from this disease can reduce your overall life expectancy. […] Beyond an adrenal crisis, Addison disease can also shorten your lifespan by damaging your immune system and other basic systems in the body. […] With appropriate management and avoidance of adrenal crisis, many people with Addison disease can live a long life, without a significantly shorter lifespan. […] This outlook, however, depends on proper treatment, following your treatment regimen carefully, and avoiding adrenal crisis events. […] Some older research shows that people who do experience complications or have severe adrenal insufficiency may lose between 3 and 11 years of life.
#15 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Infections and other complications related to different treatments used for Addison disease can lead to problems that shorten your lifespan. […] The biggest threat to your well-being, though, is an adrenal crisis. […] Infections, adrenal crisis, and other acute issues in Addison disease can lead to death or, at the very least, cause complications that can shorten your lifespan.
#16 Outcome of COVID-19 infections in patients with adrenal insufficiency and excess in: Endocrine Connections Volume 12 Issue 4 (2023)
https://ec.bioscientifica.com/view/journals/ec/12/4/EC-22-0416.xml
Of all 64 patients with adrenal gland disorders and COVID-19 infection, 59 (92%) patients reported complete remission of the disease, while 4 patients (6%) reported persistent disease and 1 patient (2%) suffered from lethal outcome. […] This European multicentre questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcomes in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.
#17 Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death – PubMed
https://pubmed.ncbi.nlm.nih.gov/19011006/
Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death. […] Until recently, life expectancy in Addison’s disease patients was considered normal. […] Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). […] Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). […] The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. […] Addison’s disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison’s disease.
#18 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#19 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Infections and other complications related to different treatments used for Addison disease can lead to problems that shorten your lifespan. […] The biggest threat to your well-being, though, is an adrenal crisis. […] Infections, adrenal crisis, and other acute issues in Addison disease can lead to death or, at the very least, cause complications that can shorten your lifespan.
#20 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#21 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#22 Addison’s Disease: What It Is, Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
The prognosis for Addisons disease is generally good. Although people who have Addisons disease will need to take medicine for the rest of their lives, they can live normal, healthy lives. […] The dosages of these medications, however, need to be closely monitored to prevent over- or under-treatment. Over-treatment with glucocorticoids (hydrocortisone) may result in obesity, Type 2 diabetes and osteoporosis. Over-treatment with fludrocortisone can cause high blood pressure (hypertension). […] Up to 50% of people with Addisons disease develop another autoimmune condition.
#23 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#24 Addison’s Disease: What It Is, Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
The prognosis for Addisons disease is generally good. Although people who have Addisons disease will need to take medicine for the rest of their lives, they can live normal, healthy lives. […] The dosages of these medications, however, need to be closely monitored to prevent over- or under-treatment. Over-treatment with glucocorticoids (hydrocortisone) may result in obesity, Type 2 diabetes and osteoporosis. Over-treatment with fludrocortisone can cause high blood pressure (hypertension). […] Up to 50% of people with Addisons disease develop another autoimmune condition.
#25 Addison’s Disease: What It Is, Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
The prognosis for Addisons disease is generally good. Although people who have Addisons disease will need to take medicine for the rest of their lives, they can live normal, healthy lives. […] The dosages of these medications, however, need to be closely monitored to prevent over- or under-treatment. Over-treatment with glucocorticoids (hydrocortisone) may result in obesity, Type 2 diabetes and osteoporosis. Over-treatment with fludrocortisone can cause high blood pressure (hypertension). […] Up to 50% of people with Addisons disease develop another autoimmune condition.
#26 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#27 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#28 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#29 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#30 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#31 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#32 Outcome of COVID-19 infections in patients with adrenal insufficiency and excess in: Endocrine Connections Volume 12 Issue 4 (2023)
https://ec.bioscientifica.com/view/journals/ec/12/4/EC-22-0416.xml
Of all 64 patients with adrenal gland disorders and COVID-19 infection, 59 (92%) patients reported complete remission of the disease, while 4 patients (6%) reported persistent disease and 1 patient (2%) suffered from lethal outcome. […] This European multicentre questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcomes in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.
#33 Outcome of COVID-19 infections in patients with adrenal insufficiency and excess in: Endocrine Connections Volume 12 Issue 4 (2023)
https://ec.bioscientifica.com/view/journals/ec/12/4/EC-22-0416.xml
Of all 64 patients with adrenal gland disorders and COVID-19 infection, 59 (92%) patients reported complete remission of the disease, while 4 patients (6%) reported persistent disease and 1 patient (2%) suffered from lethal outcome. […] This European multicentre questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcomes in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.
#34 Addison’s Disease – Endocrinology Advisor
https://www.endocrinologyadvisor.com/ddi/addisons-disease/
The availability of corticosteroid replacement therapy and advances in diagnostic testing have improved the prognosis of patients with Addisons disease. The prognosis depends on the etiology, the time frame in which Addisons disease is diagnosed and treated, and any challenges that arise from comorbid conditions. Because in its early stages Addison disease is generally characterized by nonspecific signs and symptoms, the correct diagnosis is often overlooked or delayed. The symptoms of Addisons disease often progress very slowly, which means the disease might not be identified until a severe or acute stressor transforms the condition into a life-threatening adrenal crisis. Patients with Addison disease have lower self-reported quality of life and increased mortality. […] Addisons disease is not typically thought to be life threatening. But there is evidence that traumatic brain injury can lead to deficiency in the secretion of corticotropin, resulting in adrenal insufficiency (Addisons disease) and life-threatening hyponatremia and hypotension. Given the slow progression of the symptoms of Addisons disease, the disease may not be identified until a severe or acute stressor causes a life-threatening adrenal crisis.
#35
https://www.nhs.uk/conditions/addisons-disease/
With treatment, symptoms of Addison’s disease can largely be controlled. Most people with the condition have a normal lifespan and are able to live an active life with few limitations. […] But many people with Addison’s disease also find they must learn to manage bouts of fatigue, and there may be associated health conditions, such as diabetes or an underactive thyroid (hypothyroidism).
#36 Addison’s Disease: What It Is, Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
The prognosis for Addisons disease is generally good. Although people who have Addisons disease will need to take medicine for the rest of their lives, they can live normal, healthy lives. […] The dosages of these medications, however, need to be closely monitored to prevent over- or under-treatment. Over-treatment with glucocorticoids (hydrocortisone) may result in obesity, Type 2 diabetes and osteoporosis. Over-treatment with fludrocortisone can cause high blood pressure (hypertension). […] Up to 50% of people with Addisons disease develop another autoimmune condition.
#37 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Hormonal disruptions experienced by people with Addison disease can cause many health concerns and may shorten lifespan. Effective treatment can improve your outlook. […] This article will review what effect Addison disease has on the body, and how the problems that arise from this disease can reduce your overall life expectancy. […] Beyond an adrenal crisis, Addison disease can also shorten your lifespan by damaging your immune system and other basic systems in the body. […] With appropriate management and avoidance of adrenal crisis, many people with Addison disease can live a long life, without a significantly shorter lifespan. […] This outlook, however, depends on proper treatment, following your treatment regimen carefully, and avoiding adrenal crisis events. […] Some older research shows that people who do experience complications or have severe adrenal insufficiency may lose between 3 and 11 years of life.
#38 Outcome of COVID-19 infections in patients with adrenal insufficiency and excess in: Endocrine Connections Volume 12 Issue 4 (2023)
https://ec.bioscientifica.com/view/journals/ec/12/4/EC-22-0416.xml
Of all 64 patients with adrenal gland disorders and COVID-19 infection, 59 (92%) patients reported complete remission of the disease, while 4 patients (6%) reported persistent disease and 1 patient (2%) suffered from lethal outcome. […] This European multicentre questionnaire is the first to collect data on the outcome of COVID-19 infection in patients with adrenal gland disorders. It suggests good clinical outcomes in case of duly dose adjustments and emphasizes the importance of patient education on sick day rules.
#39 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#40 Prevalence and Predictive Factors of Low-Bone Mineral Density in Patients with Addison Disease on Long-Term Corticosteroid Replacement Therapy | IntechOpen
https://mts.intechopen.com/redirector/articles/prevalence-and-predictive-factors-of-low-bone-mineral-density-in-patients-with-addison-disease-on-lo
Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. […] The aim of our study was to assess the influence of glucocorticoid replacement therapy on BMD among patients with AD and determine predictive factors of low BMD. […] Patients who developed osteoporosis were significantly older than those with normal BMD (p = 0.018). […] Menopause was a significant predictor of incident osteoporosis (p = 0.006). […] Furthermore, osteoporosis was significantly more prevalent among females (p = 0.046). […] Glucocorticoid replacement therapy in AD may induce bone loss. […] Thus, glucocorticoid therapy must be adjusted to the lowest tolerable dose. […] Identification of predictive factors of low BMD in patients with AD is useful in the management of long-term glucocorticoid therapy’s bone impact. […] Regular measurement of bone mineral density may be useful to identify patients at risk for the development of osteoporosis.
#41 Addison Disease: Practice Essentials, Epidemiology
https://emedicine.medscape.com/article/116467-overview
Morbidity and mortality associated with Addison disease usually are due to failure or delay in making the diagnosis or a failure to institute adequate glucocorticoid and mineralocorticoid replacement. […] If not treated promptly, acute addisonian crisis may result in death. This may be provoked either de novo, such as by adrenal hemorrhage, or in the setting of an acute event superimposed on chronic or inadequately treated adrenocortical insufficiency. […] Even after diagnosis and treatment, the risk of death is more than 2-fold higher in patients with Addison disease. Cardiovascular, malignant, and infectious diseases are responsible for the higher mortality rate. […] A study by Chantzichristos et al indicated that in patients with type 1 or 2 diabetes, those who also have Addison disease have a higher mortality rate than do those with diabetes alone. Over a median follow-up period of 5.9 years, the mortality rate for diabetes patients with Addison disease was 28%, compared with 10% for those without Addison disease. The increase in the estimated relative overall mortality risk was 3.89 for the Addison disease patients compared with the other group. Although cardiovascular deaths accounted for the highest mortality rate in both groups, the death rate from diabetes complications, infectious diseases, and unknown causes was greater in the patients with Addison disease than in those with diabetes alone.
#42 Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death – PubMed
https://pubmed.ncbi.nlm.nih.gov/19011006/
Normal overall mortality rate in Addison’s disease, but young patients are at risk of premature death. […] Until recently, life expectancy in Addison’s disease patients was considered normal. […] Overall SMR was 1.15 (95% confidence intervals (CI) 0.96-1.35), similar in females (1.18 (0.92-1.44)) and males (1.10 (0.80-1.39)). […] Patients diagnosed before the age of 40 had significantly elevated SMR at 1.50 (95% CI 1.09-2.01), most pronounced in males (2.03 (1.19-2.86)). […] The mean ages at death for females (75.7 years) and males (64.8 years) were 3.2 and 11.2 years less than the estimated life expectancy. […] Addison’s disease is still a potentially lethal condition, with excess mortality in acute adrenal failure, infection, and sudden death in patients diagnosed at young age. Otherwise, the prognosis is excellent for patients with Addison’s disease.
#43 Addison’s Disease: What It Is, Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/15095-addisons-disease
The prognosis for Addisons disease is generally good. Although people who have Addisons disease will need to take medicine for the rest of their lives, they can live normal, healthy lives. […] The dosages of these medications, however, need to be closely monitored to prevent over- or under-treatment. Over-treatment with glucocorticoids (hydrocortisone) may result in obesity, Type 2 diabetes and osteoporosis. Over-treatment with fludrocortisone can cause high blood pressure (hypertension). […] Up to 50% of people with Addisons disease develop another autoimmune condition.
#44 What Is the Life Expectancy for Someone with Addison Disease?
https://www.healthline.com/health/addison-disease-life-expectancy
Hormonal disruptions experienced by people with Addison disease can cause many health concerns and may shorten lifespan. Effective treatment can improve your outlook. […] This article will review what effect Addison disease has on the body, and how the problems that arise from this disease can reduce your overall life expectancy. […] Beyond an adrenal crisis, Addison disease can also shorten your lifespan by damaging your immune system and other basic systems in the body. […] With appropriate management and avoidance of adrenal crisis, many people with Addison disease can live a long life, without a significantly shorter lifespan. […] This outlook, however, depends on proper treatment, following your treatment regimen carefully, and avoiding adrenal crisis events. […] Some older research shows that people who do experience complications or have severe adrenal insufficiency may lose between 3 and 11 years of life.