Clinical and immunological characteristics of autoimmune addison disease: A nationwide swedish multicenter study

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift


Context: Studies of the clinical and immunological features of autoimmune Addison disease (AAD) are needed to understand the disease burden and increased mortality. Objective: To provide upgraded data on autoimmune comorbidities, replacement therapy, autoantibody profiles, and cardiovascular risk factors. Design, Setting, and Participants: A cross-sectional, population-based study that included 660 AAD patients from the Swedish Addison Registry (2008-2014). When analyzing the cardiovascular risk factors, 3594 individuals from the population-based survey in Northern Sweden, MONICA (monitoring of trends and determinants of cardiovascular disease), served as controls. Main Outcome Measures: The endpoints were the prevalence of autoimmune comorbidities and cardiovascular risk factors. Autoantibodies against 13 autoantigens were determined. Results: The proportion of 21-hydroxylase autoantibody-positive patients was 83%, and 62% of patients had ≥1 associated autoimmune diseases, more frequently coexisting in females (P < 0.0001). AAD patients had a lower body mass index (P < 0.0001) and prevalence of hypertension (P = 0.027) compared with controls. Conventional hydrocortisone tablets were used by 89% of the patients, with a mean dose of 28.1 ± 8.5 mg/d. The mean hydrocortisone equivalent dose normalized to the body surface was 14.8±4.4 mg/m2/d. A greater hydrocortisone equivalent dose was associated with a greater incidence of hypertension (P = 0.046). Conclusions: Careful monitoring of AAD patients is warranted to detect associated autoimmune diseases. Contemporary Swedish AAD patients did not have an increased prevalence of overweight, hypertension, type 2 diabetes mellitus, or hyperlipidemia. However, high glucocorticoid replacement doses could be a risk factor for hypertension.


  • Frida Dalin
  • Gabriel Nordling Eriksson
  • Per Dahlqvist
  • Asa Hallgren
  • Jeanette Wahlberg
  • Olov Ekwall
  • Stefan Soderberg
  • Johan Ronnelid
  • Per Olcen
  • Ola Winqvist
  • Sergiu-Bogdan Catrina
  • Berit Kristrom
  • Maria Laudius
  • Magnus Isaksson
  • Maria Halldin Stenlid
  • Jan Gustafsson
  • Gennet Gebre-Medhin
  • Sigridur Bjornsdottir
  • Annika Janson
  • Anna Karin Akerman
  • Jan Aman
  • Karel Duchen
  • Ragnhildur Bergthorsdottir
  • Gudmundur Johannsson
  • Emma Lindskog
  • Erik Waldenstrom
  • Anna Lena Hulting
  • Olle Kampe
  • Sophie Bensing
Enheter & grupper
Externa organisationer
  • Karolinska Institute
  • Uppsala universitet, Historiska institutionen
  • Umeå University
  • Linköping University
  • Göteborgs universitet
  • Örebro University
  • Karolinska University Hospital
  • Sahlgrenska University Hospital
  • Skåne University Hospital

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Reumatologi och inflammation
Sidor (från-till)379-389
Antal sidor11
TidskriftJournal of Clinical Endocrinology and Metabolism
StatusPublished - 2017 feb 1
Peer review utfördJa