Gesine Meyer1, Maike Koch2, Eva Herrmann3, Jörg Bojunga2, Klaus Badenhoop2. 1. Division of Endocrinology, Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany. gesine.meyer@kgu.de. 2. Division of Endocrinology, Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany. 3. Institut for Biostatistics and Mathematic Modelling, Goethe-University, Frankfurt, Germany.
Abstract
PURPOSE: Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. METHODS: 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. RESULTS: Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). CONCLUSIONS: These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.
PURPOSE: Several studies have shown a reduced quality of life (QoL) in patients with Addison's disease (AD), but investigations of QoL over a long-term course are lacking. Adrenal crises (AC) are life-threatening complications in AD. The purpose of this prospective study was to test whether the repeated use of QoL-questionnaires can detect prodromal periods of an AC. METHODS: 110 patients with AD were asked to complete the disease specific-QoL questionnaire AddiQoL and a short questionnaire about adverse events once monthly over a period of ten months. AC was defined if at least two of the following symptoms were reported: (a) hypotension, (b) nausea or vomiting, (c) severe fatigue, (d) documented hyponatremia, hyperkalemia, or hypoglycemia, and subsequent parenteral glucocorticoid administration was carried out. RESULTS: Prevalence of AC was 10.9/100 patient years. AddiQoL scores in patients with AC showed a trend (p = 0,08) to a wider fluctuation over time. Subjective precrises not meeting the criteria for AC were reported by 31 patients who had significantly lower AddiQoL scores (p = 0,018). CONCLUSIONS: These are the first data showing the course of QoL during a period of ten months in patients with AD. Incidence of AC exceeds previous data. Our data show, that subjective precrises in AD associate with lower QoL. AC, as well as precrises affect intraindividual AddiQol-scores over time with a trend to a stronger fluctuation. Longitudinal AddiQol scores and self-reporting of precrises via patient diaries are additional clinical tools to identify higher risk for critical events.
Authors: Marianne Øksnes; Sophie Bensing; Anna-Lena Hulting; Olle Kämpe; Annika Hackemann; Gesine Meyer; Klaus Badenhoop; Corrado Betterle; Anna Parolo; Roberta Giordano; Alberto Falorni; Lucyna Papierska; Wojciech Jeske; Anna A Kasperlik-Zaluska; V Krishna K Chatterjee; Eystein S Husebye; Kristian Løvås Journal: J Clin Endocrinol Metab Date: 2011-11-16 Impact factor: 5.958
Authors: Han J W J Repping-Wuts; Nike M M L Stikkelbroeck; Alida Noordzij; Mies Kerstens; Ad R M M Hermus Journal: Eur J Endocrinol Date: 2013-05-17 Impact factor: 6.664
Authors: Stefan R Bornstein; Bruno Allolio; Wiebke Arlt; Andreas Barthel; Andrew Don-Wauchope; Gary D Hammer; Eystein S Husebye; Deborah P Merke; M Hassan Murad; Constantine A Stratakis; David J Torpy Journal: J Clin Endocrinol Metab Date: 2016-01-13 Impact factor: 5.958
Authors: Kim M J A Claessen; Cornelie D Andela; Nienke R Biermasz; Alberto M Pereira Journal: Front Endocrinol (Lausanne) Date: 2021-07-20 Impact factor: 5.555