Abstract：
BACKGROUND:Adrenal insufficiency (AI) is associated with high morbidity and mortality. The aim of this systematic review was to enhance diagnostic approaches and summarize therapeutic strategies in the management of AI in patients with systematic lupus erythematosus (SLE) or antiphospholipid syndrome (APS). METHODS:A literature search of PubMed and Medline databases was performed and 91 publications containing 105 cases were included for the final analysis. RESULTS:The following frequency of clinical signs and symptoms was noted: abdominal pain (39.04%) was the leading symptom, followed by fever (33.33%), vomiting (23.81%), and nausea (19.05%). APS was present in 73%, SLE in 17% of the patients, while 2% had a diagnosis of both, SLE and APS. ACTH stimulation test (ACTHst) was performed in 18% of cases and 76.6% of them were unresponsive towards stimulation. Variable treatment approaches were used: hydrocortisone was most commonly used (38.09%), followed by fludrocortisone (26.67%), prednisolone (20.00%) and volume replacement treatment (11.43%), respectively. CONCLUSIONS:This analysis highlights the importance of an early diagnosis and initiation of therapeutic management when AI is suspected. In line, signs and symptoms related to autoimmune diseases in patients with AI should be reviewed crtitically.
journal_name
Autoimmun Revjournal_title
Autoimmunity reviewsauthors
Lee KH,Lee H,Lee CH,Kim JY,Kim JM,Kim SS,Jeong S,Hwang IS,Kim N,Kim NE,Shin S,Shin D,Song JS,Shin DH,Kim JD,Kim J,Lee YS,Kang H,Kim DH,Moon SH,Rho WS,Lee JY,Kronbichler A,Shin JIdoi
10.1016/j.autrev.2018.06.014subject
Has Abstractpub_date
2019-01-01 00:00:00pages
1-8issue
1eissn
1568-9972issn
1873-0183pii
S1568-9972(18)30252-0journal_volume
18pub_type
杂志文章abstract：:Since the earliest reports in 2001, immunoglobulin G4 (IgG4)-related disease has been defined as an autoimmune systemic disease characterized by the lymphoplasmacytic infiltration of affected tissues leading to fibrosis and obliterative phlebitis along with elevated serum IgG4 levels. Prior to this unifying hypothesis...
journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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更新日期：2015-05-01 00:00:00
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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pub_type： 杂志文章,收录出版,评审
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journal_title：Autoimmunity reviews
pub_type： 历史文章,杂志文章,评审
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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更新日期：2009-06-01 00:00:00
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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更新日期：2016-06-01 00:00:00
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,评审
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journal_title：Autoimmunity reviews
pub_type： 杂志文章,多中心研究
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更新日期：2014-10-01 00:00:00
