Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS): A systematic review

Keum Hwa Lee, Hyun Jeong Lee, Cheol hun Lee, Jin Yeong Kim, Jong Min Kim, Se Seung Kim, Seungmin Jeong, In Sung Hwang, Namsoo Kim, Na Eun Kim, Soogeun Shin, Dongkwan Shin, Joo Sang Song, Dong Hyun Shin, Jung Dong Kim, Jeehoon Kim, Yong Seok Lee, Hansung Kang, Dong Ha Kim, So Hyun Moon & 4 others Won Suk Rho, Joo Yeon Lee, Andreas Kronbichler, Jaeil Shin

Research output: Contribution to journalReview article

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.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalAutoimmunity Reviews
Volume18
Issue number1
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Adrenal Insufficiency
Antiphospholipid Syndrome
Signs and Symptoms
Fludrocortisone
Therapeutics
Prednisolone
PubMed
Adrenocorticotropic Hormone
Nausea
Abdominal Pain
Autoimmune Diseases
Vomiting
Hydrocortisone
Publications
Early Diagnosis
Fever
Databases
Morbidity
Mortality

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

Cite this

Lee, Keum Hwa ; Lee, Hyun Jeong ; Lee, Cheol hun ; Kim, Jin Yeong ; Kim, Jong Min ; Kim, Se Seung ; Jeong, Seungmin ; Hwang, In Sung ; Kim, Namsoo ; Kim, Na Eun ; Shin, Soogeun ; Shin, Dongkwan ; Song, Joo Sang ; Shin, Dong Hyun ; Kim, Jung Dong ; Kim, Jeehoon ; Lee, Yong Seok ; Kang, Hansung ; Kim, Dong Ha ; Moon, So Hyun ; Rho, Won Suk ; Lee, Joo Yeon ; Kronbichler, Andreas ; Shin, Jaeil. / Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) : A systematic review. In: Autoimmunity Reviews. 2019 ; Vol. 18, No. 1. pp. 1-8.
@article{efc020a972af43e096a3b73c65d74df3,
title = "Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS): A systematic review",
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.",
author = "Lee, {Keum Hwa} and Lee, {Hyun Jeong} and Lee, {Cheol hun} and Kim, {Jin Yeong} and Kim, {Jong Min} and Kim, {Se Seung} and Seungmin Jeong and Hwang, {In Sung} and Namsoo Kim and Kim, {Na Eun} and Soogeun Shin and Dongkwan Shin and Song, {Joo Sang} and Shin, {Dong Hyun} and Kim, {Jung Dong} and Jeehoon Kim and Lee, {Yong Seok} and Hansung Kang and Kim, {Dong Ha} and Moon, {So Hyun} and Rho, {Won Suk} and Lee, {Joo Yeon} and Andreas Kronbichler and Jaeil Shin",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.autrev.2018.06.014",
language = "English",
volume = "18",
pages = "1--8",
journal = "Autoimmunity Reviews",
issn = "1568-9972",
publisher = "Elsevier",
number = "1",

}

Lee, KH, Lee, HJ, 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, J 2019, 'Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS): A systematic review' Autoimmunity Reviews, vol. 18, no. 1, pp. 1-8. https://doi.org/10.1016/j.autrev.2018.06.014

Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) : A systematic review. / Lee, Keum Hwa; Lee, Hyun Jeong; Lee, Cheol hun; Kim, Jin Yeong; Kim, Jong Min; Kim, Se Seung; Jeong, Seungmin; Hwang, In Sung; Kim, Namsoo; Kim, Na Eun; Shin, Soogeun; Shin, Dongkwan; Song, Joo Sang; Shin, Dong Hyun; Kim, Jung Dong; Kim, Jeehoon; Lee, Yong Seok; Kang, Hansung; Kim, Dong Ha; Moon, So Hyun; Rho, Won Suk; Lee, Joo Yeon; Kronbichler, Andreas; Shin, Jaeil.

In: Autoimmunity Reviews, Vol. 18, No. 1, 01.01.2019, p. 1-8.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS)

T2 - A systematic review

AU - Lee, Keum Hwa

AU - Lee, Hyun Jeong

AU - Lee, Cheol hun

AU - Kim, Jin Yeong

AU - Kim, Jong Min

AU - Kim, Se Seung

AU - Jeong, Seungmin

AU - Hwang, In Sung

AU - Kim, Namsoo

AU - Kim, Na Eun

AU - Shin, Soogeun

AU - Shin, Dongkwan

AU - Song, Joo Sang

AU - Shin, Dong Hyun

AU - Kim, Jung Dong

AU - Kim, Jeehoon

AU - Lee, Yong Seok

AU - Kang, Hansung

AU - Kim, Dong Ha

AU - Moon, So Hyun

AU - Rho, Won Suk

AU - Lee, Joo Yeon

AU - Kronbichler, Andreas

AU - Shin, Jaeil

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85057260540&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85057260540&partnerID=8YFLogxK

U2 - 10.1016/j.autrev.2018.06.014

DO - 10.1016/j.autrev.2018.06.014

M3 - Review article

VL - 18

SP - 1

EP - 8

JO - Autoimmunity Reviews

JF - Autoimmunity Reviews

SN - 1568-9972

IS - 1

ER -