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International Journal of Endocrinology
Volume 2013 (2013), Article ID 482370, 5 pages
http://dx.doi.org/10.1155/2013/482370
Research Article

Delay in Diagnosis of Adrenal Insufficiency Is a Frequent Cause of Adrenal Crisis

1Clinic of Endocrinology, The Centre of Postgraduate Medical Education, Warsaw, Poland
2Department of Internal Diseases, Diabetology and Endocrinology, Medical University of Warsaw, Poland

Received 11 April 2013; Accepted 10 June 2013

Academic Editor: Mario Maggi

Copyright © 2013 Lucyna Papierska and Michał Rabijewski. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Delay of diagnosis of primary adrenal insufficiency (PAI) leads to adrenal crisis which is potentially lethal complication. The objective of our work was an assessment whether the establishment of diagnosis of adrenocortical insufficiency in Poland is so much delayed as assessed in the past. We have analysed data from 60 patients with diagnosis of PAI established in our department during the past 12 years and who are still under our care. We found that the time to diagnosis of primary adrenal insufficiency in Poland exceeds 3 months in every patient and 6 months in patients admitted with symptoms of adrenal crisis. Forty-four percent of patients were diagnosed only just after the hospitalisation due to crisis, despite the evident signs and symptoms of PAI. Lack of appetite and loss of body weight occurred in all patients and for that reason a diagnosis of chronic gastric and duodenal ulcer disease was the most often incorrect diagnosis. After the proper diagnosis and treatment, in the course of 1–11 years of observation, there was only 6 imminent adrenal crises in 5 patients. Our results indicated that training of primary care physicians in the field of recognising and treatment of adrenal insufficiency is still essential.