Predictors of adrenal crisis in patients with Addison’s disease

master's thesis

• Title (croatian): Prediktori adrenalne krize u bolesnika s Addisonovom bolešću
• Author: Tea Cindrić
• Mentor: Tina Dušek (mentor)
• Committee member: Tina Dušek (predsjednik povjerenstva)
• Committee member: Darko Kaštelan (član povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Addison disease is the disease of the adrenal gland in which the primary characteristic is the inability of the adrenal gland to produce cortisol and aldosterone. Patients require lifetime treatment with orally prescribed steroid drugs which replace cortisol and aldosterone. In the case of any stressful situation, from psychological stress to infection or some other acute disease, a very dangerous adrenal crisis can develop. Because of that, it is important to adapt the dose of the drugs, meaning, either increase the oral dose of hydrocortison or take it parenterally. The education of the patients about the risk factors for the crisis, symptoms of the crisis and about the way of adjustment treatment when needed is necessary. In this study, we used a questionnaire to find out how much are the patients, treated for Addison’s disease in the tertiary center, informed about their disease, how many risk factors and symptoms of the crisis they know, and how much they know about dose adjustment in specific situations. Among other things, we found out that interviewed men are statistically significantly diagnosed in younger age and that they are younger at the time of research than interviewed women. Twenty-two patients were participating in our study. It is established that those patients who know more risk factors for adrenal crisis, have lower incidence of adrenal crisis (P=0.03). In conclusion, the education of patients about the risk factors which precede adrenal crisis is important in prevention of developing the crisis.

Abstract (croatian)

Addisonova bolest je bolest nadbubrežne žlijezde čija je primarna karakteristika nemogućnost nadbubrežne žlijezde da proizvede kortizol i aldosteron. Ta dva hormona su važna za homeostazu organizma. Najčešći simptomi bolesti su umor, gubitak na težini, hiperpigmentacija kože, niži tlak, mučnina, potreba za slanom hranom, itd. Pacijenti se najčešće liječe doma uz doživotnu hormonsku terapiju koja će zamjenjivati ta dva hormona. U slučaju raznih stresnih situacija, od psihičkih stresora do infekcije ili druge akutne bolesti, vrlo je opasan razvoj adrenalne (Addisonove) krize, stoga je vrlo važno prilagoditi terapiju, odnosno povećati oralnu dozu ili je primiti intravenski. Vrlo je bitno educirati bolesnike o rizičnim faktorima koji ga mogu dovesti u stanje krize, o simptomima kriza kako bi na vrijeme prepoznao kirzu, i o načinu prilagodbe terapije kada se nađe u takvom stanju. Pokušali smo anketom saznati koliko su dvadeset dva pacijenta upućena u svoju bolest, koliko znaju rizika i simptoma krize i koliko znaju o prilagodbi terapije u određenim situacijama. Između ostalog, saznali smo da su ispitani muškarci statistički značajnije dijagnosticirani u mlađoj dobi i da su u doba našeg istraživanja u prosjeku mlađi od ispitanih žena. Utvrdili smo da oni ljudi koji znaju više rizičnih faktora, imaju i manje kriza. Međutim, nije pronađena nikakva statistički bitna poveznica između znanja o prilagodbi terapije i simptoma s brojem kriza u životu. Zaključili smo da je vrlo važna edukacija pacijenata o rizičnim faktorima (pa tako i rizičnim ponašanjima) koji mogu dovesti do Addisonove krize jer će pacijenti onda znati što izbjegavati da se ne bi doveli u rizično stanje, i na taj će način spriječiti razvoj adrenalne krize.

• Keywords: Addison’s disease; hormones; stressors; adrenal crisis; risk factors; education
• Keywords (croatian): Addisonova bolest; hormoni; stresori; adrenalna kriza; rizični faktori; edukacija
• Language: english
• URN:NBN: urn:nbn:hr:105:766506
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-12-21 08:25:00