| Sažetak | Addisonova bolest je primarna kronična insuficijencija kore nadbubrežnih žlijezda koja rezultira smanjenjem i prestankom lučenja mineralokortikoida, glukokortikoida i kortikalnih androgena. Relativno je rijetka bolest, a najčešći uzrok je autoimunost. Patogeneza nije u potpunosti razjašnjena, ali se smatra da bitnu ulogu imaju protutijela na enzim 21-hidroksilazu. Bolest se očituje kao slabost, smeđa hiperpigmentacija kože, gubitak na tjelesnoj masi, mučnina, povraćanje te hipotenzija. Dijagnoza se postavlja na temelju kliničke slike, razine ACTH-a u krvi te ACTH-stimulacijskog testa. Liječenje se temelji na doživotnoj nadoknadi glukokortikoida i mineralokortikoida. Cilj ovog rada je analizirati komorbiditete u bolesnika s Addisonovom bolešću. Ova retrospektivna analiza obuhvaća 27 bolesnika koji su se liječili na Zavodu za endokrinologiju KBC-a Zagreb zbog Addisonove bolesti. Podaci su prikupljeni pregledom medicinske dokumentacije dostupne u bolničkom informacijskom sustavu. Većina bolesnika su ženskog spola (59,3%), a prosječna dob u trenutku dijagnoze je bila 40,6 godina. U 96,3% bolesnika autoimunost je uzrok bolesti. Većina bolesnika (85,2%) imalo je pridruženu barem jednu autoimunu bolest, od kojih su najzastupljenije hipotireoidizam (77,8%), hipoparatireoidizam (18,5%) te vitiligo (11,1%). 59,3% ispitanika bolovalo je od komorbiditeta koji nisu autoimune prirode, među kojima su najčešći dislipidemija (37,1%) i arterijska hipertenzija (33,3%). Ovaj rad pokazuje kako je veliki udio bolesnika s Addisonovom bolešću imalo pridružene autoimune bolesti, ponajviše štitnjače, što je u skladu s rezultatima već provedenih istraživanja. |
| Sažetak (engleski) | Addison's disease is a primary chronic adrenocortical insufficiency which results in decrease and discontinuation of secretion of mineralocorticoids, glucocorticoids, and cortical androgens. It is a relatively rare disease and the most common cause is autoimmunity. The exact pathogenesis is not completely clear, but it is considered that autoantibodies against enzyme 21-hydroxylase have an important role. The disease manifests as weakness, brown hyperpigmentation of the skin, weight loss, nausea, vomiting and hypotension. The diagnosis is based on signs and symptoms, levels of ACTH in blood and ACTH stimulation test. The treatment consists of lifetime replacement of glucocorticoids and mineralocorticoids. The aim of this thesis is to analyse comorbidities in patients with Addison's disease. This retrospective study includes 27 patients who were treated for Addison's disease at the Department of Endocrinology of the Clinical Hospital Centre Zagreb. The data were collected by reviewing the medical documentation which is available through the hospital information system. Most of the patients were women (59.3%) and the mean age at the time of the diagnosis was 40.6 years. Autoimmunity was the most common cause (96.3%). Most of the patients (85.2%) had at least one autoimmune comorbidity, out of which hypothyroidism (77.8%), hypoparathyroidism (18.5%) and vitiligo (11.1%) were the most common. 59.3% of the patients had comorbidities which are not autoimmune by nature, out of which dyslipidaemia (37.1%) and arterial hypertension (33.3%) were the most frequent. This thesis shows that a large part of patients with Addison's disease have associated autoimmune diseases, mostly hypothyroidism, which correlates with other conducted studies. |
