Addison’s Disease

Addison’s Disease Ali Chakera

Focus for Discussion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Start with a case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

VE, 26F ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Addison’s Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Suspicion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Laboratory results Signs Symptoms

Testing for Addison’s disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of Addison’s disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of Addison’s disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Drugs ,[object Object],[object Object],Infiltration Haemorrhage / infarction Bilateral adrenalectomy ,[object Object],[object Object],[object Object],Infective ,[object Object],[object Object],[object Object]

Optimum treatment? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Monitoring? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical monitoring? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

On the Horizon ,[object Object],[object Object],[object Object]

Treatment in Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Is there a good screening test?

Is a baseline cortisol of value? ,[object Object],[object Object],[object Object],[object Object],[object Object]

Our results over the past year ,[object Object],[object Object],[object Object]

Synacthen Tests for Ali Chakera.xls 18 202 21.9 NNV 88.9 Specificity 73 16 57 Negative 98.6 PPV 71.8 Sensitivity 147 2 145 Positive Test > 250 No Yes Normal Adrenals 18 202 16.7 NNV 100.0 Specificity 108 18 90 Negative 100.0 PPV 55.4 Sensitivity 112 0 112 Positive Test > 300 No Yes Normal Adrenals

Our results for the past 3 years ,[object Object],[object Object],[object Object]

3 years of synacthen results.xls 57 591 15.0 NNV 98.2 Specificity 374 56 318 Negative 99.6 PPV 46.2 Sensitivity 274 1 273 Positive Test > 350 No Yes Normal Adrenals 58 590 12.8 NNV 98.3 Specificity 445 57 388 Negative 99.5 PPV 34.2 Sensitivity 203 1 202 Positive Test > 400 No Yes Normal Adrenals

Conclusions ,[object Object],[object Object],[object Object]

Addison’s Disease

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Addison’s Disease