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Journal article : Review

Clinical features, investigation, and management of Addison's disease

Abstract:
Addison's disease is the manifestation of adrenal glucocorticoid and mineralocorticoid deficiency from T-cell mediated destruction of the adrenal cortex, and is the commonest cause of primary adrenal insufficiency in adults. Due to its vague presentation, diagnosis of Addison's disease is often delayed, and in some cases, individuals present in adrenal crisis. Despite the use of corticosteroid replacement therapy, people with Addison's disease have increased mortality and reduced quality of life. Multiple features are thought to contribute to these outcomes, including inadequacy of adrenal crisis management and the inability of existing therapies to mimic circadian and ultradian rhythms of cortisol release. Current research strategies focus on understanding social and behavioural factors that contribute to adrenal crises, developing therapies that more closely mimic rhythms of physiological cortisol secretion, and developing interventions to restore adrenal steroidogenesis. This Review discusses the clinical features, investigation, and management of Addison's disease.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1016/s2213-8587(25)00393-6

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
Radcliffe Department of Medicine
Sub department:
RDM-Oxford Centre for Diabetes, Endocrinology and Metabolism
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Radcliffe Department of Medicine
Oxford college:
Keble College
Role:
Author
ORCID:
0000-0002-3170-8533


More from this funder
Funder identifier:
https://ror.org/03x94j517
Grant:
MR/P011462/1
MR/W015455/1
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Funder identifier:
https://ror.org/001aqnf71
More from this funder
Funder identifier:
https://ror.org/018mejw64


Publisher:
Elsevier
Journal:
Lancet Diabetes & Endocrinology More from this journal
Volume:
14
Issue:
3
Pages:
243-258
Place of publication:
England
Publication date:
2026-01-23
Acceptance date:
2025-12-03
DOI:
EISSN:
2213-8595
ISSN:
2213-8587
Pmid:
41587556


Language:
English
Subtype:
Review
Pubs id:
2366438
Local pid:
pubs:2366438
Deposit date:
2026-04-15
ARK identifier:

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