{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:03:05Z","timestamp":1792188185641,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,12,16]],"date-time":"2013-12-16T00:00:00Z","timestamp":1387152000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"FP7","award":["201167"],"award-info":[{"award-number":["201167"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Primary adrenal insufficiency (\n                    <jats:styled-content style=\"fixed-case\">PAI<\/jats:styled-content>\n                    ), or Addison's disease, is a rare, potentially deadly, but treatable disease. Most cases of\n                    <jats:styled-content style=\"fixed-case\">PAI<\/jats:styled-content>\n                    are caused by autoimmune destruction of the adrenal cortex. Consequently, patients with\n                    <jats:styled-content style=\"fixed-case\">PAI<\/jats:styled-content>\n                    are at higher risk of developing other autoimmune diseases. The diagnosis of\n                    <jats:styled-content style=\"fixed-case\">PAI<\/jats:styled-content>\n                    is often delayed by many months, and most patients present with symptoms of acute adrenal insufficiency. Because\n                    <jats:styled-content style=\"fixed-case\">PAI<\/jats:styled-content>\n                    is rare, even medical specialists in this therapeutic area rarely manage more than a few patients. Currently, the procedures for diagnosis, treatment and follow\u2010up of this rare disease vary greatly within Europe. The common autoimmune form of\n                    <jats:styled-content style=\"fixed-case\">PAI<\/jats:styled-content>\n                    is characterized by the presence of 21\u2010hydroxylase autoantibodies; other causes should be sought if no autoantibodies are detected. Acute adrenal crisis is a life\u2010threatening condition that requires immediate treatment. Standard replacement therapy consists of multiple daily doses of hydrocortisone or cortisone acetate combined with fludrocortisone. Annual follow\u2010up by an endocrinologist is recommended with the focus on optimization of replacement therapy and detection of new autoimmune diseases. Patient education to enable self\u2010adjustment of dosages of replacement therapy and crisis prevention is particularly important in this disease. The authors of this document have collaborated within an\n                    <jats:styled-content style=\"fixed-case\">EU<\/jats:styled-content>\n                    project (Euadrenal) to study the pathogenesis, describe the natural course and improve the treatment for Addison's disease. Based on a synthesis of this research, the available literature, and the views and experiences of the consortium's investigators and key experts, we now attempt to provide a European Expert Consensus Statement for diagnosis, treatment and follow\u2010up.\n                  <\/jats:p>","DOI":"10.1111\/joim.12162","type":"journal-article","created":{"date-parts":[[2013,11,14]],"date-time":"2013-11-14T01:27:20Z","timestamp":1384392440000},"page":"104-115","source":"Crossref","is-referenced-by-count":330,"title":["Consensus statement on the diagnosis, treatment and follow\u2010up of patients with primary adrenal insufficiency"],"prefix":"10.1111","volume":"275","author":[{"given":"E. S.","family":"Husebye","sequence":"first","affiliation":[{"name":"Department of Clinical Science University of Bergen Bergen Norway"},{"name":"Department of Medicine Haukeland University Hospital Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Allolio","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I Endocrine and Diabetes Unit University Hospital W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Arlt","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology, Diabetes and Metabolism School of Clinical and Experimental Medicine University of Birmingham Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Badenhoop","sequence":"additional","affiliation":[{"name":"Department of Medicine 1 Goethe\u2010University Hospital Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bensing","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Betterle","sequence":"additional","affiliation":[{"name":"Endocrine Unit Department of Medicine (DIMED) University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Falorni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Section of Internal Medicine and Endocrine and Metabolic Sciences University of Perugia Perugia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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