{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:38:17Z","timestamp":1764603497346},"reference-count":17,"publisher":"Walter de Gruyter GmbH","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Autoimmune Addison\u2019s disease (AAD) is the most frequent cause of adrenocortical insufficiency. The natural history of AAD usually comprises five consecutive stages with the first stage characterized by the increase of plasma renin consistent with the impairment of <jats:italic>pars glomerulosa<\/jats:italic>, which is usually the first affected layer of the adrenal cortex. We describe a 19-year-old female with Hashimoto\u2019s thyroiditis (HT) who underwent an autoantibody screening due to having the personal and family history of other autoimmune diseases in the absence of relevant clinical manifestations. She was positive for adrenal cortex autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21-OH Ab) at high titers. She had increased basal levels of ACTH with normal basal cortisol not responding to ACTH stimulation, reduced levels of dehydroepiandrosterone-sulfate but normal levels of orthostatic renin and aldosterone. This scenario was consistent with a subclinical AAD presenting with first impairments in <jats:italic>pars fasciculata<\/jats:italic> and <jats:italic>reticularis<\/jats:italic> and conserved <jats:italic>pars glomerulosa<\/jats:italic> function. Only subsequently, progressive deficiency in <jats:italic>pars glomerulosa<\/jats:italic> function has become evident. Review of the literature showed that there was only one case, reported to date, with a similar atypical natural history of AAD. The strategies for screening for ACA\/21-OH Ab in patients with HT are discussed.<\/jats:p>","DOI":"10.1515\/cclm-2017-1108","type":"journal-article","created":{"date-parts":[[2018,2,28]],"date-time":"2018-02-28T22:16:54Z","timestamp":1519856214000},"page":"896-900","source":"Crossref","is-referenced-by-count":13,"title":["The natural history of autoimmune Addison\u2019s disease with a non-classical presentation: a case report and review of literature"],"prefix":"10.1515","volume":"56","author":[{"given":"Jacopo","family":"Manso","sequence":"first","affiliation":[{"name":"Endocrinology Unit, Department of Medicine (DIMED) , University of Padova , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Pezzani","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Medicine (DIMED) , University of Padova , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Medicine (DIMED) , University of Padova , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Gallo","sequence":"additional","affiliation":[{"name":"Laboratory Medicine, Department of Medicine (DIMED) , University of Padova , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Betterle","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Medicine (DIMED) , University of Padova , Padova , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2018,2,26]]},"reference":[{"key":"2021021304033290495_j_cclm-2017-1108_ref_001_w2aab3b7d101b1b6b1ab2b2b1Aa","doi-asserted-by":"crossref","unstructured":"Husebye ES, Allolio B, Arlt W, Badenhoop K, Bensing S, Betterle C, et al. 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