{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T10:52:23Z","timestamp":1791111143453,"version":"4.1.0"},"reference-count":17,"publisher":"Walter de Gruyter GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpem-2026-0187_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This case report summarises clinical findings in four adolescents (aged 14\u201317 years) diagnosed with autoimmune adrenalitis at a German University Children\u2019s Hospital between 2019 and\u00a02025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0187_abs_002\">\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>Clinical presentation varied and included fatigue, arterial hypotension, depressive symptoms, hyperpigmentation of the skin, and in one case acute kidney failure associated with acute viral infection. All patients showed hyponatraemia, reduced cortisol levels in serum and elevated adrenocorticotropic hormone concentrations at diagnosis. Autoimmune adrenalitis was confirmed in all patients by the presence of autoantibodies against the adrenal cortex. Interestingly, three of the four cases were diagnosed within a period of only 18\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpem-2026-0187_abs_003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our case series of autoimmune adrenalitis may suggest a potential increase \u00a0in the annual incidence among adolescents. The clinical diversity of symptoms at diagnosis ranging from depression to acute kidney failure was striking. Since delayed diagnosis may lead to life-threatening complications, awareness of clinical variability is essential for physicians to achieve timely diagnosis. Cortisol levels should be routinely measured in patients with unclear fatigue and hyponatraemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpem-2026-0187","type":"journal-article","created":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T09:55:39Z","timestamp":1791107739000},"source":"Crossref","is-referenced-by-count":0,"title":["Autoimmune adrenalitis in adolescents in Germany: a series of 4 cases"],"prefix":"10.1515","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8005-1710","authenticated-orcid":false,"given":"Luise","family":"Pudig","sequence":"first","affiliation":[{"name":"University Medicine Halle, Pediatrics 1, Martin Luther University Halle , Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"Greifoner","sequence":"additional","affiliation":[{"name":"University Medicine Halle, Pediatrics 1, Martin Luther University Halle , Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Dieke","sequence":"additional","affiliation":[{"name":"University Medicine Halle, Pediatrics 1, Martin Luther University Halle , Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Constanze","family":"Vilser","sequence":"additional","affiliation":[{"name":"Department for Pediatrics , Sankt-Georg Hospital , Leipzig , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1709-4448","authenticated-orcid":false,"given":"Simone","family":"Hettmer","sequence":"additional","affiliation":[{"name":"University Medicine Halle, Pediatrics 1, Martin Luther University Halle , Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-223X","authenticated-orcid":false,"given":"Susann","family":"Weihrauch-Bl\u00fcher","sequence":"additional","affiliation":[{"name":"University Medicine Halle, Pediatrics 1, Martin Luther University Halle , Halle (Saale) , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"2026100409553047498_j_jpem-2026-0187_ref_001","doi-asserted-by":"crossref","unstructured":"Erichsen, MM, L\u00f8v\u00e5s, K, Skinningsrud, B, Wolff, AB, Undlien, DE, Svartberg, J, et al.. 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