Characterization of patients with primary adrenal insufficiency in a tertiary care hospital in Ecuador: a cross-sectional study

Abstract

Background: Primary adrenal insufficiency is a pathology of low presentation and epidemiological data in Ecuador are limited.

Objective: To determine the clinical characteristics, presentation, complications, triggering factors and biomarkers at diagnosis of PSI.

Methods: Cross-sectional study in 55 patients attended at the Eugenio Espejo Specialty Hospital in the city of Quito, Ecuador. A univariate descriptive study was performed using absolute frequencies and percentages.

Results: 69.1% of the patients with primary adrenal insufficiency were women. Eighty percent of the patients presented asthenia, 65.5% hyperpigmentation, 32.7% arterial hypotension and 23.6% weight loss. Hyponatremia was the most prevalent electrolyte disturbance with 52.7%. The most frequent comorbidity was hypothyroidism (63.6%) and associated with autoimmune polyglandular syndrome type 2 in 65.5% of the patients. A total of 63.6% were diagnosed as having chronic symptomatology. In the study population, the triggering factor of the adrenal crisis was not identified in 65.5% of the patients.

Conclusions: Primary adrenal insufficiency should be considered in the differential diagnosis of patients with non-specific signs and symptoms to facilitate a rapid and accurate diagnosis in the presence of co-existing autoimmune pathologies or endocrinopathies.