Autoimmune primary adrenal insufficiency

disease
On this page

Also known as Addison diseaseAddison's diseaseautoimmune Addison diseaseautoimmune Addison's diseaseautoimmune adrenalitisclassic Addison's diseaseprimary Addison's disease

Summary

Autoimmune primary adrenal insufficiency (MONDO:0100480) is a disease and 21 clinical trials. Top therapeutic interventions include hydrocortisone cypionate, hydrocortisone sodium succinate, and hydrocortisone. A subtype of chronic primary adrenal insufficiency — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

  • Prevalence: 1-5 / 10 000 (Europe) [Orphanet-validated]
  • Phenotypes (HPO): 56
  • Clinical trials: 21

Clinical features

Epidemiology

Prevalence records

4 prevalence record(s), Orphanet:

TypeClassValueGeographyValidation
Point prevalence1-5 / 10 00012.5EuropeValidated
Annual incidence1-5 / 10 00054Specific populationValidated
Point prevalence1-5 / 10 00014NorwayValidated
Point prevalence1-9 / 100 0009.3United KingdomValidated

Signs & symptoms

Clinical features (HPO)

56 HPO clinical features (Orphanet curated; top 50 by frequency):

HPO IDTermFrequency
HP:0008163Decreased circulating cortisol levelObligate (100%)
HP:0008207Primary adrenal insufficiencyObligate (100%)
HP:0002014DiarrheaVery frequent (80-99%)
HP:0002017Nausea and vomitingVery frequent (80-99%)
HP:0002019ConstipationVery frequent (80-99%)
HP:0002027Abdominal painVery frequent (80-99%)
HP:0002039AnorexiaVery frequent (80-99%)
HP:0002615HypotensionVery frequent (80-99%)
HP:0002960AutoimmunityVery frequent (80-99%)
HP:0003154Increased circulating ACTH levelVery frequent (80-99%)
HP:0012378FatigueVery frequent (80-99%)
HP:0000953Hyperpigmentation of the skinVery frequent (80-99%)
HP:0001324Muscle weaknessVery frequent (80-99%)
HP:0001508Failure to thriveVery frequent (80-99%)
HP:0001824Weight lossVery frequent (80-99%)
HP:0000127Renal salt wastingFrequent (30-79%)
HP:0000848Increased circulating renin levelFrequent (30-79%)
HP:0001649TachycardiaFrequent (30-79%)
HP:0001897Normocytic anemiaFrequent (30-79%)
HP:0001944DehydrationFrequent (30-79%)
HP:0002149HyperuricemiaFrequent (30-79%)
HP:0002153HyperkalemiaFrequent (30-79%)
HP:0002902HyponatremiaFrequent (30-79%)
HP:0004319Decreased circulating aldosterone levelFrequent (30-79%)
HP:0005976Hyperkalemic metabolic acidosisFrequent (30-79%)
HP:0008226Androgen insufficiencyFrequent (30-79%)
HP:0012364Decreased urinary potassiumFrequent (30-79%)
HP:0025406AstheniaFrequent (30-79%)
HP:0033834MalaiseFrequent (30-79%)
HP:0034055Anti-side-chain cleavage enzyme antibody positivityFrequent (30-79%)
HP:0034061Anti-steroid 17alpha-hydroxylase antibody positivityFrequent (30-79%)
HP:0034071Anti-21-hydroxylase antibody positivityFrequent (30-79%)
HP:0030083Salt cravingOccasional (5-29%)
HP:0100651Type I diabetes mellitusOccasional (5-29%)
HP:0000823Delayed pubertyOccasional (5-29%)
HP:0000829HypoparathyroidismOccasional (5-29%)
HP:0000835Adrenal hypoplasiaOccasional (5-29%)
HP:0000872Hashimoto thyroiditisOccasional (5-29%)
HP:0000958Dry skinOccasional (5-29%)
HP:0001045VitiligoOccasional (5-29%)
HP:0001250SeizureOccasional (5-29%)
HP:0001278Orthostatic hypotensionOccasional (5-29%)
HP:0001596AlopeciaOccasional (5-29%)
HP:0001943HypoglycemiaOccasional (5-29%)
HP:0002215Sparse axillary hairOccasional (5-29%)
HP:0002321VertigoOccasional (5-29%)
HP:0002608Celiac diseaseOccasional (5-29%)
HP:0002829ArthralgiaOccasional (5-29%)
HP:0003072HypercalcemiaOccasional (5-29%)
HP:0006462Generalized bone demineralizationOccasional (5-29%)

Identifiers

Disease identifiers

FieldValue
Canonical nameautoimmune primary adrenal insufficiency
Mondo IDMONDO:0100480
Orphanet85138
ICD-111920929898
NCITC113814
UMLSC0271737
MedGen543526
GARD0005740
Is cancer (heuristic)no

Also known as: Addison disease · Addison’s disease · autoimmune Addison disease · autoimmune Addison’s disease · autoimmune adrenalitis · classic Addison’s disease · primary Addison’s disease

Data availability: 7 cell lines.

Disease family

This is a subtype of chronic primary adrenal insufficiency. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: disease › human disease › disease by body system or component › endocrine system disorderadrenal gland disorderadrenal cortex disorderadrenocortical insufficiencyprimary adrenal insufficiencychronic primary adrenal insufficiencyautoimmune primary adrenal insufficiency

Related subtypes (7): adrenocortical hypofunction, chronic primary congenital, familial adrenal hypoplasia with absent pituitary luteinizing hormone, familial glucocorticoid deficiency, triple-A syndrome, X-linked adrenal hypoplasia congenita, inherited isolated adrenal insufficiency due to partial CYP11A1 deficiency, congenital adrenal hyperplasia

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

No tiered GWAS variants or ClinVar records for this disease.

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

No druggable-target or therapeutic data for this disease’s cohort.

Clinical trials & evidence

Clinical trials

Clinical trials: 21.

Phase distribution (across all retrieved trials)

PhaseTrials
Not specified14
PHASE42
PHASE22
PHASE31
PHASE2/PHASE31
PHASE1/PHASE21

Top trials by phase / activity

NCTPhaseStatusTitle
NCT03210545PHASE4COMPLETEDA Study of Markers of Glucocorticoid Effects in Patients With Addisons Disease (DOSCORT)
NCT05350020PHASE4UNKNOWNThe Effects of Two Brands of Hydrocortisone Injected Intramuscularly Into Deltoid and Thigh Muscles
NCT00004313PHASE3COMPLETEDPhase III Randomized, Double-Blind, Placebo-Controlled Study of Dehydroepiandrosterone Replacement for Primary Adrenal Insufficiency
NCT01063569PHASE2/PHASE3COMPLETEDGlucocorticoid Treatment in Addison’s Disease
NCT01840189PHASE2TERMINATEDContinuous Subcutaneous Hydrocortisone Infusion In Addison’s Disease and Type 1 Diabetes
NCT01847690PHASE2UNKNOWNEffect of Cortisol on Physical Exertion in Patients With Primary Adrenal Failure
NCT02096510PHASE1/PHASE2COMPLETEDUltradian Subcutaneous Hydrocortisone Infusion in Addison Disease and Congenital Adrenal Hyperplasia
NCT01793168Not specifiedRECRUITINGRare Disease Patient Registry & Natural History Study - Coordination of Rare Diseases at Sanford
NCT04252001Not specifiedNOT_YET_RECRUITINGGrowing up With the Young Endocrine Support System (YESS!)
NCT07413874Not specifiedNOT_YET_RECRUITINGTelehealth Music Therapy for Adults With Endocrine Disorder and Depression
NCT00251836Not specifiedCOMPLETEDAdrenal Function After Living Kidney Donation
NCT00444119Not specifiedCOMPLETEDSurvey in Patients With Chronic Adrenal Insufficiency in Germany
NCT00688987Not specifiedCOMPLETEDThe Hypothalamic-Pituitary-Adrenal (HPA) Axis as an Effector System in Weight Regulation
NCT01271296Not specifiedCOMPLETEDEffects and Interactions of Liquorice and Grapefruit on Glucocorticoid Replacement Therapy in Addison’s Disease
NCT01452893Not specifiedCOMPLETEDCounterregulatory Hormone Production in Adrenal Insufficiency and Diabetes Type I
NCT01657123Not specifiedUNKNOWNExercise Capacity and Recovery in Addison’s Disease
NCT02152553Not specifiedCOMPLETEDBiomarker(s) for Glucocorticoids
NCT03941184Not specifiedCOMPLETEDSpontaneous Coronary Artery Dissection (SCAD) and Autoimmunity
NCT04374721Not specifiedUNKNOWNClinical Study on Circadian Genes Dysregulation in Patients With Glucocorticoid Disorders
NCT04789993Not specifiedUNKNOWNAdditional Autoimmune Diseases With Type 1 Diabetes in Pediatrics at Diabetes Diagnosis and During Follow-up
NCT05515055Not specifiedUNKNOWNDoes Relative Hypoglycaemia &/or Sleep Disturbance Contribute to the Lethargy Observed in Addison’s Disease

Drugs tested across these trials (top 30)

MoleculeMax phaseTrials referencing
HYDROCORTISONE CYPIONATE43
HYDROCORTISONE SODIUM SUCCINATE43
HYDROCORTISONE42
BETAMETHASONE41
PRASTERONE41
GRAPEFRUIT JUICE11
CHEMBL3139901