addisonpatiënten als oorzaak van de klachten kan worden geïdentificeerd, zoals in diermodellen, zou catecholaminesuppletie wellicht een behandelmogelijkheid zijn. echter, een off-label proefbehandeling met een b2-agonist (i.c. salbutamol opgetitreerd tot 300 mcg s.c.) veroorzaakte bij patiënte B een dusdanige orthostatische hypotensie, dat b2-agonisten bij deze patiënte ongeschikt blijken om te combineren met inspanning. Deze bijwerking werd gemeld aan het Nederlands Bijwerkingen Centrum Lareb. Daarnaast kan een parenterale b2-agonist hypokaliaemie veroorzaken [30]. Afhankelijkheden Deze studie is mede mogelijk gemaakt door de Nederlandse vereniging voor Addison en Cushing patiënten (NVACP). Referenties 1. Laureti, S., et al., Is the prevalence of Addison’s disease underestimated? J Clin Endocrinol Metab, 1999. 84(5): p. 1762. 2. Heijmans M.J.W.M. and Rijken P.M., De impact van de ziekte van Addison, het syndroom van Cushing of AGS op het dagelijks leven en de zorg – een onderzoek vanuit patiëntenperspectief. NIVEL, 2006. 3. Green-Golan, L., et al., Patients with classic congenital adrenal hyperplasia have decreased epinephrine reserve and defective glycemic control during prolonged moderate-intensity exercise. J Clin Endocrinol Metab, 2007. 92(8): p. 3019-24. 4. Zelissen, P.M.J., Addison Patiënten in Nederland. Medische gegevens van het onderzoek. 1994. 5. Yang, H.T., et al., Adrenodemedullation affects endurance but not hepatic fructose 2,6-bisphosphate. Am J Physiol, 1988. 254(4 Pt 2): p. R572-7. 6. Yang, H.T., K.I. Carlson, and W.W. Winder, Insulin does not influence muscle glycogenolysis in adrenodemedullated exercising rats. Am J Physiol, 1987. 253(4 Pt 2): p. R535-40. 7. Winder, W.W., et al., Epinephrine, glucose, and lactate infusion in exercising adrenodemedullated rats. J Appl Physiol, 1987. 62(4): p. 1442-7. 8. Arnall, D.A., et al., Effect of infusing epinephrine on liver and muscle glycogenolysis during exercise in rats. Am J Physiol, 1986. 250(6 Pt 1): p. E641-9. 9. Winder, W.W., M.L. Terry, and V.M. Mitchell, Role of plasma epinephrine in fasted exercising rats. Am J Physiol, 1985. 248(3 Pt 2): p. R302-7. 10. Weise, M., et al., Patients with classic congenital adrenal hyperplasia have decreased epinephrine reserve and defective glucose elevation in response to high-intensity exercise. J Clin Endocrinol Metab, 2004. 89(2): p. 591-7. 11. Volkl, T.M., et al., Obesity among children and adolescents with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Pediatrics, 2006. 117(1): p. e98-105. 12. Kjaer, M., et al., Adrenaline and glycogenolysis in skeletal muscle during exercise: a study in adrenalectomised humans. J Physiol, 2000. 528 Pt 2: p. 371-8. 13. Jakobi, J.M., et al., Quadriceps muscle function and fatigue in women with Addison’s disease. Muscle Nerve, 2001. 24(8): p. 1040-9. 14. Kasperlik-Zaluska, A.A., et al., Association of Addison’s disease with autoimmune disorders--a long-term observation of 180 patients. Postgrad Med J, 1991. 67(793): p. 984-7. 15. Howlett, K., et al., Effect of adrenaline on glucose kinetics during exercise in adrenalectomised humans. J Physiol, 1999. 519 Pt 3: p. 911-21. 16. Bornstein, S.R., et al., Plasma catecholamines in patients with Addison’s disease. Clin Endocrinol (Oxf), 1995. 42(2): p. 215-8. 17. Wurtman, R.J. and L.A. Pohorecky, Adrenocortical control of epinephrine synthesis in health and disease. Adv Metab Disord, 1971. 5: p. 53-76. 18. Zuckerman-Levin, N., et al., The importance of adrenocortical glucocorticoids for adrenomedullary and physiological response to stress: a study in isolated glucocorticoid deficiency. J Clin Endocrinol Metab, 2001. 86(12): p. 5920-4. 19. Carlson, K.I., et al., Epinephrine is unessential for stimulation of liver glycogenolysis during exercise. J Appl Physiol, 1985. 58(2): p. 544-8. 20. Marker, J.C., et al., Effect of adrenodemedullation on metabolic responses to high-intensity exercise. Am J Physiol, 1986. 251(3 Pt 2): p. R552-9. 21. Weise, M., et al., Stress dose of hydrocortisone is not beneficial in patients with classic congenital adrenal hyperplasia undergoing short-term, high-intensity exercise. J Clin Endocrinol Metab, 2004. 89(8): p. 3679-84. 22. van der Hoorn, F.A., et al., Determination of catecholamines in human plasma by high-performance liquid chromatography: comparison between a new method with fluorescence detection and an established method with electrochemical detection. J Chromatogr, 1989. 487(1): p. 17-28. 23. Oparil, S., et al., Role of renin in acute postural homeostasis. Circulation, 1970. 41(1): p. 89-95. 24. Chwalbinska-Moneta, J., et al., Early effects of short-term endurance training on hormonal responses to graded exercise. J Physiol Pharmacol, 2005. 56(1): p. 87-99. 25. Berkin, K.E., et al., Circulating adrenaline and noradrenaline concentrations during exercise in patients with exercise induced asthma and normal subjects. Thorax, 1988. 43(4): p. 295-9. 26. Khoo, E.Y., et al., Effects of exenatide on circulating glucose, insulin, glucagon, cortisol and catecholamines in healthy volunteers during exercise. Diabetologia, 2010. 53(1): p. 139-43. 27. Bracken, R.M., D.M. Linnane, and S. Brooks, Plasma catecholamine and nephrine responses to brief intermittent maximal intensity exercise. Amino Acids, 2009. 36(2): p. 209-17. nummer 3 | juli 2014 | Sport & Geneeskunde 37 Pagina 36

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