ɪnðɪ ˈæbsəns ʌv klˈɪɹ tɹˈɪɡɚɹɪŋ fˈæktɚz, ˈɛpɪsˌoʊdz ʌv ˌeɪdˈiː ðæt ɑːɹ ɹᵻkˈɜːɹənt kæn biː ɪmpˈoːɹtənt sˈaɪnz ðæt ðɛɹ ɪz ɐn ˌʌndɪtˈɛktᵻd ˌʌndɚlˈaɪɪŋ pæθˈɑːlədʒi ɪn ɐ pˈeɪʃənt ðæt həznɑːt jˈɛt bˌɪn ᵻlˈuːsᵻdˌeɪɾᵻd.
In the absence of clear triggering factors, episodes of AD that are recurrent can be important signs that there is an undetected underlying pathology in a patient that has not yet been elucidated.