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Hair cortisol AND cushing

S A A van den Berg, N E van 't Veer, J M A Emmen, R H T van Beek
SUMMARY: We present a case of iatrogenic Cushing's syndrome, induced by treatment with fluticasone furoate (1-2 dd, 27.5 µg in each nostril) in a pediatric patient treated for congenital HIV. The pediatric patient described in this case report is a young girl of African descent, treated for congenital HIV with a combination therapy of Lopinavir/Ritonavir (1 dd 320/80 mg), Lamivudine (1 dd 160 mg) and Abacavir (1 dd 320 mg). Our pediatric patient presented with typical Cushingoid features (i...
2017: Endocrinology, Diabetes & Metabolism Case Reports
Vincent L Wester, Martin Reincke, Jan W Koper, Erica L T van den Akker, Laura Manenschijn, Christina M Berr, Julia Fazel, Yolanda B de Rijke, Richard A Feelders, Elisabeth F C van Rossum
OBJECTIVE: Current first-line screening tests for Cushing's syndrome (CS) only measure time-point or short-term cortisol. Hair cortisol content (HCC) offers a non-invasive way to measure long-term cortisol exposure over several months of time. We aimed to evaluate HCC as a screening tool for CS. DESIGN: Case-control study in two academic referral centers for CS. METHODS: Between 2009 and 2016, we collected scalp hair from patients suspected of CS and healthy controls...
June 2017: European Journal of Endocrinology
Aaron Hodes, Maya B Lodish, Amit Tirosh, Jerrold Meyer, Elena Belyavskaya, Charalampos Lyssikatos, Kendra Rosenberg, Andrew Demidowich, Jeremy Swan, Nichole Jonas, Constantine A Stratakis, Mihail Zilbermint
PURPOSE: Hair cortisol evaluation has been used to help detect patients with suspected Cushing syndrome. Our goal was to correlate segmental hair cortisol with biochemical testing in patients with Cushing syndrome and controls. This study was a prospective analysis of hair cortisol in confirmed Cushing syndrome cases over 16 months. METHODS: Thirty-six subjects (26.5 ± 18.9 years, 75% female, and 75% Caucasian) were analyzed by diurnal serum cortisol, 24 h urinary free cortisol corrected for body surface area (UFC/BSA), and 24 h urinary 17-hydroxysteroids corrected for creatinine (17OHS/Cr)...
April 2017: Endocrine
G Noppe, E L T van den Akker, Y B de Rijke, J W Koper, V W Jaddoe, E F C van Rossum
BACKGROUND: Childhood obesity is an important risk factor for premature development of the metabolic syndrome (MetS) at adulthood. There is need for understanding of the mechanisms underlying the MetS and obesity. Patients with Cushing's disease suffer from similar metabolic complications, leading to the hypothesis that inter-individual cortisol variation may contribute to the onset of obesity. In addition, glucocorticoid receptor (GR)-gene polymorphisms resulting in differential glucocorticoid (GC) sensitivity, have been associated with an adverse metabolic profile...
July 26, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Dawn Shaver
BACKGOUND: Cushing's syndrome is a rare disease that is caused by the overproduction of cortisol by the adrenal glands. This can be caused by a tumor of the adrenal glands, the lungs or the pituitary gland. When a pituitary tumor produces too much ACTH (adrenocorticotropic hormone), it causes the overproduction of cortisol by the adrenal glands. When the pituitary is the source of the over production, it is called Cushing's disease. CASE DESCRIPTION: A 32-year-old female who developed symptoms of Cushing's about one and a half years prior to her visit at a large teaching hospital in the Mid-Atlantic...
2015: Surgical Neurology International
Vincent L Wester, Elisabeth F C van Rossum
Cortisol measurements in blood, saliva and urine are frequently used to examine the hypothalamus-pituitary-adrenal (HPA) axis in clinical practice and in research. However, cortisol levels are subject to variations due to acute stress, the diurnal rhythm and pulsatile secretion. Cortisol measurements in body fluids are not always a reflection of long-term cortisol exposure. The analysis of cortisol in scalp hair is a relatively novel method to measure cumulative cortisol exposure over months up to years. Over the past years, hair cortisol concentrations (HCC) have been examined in association with a large number of somatic and mental health conditions...
October 2015: European Journal of Endocrinology
Rene Baudrand, Anand Vaidya
PURPOSE OF REVIEW: The present review highlights recent investigations in the prior 18 months focusing on the role of dysregulated cortisol physiology in obesity as a potential modifiable mechanism in the pathogenesis of obesity-related cardiometabolic disorders. RECENT FINDINGS: Given the clinical resemblance of obesity-related metabolic disorders with the Cushing's syndrome, new studies have investigated the intracellular regulation and metabolism of cortisol, new measurements of cortisol in scalp hair as a tool for long-term exposure to cortisol, and the cortisol-mineralocorticoid receptor pathway...
June 2015: Current Opinion in Endocrinology, Diabetes, and Obesity
Insook Jeong, Moonyeon Oh, Ja Hye Kim, Ja Hyang Cho, Jin-Ho Choi, Han-Wook Yoo
Cushing disease is caused by excessive adrenocorticotropic hormone (ACTH) production by the pituitary adenoma. Transsphenoidal surgery is its first-line treatment. The incidence of Cushing disease in children and adolescents is so rare that long-term prognoses have yet to be made in most cases. We followed-up on a 16-year-old male Cushing disease patient who presented with rapid weight gain and growth retardation. The laboratory findings showed increased 24-hour urine free cortisol and lack of overnight cortisol suppression by low-dose dexamethasone test...
September 2014: Annals of Pediatric Endocrinology & Metabolism
Gerard Noppe, Elisabeth F C Van Rossum, Jan Willem Koper, Laura Manenschijn, G Jan Bruining, Yolanda B de Rijke, Erica L T van den Akker
BACKGROUND: Cortisol is produced in a circadian rhythm controlled by the hypothalamus-pituitary-adrenal axis, making it cumbersome to measure long-term cortisol exposure. Hair has proven to be a reliable matrix for long-term cortisol measurement in adults and can be used as diagnostic tool for (cyclic) Cushing's syndrome. The diagnostic applicability in children has not been studied, nor have the effects of development and hair care been evaluated in children. We aimed to establish reference ranges of hair cortisol concentrations (HCC) in healthy children and to evaluate the effects of age, gender, puberty and characteristics of hair care...
2014: Hormone Research in Pædiatrics
Vincent L Wester, Sabine M Staufenbiel, Margriet A B Veldhorst, Jenny A Visser, Laura Manenschijn, Jan W Koper, Francoise J M Klessens-Godfroy, Erica L T van den Akker, Elisabeth F C van Rossum
OBJECTIVE: In obese subjects a relatively high cortisol output in urine has been observed compared to nonobese individuals. However, cortisol levels in blood, saliva, and urine in association with obesity have been inconsistent across studies, possibly due to the high variability of systemic cortisol levels. Cortisol levels measured in scalp hair provide a marker for long-term cortisol exposure, and have been associated with cardiovascular disease in an elderly population and to disease course in Cushing's disease...
September 2014: Obesity
Keisuke Nagasaki, Reiko Horikawa, Jun-Ichi Nagaishi, Toshiro Honna, Akihiko Sekiguchi, Yukiko Tsunematsu, Toshiaki Tanaka
We present a 3-yr-old girl with a virilizing adrenocortical carcinoma invading into the right atrium with histological high-grade malignancy and p53 mutation. Development of facial acne and pubic hair were noted at 3 yr and 2 mo. The levels of androgens were high. Diurnal variation in ACTH and cortisol were absent. Abdominal computed tomography revealed a large right suprarenal mass, with extension into the inferior vena cava and right atrium. Based on the diagnosis of a right virilizing adrenocortical tumor with Cushing syndrome, surgery was performed by a combined thoracoabdominal approach with the patient on cardiopulmonary bypass...
2004: Clinical Pediatric Endocrinology: Case Reports and Clinical Investigations: Official Journal of the Japanese Society for Pediatric Endocrinology
Adaeze C Wosu, Unnur Valdimarsdóttir, Alexandra E Shields, David R Williams, Michelle A Williams
Assessment of cortisol concentrations in hair is one of the latest innovations for measuring long-term cortisol exposure. We performed a systematic review of correlates of cortisol in human hair to inform the design, analysis, and interpretation of future epidemiologic studies. Relevant publications were identified through electronic searches on PubMed, WorldCat, and Web of Science using keywords, "cortisol," "hair," "confounders," "chronic," "stress," and "correlates." Thirty-nine studies were included in this review...
December 2013: Annals of Epidemiology
Sherry L Iuliano, Edward R Laws
PURPOSE: To present a case study of a 34-year-old woman with Cushing's disease and provide nurse practitioners (NPs) with the understanding of the clinical presentation needed for early recognition and treatment of the disease. DATA SOURCES: A comprehensive review of published literature on Cushing's disease. Findings from history, physical examination, and diagnostic studies of a woman presenting to primary care NPs, physicians and other healthcare providers with multiple symptoms of Cushing's disease...
August 2013: Journal of the American Association of Nurse Practitioners
S Corradini, P A Accorsi, A Boari, V Beghelli, M Mattioli, P Famigli-Bergamini, F Fracassi
BACKGROUND: Measurement of hair cortisol is a noninvasive technique used for several purposes in humans and in animals. OBJECTIVES: To measure hair cortisol concentrations (HCC) in dogs with spontaneous hypercortisolism (HC) and determine whether it can represent a useful diagnostic test for this syndrome. ANIMALS: Twenty-two dogs with spontaneous HC before treatment, 28 sick control dogs (SCD), and 40 healthy dogs. METHODS: In this prospective, observational clinical study, the HCC was measured by an RIA assay after extraction in HC dogs, in dogs with other chronic diseases, and in healthy dogs...
September 2013: Journal of Veterinary Internal Medicine
Jakob Hauser, Stefan Riedl, Ina Michel-Behnke, Milen Minkov, Eva Perneczky, Ernst Horcher
Nonfamilial cardiomyopathies in childhood have been only sporadically ascribed to endocrine disorders. We report on a 4-month-old male infant presenting with Cushing's syndrome associated with excessive body weight (8.9 kg; >97th percentile) and features of virilization (Tanner stage 2 for pubic hair development). Abdominal sonography showed a large adrenal tumor. Echocardiography revealed myocardial hypertrophy with severe subaortic obstruction. Blood tests showed excessive androgen and cortisol serum levels with absent circadian rhythm as well as suppressed corticotropin...
August 2013: Pediatrics
L Manenschijn, J W Koper, E L T van den Akker, L J M de Heide, E A M Geerdink, F H de Jong, R A Feelders, E F C van Rossum
BACKGROUND: Measurement of cortisol in 24-h urine collections and midnight saliva are standard screening tests for Cushing's syndrome (CS). These tests reflect cortisol levels during a maximum of 24 h and do not provide historical information. Therefore, they can yield normal results in case of cyclic CS, which is a rare disorder that is characterized by alternating episodes of endogenous cortisol excess and normal cortisol secretion. The measurement of cortisol in scalp hair is a novel tool that might be helpful to establish the diagnosis of (cyclic) CS...
October 2012: Journal of Clinical Endocrinology and Metabolism
Maria Francesca Messina, Mariella Valenzise, Salvatore Aversa, Teresa Arrigo, Filippo De Luca
A boy aged 7.6 years presented to our Unit of Paediatric Endocrinology for evaluation of obesity. Progressive weight gain (10 kg) started 6 months earlier after an accidental penetrating orbital injury on the right eye. During this period the child has been treated with oral betamethasone (0.5 mg/day) for 1 month and dexamethasone 2% ocular drops (2 hourly by day) for 6 months. Physical examination showed he was 113.5 cm in height (-1.5 SD), weight 36.0 kg, blood pressure 110/90 mmHg (90th centile), body mass index 28 (+5 SD), truncal obesity, buffalo hump, "moon-face", increased lanugo hair and supraclavicular fullness...
2009: BMJ Case Reports
Ana Tiganescu, Elizabeth A Walker, Rowan S Hardy, Andrew E Mayes, Paul M Stewart
Glucocorticoids (GCs) are highly detrimental to skin integrity and function both when applied topically for anti-inflammatory treatments and during conditions of circulating excess, e.g., Cushing's syndrome. Within target tissues, GC availability is regulated at a prereceptor level, independently of systemic levels, by isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD) that interconvert active cortisol and inactive cortisone. Many of the adverse effects of GCs on skin are also reminiscent of the natural aging process...
January 2011: Journal of Investigative Dermatology
Tobias Stalder, Clemens Kirschbaum, Kareen Heinze, Susann Steudte, Paul Foley, Antje Tietze, Lucia Dettenborn
The assessment of cortisol levels in human hair has recently been suggested to provide a retrospective index of cumulative cortisol exposure over periods of up to 6 months. The current study examined the utility of hair cortisol analysis to retrospectively detect hypercortisolism during active drinking phases in alcoholics in acute withdrawal (n=23), the normalisation of cortisol output in abstinent alcoholics (n=25) and cortisol levels in age- and gender-matched controls (n=20). Scalp-near 3-cm hair segments were sampled and analysed for cortisol content...
December 2010: Biological Psychology
I A Harsch, E G Hahn
A 41-year-old female was admitted to our clinic due to weight gain and facial edema. The patient also reported hair loss, amenorrhea and the formation of striae. The laboratory diagnostics ensured the diagnosis of Cushing's syndrome. Unfortunately, the patient was among the 5-10% of patients in whom neither laboratory testing nor imaging revealed the source of the cortisol excess. Due to the dramatic decrease of her general condition, and the appearance of hypertension and diabetes mellitus we chose to refer the patient to bilateral minimally invasive adrenalectomy...
March 2010: Der Internist
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