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Pituitary insufficiency

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https://www.readbyqxmd.com/read/28301846/programming-of-the-hypothalamus-pituitary-adrenal-axis-by-very-preterm-birth
#1
Martijn J J Finken, Bibian van der Voorn, Jonneke J Hollanders, Charlotte A Ruys, Marita de Waard, Johannes B van Goudoever, Joost Rotteveel
BACKGROUND: Many very preterm (i.e., <32 weeks of gestation) newborns fail to mount an adequate adrenocortical response to stress or illness, termed relative adrenal insufficiency. Conversely, later in life these infants show features of increased glucocorticoid bioactivity, such as abdominal adiposity, insulin resistance, raised blood pressure, shorter stature and internalizing problem behavior. SUMMARY: Studies suggested that very preterm newborns have impairments along multiple levels of the hypothalamus-pituitary-adrenal (HPA) axis...
March 17, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28294170/exploring-inter-organ-crosstalk-to-uncover-mechanisms-that-regulate-%C3%AE-cell-function-and-mass
#2
REVIEW
J Shirakawa, D F De Jesus, R N Kulkarni
Impaired β-cell function and insufficient β-cell mass compensation are twin pathogenic features that underlie type 2 diabetes (T2D). Current therapeutic strategies continue to evolve to improve treatment outcomes in different ethnic populations and include approaches to counter insulin resistance and improve β-cell function. Although the effects of insulin secretion on metabolic organs such as liver, skeletal muscle and adipose is directly relevant for improving glucose uptake and reduce hyperglycemia, the ability of pancreatic β-cells to crosstalk with multiple non-metabolic tissues is providing novel insights into potential opportunities for improving β-cell function and/or mass that could have beneficial effects in patients with diabetes...
March 15, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28288009/update-on-adrenal-insufficiency-diagnosis-and-management-in-pregnancy
#3
Fabienne Langlois, Dawn S T Lim, Maria Fleseriu
PURPOSE OF REVIEW: Adrenal insufficiency in pregnancy, although relatively rare, has significant clinical implications on both maternal and fetal outcomes. Hypothalamo-pituitary-adrenal axis dynamics and physiological changes are complex, thus diagnosis and management of adrenal insufficiency in pregnancy remain challenging. RECENT FINDINGS: Studies consistently demonstrate a rise in total serum cortisol with pregnancy, but less data are available on free cortisol levels...
March 10, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28286277/extent-of-resection-visual-and-endocrinological-outcomes-for-endoscopic-endonasal-surgery-for-recurrent-pituitary-adenomas
#4
Hyunwoo Do, Varun R Kshettry, Alan Siu, Irina Belinsky, Christopher J Farrell, Gurston Nyquist, Marc Rosen, James J Evans
OBJECTIVE: To assess outcomes after endoscopic endonasal surgery for recurrent or residual pituitary adenomas. METHODS: We retrospectively analyzed 61 patients from 2009 - 2016 that underwent endoscopic endonasal surgery for recurrent or residual pituitary adenomas after prior microscopic or endoscopic transphenoidal operation. RESULTS: Prior surgical approach was endoscopic endonasal in 55.7% and microscopic in 44.2%. The mean preoperative maximal tumor diameter was 2...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28251898/pituitary-stalk-interruption-syndrome-a-rare-and-severe-cause-of-pituitary-deficiency-laboratory-diagnosis-of-a-newborn-case
#5
Thomas Boueilh, Corentin Bassi, Stéphanie Rouleau, Sébastien Le Crugel, Valérie Moal, Florence Boux de Casson, Régis Coutant, Delphine Mirebeau-Prunier, Pascal Reynier, Chadi Homedan
We report the case of a newborn with neonatal hypotonia associated to a micropenis and a bilateral cryptorchidia. The discovery of severe hypoglycemia at 0.22 mmol/L led to further biological investigations that revealed sharply decreased levels of several hypophyseal hormones. Altered corticotropic, somatotropic, thyreotropic, and gonadotropic axes finally suggested congenital hypophyseal insufficiency. This diagnostic was confirmed by a brain MRI (magnectic resonance imaging), which revealed a total interruption of the pituitary stalk...
March 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28250299/successful-pregnancies-and-deliveries-in-a-patient-with-evolving-hypopituitarism-due-to-pituitary-stalk-transection-syndrome-role-of-growth-hormone-replacement
#6
Miyako Yoshizawa, Yasuhiko Ieki, Eisuke Takazakura, Kaori Fukuta, Takao Hidaka, Takanobu Wakasugi, Akira Shimatsu
We herein report a 31-year-old Japanese woman with evolving hypopituitarism due to pituitary stalk transection syndrome. She had a history of short stature treated with growth hormone (GH) in childhood and had hypothyroidism and primary amenorrhea at 20 years old. Levothyroxine replacement and recombinant follicle stimulating hormone-human chorionic gonadotropin (FSH-hCG) therapy for ovulation induction were started. GH replacement therapy (GHRT) was resumed when she was 26 years old. She developed mild adrenocortical insufficiency at 31 years old...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28248860/rapid-exacerbation-of-lymphocytic-infundibuloneurohypophysitis
#7
Kimitaka Shibue, Toshihito Fujii, Hisanori Goto, Yui Yamashita, Yoshihisa Sugimura, Masahiro Tanji, Akihiro Yasoda, Nobuya Inagaki
RATIONALE: Lymphocytic hypophysitis is a relatively rare autoimmune disease defined by lymphocytic infiltration to the pituitary. Its rarity and wide spectrum of clinical manifestations make clarification of the pathology difficult. Here, we describe a case we examined from the primary diagnosis to final discharge, showing the serial progression of lymphocytic infundibuloneurohypophysitis (LINH) to panhypopituitarism with extrapituitary inflammatory invasion in a short period, and responding favorably to high-dose glucocorticoid treatment...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28245453/a-novel-clinical-entity-of-autoimmune-endocrinopathy-anti-pit-1-antibody-syndrome
#8
Genzo Iguchi, Hironori Bando, Yutaka Takahashi
Pituitary-specific transcription factor 1 (PIT-1; POU domain, class 1, transcription factor 1 (POU1F1)) is an essential transcription factor for the differentiation of somatotrophs, lactotrophs, and thyrotrophs, and for the expression of growth hormone (GH), prolactin (PRL), and thyroid-stimulating hormone (TSH). Mutations in PIT-1 cause congenital defects in GH and PRL secretion and severe TSH insufficiency. Anti-PIT-1 antibody syndrome, firstly reported in 2011, is characterized by acquired GH, PRL, and TSH deficiencies without PIT-1 mutation and is associated with the presence of the circulating antibody against PIT-1 protein as a marker...
2017: Frontiers of Hormone Research
https://www.readbyqxmd.com/read/28228961/concurrent-van-der-woude-syndrome-and-turner-syndrome-a-case-report
#9
Evan Los, Hayley Baines, Ines Guttmann-Bauman
Most cases of Van der Woude syndrome are caused by a mutation to interferon regulatory factor 6 on chromosome 1. Turner syndrome is caused by complete or partial absence of the second sex chromosome in girls. We describe a unique case of the two syndromes occurring concurrently though apparently independently in a girl with Van der Woude syndrome diagnosed at birth and Turner syndrome at 14 years 9 months. Short stature was initially misattributed to Van der Woude syndrome and pituitary insufficiency associated with clefts before correctly diagnosing Turner syndrome...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28217067/septo-optic-dysplasia-de-morsier-s-syndrome
#10
Pedro Reis, Joana Mourão
Septo-optic dysplasia (SOD)/de Morsier's syndrome is characterized by optic nerve hypoplasia, pituitary endocrine dysfunction, and midline brain abnormalities. Hypopituitarism, hypothyroidism, hypogonadism, and adrenal insufficiency can lead to severe hypoglycemia, adrenal crisis, seizures, and sudden death. Anesthetic management of SOD was associated with high perioperative mortality. A 9-year-old male child proposed for dental treatments/extractions. Medical history of SOD with hypopituitarism, hypothyroidism, and delayed psychomotor development was observed...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28204898/surgical-treatment-and-outcome-of-tsh-producing-pituitary-adenomas
#11
Roman Rotermund, Nina Riedel, Till Burkhardt, Jakob Matschke, Nils-Ole Schmidt, Jens Aberle, Jörg Flitsch
BACKGROUND: Thyrotropin-producing adenomas (TSHomas) account for approximately 1-2% of all pituitary tumors. Recently, there has been debate on primary treatment as some studies suggest a high rate of hypopituitarism after transsphenoidal surgery and therefore suggest primary use of somatostatin analogs (SSA) instead. We would like to challenge this assumption by presenting our single-center experience with transsphenoidal surgery for TSHoma. METHODS: Fifteen patients treated consecutively between May 2010 and December 2016 were analyzed for long-term postoperative remission and pituitary function...
February 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28202834/-a-case-of-lymphocytic-adenohypophysitis-presenting-visual-disturbance-in-the-third-trimester-of-pregnancy
#12
Ryo Yaoita, Miiko Ito, Kenichiro Matsuda, Yasuaki Kokubo, Shinya Sato, Yukihiko Sonoda
Lymphocytic hypophysitis(LH)has first been described as an autoimmune endocrinopathy by Goudie in 1962. In particular, lymphocytic adenohypophysitis(LAH)is usually associated with pregnancy and hypopituitarism due to insufficient endocrine of ACTH. However, several cases of LAH in pregnant patients showing only visual disturbances have recently been documented. We treated a patient with LAH presenting only the chiasma syndrome in the third trimester without hypopituitarism. A 27-year-old woman unexpectedly experienced visual disturbance starting in the 28th week of pregnancy...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28196880/agrp-to-kiss1-neuron-signaling-links-nutritional-state-and-fertility
#13
Stephanie L Padilla, Jian Qiu, Casey C Nestor, Chunguang Zhang, Arik W Smith, Benjamin B Whiddon, Oline K Rønnekleiv, Martin J Kelly, Richard D Palmiter
Mammalian reproductive function depends upon a neuroendocrine circuit that evokes the pulsatile release of gonadotropin hormones (luteinizing hormone and follicle-stimulating hormone) from the pituitary. This reproductive circuit is sensitive to metabolic perturbations. When challenged with starvation, insufficient energy reserves attenuate gonadotropin release, leading to infertility. The reproductive neuroendocrine circuit is well established, composed of two populations of kisspeptin-expressing neurons (located in the anteroventral periventricular hypothalamus, Kiss1(AVPV), and arcuate hypothalamus, Kiss1(ARH)), which drive the pulsatile activity of gonadotropin-releasing hormone (GnRH) neurons...
February 28, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28190613/therapeutics-for-equine-endocrine-disorders
#14
REVIEW
Andy E Durham
Equine endocrine disease is commonly encountered by equine practitioners. Pituitary pars intermedia dysfunction (PPID) and equine metabolic syndrome (EMS) predominate. The most logical therapeutic approach in PPID uses dopamine agonists; pergolide mesylate is the most common. Bromocryptine and cabergoline are alternative drugs with similar actions. Drugs from other classes have a poor evidence basis, although cyproheptadine and trilostane might be considered. EMS requires management changes as the primary approach; reasonable justification for use of drugs such as levothyroxine and metformin may apply...
February 9, 2017: Veterinary Clinics of North America. Equine Practice
https://www.readbyqxmd.com/read/28160246/hypogonadotropic-hypogonadism-in-males-with-glycogen-storage-disease-type-1
#15
Evelyn M Wong, Anna Lehman, Philip Acott, Jane Gillis, Daniel L Metzger, Sandra Sirrs
BACKGROUND: Glycogen storage disease type 1 is an autosomal recessive disorder with an incidence of 1 in 100,000. Long-term complications include chronic blood glucose lability, lactic academia, short stature, osteoporosis, delayed puberty, gout, progressive renal insufficiency, systemic or pulmonary hypertension, hepatic adenomas at risk for malignant transformation, anemia, vitamin D deficiency, hyperuricemic nephrocalcinosis, inflammatory bowel syndrome (type 1b), hypertriglyceridemia, and irregular menstrual cycles...
February 4, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28152431/blunted-cortisol-response-to-psychosocial-stress-in-atopic-patients-is-associated-with-decrease-in-salivary-alpha-amylase-and-aldosterone-focus-on-sex-and-menstrual-cycle-phase
#16
N Hlavacova, P Solarikova, M Marko, I Brezina, D Jezova
A decreased responsiveness of the hypothalamic-pituitary-adrenocortical axis to stress stimuli in patients with atopy is well documented. The aim of this study was to investigate personality traits, salivary alpha-amylase activity and the aldosterone response to psychosocial stress procedure based on public speech in atopic patients with respect to sex and the menstrual cycle (MC) phase. The study was performed in 106 subjects of both sexes, 53 atopic patients suffering from allergic rhinitis, allergic asthma or atopic dermatitis and 53 age-, sex-, the MC phase- and BMI- matched healthy controls...
January 16, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28129900/-atypical-and-rare-cardiac-revelation-about-sheehan-s-syndrome-a-report-of-three-cases
#17
N Bouznad, G El Mghari, M El Hattaoui, N El Ansari
Sheehan syndrome is a potentially serious complication in the postpartum period corresponding to ischemic necrosis of the anterior pituitary related to postpartum haemorrhage. We report three original observations showing an unusual mode of revelation of this syndrome. The first observation is that of a 46-year-old patient admitted initially to resuscitation for a recovered cardiorespiratory arrest, severe hypoglycemia and profound hyponatremia. The second is that of a 45-year-old patient, admitted for recurrent cardiac tamponade after pericardial and pleural puncture and pericardial drainage; clinical survey found signs of slight panhypopituitarism...
January 24, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28077499/dynamic-gnrh-and-hcg-testing-establishment-of-new-diagnostic-reference-levels
#18
A Kirstine Bang, Loa Nordkap, Kristian Almstrup, Lærke Priskorn, Jørgen Holm Petersen, Ewa Rajpert-De Meyts, Anna-Maria Andersson, Anders Juul, Niels Jørgensen
OBJECTIVE: Gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) stimulation tests may be used to evaluate the pituitary and testicular capacity. Our aim was to evaluate changes in follicular-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone after GnRH and hCG stimulation in healthy men and assess the impact of six single nucleotide polymorphisms on the responses. DESIGN: GnRH and hCG stimulation tests were performed on 77 healthy men, 18-40 years (reference group) at a specialized andrology referral center at a university hospital...
April 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28067604/central-hypogonadism-due-to-a-giant-silent-fsh-secreting-atypical-pituitary-adenoma-effects-of-adenoma-dissection-and-short-term-leydig-cell-stimulation-by-luteinizing-hormone-lh-and-human-chorionic-gonadotropin-hcg
#19
Daniele Santi, Giorgia Spaggiari, Livio Casarini, Flaminia Fanelli, Marco Mezzullo, Uberto Pagotto, Antonio R M Granata, Cesare Carani, Manuela Simoni
We present a case report of an atypical giant pituitary adenoma secreting follicle-stimulating hormone (FSH). A 55-year-old patient presented for erectile dysfunction, loss of libido and fatigue. The biochemical evaluation showed very high FSH serum levels in the presence of central hypogonadism. Neither testicular enlargement nor increased sperm count was observed, thus a secretion of FSH with reduced biological activity was supposed. The histological examination after neuro-surgery showed an atypical pituitary adenoma with FSH-positive cells...
January 9, 2017: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/28029028/the-recovery-of-hypothalamic-pituitary-adrenal-axis-is-rapid-in-subclinical-cushing-syndrome
#20
Hee Kyung Kim, Jee Hee Yoon, Yun Ah Jeong, Ho Cheol Kang
BACKGROUND: In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown. METHODS: Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively...
December 2016: Endocrinology and Metabolism
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