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Pituitary insufficiency

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https://www.readbyqxmd.com/read/29147134/the-clinical-course-after-glucocorticoid-treatment-in-patients-with-inflammatory-bowel-disease-is-linked-to-suppression-of-the-hypothalamic-pituitary-adrenal-axis-a-retrospective-observational-study
#1
Aghil Ibrahim, Per Dahlqvist, Tommy Olsson, David Lundgren, Mårten Werner, Ole B Suhr, Pontus Karling
Background: Adrenal insufficiency (AI) secondary to treatment with glucocorticoids (GCs) is common in patients with inflammatory bowel disease (IBD), but little is known about the relationship between AI and the clinical course in IBD. The aim of the study was to compare the clinical course in IBD patients with normal adrenal function versus patients with subnormal adrenal function. Methods: A retrospective observational study on 63 patients with IBD who had performed a low-dose short Synacthen test (LDSST) (1 μg) immediately (1-7 days) after a standard course of GCs...
November 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29144817/seasonal-variation-of-vitamin-d-and-serum-thyrotropin-levels-and-its-relationship-in-a-euthyroid-caucasian-population
#2
Gautam Das, Peter N Taylor, Heather Javaid, Brian P Tennant, John Geen, Andrew Aldridge, Onyebuchi Okosieme
OBJECTIVES: It is unclear whether seasonal variations in vitamin D concentrations affect the hypothalamo-pituitary-thyroid (HPT) axis. We investigated the seasonal variability of vitamin D and serum thyrotropin (TSH) levels and their inter-relationship. METHODS: Analysis of 401 patients referred with non-specific symptoms of tiredness who had simultaneous measurements of 25(OH)D3 and thyroid function. Patients were categorised according to the season of blood sampling and their vitamin D status...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29137961/adrenal-insufficiency-in-critical-patients-new-ethiopathogenic-concepts-and-therapeutic-implications
#3
Laura Mateos Moreno, Nuria Palacios García, Francisco Javier Estrada García
Recently, there have been advances in understanding of the changes that occur in the hypothalamic-pituitary-adrenal axis during the different stages of critical disease. Such advances have led to a paradigm change, so that the aforementioned adaptations are no longer considered the result of adrenal axis activation, but a consequence of decreased cortisol metabolism illness. Knowledge of this new pathophysiological bases should lead to reconsider the diagnosis and treatment of adrenal insufficiency in critically ill patients, a condition poorly understood to date...
November 11, 2017: Endocrinología, diabetes y nutrición
https://www.readbyqxmd.com/read/29131060/aging-induced-modulation-of-pituitary-adenylate-cyclase-activating-peptide-and-vasoactive-intestinal-peptide-induced-vasomotor-responses-in-the-arteries-of-mice
#4
Ivan Ivic, Margit Solymar, Balazs D Fulop, Hitoshi Hashimoto, Gabor Toth, Andrea Tamas, Tamas Juhasz, Akos Koller, Dora Reglodi
Pituitary adenylate cyclase-activating peptide (PACAP; 1-38 and 1-27) and vasoactive intestinal peptide (VIP) are related neuropeptides of the secretin/glucagon family. Overlapping signaling through G-protein-coupled receptors mediates their vasomotor activity. We previously showed that PACAP deficiency (PACAP-KO) shifts the mechanisms of vascular response and maintains arterial relaxation through the VIP backup mechanism and (mainly) its VPAC1R, but their age-dependent modulation is still unknown. We hypothesized that backup mechanisms exist, which maintain the vasomotor activity of these peptides also in older age...
November 9, 2017: Journal of Vascular Research
https://www.readbyqxmd.com/read/29121431/outcomes-of-oral-lichen-planus-and-oral-lichenoid-lesions-treated-with-topical-corticosteroid
#5
M A Gonzalez-Moles, J A Gil-Montoya, L Gonzalez-Ruiz, P Ramos, M Bravo
OBJECTIVE: To determine corticosteroid treatment effectiveness in patients with Oral Lichen Planus/Oral Lichenoid Lesions (OLP/OLL). MATERIAL AND METHODS: Twenty-one OLP and eighty-one OLL patients received 0.05% clobetasol propionate (CP) or 0.05% triamcinolone acetonide (TA) in aqueous solution (AS) or orabase (OB), evaluating responses to treatment and follow-up compliance. RESULTS: Lesions were atrophic (72/102; 70.6%), extensive (58/100; 58%), producing eating difficulties (62/102; 60...
November 9, 2017: Oral Diseases
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#6
Gueorgui Dubrocq, Andrea Estrada, Shannon Kelly, Natella Rakhmanina
An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#7
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29106702/hypothalamic-pituitary-adrenal-hpa-axis-suppression-after-treatment-with-glucocorticoid-therapy-for-childhood-acute-lymphoblastic-leukaemia
#8
REVIEW
Niki Rensen, Reinoud Jbj Gemke, Elvira C van Dalen, Joost Rotteveel, Gertjan Jl Kaspers
BACKGROUND: Glucocorticoids play a major role in the treatment of acute lymphoblastic leukaemia (ALL). However, supraphysiological doses can suppress the hypothalamic-pituitary-adrenal (HPA) axis. HPA axis suppression resulting in reduced cortisol response may cause an impaired stress response and an inadequate host defence against infection, which remain a cause of morbidity and death. Suppression commonly occurs in the first days after cessation of glucocorticoid therapy, but the exact duration is unclear...
November 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29102970/cabergoline-induced-fibrosis-of-prolactinomas-a-neurosurgical-perspective
#9
Niraj Mohan, Yi Yan Chia, Giap Hean Goh, Eric Ting, Kejia Teo, Tseng Tsai Yeo
Presently, the standard of care for prolactinomas, a type of pituitary adenoma, is dopaminergic agents such as bromocriptine and cabergoline. However, dopaminergic agents may induce fibrosis of cardiac valves leading to valvular insufficiency, necessitating surgical treatment of prolactinoma. Fibrosis of prolactinoma can be induced by prolonged medical treatment with bromocriptine, and this usually occurs after years of treatment. In comparison to bromocriptine, there have been no reports of cabergoline-induced fibrosis of prolactinoma...
November 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29095270/pituitary-insufficiency-following-traumatic-thoracic-injury-in-an-adolescent-male-patient-a-case-report-and-literature-review
#10
REVIEW
Aleksandra Gilis-Januszewska, Łukasz Kluczyński, Małgorzata Wilusz, Jacek Pantofliński, Renata Turek-Jabrocka, Dorota Pach, Alicja Hubalewska-Dydejczyk
RATIONALE: Traumatic thoracic injuries in adolescents are rare but could be connected with traumatic brain injuries (TBI) and development of chronic hypopituitarism. Early recognition of these endocrine problems is a significant challenge to clinicians. We present difficulties in diagnosis of hypothalamic-pituitary insufficiency following traumatic thoracic injury in adolescence. We also review the literature of similar cases. PATIENT CONCERNS: We present a case of a 24-years-old male...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29067249/serum-dehydroepiandrosterone-sulfate-in-assessing-the-integrity-of-the-hypothalamic-pituitary-adrenal-axis
#11
Suranut Charoensri, Laor Chailurkit, Dittapol Muntham, Pongamorn Bunnag
OBJECTIVE: To evaluate the relationship between age- and gender-adjusted dehydroepiandrosterone sulfate (DHEA-S) levels and low-dose adrenocorticotropic hormone (ACTH) stimulation in assessing the integrity of the hypothalamic-pituitary-adrenal (HPA) axis, in patients who were at risk of HPA insufficiency, including those currently being treated with glucocorticoids. METHODS: Forty-six participants with a suspicion of secondary adrenal insufficiency were recruited from the Diabetes and Endocrinology Clinic at Ramathibodi Hospital, Mahidol University, Bangkok...
March 2017: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29067215/nivolumab-induced-hypothyroidism-and-selective-pituitary-insufficiency-in-a-patient-with-lung-adenocarcinoma-a-case-report-and-review-of-the-literature
#12
Myrto Kastrisiou, Fereniki-Lida Kostadima, Aristides Kefas, George Zarkavelis, Nikos Kapodistrias, Evangelos Ntouvelis, Dimitrios Petrakis, Alexandra Papadaki, Amalia Vassou, George Pentheroudakis
Immune checkpoint blockade including programmed cell death 1 pathway inhibition with agents such as nivolumab is gaining ground in a wide array of malignancies, so far demonstrating significantly improved survival rates even in metastatic, often multiply pretreated settings. Although targeted in nature and generally well-tolerated compared with conventional anticancer treatments, these agents are often linked to a newly emerged group of adverse reactions, referred to as immune-related adverse events, which can also affect endocrine organs...
2017: ESMO Open
https://www.readbyqxmd.com/read/29064038/hypofractionated-high-energy-proton-beam-irradiation-is-an-alternative-treatment-for-who-grade-i-meningiomas
#13
Pavlos Vlachogiannis, Olafur Gudjonsson, Anders Montelius, Erik Grusell, Ulf Isacsson, Kristina Nilsson, Erik Blomquist
BACKGROUND: Radiation treatment is commonly employed in the treatment of meningiomas. The aim of this study was to evaluate the effectiveness and safety of hypofractionated high-energy proton therapy as adjuvant or primary treatment for WHO grade I meningiomas. METHOD: A total of 170 patients who received irradiation with protons for grade I meningiomas between 1994 and 2007 were included in the study. The majority of the tumours were located at the skull base (n = 155)...
October 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29063119/-inflammatory-mechanism-of-depression-and-its-new-strategy%C3%A2-for-diagnosis-and%C3%A2-treatment
#14
Wen-Jun Su, Zhi-Yong Cao, Chun-Lei Jiang
Depression is a major class of mental illness; owing to its high prevalence, high disability rate and heavy disease burden, it has become a stern and formidable global health problem. It is generally believed that the etiology of depression is multifactorial, which is related to gender differences, chronic stress, dietary behavior and drug abuse. At present, the exact pathophysiological mechanism of depression still remains unclear, but researchers across the globe put forward various hypotheses to interpret the possible access to this disease, including monoamine neurotransmitter disturbance, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, lack of neurotrophic factors and excessive pro-inflammatory cytokines...
October 25, 2017: Sheng Li Xue Bao: [Acta Physiologica Sinica]
https://www.readbyqxmd.com/read/29053578/treatment-with-synthetic-glucocorticoids-and-the-hypothalamus-pituitary-adrenal-axis
#15
REVIEW
Rosa Maria Paragliola, Giampaolo Papi, Alfredo Pontecorvi, Salvatore Maria Corsello
Chronic glucocorticoid (GC) treatment represents a widely-prescribed therapy for several diseases in consideration of both anti-inflammatory and immunosuppressive activity but, if used at high doses for prolonged periods, it can determine the systemic effects characteristic of Cushing's syndrome. In addition to signs and symptoms of hypercortisolism, patients on chronic GC therapy are at risk to develop tertiary adrenal insufficiency after the reduction or the withdrawal of corticosteroids or during acute stress...
October 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29027568/-diagnostics-and-treatment-of-acromegaly-necessity-for-targeted-monitoring-of-comorbidities
#16
S Petersenn, M Christ-Crain, M Droste, R Finke, J Flitsch, I Kreitschmann-Andermahr, A Luger, J Schopohl, G Stalla
Acromegaly is a rare and severe condition, presenting with typical signs and symptoms. The diagnosis is often initially made years after the first manifestations of the disease. In more than 99% of patients the disease is caused by a benign pituitary tumor that secretes growth hormone (GH). The diagnosis is based on the presence of increased insulin-like growth factor 1 (IGF-1) levels and a lack of GH suppression in the oral glucose tolerance test. The standard imaging procedure for tumor detection is magnetic resonance imaging in the region of the sella turcica...
November 2017: Der Internist
https://www.readbyqxmd.com/read/29025209/delayed-diagnosis-of-pituitary-stalk-interruption-syndrome-with-severe-recurrent-hyponatremia-caused-by-adrenal-insufficiency
#17
Kyung Mi Jang, Cheol Woo Ko
Pituitary stalk interruption syndrome (PSIS) involves the occurrence of a thin or absent pituitary stalk, hypoplasia of the adenohypophysis, and ectopic neurohypophysis. Diagnosis is confirmed using magnetic resonance imaging. Patients with PSIS have a variable degree of pituitary hormone deficiency and a wide spectrum of clinical manifestations. The clinical course of the disease in our patient is similar to that of a syndrome of inappropriate antidiuretic hormone secretion. This is thought to be caused by failure in the suppression of vasopressin secretion due to hypocortisolism...
September 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29025202/clinical-manifestations-of-rathke-s-cleft-cysts-and-their-natural-progression-during-2-years-in-children-and-adolescents
#18
Jo Eun Jung, Juhyun Jin, Mo Kyung Jung, Ahreum Kwon, Hyun Wook Chae, Duk Hee Kim, Ho-Seong Kim
PURPOSE: Rathke's cleft cyst (RCC) is an asymptomatic benign lesion. With increased interest in pediatric endocrinology, the prevalence of RCCs in children is also increasing. However, the clinical relevance and proper management of RCC is not well defined in children. Therefore, we investigated the clinical manifestations and radiologic features of RCC in children and adolescents, as well as the natural progression of RCC. METHODS: We retrospectively reviewed the medical records of 91 children and adolescents with RCC diagnosed with magnetic resonance imaging (MRI) in Severance Children's Hospital from January 2006 to December 2015...
September 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28992707/-overgrowth-in-children-and-in-adults-novel-clinical-view-novel-genes-novel-phenotypes
#19
Jan Lebl, Lukáš Plachý, Květa Bláhová, Lenka Elblová, Filip Fencl, Stanislava Koloušková, Štěpánka Průhová
Novel genetic findings allow to more reliably elucidate the aetiology and pathogenesis of overgrowth syndromes in children and in adults. The relatively prevalent overgrowth syndromes in foetuses and neonates include Beckwith-Wiedemann (BWS) and Sotos syndromes; in addition, several rare conditions may occur e.g. Simpson-Golabi-Behmel and Weaver syndromes. These syndromes are not connected with overproduction of growth hormone. Their carriers are at risk of hypoglycaemia (in BWS), of congenital malformations and of childhood tumours...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28990677/left-ventricular-twist-is-impaired-in-acromegaly-insights-from-the-three-dimensional-speckle-tracking-echocardiographic-magyar-path-study
#20
Árpád Kormányos, Péter Domsik, Anita Kalapos, Andrea Orosz, Csaba Lengyel, Zsuzsanna Valkusz, Attila Trencsányi, Tamás Forster, Attila Nemes
INTRODUCTION: Acromegaly is a rare, chronic, disfiguring, and debilitating disease caused, in 90% of cases, by a benign monoclonal growth hormone-secreting pituitary adenoma. The present study aimed to assess left ventricular (LV) rotational and twist mechanics in acromegalic patients and to compare their results to age- and gender-matched healthy controls. METHODS: The present study comprised 24 acromegalic patients, from which 4 were excluded due to insufficient image quality (mean age: 57...
October 9, 2017: Journal of Clinical Ultrasound: JCU
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