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https://www.readbyqxmd.com/read/28938462/stereotactic-radiosurgery-for-cushing-s-disease-results-of-an-international-multicenter-study
#1
Gautam U Mehta, Dale Ding, Mohana Rao Patibandla, Hideyuki Kano, Nathaniel Sisterson, Yan-Hua Su, Michal Krsek, Ahmed M Nabeel, Amr El-Shehaby, Khaled A Kareem, Nuria Martinez-Moreno, David Mathieu, Brendan McShane, Kevin Blas, Douglas Kondziolka, Inga Grills, John Y Lee, Roberto Martinez-Alvarez, Wael A Reda, Roman Liscak, Cheng-Chia Lee, L Dade Lunsford, Mary Lee Vance, Jason P Sheehan
Context: Cushing's disease (CD) due to ACTH-secreting pituitary tumors can be a management challenge. Objective: To better understand the outcomes of stereotactic radiosurgery (SRS) for CD and define its role in management. Design: International, multicenter, retrospective cohort analysis. Setting: Ten medical centers participating in the International Gamma Knife Research Foundation (IGKRF). Patients: Patients with CD with greater than 6 months endocrine follow-up...
August 29, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28937294/hypertensive-crisis-in-pregnancy-due-to-a-metamorphosing-pheochromocytoma-with-postdelivery-cushing-s-syndrome
#2
Katharina Langton, Matthias Gruber, Jimmy Masjkur, Charlotte Steenblock, Mirko Peitzsch, Jörn Meinel, Jacques Lenders, Stefan Bornstein, Graeme Eisenhofer
Pheochromocytomas in pregnancy are rare but potentially lethal. Even rarer is the combination of pheochromocytoma in pregnancy with subsequent development of ectopic Cushing's syndrome. We report a 36-year-old woman, previously diagnosed with essential hypertension, who developed severe hypertension in pregnancy complicated by insulin-dependent gestational diabetes. A cesarean section was performed at 32 weeks following a hypertensive crisis after routine administration of betamethasone. Postnatal persistence of signs and symptoms of catecholamine excess led to the diagnosis of a left adrenal pheochromocytoma...
September 22, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28931176/the-role-of-cortisol-acth-ratio-for-screening-of-subclinical-hypercortisolism-in-patients-with-adrenal-incidentalomas
#3
Lele Li, Guoqing Yang, Jingtao Dou, Weijun Gu, Zhaohui Lv, Juming Lu, Yiming Mu
Introduction The cortisol/ACTH ratio was supposed to be helpful in the screening of subclinical hypercortisolism (SHC) in the published literatures. This study assessed the cortisol/ACTH ratio in patients with adrenal incidentaloma (AI) confirmed to have SHC and investigated its role for screening SCS in patients with AI. Methods This descriptive retrospective study included 183 patients with AIs [45 with SHC and 138 with non-functional adenoma (NFA)]. Cortisol and ACTH levels were measured at 8:00, 16:00, and 0:00, and the cortisol/ACTH ratio was calculated...
September 20, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28929506/factitious-acth-dependent-apparent-hypercortisolism-the-problem-with-late-night-salivary-cortisol-measurements-collected-at-home
#4
G A Kline, J D Buse, J G Van Der Gugten, D T Holmes, A C Chin, S M H Sadrzadeh
Cushing's Syndrome (CS) is critical to identify because of the numerous and sometimes irreversible sequelae. Surreptitious glucocorticoid use is usually a straightforward consideration in the Cushingoid patient having suppressed ACTH levels, in the absence of adrenal mass or hyperplasia, and in whom screening tests for CS have unexpectedly low or high results depending on the specific steroid used and vulnerability of the assay employed to analytical cross-reactivity. We present a case of a patient with factitious hypercortisolism without suppressed ACTH...
September 20, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28928236/histone-deacetylase-inhibition-ameliorates-hypertension-and-hyperglycemia-in-a-model-of-cushing-s-syndrome
#5
Hae-Ahm Lee, Seol-Hee Kang, Mina Kim, Eunjo Lee, Hyun-Min Cho, Eun-Kyung Moon, Inkyeom Kim
Cushing's syndrome (CS) caused by hypercortisolism is occasionally accompanied by metabolic disorders such as hypertension, diabetes mellitus (DM), dyslipidemia and central obesity. Thus, morbidity and mortality, observed in cardiovascular disease, are elevated in patients with CS. We hypothesized that HDAC inhibition (HDACi) decreased transcriptional activity of glucocorticoid receptor (GR), which ameliorates hypertension and hyperglycemia in patients with CS. To establish an animal model of hypercortisolism, Sprague-Dawley rats were infused with adrenocorticotropic hormone (ACTH, 40 ng/day) or dexamethasone (Dex, 10 μg/day) via osmotic minipumps for 4 weeks...
September 19, 2017: American Journal of Physiology. Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28920935/spinal-cord-injury-induced-immunodeficiency-is-mediated-by-a-sympathetic-neuroendocrine-adrenal-reflex
#6
Harald Prüss, Andrea Tedeschi, Aude Thiriot, Lydia Lynch, Scott M Loughhead, Susanne Stutte, Irina B Mazo, Marcel A Kopp, Benedikt Brommer, Christian Blex, Laura-Christin Geurtz, Thomas Liebscher, Andreas Niedeggen, Ulrich Dirnagl, Frank Bradke, Magdalena S Volz, Michael J DeVivo, Yuying Chen, Ulrich H von Andrian, Jan M Schwab
Acute spinal cord injury (SCI) causes systemic immunosuppression and life-threatening infections, thought to result from noradrenergic overactivation and excess glucocorticoid release via hypothalamus-pituitary-adrenal axis stimulation. Instead of consecutive hypothalamus-pituitary-adrenal axis activation, we report that acute SCI in mice induced suppression of serum norepinephrine and concomitant increase in cortisol, despite suppressed adrenocorticotropic hormone, indicating primary (adrenal) hypercortisolism...
September 18, 2017: Nature Neuroscience
https://www.readbyqxmd.com/read/28906379/accessory-ovarian-steroid-cell-tumor-producing-testosterone-and-cortisol-a-case-report
#7
Li Zang, Mingxia Ye, Guoqing Yang, Jinlong Li, Mei Liu, Jin Du, Weijun Gu, Nan Jin, Lijuan Yang, Jianming Ba, Jingtao Dou, Wensheng Fan, Yiming Mu, Yuanguang Meng, Zhaohui Lyu
RATIONALE: An accessory ovary is a rare structure containing normal ovarian tissue, which has a direct or ligamentous connection with a normal and eutopic ovary. PATIENT CONCERNS: In the study, we reported a 46-year-old woman presented with secondary amenorrhea and virilization symptoms for 1 year. DIAGNOSES: Endocrine evaluation revealed slightly elevated serum cortisol, extremely elevated 24-hour urinary-free cortisol and serum testosterone...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28870207/effects-of-trilostane-on-urinary-catecholamines-and-their-metabolites-in-dogs-with-hypercortisolism
#8
Nadja Sieber-Ruckstuhl, Elena Salesov, Saskia Quante, Barbara Riond, Katharina Rentsch, Regina Hofmann-Lehmann, Claudia Reusch, Felicitas Boretti
BACKGROUND: Glucocorticoids influence the synthesis and metabolism of catecholamines (epinephrine and norepinephrine) and metanephrines (metanephrine and normetanephrine). The aim of this study was to measure urinary catecholamines and metanephrines in dogs with hypercortisolism before and during trilostane therapy. Urine samples were collected during initial work up and during therapy with trilostane in 14 dogs with hypercortisolism and in 25 healthy dogs. Epinephrine, norepinephrine, metanephrine and normetanephrine were measured using high-pressure liquid chromatography and expressed as ratios to urinary creatinine concentration...
September 4, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28866749/the-radiographically-diagnosed-adrenal-myelolipoma-what-do-we-really-know
#9
Michael J Campbell, Mary Obasi, Bingling Wu, Michael T Corwin, Ghaneh Fananapazir
PURPOSE: Adrenal myelolipomas are uncommon, benign tumors of the adrenal glands that are not routinely evaluated for autonomous hormone secretion or followed by repeat imaging, but may lead to retroperitoneal hemorrhage. Little is known about the natural history these tumors with the majority of previous publications being confined to case reports and small case series. METHODS: We reviewed the computed tomography (CT) reports of 62,279 patients evaluated at a tertiary referral center between 2002 and 2015 for the presence of an adrenal myelolipoma >1 cm in size...
September 2, 2017: Endocrine
https://www.readbyqxmd.com/read/28864397/adrenocortical-tumors-associated-with-the-tp53-p-r337h-germline-mutation-can-be-identified-during-child-care-consultations
#10
Maria J Mastellaro, Raul C Ribeiro, Antônio G Oliveira-Filho, Ana L Seidinger, Izilda A Cardinalli, Eliana C M Miranda, Simone S Aguiar, Silvia R Brandalise, José A Yunes, Antônio A Barros-Filho
OBJECTIVE: To evaluate the clinical features associated with adrenocortical hormone overexpression and familial cancer profiling as potential markers for early detection of adrenocortical tumors in children from South and Southeast Brazil. METHODS: The clinical manifestations and anthropometric measurements of 103 children diagnosed with adrenocortical tumors were analyzed. RESULTS: Between 1982 and 2011, 69 girls and 34 boys diagnosed with adrenocortical tumors were followed-up for a median time of 9...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28859919/nationwide-analysis-of-adrenocortical-carcinoma-reveals-higher-perioperative-morbidity-in-functional-tumors
#11
Punam P Parikh, Gustavo A Rubio, Josefina C Farra, John I Lew
BACKGROUND: Current adrenalectomy outcomes for functional adrenocortical carcinoma (ACC) remain unclear. This study examines nationwide in-hospital post-adrenalectomy outcomes for ACC. METHODS: A retrospective analysis of the Nationwide Inpatient Sample database (2006-2011) to identify unilateral adrenalectomy patients for functional or nonfunctional ACC was performed. Patient demographics, comorbidities and postoperative outcomes were evaluated by t-test, Chi-square and multivariate regression...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28853111/staged-bilateral-laparoscopic-adrenalectomy-for-infantile-acth-independent-cushing-s-syndrome-bilateral-micronodular-non-pigmented-adrenal-hyperplasia-a-case-report
#12
Nasser Simforoosh, Maryam Razzaghy Azar, Mohmmad Hossein Soltani, Mona Nourbakhsh, Hamidreza Shemshaki
ACTH-independent Cushing's syndrome is an uncommon disorder in children. While laparoscopic adrenalectomy is well-established in adults, it is rarely used in infants and is associated with some concerns. A seven-month infant was referred to our hospital due to progressive signs and symptoms of Cushing's syndrome. Laboratory data confirmed ACTH-independent hypercortisolism. No history of exogenous corticosteroid contact was observed. The patient underwent left transperitoneal laparoscopic adrenalectomy when she was 7 months old, nevertheless,complete response was not seen...
August 29, 2017: Urology Journal
https://www.readbyqxmd.com/read/28851260/effect-of-hypercortisolism-on-bone-mineral-density-and-bone-metabolism-a-potential-protective-effect-of-adrenocorticotropic-hormone-in-patients-with-cushing-s-disease
#13
Weihong Guo, Fengao Li, Chonggui Zhu, Baoping Wang, Kunling Wang, Chenlin Dai, Hongwei Jia, Hongyan Wei, Qing He, Jin Cui, Menghua Yuan, Shaofang Tang, Wei Liu, Tiehong Zhu, Zhihong Gao, Fangqiu Zheng, Zhongshu Ma, Huiqi Qu, Mei Zhu
Objective To investigate the effects of Cushing's disease (CD) and adrenal-dependent Cushing's syndrome (ACS) on bone mineral density (BMD) and bone metabolism. Methods Data were retrospectively collected for 55 patients with hypercortisolism (CD, n = 34; ACS n = 21) from January 1997 to June 2014. BMD was examined in all patients, and bone turnover markers were tested in some patients. Healthy controls (n = 18) were also recruited. Results The lumbar spine and femoral neck BMD were significantly lower in the ACS and CD groups than in the control group...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28846797/otolaryngic-manifestations-of-cushing-disease
#14
Edward C Kuan, Kevin A Peng, Jeffrey D Suh, Marvin Bergsneider, Marilene B Wang
Cushing disease is a relatively rare cause of Cushing syndrome secondary to a hyperfunctioning pituitary adenoma. In addition to signs and symptoms of hypercortisolism, Cushing disease may present with diverse otolaryngic manifestations, which may guide diagnosis and management. We performed a retrospective chart review of patients who were found to have Cushing disease and who underwent transnasal transsphenoidal surgery for pituitary adenomas between January 1, 2007, and July 1, 2014, at a tertiary academic medical center...
August 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28838299/peculiarities-of-feline-hyperadrenocorticism-update-on-diagnosis-and-treatment
#15
Lara A Boland, Vanessa R Barrs
Practical relevance: Hyperadrenocorticism (HAC) is a relatively uncommon endocrinopathy of older cats, with a mean age at diagnosis of 10 years. In addition to pituitary-dependent and adrenal-dependent hypercortisolism, clinical signs of HAC can result from adrenal sex steroid-producing tumours. Clinical challenges: While HAC in cats has many similarities to canine HAC, there are key differences in presentation, diagnosis and response to therapy. Most, but not all, cats with HAC have concurrent diabetes mellitus, which is often insulin resistant...
September 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28819015/adrenal-cushing-s-syndrome-during-pregnancy
#16
Corina Andreescu, Rehmat Ali Alwani, Johannes Hofland, Leendert Looijenga, Wouter de Herder, Leo Hofland, Richard A Feelders
Cushing syndrome (CS) during pregnancy is a rare condition with only a few cases reported in the literature. Misdiagnosis of CS is common because of overlapping features like fatigue, weight gain, striae and emotional changes that can occur during normal pregnancy. Changes in maternal hormones and their binding proteins complicate assessment of glucocorticoid hormone levels during gestation. CS during pregnancy is most frequently due to an adrenal adenoma and to a lesser degree to adrenocorticotropic hormone (ACTH) hypersecretion by a pituitary adenoma...
August 17, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28815484/diagnostic-performance-of-a-newly-developed-salivary-cortisol-and-cortisone-measurement-using-an-lc-ms-ms-method-with-simple-and-rapid-sample-preparation
#17
K Mészáros, G Karvaly, Z Márta, B Magda, J Tőke, N Szücs, M Tóth, K Rácz, A Patócs
BACKGROUND: Late-night salivary cortisol level is one of the first-line tests recommended by the Endocrine Society for the diagnosis of endogenous hypercortisolism. Most routine laboratories measure cortisol levels using immunoassay tests which fail to determine low cortisol levels accurately due to the numerous interfering substances. A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method with simple and rapid sample preparation was developed for the simultaneous measurement of cortisol and cortisone and its performance in the diagnosis of endogenous hypercortisolism was evaluated...
August 16, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28781093/hair-cortisol-as-a-biological-marker-for-burnout-symptomatology
#18
Marlene Penz, Tobias Stalder, Robert Miller, Vera M Ludwig, Magdalena K Kanthak, Clemens Kirschbaum
Burnout is a syndrome with negative impact on cognitive performance and mood as a consequence of long-term stress at work. It is further associated with increased risk for mental and physical diseases. One potential pathway to mediate chronic work-stress and adverse health conditions in burnout is through alterations in long-term glucocorticoid secretion. Here, we present cross-sectional data on hair cortisol/cortisone (hairF/hairE) concentrations and burnout from a population-based sample of the Dresden Burnout Study (DBS; N=314 hair samples)...
July 23, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28757388/effects-of-single-or-combined-induction-of-diabetes-mellitus-and-knee-osteoarthritis-on-some-biochemical-and-haematological-parameters-in-rats
#19
Wale J Adeyemi, Luqman A Olayaki
Clinical evidences on the coexistence of diabetes mellitus (DM) and osteoarthritis (OA) dated back to the 1960s. Therefore, the study investigated the effects of induced DM and/or knee osteoarthritis (KOA) on some biochemical and haematological parameters in adult male Wistar rats. Twenty rats were used for this study. They were randomly divided into 4 groups (N=5 rats) which included: Normal control; Osteoarthritic (OA) control; Diabetic control; and, Diabetic+Osteoarthritic (D+OA) control. DM was induced in overnight fasted rats by the administration of streptozotocin (65mg/kg b...
July 28, 2017: Experimental and Molecular Pathology
https://www.readbyqxmd.com/read/28718178/body-composition-is-different-after-surgical-or-pharmacological-remission-of-cushing-s-syndrome-a-prospective-dxa-study
#20
Filippo Ceccato, Michela Boccato, Marialuisa Zilio, Mattia Barbot, Anna Chiara Frigo, Giovanni Luisetto, Marco Boscaro, Carla Scaroni, Valentina Camozzi
Patients with active Cushing's syndrome (CS) exhibit an increase of the visceral adipose tissue, increasing the risk of cardiovascular events. Until now, it is not yet clear whether remission of CS leads to a normalization of body composition, or if different strategies to control hypercortisolism could result in a different clinical outcome concerning adipose tissue distribution. Therefore, we analyzed body composition changes using dual-energy X-ray absorptiometry (DXA) in patients with CS in a prospective and controlled study...
September 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
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