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Cushing's disease

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https://www.readbyqxmd.com/read/29244084/the-value-of-peri-operative-levels-of-acth-dhea-and-dhea-s-and-tumor-size-in-predicting-recurrence-of-cushing-s-disease
#1
Nadine El Asmar, Aman Rajpal, Warren R Selman, Baha M Arafah
Background and Objectives: Despite the development of hypocortisolemia after corticotroph surgical adenomectomy, 15-20% patients have recurrence of Cushing's disease (CD). In this study, we investigated the impact of tumor size and the value of peri-operative assessment of ACTH and adrenal steroid levels in predicting recurrence. Methods: Peri-operatively, no glucocorticoids were administered until the serum cortisol was ≤ 3 ug/dL. Blood samples were obtained before and repeatedly after adenomectomy in 79 patients with CD...
December 13, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29241753/alopecia-and-the-metabolic-syndrome
#2
Cheryl Lie, Choon Fong Liew, Hazel H Oon
Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies supports this association...
January 2018: Clinics in Dermatology
https://www.readbyqxmd.com/read/29223281/human-studies-on-hypothalamo-pituitary-adrenal-hpa-axis
#3
REVIEW
Kamani Liyanarachchi, Richard Ross, Miguel Debono
The daily rhythm of the hypothalamo-pituitary-adrenal (HPA) axis is regulated by the central clock in the suprachiasmatic nucleus. Cortisol, a glucocorticoid, acts as a secondary messenger between the central clock and the peripheral tissues. Changes in clock time, as seen in shift workers, alters the HPA axis and results in metabolic disturbances associated with ill health. Depression, anorexia nervosa and obstructive sleep apnoea, are associated with cortisol rhythm phase shifts and increased cortisol exposure...
October 2017: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29219752/negative-surgical-exploration-in-patients-with-cushing-s-disease-benefit-of-two-thirds-gland-resection-on-remission-rate-and-a-review-of-the-literature
#4
Steven B Carr, Bette K Kleinschmidt-DeMasters, Janice M Kerr, Katja Kiseljak-Vassiliades, Margaret E Wierman, Kevin O Lillehei
OBJECTIVE The authors report their single-institution experience with the pathological findings, rates of remission, and complications in patients with presumed Cushing's disease (CD) who underwent a two-thirds pituitary gland resection when no adenoma was identified at the time of transsphenoidal surgery (TSS). The authors also review the literature on patients with CD, negative surgical exploration, and histological findings. METHODS This study is a retrospective analysis of cases found in neurosurgery and pathology department databases between 1989 and 2011...
December 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29211058/decreased-lymphocytes-and-increased-risk-for-infection-are-common-in-endogenous-pediatric-cushing-syndrome
#5
Christina Tatsi, Rebecca Boden, Ninet Sinaii, Meg Keil, Charalampos Lyssikatos, Elena Belyavskaya, Sergio D Rosenzweig, Constantine A Stratakis, Maya B Lodish
BackgroundHypercortisolemia results in changes of the immune system and elevated infection risk, but data on the WBC changes in pediatric Cushing syndrome (CS) are not known. We describe the changes of the WBC lineages in pediatric endogenous hypercortisolemia, their associations with the markers of disease severity, and the presence of infections.MethodsWe identified 197 children with endogenous CS. Clinical and biochemical data were recorded. Sixty-six children with similar age and gender, and normocortisolemia served as controls...
December 6, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29208661/plasma-steroid-metabolome-for-diagnosis-and-subtyping-patients-with-cushing-syndrome
#6
Graeme Eisenhofer, Jimmy Masjkur, Mirko Peitzsch, Guido Di Dalmazi, Martin Bidlingmaier, Matthias Grüber, Julia Fazel, Andrea Osswald, Felix Beuschlein, Martin Reincke
BACKGROUND: Diagnosis of Cushing syndrome requires a multistep process that includes verification of hypercortisolism followed by identification of the cause of adrenocortical hyperfunction. This study assessed whether pituitary, ectopic, and adrenal subtypes of Cushing syndrome were characterized by distinct plasma steroid profiles that might assist diagnosis. METHODS: In this retrospective cross-sectional study, mass spectrometric measurements of a panel of 15 plasma steroids were applied to 222 patients tested for Cushing syndrome...
December 5, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29197558/clinical-utility-of-an-ultrasensitive-late-night-salivary-cortisol-assay-by-tandem-mass-spectrometry
#7
Lillian R Sturmer, Dylan Dodd, Christina S Chao, Run-Zhang Shi
BACKGROUND: Late night salivary cortisol measurement is a clinically important and convenient screening test for Cushing's syndrome. Tandem mass spectrometry (LC-MS/MS) assays have superior sensitivity and specificity compared to immunoassays. Our goal was to improve a LC-MS/MS method to measure salivary cortisol in both adult and pediatric patients and to characterize its analytical performance by method validation and clinical performance by chart review. METHODS: We improved a LC-MS/MS method originally developed for urine cortisol to measure low level salivary cortisol...
November 29, 2017: Steroids
https://www.readbyqxmd.com/read/29184811/dermatologic-manifestations-of-endocrine-disorders
#8
REVIEW
Michael Lause, Alisha Kamboj, Esteban Fernandez Faith
The skin serves as a window for clinicians to understand, diagnose, and monitor endocrine disease. Dermatologic manifestations of endocrinopathies contribute significantly to an individual's health and quality of life. In this review, we outline various disorders of the hypothalamic-pituitary axis, thyroid gland, pancreas, adrenal gland, and androgen axis as well as hereditary endocrine syndromes. In acromegaly, glycosaminoglycan deposition contributes to a thickening of skin and soft tissue, which manifests as coarsening and enlargement of facial and acral structures...
October 2017: Translational pediatrics
https://www.readbyqxmd.com/read/29184271/a-case-of-cushing-s-syndrome-in-pregnancy
#9
Leila Pourali, Atiyeh Mohammadzade Vatanchi, Anahita Hamidi
Cushing's syndrome (CS) occurs rarely during pregnancy. CS can be caused by prolonged abnormal exposure to excess glucocorticoids leading to special and significant signs and symptoms. It is often difficult to diagnose pathological hypercortisolism in pregnant women since some symptoms of the disease might be due to a complicated pregnancy, including preeclampsia or gestational diabetes. In this study, we report the case of a 29-year-old female who referred to our institution with hypertension, weakness, steria, and truncal obesity...
November 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29161691/failure-to-thrive-in-the-context-of-carney-complex
#10
Amit Tirosh, Adi Auerbach, Belen Bonella, Phaedon D Zavras, Elena Belyavskaya, Charalampos Lyssikatos, Karen Meir, Ram Weiss, Hagit Daum, Maya B Lodish, David Gillis, Constantine A Stratakis
BACKGROUND/AIMS: Carney complex (CNC) is a rare syndrome associated with multiple tumors and several other unique manifestations. We describe the clinical, genetic, and laboratory findings in a cohort of patients with CNC and failure to thrive (FTT). METHODS: A retrospective case series of pediatric patients with CNC presenting with FTT. RESULTS: We describe a patient with infantile Cushing syndrome (CS) who presented with severe FTT and liver disease; the patient was subsequently diagnosed with CNC...
November 21, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/29161416/combined-ovarian-and-adrenal-venous-sampling-in-the-localization-of-acth-independent-ectopic-cushing-s-syndrome
#11
Shi Chen, Ran Li, Xiaobo Zhang, Lin Lu, Ji Li, Hui Pan, Huijuan Zhu
Context: Cushing's syndrome is rarely caused by the secretion of cortisol from the ovarian tumors. It is important to determine whether the ovarian tumor is capable of secreting cortisol or not in clinical decision making. Selective ovarian and adrenal venous sampling has not been reported previously in the localization of ACTH-independent ectopic Cushing's syndrome. Case description: Herein, we presented a case of 40-year-old Chinese woman who has been manifested with weight gain, hirsutism, hypertension and menstrual disorder over a period of 6 months...
November 16, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29159047/voxel-based-comparison-of-brain-glucose-metabolism-between-patients-with-cushing-s-disease-and-healthy-subjects
#12
Shuai Liu, Yinyan Wang, Kaibin Xu, Fan Ping, Fang Li, Renzhi Wang, Xin Cheng
Cognitive impairment and psychiatric symptoms are common in patients with Cushing's disease (CD) owing to elevated levels of glucocorticoids. Molecular neuroimaging methods may help to detect changes in the brain of patients with CD. The aim of this study was to investigate the characteristics of brain metabolism and its association with serum cortisol level in CD. We compared brain metabolism, as measured using [18F]-fluorodeoxyglucose positron emission tomography (FDG PET), between 92 patients with CD and 118 normal subjects on a voxel-wise basis...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29158903/severe-cushing-s-syndrome-and-bilateral-pulmonary-nodules-beyond-ectopic-acth
#13
Carlos Tavares Bello, Emma van der Poest Clement, Richard Feelders
Cushing's syndrome is a rare disease that results from prolonged exposure to supraphysiological levels of glucocorticoids. Severe and rapidly progressive cases are often, but not exclusively, attributable to ectopic ACTH secretion. Extreme hypercortisolism usually has florid metabolic consequences and is associated with an increased infectious and thrombotic risk. The authors report on a case of a 51-year-old male that presented with severe Cushing's syndrome secondary to an ACTH-secreting pituitary macroadenoma, whose diagnostic workup was affected by concurrent subclinical multifocal pulmonary infectious nodules...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29154455/translational-evidence-of-prothrombotic-and-inflammatory-endothelial-damage-in-cushing-syndrome-after-remission
#14
Gloria Aranda, Rebeca Fernandez-Ruiz, Marta Palomo, Mónica Romo, Mireia Mora, Irene Halperin, Gregori Casals, Joaquim Enseñat, Oscar Vidal, Maribel Diaz-Ricart, Felicia A Hanzu
OBJECTIVE: Sustained evidence from observational studies indicates that after remission of Cushing Syndrome (CS) a cardiovascular risk phenotype persists. Here we performed a translational study in active CS and CS in remission to evaluate the subclinical cardiometabolic burden and to explore the direct proinflammatory and prothrombotic potential of their sera on the endothelium in an in vitro translational atherothrombotic cell model. PATIENTS: Cross-sectional study...
November 20, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/29145000/proopiomelanocortin-processing-and-prohormone-convertase-1-level-in-dogs-with-pituitary-corticotroph-tumors
#15
G Benchekroun, P de Fornel-Thibaud, D Rosenberg
Preliminary data suggest that prohormone convertase 1 (PC1/3) protein expression and proopiomelanocortin (POMC) processing are altered in large corticotroph tumors. The aim of this study was to characterize the levels of ACTH precursors and PC1/3 protein in small and large corticotroph tumors of dogs with Cushing's disease. Pituitary tumors of dogs with Cushing's disease were collected postmortem 30 min to 12h after natural death or euthanasia, and classified as small or large. POMC, pro-ACTH, and PC1/3 were detected by Western blotting...
October 13, 2017: Domestic Animal Endocrinology
https://www.readbyqxmd.com/read/29143885/consensus-driven-in-hospital-cortisol-assessment-after-acth-secreting-pituitary-adenoma-resection
#16
Yana Stolyarov, James Mirocha, Adam N Mamelak, Anat Ben-Shlomo
PURPOSE: Remission from Cushing disease (CD) after pituitary adenoma resection may be predicted by a postoperative reduction in serum cortisol level. A 2008 consensus statement recommends assessing morning cortisol levels during the first postoperative week, and replacing glucocorticoid (GC) if cortisol nadir of < 2 or < 5 µg/dL is achieved. We sought to evaluate adherence to consensus recommendations following adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma resection at our tertiary medical center, and assess time to cortisol nadir to better define the window for assessment and intervention...
November 16, 2017: Pituitary
https://www.readbyqxmd.com/read/29143179/diagnostic-work-up-in-steroid-myopathy
#17
REVIEW
Marco Alessandro Minetto, Valentina D'Angelo, Emanuela Arvat, Santosh Kesari
INTRODUCTION: Steroid myopathy is a well-known sign of endogenous Cushing's syndrome as well as a side effect of glucocorticoid administration. The clinical finding of muscle weakness and the clinical inspection of the muscle size are the most commonly used diagnostic tools, sometimes in combination with needle electromyography, but there are no means to detect the myopathy before the appearance of clinical or electrodiagnostic signs. Until now, no guidelines have been produced for a disease-specific evaluation of muscle impairment in patients with Cushing's syndrome...
November 15, 2017: Endocrine
https://www.readbyqxmd.com/read/29142029/routine-use-of-quantitative-disease-activity-measurements-among-us-rheumatologists-implications-for-treat-to-target-management-strategies-in-rheumatoid-arthritis
#18
Jeffrey R Curtis, Lang Chen, Maria I Danila, Kenneth G Saag, Kathy L Parham, John J Cush
OBJECTIVE: The aim of our study was to examine why real-world practices and attitudes regarding quantitative measurements of rheumatoid arthritis (RA) have received limited attention. METHODS: An e-mail survey asked US rheumatologists to self-report on their use of quantitative measurements (metric). RESULTS: Among 439 respondents, metric rheumatologists (58%) were more likely to be in group practice and to use tumor necrosis factor inhibitors...
November 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/29134965/depression-is-associated-with-more-aggressive-inflammatory-bowel-disease
#19
Bharati Kochar, Edward L Barnes, Millie D Long, Kelly C Cushing, Joseph Galanko, Christopher F Martin, Laura E Raffals, Robert S Sandler
OBJECTIVES: Depression is prevalent in inflammatory bowel disease (IBD) patients. The impact of depression on IBD is not well-studied. It is unknown how providers should assess depression. METHODS: We used data from the Sinai-Helmsley Alliance for Research Excellence cohort, to assess methods of diagnosing depression and effects of baseline depression on disease activity at follow-up. A patient health questionnaire (PHQ-8) score ≥5 was consistent with mild depression...
November 14, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29134558/development-of-hyperkalemia-following-treatment-with-dapagliflozin-dapa-in-a-patient-with-type-2-diabetes-after-bilateral-adrenalectomy
#20
Daichi Miyaoka, Akihiro Tsuda, Noriyuki Hayashi, Norikazu Toi, Akiyo Yamasaki, Yuki Nagata, Shinya Nakatani, Masafumi Kurajoh, Shinsuke Yamada, Tomoaki Morioka, Yasuo Imanishi, Masanori Emoto, Masaaki Inaba
Dapagliflozin (DAPA), a sodium-glucose co-transporter 2 (SGLT2) inhibitor, is known to have a beneficial diuretic effect, in addition to a glucose-lowering effect. Although SGLT2 inhibitor has been reported, the increase of hyperkalemia in patients treated with renin-angiotensin-aldosterone system (RAAS) inhibitors, their mechanism of action is unclear. We report the first case of a type 2 diabetes (T2DM) patient with potential mineralocorticoid deficiency who developed hyperkalemia after administration of DAPA...
November 13, 2017: CEN Case Reports
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