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Addison Disease

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https://www.readbyqxmd.com/read/28609345/histopathologic-findings-of-cutaneous-hyperpigmentation-in-addison-disease-and-immunostain-of-the-melanocytic-population
#1
Angel Fernandez-Flores, David S Cassarino
The histopathological features of cutaneous hyperpigmentation in Addison disease have very occasionally been reported, and they include acanthosis, hyperkeratosis, focal parakeratosis, spongiosis, superficial perivascular lymphocytic infiltrate, basal melanin hyperpigmentation, and superficial dermal melanophages. We present a study on 2 biopsies from the arm and the thigh in a 77-year-old woman with a long clinical history of Addison disease as well as senile purpura and alopecia of female pattern. The patient presented diffuse hyperpigmentation of the skin, more pronounced on her face, and left upper forehead...
May 31, 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28609284/premature-ovarian-failure-could-be-an-alarming-sign-of-polyglandular-autoimmune-dysfunction
#2
Aasem Saif, M Assem
A 31-year-old lady, diagnosed to have premature ovarian failure in the gynecology clinic, was referred for endocrine assessment because of an abnormal thyroid function test. Clinical examination revealed hypotension, and fungal skin infection under her atrophic breasts. Thyroid stimulating hormone (TSH) level was very high. Assessment of the suprarenal function revealed evidence of Addison's disease. Polyglandular autoimmune dysfunction was diagnosed. She was treated with prednisone, fludrocortisone, and levothyroxine with significant improvement of her general condition and blood pressure...
April 25, 2017: Endocrine Regulations
https://www.readbyqxmd.com/read/28571196/addison-s-disease-mimicking-as-acute-pancreatitis-a-case-report
#3
Sayani Chaudhuri, Karthik N Rao, Navin Patil, Balaji Ommurugan, George Varghese
Over past two decades there has been significant improvement in medical field in elucidating the underlying pathophysiology and genetics of Addison's disease. Adrenal insufficiency (Addison's disease) is a rare disease with an incidence of 0.8/100,000 cases. The diagnosis may be delayed if the clinical presentation mimics a gastrointestinal disorder or psychiatric illness. We report a case of Addison's disease presenting as acute pain in abdomen mimicking clinical presentation of acute pancreatitis.
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567288/gad-antibody-associated-limbic-encephalitis-in-a-young-woman-with-apeced
#4
Anna Kopczak, Adrian-Minh Schumacher, Sandra Nischwitz, Tania Kümpfel, Günter K Stalla, Matthias K Auer
The autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) syndrome is a genetic disorder caused by a mutation in the autoimmune regulator (AIRE) gene. Immune deficiency, hypoparathyroidism and Addison's disease due to autoimmune dysfunction are the major clinical signs of APECED. We report on a 21-year-old female APECED patient with two inactivating mutations in the AIRE gene. She presented with sudden onset of periodic nausea. Adrenal insufficiency was diagnosed by means of the ACTH stimulation test...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28557715/amyloidosis-cutis-dyschromica-a-rare-cause-of-hyperpigmentation-a-new-case-and-literature-review
#5
Oya Kuseyri, Dorothea Haas, Nina Lang, Knut Schäkel, Markus Bettendorf
Amyloidosis cutis dyschromica is a rare form of primary cutaneous amyloidosis without systemic involvement and characterized by asymptomatic, progressive hyper- and hypopigmentation. We present the first case of a patient with amyloidosis cutis dyschromica diagnosed previously elsewhere as having Addison disease with generalized hyperpigmentation of the skin. This case suggests that in patients presenting with asymptomatic cutaneous dyschromia a skin biopsy for histopathological examination should be considered...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28553251/no-difference-in-mood-and-quality-of-life-in-dhea-s-deficient-adults-with-addison-s-disease-vs-type-2-diabetes-patients-with-normal-dhea-s-levels-implications-for-management-of-these-conditions
#6
Adrian H Heald, Andreas Walther, Julian R E Davis, Gabriela Y C Moreno, John Kane, Mark Livingston, Helen L Fowler
Patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulfate (DHEA-S). There is considerable debate about the specific effects of DHEA deficiency on energy level and mood. We measured emotional well-being in 16 patients with Addison's disease and a group of 16 hospital attendees with type 2 diabetes. Participants completed the General Health Questionnaire-28 (GHQ-28), the Hospital Anxiety and Depression Scale (HADS), the World Health Organization's quality of life assessment (WHOQOL-BREF) and the Holmes-Rahe life event scale...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28540407/a-new-mutation-site-in-the-aire-gene-causes-autoimmune-polyendocrine-syndrome-type-1
#7
Wufei Zhu, Zhen Hu, Xiangyu Liao, Xing Chen, Wenrong Huang, Yu Zhong, Zhaoyang Zeng
Autoimmune polyendocrine syndrome type 1 (APS-1, OMIM 2403000) is a rare autosomal recessive disease that is caused by autoimmune regulator (AIRE). The main symptoms of APS-1 are chronic mucocutaneous candidiasis, autoimmune adrenocortical insufficiency (Addison's disease) and hypoparathyroidism. We collected APS-1 cases and analysed them. The AIRE genes of the patient and his family members were sequenced to identify whether the APS-1 patient had an AIRE mutation. We discovered a mutation site (c.206A>C) that had never before been reported in the AIRE gene located in exon 2 of the AIRE gene...
May 24, 2017: Immunogenetics
https://www.readbyqxmd.com/read/28538644/validation-of-a-clinical-trial-composite-endpoint-for-patients-with-necrotizing-soft-tissue-infections
#8
Eileen M Bulger, Addison May, Wayne Dankner, Greg Maislin, Bryce Robinson, Anat Shirvan
OBJECTIVE: Our objective was to develop and validate a composite endpoint for patients with necrotizing soft tissue infections (NSTI) that incorporates: local tissue injury, systemic organ dysfunction, and mortality. METHODS: The Necrotizing Infection Clinical Composite Endpoint (NICCE) was defined as follows:(i) Alive at day 28 (ii) ≤3 debridements prior to day 14 (iii) No amputation beyond first debridement (iv) Modified SOFA score (mSOFA) at day 14 ≤1. To be considered a success, all individual criteria must be met...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28492593/eruptive-melanocytic-nevi-during-azathioprine-therapy-for-antisynthetase-syndrome
#9
Stephanie A Steinweg, Christian R Halvorson, Grace F Kao, Sridhar Dronavalli
Eruptive melanocytic nevi (EMN) are rare multiple benign melanocytic nevi that develop within a few months. The phenomenon has been associated with a variety of dermatologic and systemic conditions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, epidermolysis bullosa, Addison disease, human immunodeficiency virus infection, and internal malignancy, among others. It also is commonly attributed to medications, particularly immunosuppressive and chemotherapeutic agents. We report a case of EMN in a 50-year-old man undergoing azathioprine therapy for antisynthetase syndrome...
April 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28487318/impact-of-coronary-calcification-on-clinical-management-in-patients-with-acute-chest-pain
#10
RANDOMIZED CONTROLLED TRIAL
Daniel O Bittner, Thomas Mayrhofer, Fabian Bamberg, Travis R Hallett, Sumbal Janjua, Daniel Addison, John T Nagurney, James E Udelson, Michael T Lu, Quynh A Truong, Pamela K Woodard, Judd E Hollander, Chadwick Miller, Anna Marie Chang, Harjit Singh, Harold Litt, Udo Hoffmann, Maros Ferencik
BACKGROUND: Coronary artery calcification (CAC) may impair diagnostic assessment of coronary computed tomography angiography (CTA). We determined whether CAC affects efficiency of coronary CTA in patients with suspected acute coronary syndrome (ACS). METHODS AND RESULTS: This is a pooled analysis of ACRIN-PA (American College of Radiology Imaging Network-Pennsylvania) 4005 and the ROMICAT-II trial (Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography) comparing an initial coronary CTA strategy to standard of care in acute chest pain patients...
May 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28483191/effectiveness-of-acupressure-at-the-zusanli-st-36-acupoint-as-a-comfortable-treatment-for-diabetes-mellitus-a-pilot-study-in-indonesia
#11
Fitrullah, Addison Rousdy
Diabetes mellitus is a dangerous disease worldwide. Indonesia has 10 million diabetic and 17.9 million prediabetic citizens. Unfortunately, less than half of these diabetic individuals are aware of their conditions and less than 1% of those receiving medical treatment achieve their healing targets. Because acupressure is believed to be an effective treatment without the use of drugs, in this study we investigated acupressure as a comfortable and effective way of treating patients with diabetes mellitus. This pilot study involved 30 participants who were split into two groups: 15 each in the experimental and the control groups...
April 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28446858/a-case-of-autoimmune-polyglandular-syndrome-ype-2-associated-with-atypical-form-of-scleromyxedema
#12
Oleksander Prylutskyi, Olga Prylutska, Anatoliy Degonskyi, Kseniia Tkachenko
BACKGROUND: Autoimmune polyglandular syndrome type 2 represents an uncommon endocrine disorder composed by Addison's disease with autoimmune thyroid disease (Schmidt's syndrome) and/or type 1 diabetes mellitus. Scleromyxedema is a rare progressive cutaneous mucinosis usually associated with systemic involvement and paraproteinemia. To the best of our knowledge, there is no case report of Schmidt's syndrome associated with scleromyxedema. CASE DETAILS: A 34-year-old woman was admitted to Donetsk Clinical Territorial Medical Association due to acute general weakness, reduced vision, dryness of integuments, memory decline, fatigue, weight loss, rash on the face trunk and extremities...
September 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#13
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28412706/endocrine-comorbidities-in-patients-with-psoriatic-arthritis-a-population-based-case-controlled-study
#14
Amir Haddad, Ron Ilan Ashkenazi, Haim Bitterman, Ilan Feldhamer, Sari Greenberg-Dotan, Idit Lavi, Erez Batat, Irina Bergman, Arnon Dov Cohen, Devy Zisman
OBJECTIVE: To investigate endocrine comorbidities in patients with psoriatic arthritis (PsA). METHODS: A retrospective, cross-sectional study was performed with the database of Clalit Health Services, the largest healthcare provider in Israel, between 2002 and 2014. Patients with PsA were identified and matched by age and sex to healthy controls. The following morbidities were analyzed: hypo/hyperthyroidism, hypo/hyperparathyroidism, hyperprolactinemia, Cushing disease, Addison disease, diabetes insipidus, diabetes mellitus (DM), pituitary adenoma, acromegaly, and osteoporosis...
April 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28404594/health-related-quality-of-life-of-patients-with-hypothalamic-pituitary-adrenal-axis-dysregulations-a-cohort-study
#15
Charlotte De Bucy, Laurence Guignat, Tanya Niati, Jerome Bertherat, Joel Coste
OBJECTIVE: Health-related quality of life (HrQoL) is increasingly considered to be an important outcome of care for hypothalamic-pituitary-adrenal (HPA) axis dysregulation. The objective of this study was to assess the influence of type of HPA axis dysregulation and cortisol status on HrQOL and its evolution with time and treatment. DESIGN: Prospective cohort study. METHODS: Between September 2007 and April 2014, HrQoL questionnaires were administered during routine management to all patients with HPA axis dysregulation hospitalized in a single department and this was repeated after 6- 12-, 24- and 36-month during standard follow-up...
April 12, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28390450/a-complex-interplay-cognitive-behavioural-therapy-for-severe-health-anxiety-in-addison-s-disease-to-reduce-emergency-department-admissions
#16
Jo Daniels, Elizabeth Sheils
BACKGROUND: Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. AIMS: This paper describes a single case study of a patient with severe health anxiety and co-morbid AD...
July 2017: Behavioural and Cognitive Psychotherapy
https://www.readbyqxmd.com/read/28380718/a-naturalistic-study-of-driving-behavior-in-older-adults-and-preclinical-alzheimer-disease
#17
Ganesh M Babulal, Sarah H Stout, Tammie L S Benzinger, Brian R Ott, David B Carr, Mollie Webb, Cindy M Traub, Aaron Addison, John C Morris, David K Warren, Catherine M Roe
A clinical consequence of symptomatic Alzheimer's disease (AD) is impaired driving performance. However, decline in driving performance may begin in the preclinical stage of AD. We used a naturalistic driving methodology to examine differences in driving behavior over one year in a small sample of cognitively normal older adults with ( n = 10) and without ( n = 10) preclinical AD. As expected with a small sample size, there were no statistically significant differences between the two groups, but older adults with preclinical AD drove less often, were less likely to drive at night, and had fewer aggressive behaviors such as hard braking, speeding, and sudden acceleration...
January 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28370206/adjuvant-psychological-therapy-in-long-term-endocrine-conditions
#18
J Daniels, J M Turner-Cobb
Consideration of psychological distress in long-term endocrine conditions is of vital importance given the prevalence of anxiety and depression in such disorders. Poor mental health can lead to compromised self-care, higher utilization of health services, lower rates of adherence, reduced quality of life and ultimately poorer outcomes. Adjuvant psychological therapy offers an effective resource to reduce distress in endocrine conditions. While the vast majority of work in this area has focused on psychological screening and intervention in diabetes, identification and recognition of psychological distress are equally important in other endocrinological conditions, with supportive evidence in polycystic ovary syndrome and Addison's disease...
June 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28348901/addison-s-disease-and-possible-cannabis-withdrawal-syndrome-presenting-as-an-eating-disorder-in-a-thirty-year-old-female
#19
Kimberly Lazare
A 30-year-old female with a history of anxiety, cannabis use, and Avoidant/Restrictive Food Intake Disorder presented for residential treatment of a Cannabis Use Disorder. Upon arrival, she had not eaten for two days and was found to be hypotensive with electrolyte disturbances. She was admitted to a nearby hospital, where the Internist diagnosed her with Addison's disease. She was treated with corticosteroid therapy, with rapid normalization of her electrolytes, eating, and anxiety. This is the first published case of undiagnosed Addison's disease presenting as an eating disorder, with cannabis use likely contributing to symptoms...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28316939/application-of-established-pathophysiologic-processes-brings-greater-clarity-to-diagnosis-and-treatment-of-hyponatremia
#20
EDITORIAL
John K Maesaka, Louis J Imbriano, Nobuyuki Miyawaki
Hyponatremia, serum sodium < 135 mEq/L, is the most common electrolyte abnormality and is in a state of flux. Hyponatremic patients are symptomatic and should be treated but our inability to consistently determine the causes of hyponatremia has hampered the delivery of appropriate therapy. This is especially applicable to differentiating syndrome of inappropriate antidiuresis (SIAD) from cerebral salt wasting (CSW) or more appropriately, renal salt wasting (RSW), because of divergent therapeutic goals, to water-restrict in SIAD and administer salt and water in RSW...
March 6, 2017: World Journal of Nephrology
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