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Adrenal failure

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https://www.readbyqxmd.com/read/29676380/fatal-meningococcal-septicemia-without-meningeal-signs-contribution-of-the-peripheral-smear-in-diagnosis-report-of-a-case
#1
Deepti Mutreja, Nikhil Moorchung, S J Manasa, Jeenu Varghese
Acute meningococcemia is characterized by extensive purpurae consisting of both petechiae and ecchymoses. This condition can be rapidly fatal without treatment due to shock and severe consumptive coagulopathy. We report a case of fatal meningococcal septicemia in a military recruit who presented with fever and associated rapidly progressive purpuric rash (purpura fulminans) without any meningeal signs. Evaluation revealed evidence of disseminated intravascular coagulopathy and multiorgan failure. Diplococci were demonstrated in peripheral blood neutrophils and monocytes...
April 2018: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/29675278/adrenocorticotropic-hormone-secreting-pheochromocytoma-underlying-glucocorticoid-induced-pheochromocytoma-crisis
#2
Gil A Geva, David J Gross, Haggi Mazeh, Karine Atlan, Iddo Z Ben-Dov, Matan Fischer
Context: Pheochromocytomas are hormone secreting tumors of the medulla of the adrenal glands found in 0.1-0.5% of patients with hypertension. The vast majority of pheochromocytomas secrete catecholamines, but they have been occasionally shown to also secrete interleukins, calcitonin, testosterone, and in rare cases adrenocorticotropic hormone. Pheochromocytoma crisis is a life threatening event in which high levels of catecholamines cause a systemic reaction leading to organ failure. Case Description: A 70-year-old man was admitted with acute myocardial ischemia following glucocorticoid administration as part of an endocrine workup for an adrenal mass...
2018: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29675258/livedo-reticularis-a-cutaneous-clue-to-an-underlying-endocrine-crisis
#3
Natasha Shrikrishnapalasuriyar, Mirena Noyvirt, Philip Evans, Bethan Gibson, Elin Foden, Atul Kalhan
A 54-year-old woman was admitted to hospital with a presumed allergic reaction to a single dose of amoxicillin given for a suspected upper respiratory tract infection. She complained of chest tightness although there was no wheeze or stridor. On examination, she was pyrexial, tachycardic, hypertensive and had a diffuse mottled rash on her lower limbs. Her initial investigations showed raised inflammatory markers. She was treated in the intensive care for a presumed anaphylactic reaction with an underlying sepsis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29672894/unexpected-adverse-effect-of-metyrapone-a-case-report
#4
A Rouland, A Nguyen, C Fourmont, M Lapray, B Vergès, J M Petit, B Bouillet
Hypercortisolism, or Cushing's syndrome, is a disease which can be treated surgically or with medications such as mitotane, ketoconazole or metyrapone. However, the use of metyrapone is not common, and the adverse effects are not well known. A metyrapone overdose is usually associated with gastro-intestinal symptoms and signs of adrenal failure. To our knowledge, no other side effects have been reported in connection with an ingestion of high doses of metyrapone. This article is protected by copyright. All rights reserved...
April 19, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29650226/are-cushing-s-disease-patients-curable
#5
Xavier Bertagna
Treatment of Cushing's disease remains a challenge. Whereas pituitary surgery can "cure" the patient and restore a completely normal pituitary adrenal axis, there are immediate failures and late recurrences which ultimately require alternate therapeutic approaches. These are numerous, but so are their drawbacks, and all appear to be "default options". For the future, pituitary adenoma has to remain the "reasonable obsession" of efficient and optimistic therapists….
April 9, 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29622713/uncommon-presentation-rare-complication-and-previously-undescribed-oncologic-association-of-pheochromocytoma-the-great-masquerader
#6
David Lawrence, Kevan Salimian, Thorsten Leucker, Seth Martin
We describe the case of a 67-year-old man presenting with ventricular tachycardia (VT) and systolic heart failure secondary to a left adrenal phaeochromocytoma. After treatment with amiodarone, the patient's VT resolved. However, his course was complicated by femoral deep venous thrombosis secondary to an incidentally discovered dedifferentiated liposarcoma of the thigh, for which he was prescribed a course of enoxaparin. The patient was discharged with plans for adrenalectomy following achievement of sufficient preoperative heart rate and blood pressure control with alpha-adrenergic receptor blockade, but re-presented to an outside facility in haemorrhagic shock, where he ultimately expired...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29616752/adrenal-hemorrhage-a-single-center-experience-and-literature-review
#7
Izabela M Karwacka, Łukasz Obołończyk, Krzysztof Sworczak
BACKGROUND: Adrenal hemorrhage (AH) is a rare condition that can lead to acute adrenal insufficiency and may be fatal. The risk factors of AH include focal adrenal lesion, abdominal trauma and anticoagulation therapy. The clinical manifestation of AH varies widely; the symptoms may be related to adrenal insufficiency or may reflect multiple organ failure. However, in many cases, the course of AH is asymptomatic. OBJECTIVES: The study is a retrospective analysis of 23 cases of AH, whose aim is to discuss the etiology and the management of selected patients, as well as a literature review...
March 27, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29568655/posaconazole-induced-adrenal-insufficiency-in-a-case-of-chronic-myelomonocytic-leukemia
#8
Ann Miller, Lauren K Brooks, Silpa Poola-Kella, Rana Malek
Introduction: Posaconazole is an azole used in treatment and prophylaxis of a broad spectrum of fungal infections. Antifungals such as ketoconazole have been shown to cause primary adrenal insufficiency (AI) as a result of direct inhibition on the steroidogenesis pathway. There is only one reported case of primary AI induced by posaconazole in a patient with mucormycosis. We report a case of posaconazole-related primary AI. Case: A 63-year-old man with chronic myelomonocytic leukemia was admitted for fatigue and intermittent nausea and vomiting...
2018: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29560018/adrenal-hemangioma-a-case-of-retroperitoneal-tumor
#9
Genta Iwamoto, Kota Shimokihara, Takashi Kawahara, Daiji Takamoto, Masahiro Yao, Jun-Ichi Teranishi, Masako Otani, Hiroji Uemura
Introduction: Adrenal hemangioma is a rare disease, with only some 60 cases reported previously. Due to the difficulty of the preoperative diagnosis of adrenal hemangioma, almost all of the cases were diagnosed by a histopathological analysis of surgical specimens. Case Presentation: A 52-year-old man was referred to our department for further examination of his left retroperitoneal tumor. He had received hemodialysis due to chronic renal failure resulting from membranous nephropathy...
2018: Case Reports in Medicine
https://www.readbyqxmd.com/read/29549931/impairment-of-thyroid-function-in-critically-ill-patients-in-the-intensive-care-units
#10
Eashaa Kumar, Michael T McCurdy, Christian A Koch, Abdurrahman Hamadah, Tibor Fülöp, Kamel A Gharaibeh
Unexplained hypotension in the intensive care unit is commonly attributed to volume depletion, cardiorespiratory failure, sepsis, or relative adrenal insufficiency. In these acute conditions, thyroid hormone levels measured in blood, serum or plasma are often altered and solely attributed to critical illness. We report a series of 3 critically ill patients with prolonged respiratory failure, suppressed mental status and unexplained hypotension. Thyroid stimulating hormone levels ranged from normal to mildly elevated (2...
March 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29540066/a-systematic-review-of-biological-mechanisms-of-fatigue-in-chronic-illness
#11
Lea Ann Matura, Susan Malone, Rosario Jaime-Lara, Barbara Riegel
Fatigue, a commonly reported symptom, is defined as an overwhelming, debilitating, and sustained sense of exhaustion that decreases the ability to function and carry out daily activities. To date, cancer researchers have been in the forefront in investigating the possible biological mechanisms of fatigue, identifying inflammation, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and activation of the autonomic nervous system. The purpose of this systematic review is to describe fatigue and what is known about the biological mechanisms described in cancer in five chronic, noninfectious illnesses: heart failure, multiple sclerosis, chronic kidney disease, rheumatoid arthritis, and chronic obstructive pulmonary disease...
January 1, 2018: Biological Research for Nursing
https://www.readbyqxmd.com/read/29534916/metoclopramide-induced-pheochromocytoma-crisis
#12
James B Leonard, Kashif M Munir, Hong K Kim
Metoclopramide (MCP) is a commonly used anti-emetic in the emergency department (ED). Its use is generally well tolerated; although infrequent adverse reactions such as extrapyramidal reactions or tardive dyskinesia are reported. However, many ED providers are not familiar with the potentially life-threatening hypertensive emergency that can be precipitated by MCP administration in patients with pheochromocytoma. A previously healthy 36-year-old woman presented to the ED with headache and nausea. She developed acute hypertensive emergency (acute agitation, worsening headache, chest pain and wide complex tachycardia) when her blood pressure (BP) increased to 223/102mmHg (initial BP, 134/86mmHg) after receiving intravenous MCP...
March 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29524270/does-the-hormone-endogenous-ouabain-exist-in-the-human-circulation
#13
REVIEW
Risto J Kaaja, M Gary Nicholls
Studies in the early 1990s suggested that a hormone identical to ouabain or an isomer of ouabain is secreted by the adrenal glands into the circulation and plays a role in the regulation of arterial pressure and cardiac and renal function. This hormone, known as endogenous ouabain (EO), was claimed to contribute to the pathophysiology of a number of disorders including heart failure, renal failure, pregnancy-induced, and essential hypertension. However, some research groups have been unable to confirm the presence of EO in the human circulation and the issue remains in dispute...
March 10, 2018: BioFactors
https://www.readbyqxmd.com/read/29523633/management-of-endocrine-disease-management-of-cushing-s-syndrome-during-pregnancy-solved-and-unsolved-questions
#14
Thierry Brue, Vincent Amodru, Frédéric Castinetti
With fewer than 200 reported cases, Cushing's syndrome (CS) in pregnancy remains a diagnostic and therapeutic challenge. In normal pregnancies, misleading signs may be observed such as striae or hypokalemia, while plasma cortisol and urinary free cortisol may rise up to 2-3-fold. While the dexamethasone suppression test is difficult to use, reference values for salivary cortisol appear valid. The predominant cause is adrenal adenoma (sometimes without decreased ACTH), rather than Cushing's disease. There are considerable imaging pitfalls in Cushing's disease...
March 9, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29514624/lack-of-genetic-susceptibility-in-takotsubo-cardiomyopathy-a-case-control-study
#15
Emma Mattsson, Peter Saliba-Gustafsson, Ewa Ehrenborg, Per Tornvall
BACKGROUND: Takotsubo cardiomyopathy (TCM), also known as "broken heart syndrome", is a type of heart failure characterized by transient ventricular dysfunction in the absence of obstructive coronary lesions. Although associated with increased levels of catecholamines, pathophysiological mechanisms are unknown. Relapses and family heritability indicate a genetic predisposition. Several small studies have investigated associations between three different loci; the β1-adrenic receptor (ADRB1), G-protein-coupled receptor kinase 5 (GRK5), Bcl-associated athanogene 3 (BAG3) and TCM but no consensus has been reached...
March 7, 2018: BMC Medical Genetics
https://www.readbyqxmd.com/read/29498364/elevated-serum-rantes-chemokine-in-autoimmune-addison-s-disease
#16
Marta Fichna, Magdalena Żurawek, Bartłomiej Budny, Hanna Komarowska, Elżbieta Niechciał, Piotr Fichna, Marek Ruchała
INTRODUCTION    RANTES (Regulated on Activation, Normal T-cell Expressed and Secreted) chemokine, the product of CCL5 gene, is involved in trafficking immune cells into the inflammation site. It acts as co-activator of T cells and promotes polarization of the immune response towards the Th1 profile. In autoimmune Addison's disease (AAD) adrenal cortex is gradually destroyed by adrenal-specific immune cell infiltration. RANTES might be implicated in autoimmune adrenal failure through recruitment and activation of the immune cells...
March 2, 2018: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/29492088/aaa-syndrome-case-report-of-a-rare-disease
#17
S Waqar H Shah, Arshad K Butt, K Malik, Altaf Alam, Adnan Shahzad, Anwaar A Khan
Triple A (Allgrove) syndrome, an autosomal recessive disease is characterized by achalasia, alacrimia and ACTH-resistant adrenal failure with progressive neurological syndrome including central, peripheral and autonomic nervous system impairment, and mild mental retardation. The triple A syndrome gene, designated AAAS, localized on chromosome 12q 13 encodes for a 546 amino acid protein called ALADIN (Alacrimia-Achlasia-Adrenal Insufficiency and Neurologic disorder). This report relates to two sisters, aged 8 and 12 years, who had vomiting, muscle weakness, alacrimia, excessive fatigue and dysphagia...
November 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29467229/management-of-endocrine-disease-can-we-cure-cushing-s-disease
#18
Xavier Bertagna
One of today's challenges in endocrinology is the treatment of Cushing's disease: Whereas pituitary surgery has the potential to "cure" the patient and restore a completely normal pituitary adrenal axis, there are immediate failures and late recurrences that will ultimately require alternate therapeutic approaches. Their high number is in direct correlation with their serious limitations and they all appear to be "default options". This "personal view" tries to shed some light on the inescapable difficulties of the current treatments of Cushing's disease, and to provide some optimistic view for the future where the pituitary adenoma should be the "reasonable obsession" of a successful therapeutist…...
February 21, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29467114/adrenal-venous-sampling-the-learning-curve-of-a-single-interventionalist-with-282-consecutive-procedures
#19
Hugo Jakobsson, Katerina Farmaki, Augustinas Sakinis, Olof Ehn, Gudmundur Johannsson, Oskar Ragnarsson
PURPOSE: Primary aldosteronism (PA) is a common cause of secondary hypertension. Adrenal venous sampling (AVS) is the gold standard for assessing laterality of PA, which is of paramount importance to decide adequate treatment. AVS is a technically complicated procedure with success rates ranging between 30% and 96%. The aim of this study was to investigate the success rate of AVS over time, performed by a single interventionalist. METHODS: This was a retrospective study based on consecutive AVS procedures performed by a single operator between September 2005 and June 2016...
February 21, 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29464222/nivolumab-a-new-immunomodulatory-drug-a-new-adverse-effect-adrenal-crisis
#20
Funda Karbek Akarca, Ozge Can, Sercan Yalcinli, Yusuf Ali Altunci
Owing to the advancements in medicine, new information is obtained regarding cancer, new antineoplastic agents are developed. Frequent use of these new pharmacological agents emergency physicians to be vigilant about their side effects. We present a case of adrenal crisis in a patient with non-small cell lung cancer (NSCLC), caused by an immunomodulatory drug; nivolumab. While adverse events are related to other immunomodulatory drugs have been reported in literature, our case is the first nivolumab-related adrenal failure to be reported...
December 2017: Turkish Journal of Emergency Medicine
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