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Adrenal fatigue

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https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#1
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/29095280/primary-hypothyroidism-and-isolated-acth-deficiency-induced-by-nivolumab-therapy-case-report-and-review
#2
REVIEW
Mei Fang Zeng, Li Chen, Hong Ying Ye, Wei Gong, Li Nuo Zhou, Yi Ming Li, Xiao Long Zhao
RATIONALE: Nivolumab is a monoclonal IgG antibody blocking programmed death receptor-1 (PD1), leading to restoration of the natural T-cell-mediated immune response against the cancer cells. However, it also causes plenty of autoimmune-related adverse events, which often involves endocrine system. PATIENT CONCERNS: A 54-year-old male with renal clear cell carcinoma was treated with nivolumab intravenously. Routine monitoring showed elevated thyroid-stimulating hormone and low free thyroxine after the 6th administration of nivolumab...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29076676/adrenal-insufficiency-in-pakistani-hiv-infected-patients
#3
Bahjat Afreen, Khurshid Ahmed Khan, Amna Riaz
BACKGROUND: Adrenal insufficiency (AI) is the most common endocrine complication among patients with AIDS/HIV infection and there are number of causes of AI in HIV patients. Human immunodeficiency virus directly as well as indirectly destroys adrenal glands. The estimates of its prevalence and severity vary. AI is the most life threatening but readily correctable endocrine complication that occurs in persons with HIV infection. This study was carried out to determine the frequency of Adrenal Insufficiency in HIV patients and their clinical features as proper diagnosis and timely treatment have been shown to improve quality of life and long-term mortality in AIDS patients...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29066187/a-case-of-primary-adrenal-failure-in-the-emergency-department
#4
Al Giwa
BACKGROUND: Primary adrenal failure is considered to be an extremely rare disease presenting in the ED, with an incidence reported to be as low as 50 cases per 1,000,000 persons (Klauer, 2017). I would like to present a case of a young man who presented to the ED, with what I suspected to be this rare entity. CASE REPORT: A 26year old otherwise healthy male presented to our ED with complaints of weakness, nausea, vomiting, and hiccups of 1.5-day duration. He also complained of lightheadedness, describing it as if he was going to pass out...
October 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29062559/secondary-adrenal-insufficiency-due-to-the-co-administration-of-ritonavir-and-inhaled-fluticasone-propionate-case-report
#5
Ali Al-Maqbali, Bina Kamble, Salim Al-Qassabi, Ali Elgalib
Ritonavir is a powerful inhibitor of the cytochrome P450 3A4 (CYP3A4) isoenzyme. It is used as a pharmaceutical enhancer in the management of HIV-positive patients. However, when co-administered with other drugs that are metabolised via the CYP3A4 pathway, ritonavir can potentially cause serious drug-drug interactions. Inhaled fluticasone propionate, which is used to treat asthma and chronic obstructive airway disease, is particularly prone to such interactions due to its physiological attributes. We report a HIV-positive 48-year-old male patient who presented to Al Nahdha Hospital, Muscat, Oman, in 2012 with weight loss, generalised weakness and fatigue and diagnosed with secondary adrenal insufficiency as a result of concomitant ritonavir and inhaled fluticasone...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28985742/health-related-quality-of-life-in-children-with-congenital-adrenal-hyperplasia
#6
Alyssa Halper, Mary C Hooke, Maria Teresa Gonzalez-Bolanos, Nancy Vanderburg, Thang N Tran, Jane Torkelson, Kyriakie Sarafoglou
BACKGROUND: Children with congenital adrenal hyperplasia (CAH) require life-long glucocorticoid replacement and have daily intermittent hyper/hypocortisolemia and hyperandrogenemia. Health-related quality of life (HRQL) is important for understanding the impact the disease and therapy have on physical, mental, emotional, and social functioning. Little is known about HRQL in CAH. We compared HRQL in children with CAH to healthy norms and examined how these scores related to physiologic variables...
October 6, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28937294/hypertensive-crisis-in-pregnancy-due-to-a-metamorphosing-pheochromocytoma-with-postdelivery-cushing-s-syndrome
#7
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/28919626/addison-s-disease-a-diagnostic-dilemma
#8
S Afroz, S Bain
Adrenal insufficiency is a rare disease, but is life threatening when overlooked. Addison's disease may be an acquired form of adrenal insufficiency due to the destruction or dysfunction of the adrenal cortex. It affects both glucocorticoid and mineralocorticoid function. Main presenting symptoms of Addison's disease such as fatigue, anorexia, vomiting and convulsion often mimics central nervous system (CNS) infections. We describe a case of Addison's disease who was initially misdiagnosed as a case of meningo-encephalitis subsequently renal tubular acidosis and finally Addison's disease...
July 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28918107/depression-evening-salivary-cortisol-and-inflammation-in-chronic-fatigue-syndrome-a-psychoneuroendocrinological-structural-regression-model
#9
Sara F Milrad, Daniel L Hall, Devika R Jutagir, Emily G Lattie, Sara J Czaja, Dolores M Perdomo, Mary Ann Fletcher, Nancy Klimas, Michael H Antoni
INTRODUCTION: Chronic Fatigue Syndrome (CFS) is a poorly understood illness that is characterized by diverse somatic symptoms, hypothalamic pituitary adrenal (HPA) axis dysfunction and heightened inflammatory indicators. These symptoms are often exacerbated and accompanied by psychological distress states and depression. Since depression is known to be associated with HPA axis dysfunction and greater inflammation, a psychoneuroendocrinological (PNE) model of inflammation was examined in persons diagnosed with CFS in order to uncover underlying biopsychosocial mechanisms in this poorly understood chronic illness...
September 14, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/28895486/iatrogenic-adrenal-insufficiency-secondary-to-combination-therapy-with-elvitegravir-cobicistat-tenofovir-disoproxil-fumarate-emtricitabine-and-interlaminar-triamcinolone-injection-in-an-aids-patient
#10
Chanie Wassner, Sutapa Maiti, Kurt Kodroff, Henry Cohen
We report the first identified case of suspected iatrogenic adrenal insufficiency after an interlaminar injection of triamcinolone acetonide while on concomitant Stribild (elvitegravir 150 mg/cobicistat 150 mg/tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg [EVG/c/TDF/FTC]). A 49-year-old female with HIV on EVG/c/TDF/FTC therapy presented to our endocrinology clinic to be evaluated for suspected Cushing syndrome. Prior to presentation, the patient had been given 2 interlaminar spinal injections of triamcinolone...
January 1, 2017: Journal of the International Association of Providers of AIDS Care
https://www.readbyqxmd.com/read/28844812/antidepressant-like-effects-of-3-carboxamido-seco-nalmefene-3cs-nalmefene-a-novel-opioid-receptor-modulator-in-a-rat-ifn-%C3%AE-induced-depression-model
#11
Charlotte K Callaghan, Jennifer Rouine, Reginald L Dean, Brian I Knapp, Jean M Bidlack, Daniel R Deaver, Shane M O'Mara
Patients receiving the cytokine immunotherapy, interferon-alpha (IFN-α) frequently present with neuropsychiatric consequences and cognitive impairments. Patients (25-80%) report symptoms of depression, including, anhedonia, irritability, fatigue and impaired motivation. Our lab has previously demonstrated treatment (170,000IU/kg sc, 3 times per week for 4weeks) of the pro-inflammatory cytokine, IFN-α, induced a depressive phenotype in rats in the forced swim test (FST). Here, we examine the biological mechanisms underlying behavioral changes induced by IFN-α, which may be reflective of mechanisms underlying inflammation associated depression...
August 24, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28835258/acute-hypopituitarism-associated-with-periorbital-swelling-and-cardiac-dysfunction-in-a-patient-with-pituitary-tumor-apoplexy-a-case-report
#12
Nobumasa Ohara, Yuichiro Yoneoka, Yasuhiro Seki, Katsuhiko Akiyama, Masataka Arita, Kazumasa Ohashi, Kazuo Suzuki, Toshinori Takada
BACKGROUND: Pituitary tumor apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction in a preexisting pituitary adenoma. It typically manifests as an acute episode of headache, visual disturbance, mental status changes, cranial nerve palsy, and endocrine pituitary dysfunction. However, not all patients present with classical symptoms, so it is pertinent to appreciate the clinical spectrum of pituitary tumor apoplexy presentation. We report an unusual case of a patient with pituitary tumor apoplexy who presented with periorbital edema associated with hypopituitarism...
August 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28830899/primary-adrenal-lymphoma-with-initial-presentation-concerning-for-bilateral-adrenal-pheochromocytomas
#13
Flavian Grace Joseph, Sheila Cook, Durgesh Gowda
Primary adrenal non-Hodgkin's lymphoma is rarely encountered. Clinical presentation is non-specific with fatigue, abdominal pain and B-symptoms being more commonly reported. We report a case of primary bilateral adrenal lymphoma who initially presented with clinical features suspicious for pheochromocytoma. The patient was recently diagnosed with hypertension and had a family history of early ischaemic heart disease. Plasma free metanephrines were also elevated. Pheochromocytoma was deemed unlikely following multiple investigations and the diagnosis of lymphoma was made following adrenal biopsy...
August 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28819015/adrenal-cushing-s-syndrome-during-pregnancy
#14
C E Andreescu, R A Alwani, J Hofland, L H J Looijenga, W W de Herder, L J Hofland, R 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...
November 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28818109/metastatic-colorectal-cancer-responsive-to-regorafenib-for-2-years-a-case-report
#15
Kenji Yoshino, Dai Manaka, Ryo Kudo, Shunpei Kanai, Eisei Mitsuoka, Satoshi Kanto, Shinya Hamasu, Sayuri Konishi, Ryuta Nishitai
BACKGROUND: Regorafenib is an oral multikinase inhibitor that has been demonstrated as clinically effective in patients with metastatic colorectal cancer in phase III studies. Although disease control was achieved in 40% of the pretreated patients with metastatic colorectal cancer in the pivotal studies, radiological response has rarely been reported. Severe adverse events associated with regorafenib are known to occur during the first and second courses of treatment. We present a case of a 62-year-old Japanese patient whose metastatic colorectal cancer has been responding to treatment with regorafenib for 2 years...
August 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28804590/feminizing-adrenocortical-carcinoma-without-gynecomastia
#16
Farida Chentli, Fadila Chabour, Djafer Bouchibane, Nouria Nouar
Malignant feminizing adrenocortical tumors are exceedingly rare. Their main presentation is gynecomastia. In these estrogen secreting tumors (with or without other adrenocortical hormones) lack of gynecomastia is exceptional as in our case. A 44-year-old man presented with abdominal pain. Radiological assessment revealed a tumor measuring 120 × 95 mm in the retroperitoneal area with numerous metastases. Pathological examination pleaded for an adrenal origin with a Weiss's score of 5. Six months later, the tumor relapsed, and he had a second surgery and was sent for hormone assessment...
July 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28759180/central-hypoadrenocorticism-associated-with-rathke-s-cleft-cyst
#17
Fumika Kawano, Tomoyo Itonaga, Masanori Inoue, Miwako Maeda, Hiroaki Miyahara, Kenji Ihara
Rathke's cleft cysts (RCCs) are non-neoplastic, sellar or suprasellar epithelium-lined cysts originating from Rathke's pouch in the pituitary gland. Patients with RCCs are usually asymptomatic, but some have only been identified when symptoms manifested in middle age. The characteristics of these patients during childhood or adolescence remains unknown. We describe an 18-year-old girl who had occasionally suffered from malicious fatigue in the morning since her early teens. Brain magnetic resonance imaging (MRI) revealed T1 hyperintense/T2 hypointense signals between the anterior and posterior pituitary glands, indicating the presence of RCC...
July 2017: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28641771/fatigue-in-multiple-sclerosis-is-it-related-to-cytokines-and-hypothalamic-pituitary-adrenal-axis
#18
Aylin Akcali, Fatma Zengin, Sefika Nur Aksoy, Orhan Zengin
BACKGROUND: Fatigue is a common symptom of Multiple Sclerosis (MS) that diminishes the quality of life of patients, but its exact mechanism remains poorly understood. There is not a generally adopted scale to determine MS fatigue. Studies that investigated physiopathology of fatigue symptom have shown dysregulation of hypothalamic-pituitaryadrenal (HPA) axis. In the current study, we aimed to compare the results obtained with two separate scales, namely the Fatigue Severity Scale (FSS) and the Neurological Fatigue Index-Multiple Sclerosis (NFI-MS), and assess the relationship between fatigue and serum IL-1β, TNF-α, IL-35, IL-2, IL-10, ACTH, cortisol, α-MSH, β-MSH, γ-MSH and CLIP (Corticotropinlike intermediate lobe peptide) in MS patients categorized as fatigued and non-fatigued on the basis of FSS scores...
July 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28641158/determinants-of-cortisol-during-pregnancy-the-abcd-cohort
#19
Laura S Bleker, Tessa J Roseboom, Tanja G Vrijkotte, Rebecca M Reynolds, Susanne R de Rooij
BACKGROUND: Psychosocial stress during pregnancy has been proposed as a major contributor of glucocorticoid-mediated programming of the fetal hypothalamic-pituitary adrenal (HPA) axis, with later adverse health consequences. However, evidence linking maternal stress to maternal cortisol values during pregnancy is inconclusive. A possible explanation for this is that other maternal factors overshadow any potential effects of stress on cortisol levels. We studied a large cohort of pregnant women with extensive data on pregnancy characteristics to determine the respective contributions of biological, environmental and psychosocial stress factors to cortisol levels in pregnancy...
May 31, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28508370/a-proteomic-evaluation-of-sympathetic-activity-biomarkers-of-the-hypothalamus-pituitary-adrenal-axis-by-western-blotting-technique-following-experimental-traumatic-brain-injury
#20
Hale Zerrin Toklu, Yasemin Sakarya, Nihal Tümer
Endocrine disorders and autonomic dysfunction are common paradigms following traumatic brain injury (TBI). Alterations in the hypothalamus-pituitary-adrenal (HPA) axis following TBI may result in impaired vasopressor response, energy imbalance, fatigue, depression, or neurological disorders. Autonomic dysfunction is a common disorder following TBI. The sympathetic activity markers on HPA axis can be measured by Western blot protein analysis. Tyrosine hydroxylase, dopamine beta hydroxylase are the key enzymes for the synthesis of norepinephrine; and neuropeptide Y (NPY) is the peptide that is co-stored and co-released with norepinephrine...
2017: Methods in Molecular Biology
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