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https://www.readbyqxmd.com/read/27903023/-adrenal-insufficiency
#1
Stephanie Burger-Stritt, Stefanie Hahner
Even under established replacement therapy, chronic adrenal insufficiency is associated with an impairment in daily life activities and a higher number of sick-days. In patients with individually adjusted glucocorticoid doses (avoiding over-replacement) the frequency of glucocorticoid side effects is low. Besides the standard treatment with conventional hydrocortisone, new formulas aiming at more adjusted physiological circadian cortisol profiles or improved individual dosing have been evaluated in recent clinical trials...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27899384/rifampicin-induced-adrenal-crisis-in-a-patient-with-tuberculosis-a-therapeutic-challenge
#2
Nicholas Denny, Sarika Raghunath, Praveen Bhatia, Muntasir Abdelaziz
A 55-year-old Indian man presented with productive cough and a large left pleural effusion. Pleural fluid culture grew Mycobacterium tuberculosis, and he was started on antituberculosis therapy. One week later, the patient presented to hospital with drowsiness, dehydration and hypotension. He was transferred to critical care and only improved after starting hydrocortisone and stopping rifampicin. His short synACTHen test subsequently confirmed primary adrenal insufficiency, and a CT of the abdomen showed bilateral adrenal enlargement...
November 29, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27855238/adrenal-crisis-secondary-to-bilateral-adrenal-haemorrhage-after-hemicolectomy
#3
Anthony Logaraj, Venessa H M Tsang, Shahrir Kabir, Julian C Y Ip
: Adrenal haemorrhage is a rare cause of adrenal crisis, which requires rapid diagnosis, prompt initiation of parenteral hydrocortisone and haemodynamic monitoring to avoid hypotensive crises. We herein describe a case of bilateral adrenal haemorrhage after hemicolectomy in a 93-year-old female with high-grade colonic adenocarcinoma. This patient's post-operative recovery was complicated by an acute hypotensive episode, hypoglycaemia and syncope, and subsequent computed tomography (CT) scan of the abdomen revealed bilateral adrenal haemorrhage...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27855232/novel-scc-mutation-in-a-patient-of-mexican-descent-with-sex-reversal-salt-losing-crisis-and-adrenal-failure
#4
Jasmeet Kaur, Alan M Rice, Elizabeth O'Connor, Anil Piya, Bradley Buckler, Himangshu S Bose
: Congenital adrenal hyperplasia (CAH) is caused by mutations in cytochrome P450 side chain cleavage enzyme (CYP11A1 and old name, SCC). Errors in cholesterol side chain cleavage by the mitochondrial resident CYP11A1 results in an inadequate amount of pregnenolone production. This study was performed to evaluate the cause of salt-losing crisis and possible adrenal failure in a pediatric patient whose mother had a history of two previous stillbirths and loss of another baby within a week of birth...
2016: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/27833402/short-term-outcomes-and-safety-of-computed-tomography-guided-percutaneous-microwave-ablation-of-solitary-adrenal-metastasis-from-lung-cancer-a-multi-center-retrospective-study
#5
Min Men, Xin Ye, Weijun Fan, Kaixian Zhang, Jingwang Bi, Xia Yang, Aimin Zheng, Guanghui Huang, Zhigang Wei
OBJECTIVE: To retrospectively evaluate the short-term outcomes and safety of computed tomography (CT)-guided percutaneous microwave ablation (MWA) of solitary adrenal metastasis from lung cancer. MATERIALS AND METHODS: From May 2010 to April 2014, 31 patients with unilateral adrenal metastasis from lung cancer who were treated with CT-guided percutaneous MWA were enrolled. This study was conducted with approval from local Institutional Review Board. Clinical outcomes and complications of MWA were assessed...
November 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/27810905/management-of-endocrine-disease-regenerative-therapies-in-autoimmune-addison-s-disease-aad
#6
Earn Hui Gan, Simon Hs Pearce
The treatment for autoimmune Addison's disease (AAD) has remained virtually unchanged in the last 60 years. Most patients have symptoms that are relatively well controlled with exogenous steroid replacement but there may be persistent symptoms, recurrent adrenal crisis and poor quality of life, despite good compliance with optimal current treatments. Treatment with conventional exogenous steroid therapy is also associated with premature mortality, increased cardiovascular risk and complications related to excessive steroid replacement...
November 3, 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27806534/association-between-adrenal-hematoma-and-mortality-in-pediatric-multiple-blunt-traumas-an-autopsy-evaluation
#7
Farrokh Taftachi, Leyla Abdolkarimi, Maryam Ameri, Azadeh Memarian, Alireza Behzadi, Hooman Bakhshandeh
Adrenal hematoma is a common hidden catastrophic complication in pediatric victims of multiple blunt traumas. Adrenal hematoma has no obvious symptoms and may not be detected by diagnostic methods such as magnetic resonance imaging, computed tomography scan, and sonography; consequently, this complication may be neglected in children with multiple blunt traumas and cause death through sudden adrenal crisis.The current study was conducted on 55 dead children (<13 y) and 110 matured youths (13-17 y) who died in consequence of multiple blunt traumas, comprising car crashes, fall from heights, and falling debris...
August 4, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27803964/adrenal-crisis-while-on-high-dose-steroid-treatment-what-rheumatologist-should-consider
#8
REVIEW
Döndü Üsküdar Cansu, Güven Barış Cansu, Deniz Arik, Cengiz Korkmaz
Steroid treatment is commonly recommended for autoimmune disorders in rheumatology practice. While adrenal crisis may occur upon existence of an inducing factor in patients with known or unknown adrenal insufficiency as well as in those with a suppressed hypothalamic-pituitary-adrenal (HPA) axis due to chronic steroid use, addisonian crisis rarely develops in patients on supraphysiological doses of steroid and, when emerged, it might be very difficult to recognize. Here, we present a patient who developed adrenal crisis while receiving high-dose methylprednisolone treatment due to retroperitoneal fibrosis and we also discuss possible mechanisms with a brief literature review...
November 1, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27796263/uniparental-isodisomy-of-chromosome-1-unmasking-an-autosomal-recessive-3-beta-hydroxysteroid-dehydrogenase-type-ii-related-congenital-adrenal-hyperplasia
#9
Karin Panzer, Osayame Ekhaguere, Benjamin Darbro, Cook Jennifer, Oleg Shchelochkov
BACKGROUND: Steroid 3-beta hydroxysteroid dehydrogenase type II deficiency is a rare autosomal recessive form of congenital adrenal hyperplasia. We report the genetic basis of 3-beta hydroxysteroid dehydrogenase type II deficiency arising from uniparental isodisomy of chromosome 1. CLINICAL CASE: We describe a term undervirilized male whose newborn screen indicated borderline congenital adrenal hyperplasia. He presented on day of life 7 in salt-wasting adrenal crisis...
October 31, 2016: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/27766109/adrenal-suppression-in-children-treated-with-swallowed-fluticasone-and-oral-viscous-budesonide-for-eosinophilic-esophagitis
#10
Alexandra Ahmet, Eric I Benchimol, Ellen B Goldbloom, Janice L Barkey
BACKGROUND: Adrenal suppression (AS), a glucocorticoid (GC) side effect associated with significant morbidity, is well described related to inhaled corticosteroid therapy for asthma. Swallowed topical glucocorticoid therapy is the main pharmacotherapy treatment for eosinophilic esophagitis (EoE) and therefore children with EoE are potentially at increased risk of AS. METHODS: In this prospective cohort study, we included children and youth <18 years diagnosed with EoE and treated with swallowed fluticasone or oral viscous budesonide for more than 1 month...
2016: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/27759750/pheochromocytoma-presenting-as-a-mimic-of-acute-coronary-syndrome
#11
Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
https://www.readbyqxmd.com/read/27759634/delayed-diagnosis-with-autoimmune-polyglandular-syndrome-type-2-causing-acute-adrenal-crisis-a-case-report
#12
Xiaojing Wang, Fan Ping, Cuijuan Qi, Xinhua Xiao
BACKGROUND: Autoimmune polyglandular syndrome type 2 (APS-2), also known as Schmidt's syndrome, is an uncommon disorder characterized by the coexistence of Addison's disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. Addison's disease as the obligatory component is potentially life-threatening. Unfortunately, the delayed diagnosis of Addison's disease is common owing to its rarity and the nonspecific clinical manifestation. METHODS: Here we reported a case of 38-year-old female patient who presented with 2 years' history of Hashimoto's thyroiditis and received levothyroxine replacement...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27749582/nfkb2-mutation-in-common-variable-immunodeficiency-and-isolated-adrenocorticotropic-hormone-deficiency-a-case-report-and-review-of-literature
#13
Chuan Shi, Fen Wang, Anli Tong, Xiao-Qian Zhang, Hong-Mei Song, Zheng-Yin Liu, Wei Lyu, Yue-Hua Liu, Wei-Bo Xia
BACKGROUND: Common variable immunodeficiency (CVID) with central adrenal insufficiency is a recently defined clinical syndrome caused by mutations in the nuclear factor kappa-B subunit 2 (NFKB2) gene. We present the first case of NFKB2 mutation in Asian population. METHODS AND RESULTS: An 18-year-old Chinese female with adrenocorticotropic hormone (ACTH) deficiency was admitted due to adrenal crisis and pneumonia. She had a history of recurrent respiratory infections since childhood and ectodermal abnormalities were noted during physical examination...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27745849/black-and-white-autoimmunity-early-warning-colours-of-adrenal-crisis
#14
Thomas Cuny, Marc Klein
No abstract text is available yet for this article.
October 10, 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/27734706/-congenital-adrenal-hyperplasia-in-adults
#15
Jana Vrbíková
Congenital adrenal hyperplasia is a life-long disease requiring an integrated therapy. It may negatively influence the quality of life. In childhood, the main problems of the care of these patients involve sex determination and ensuring optimum growth and puberty. The therapeutic goals for adults are the prevention of Addisonian crisis and ensuring the best possible quality of life, including fertility.Key words: androgens - cardiovascular risk - congenital adrenal hyperplasia - bone density - testicular rest tumors...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27729064/histopathological-analysis-of-spontaneous-large-necrosis-of-adrenal-pheochromocytoma-manifested-as-acute-attacks-of-alternating-hypertension-and-hypotension-a-case-report
#16
Nobumasa Ohara, Yasuyuki Uemura, Naomi Mezaki, Keita Kimura, Masanori Kaneko, Hirohiko Kuwano, Katsuya Ebe, Toshio Fujita, Takeshi Komeyama, Hiroyuki Usuda, Yuto Yamazaki, Takashi Maekawa, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi
BACKGROUND: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear. CASE PRESENTATION: A 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains...
October 12, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27723273/frequency-and-duration-of-adrenal-suppression-following-glucocorticoid-therapy-in-children-with-rheumatic-diseases
#17
Alexandra Ahmet, Vincent Brienza, Audrey Tran, Julie Lemieux, Mary Aglipay, Nick Barrowman, Ciaran Duffy, Johannes Roth, Roman Jurencak
OBJECTIVE: Adrenal suppression (AS), a glucocorticoid (GC) side effect with potentially significant morbidity, is poorly understood. The purpose of our study was to determine frequency, duration and predictors of AS following a gradual taper of GC in children with rheumatologic conditions. METHODS: Prospective observational cohort study was conducted. All patients ≤16 years ready to discontinue GC after >4weeks of therapy were included. Morning cortisol was tested 4 weeks after GC taper to physiologic doses and then repeatedly until normalization...
October 9, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27698338/alacrima-as-a-harbinger-of-adrenal-insufficiency-in-a-child-with-allgrove-aaa-syndrome
#18
Brande Brown, Levon Agdere, Cornelia Muntean, Karen David
BACKGROUND Allgrove syndrome, or triple "A" syndrome (3A syndrome), is a rare autosomal recessive syndrome with variable phenotype, and an estimated prevalence of 1 per 1,000,000 individuals. Patients usually display the triad of achalasia, alacrima, and adrenocorticotropin (ACTH) insensitive adrenal insufficiency, though the presentation is inconsistent. CASE REPORT Here, the authors report a case of Allgrove syndrome in a pediatric patient with delayed diagnosis in order to raise awareness of this potentially fatal disease as a differential diagnosis of alacrima...
October 4, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27688679/pheochromocytoma-presenting-as-an-acute-coronary-syndrome-complicated-by-acute-heart-failure-the-challenge-of-a-great-mimic
#19
Giuseppe Damiano Sanna, Giuseppe Talanas, Giuseppina Fiore, Antonella Canu, Pierfranco Terrosu
Pheochromocytoma is a rare neuroendocrine tumor with a highly variable clinical presentation. The serious and potentially lethal cardiovascular complications of these tumors are related to the effects of secreted catecholamines. We describe a case of a 50-year-old woman urgently admitted to our hospital because of symptoms and clinical and instrumental findings consistent with an acute coronary syndrome complicated by acute heart failure. Urgent coronary angiography showed normal coronary arteries. During her hospital stay, the recurrence of episodes characterized by a sudden increase in blood pressure, cold sweating, and nausea allowed us to hypothesize a pheochromocytoma...
October 2016: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/27631672/glucocorticoid-replacement-regimens-in-chronic-adrenal-insufficiency-a-systematic-review-and-meta-analysis
#20
Alaa Al Nofal, Irina Bancos, Khalid Benkhadra, Naykky Maruquel Singh Ospina, Asma Javed, Ekta Kapoor, Kalpana Muthusamy, Juan P Brito, Adina F Turcu, Zhen Wang, Larry Prokop, Dana Z Erickson, Aida N Lteif, Neena Natt, Mohammad Hassan Murad
INTRODUCTION: Various glucocorticoid regimens have been used in the treatment of patients with adrenal insufficiency, yet the differences between such regimens on health outcomes are unclear. OBJECTIVE: We performed a systematic review and meta-analysis to compare the effect of various glucocorticoid regimens on quality of life, bone density, incidence of adrenal crisis and death. In pediatric studies, we searched for final adult height. METHODS: We searched 6 databases through July 2016...
September 15, 2016: Endocrine Practice
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