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Adrenal crisis

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https://www.readbyqxmd.com/read/29147570/management-of-an-acute-catecholamine-induced-cardiomyopathy-and-circulatory-collapse-a-multidisciplinary-approach
#1
R T Casey, B G Challis, D Pitfield, R M Mahroof, N Jamieson, C J Bhagra, A Vuylsteke, S J Pettit, K C Chatterjee
A phaeochromocytoma (PC) is a rare, catecholamine-secreting neuroendocrine tumour arising from the adrenal medulla. Presenting symptoms of this rare tumour are highly variable but life-threatening multiorgan dysfunction can occur secondary to catecholamine-induced hypertension or hypotension and subsequent cardiovascular collapse. High levels of circulating catecholamines can induce an acute stress cardiomyopathy, also known as Takotsubo cardiomyopathy. Recent studies have focused on early diagnosis and estimation of the prevalence of acute stress cardiomyopathy in patients with PC, but very little is reported about management of these complex cases...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29118987/massive-adrenal-incidentalomas-and-late-diagnosis-of-congenital-adrenal-hyperplasia-in-prostate-cancer
#2
Xin Feng, Gregory Kline
In a 61-year-old Caucasian male with prostate cancer, leuprolide and bicalutamide failed to suppress the androgens. He presented to endocrinology with persistently normal testosterone and incidental massive (up to 18 cm) bilateral adrenal myelolipomas on CT scan. Blood test did not reveal metanephrine excess. The patient was noted to have short stature (151 cm) and primary infertility. Elementary school photographs demonstrated precocious puberty. Physical examination revealed palpable abdominal (adrenal) masses...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#3
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/29109870/acute-onset-panhypopituitarism-nearly-missed-by-initial-cosyntropin-testing
#4
Claudine A Blum, Daniel Schneeberger, Matthias Lang, Janko Rakic, Marc Philippe Michot, Beat Müller
Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome. Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Diabetes insipidus was diagnosed due to polyuria and treated with 4 mg desmopressin...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29098731/clues-for-early-detection-of-autoimmune-addison-s-disease-myths-and-realities
#5
Å B Saevik, A-K Åkerman, K Grønning, I Nermoen, S F Valland, T E Finnes, M Isaksson, P Dahlqvist, R Bergthorsdottir, O Ekwall, J Skov, B G Nedrebø, A-L Hulting, J Wahlberg, J Svartberg, C Höybye, I H Bleskestad, A P Jørgensen, O Kämpe, M Øksnes, S Bensing, E S Husebye
BACKGROUND: Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce. OBJECTIVE: Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. MATERIAL AND METHODS: A multicentre retrospective study including 272 patients diagnosed with AAD at hospitals in Norway and Sweden during 1978-2016...
November 3, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29089364/primary-adrenal-insufficiency-in-adult-population-a-portuguese-multicentre-study-by-the-adrenal-tumours-study-group
#6
Lia Ferreira, Joao Silva, Susana Garrido, Carlos Bello, Diana Oliveira, Hélder Simões, Isabel Paiva, Joana Guimarães, Marta Ferreira, Maria Teresa Pereira, Rita Bettencourt-Silva, Ana Filipa Martins, Tiago Silva, Vera Fernandes, Maria Ferreira
INTRODUCTION: Primary adrenal insufficiency (PAI) is a rare but severe and potentially life-threatening condition. No previous studies have characterized Portuguese patients with PAI. AIMS: To characterize the clinical presentation, diagnostic workup, treatment and follow-up of Portuguese patients with confirmed PAI. METHODS: This multicentre retrospective study examined PAI patients in 12 Portuguese hospitals. RESULTS: We investigated 278 patients with PAI (55...
October 31, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/29075801/understanding-adrenal-crisis
#7
Karin Amrein, Gennaro Martucci, Stefanie Hahner
No abstract text is available yet for this article.
October 26, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29073619/sodium-chloride-supplementation-is-not-routinely-performed-in-the-majority-of-german-and-austrian-infants-with-classic-salt-wasting-congenital-adrenal-hyperplasia-and-has-no-effect-on-linear-growth-and-hydrocortisone-or-fludrocortisone-dose
#8
Walter Bonfig, Friedhelm Roehl, Stefan Riedl, Jürgen Brämswig, Annette Richter-Unruh, Susanne Fricke-Otto, Angela Hübner, Markus Bettendorf, Eckhard Schönau, Helmut Dörr, Reinhard W Holl, Klaus Mohnike
INTRODUCTION: Sodium chloride supplementation in salt-wasting congenital adrenal hyperplasia (CAH) is generally recommended in infants, but its implementation in routine care is very heterogeneous. OBJECTIVE: To evaluate oral sodium chloride supplementation, growth, and hydrocortisone and fludrocortisone dose in infants with salt-wasting CAH due to 21-hydroxylase in 311 infants from the AQUAPE CAH database. RESULTS: Of 358 patients with classic CAH born between 1999 and 2015, 311 patients had salt-wasting CAH (133 females, 178 males)...
October 26, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/29062584/adrenal-insufficiency-in-pediatric-eosinophilic-esophagitis-patients-treated-with-swallowed-topical-steroids
#9
Stephanie Hsu, Colleen Wood, Zhaoxing Pan, Haseeb Rahat, Philip Zeitler, David Fleischer, Calies Menard-Katcher, Glenn T Furuta, Dan Atkins
Swallowed topical steroids (STS) are the only effective pharmacological therapy for eosinophilic esophagitis (EoE). Thus far, studies of small populations of EoE patients have reported conflicting results in relation to adrenal insufficiency (AI). We sought to measure AI in a clinical setting in children taking STS for EoE. We performed a quality improvement study of pediatric EoE patients seen in a multidisciplinary clinic, who were treated with STS for at least 3 months. Two hundred twenty-five patients completed questionnaires to assess for signs of AI...
September 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29060958/a-case-of-hypertensive-crisis-without-a-surge-in-adrenal-hormones-after-radiofrequency-ablation-as-a-treatment-for-primary-hepatocellular-carcinoma
#10
Kyung Jin Lee, Soo Hyung Ryu
Radiofrequency ablation (RFA) is a minimally invasive procedure that has been considered as a relatively safe treatment for patients with small hepatocellular carcinoma (HCC). However, RFA has been shown to be associated with complications including mechanical and thermal damage. A 74-year-old man with hepatitis C virus-associated HCC was admitted to our hospital. Abdominal computed tomography revealed two lobulated-HCC in segments 4 and 5. He had no medical history of hypertension and cardiac disease. During RFA, blood pressure was elevated to 200/140 mmHg...
October 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29056949/life-threatening-stress-induced-cardiomyopathy-combined-with-acute-adrenal-crisis
#11
Ae-Young Her, Yong Hoon Kim
No abstract text is available yet for this article.
June 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28966452/adrenal-crisis-and-autoimmune-polyglandular-syndromes
#12
Zachary K Freeland, Richard Lueking, Ginger Tsai-Nguyen, Thoris Pan, Adan Mora
We report a 67-year-old woman who presented with adrenal crisis as a manifestation of autoimmune polyglandular syndrome 2, a polygenic disorder characterized by concurrent primary adrenal insufficiency and either autoimmune thyroid disease or type 1 diabetes mellitus.
October 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28954735/bcli-polymorphism-of-the-glucocorticoid-receptor-and-adrenal-crisis-in-primary-adrenal-insufficiency
#13
Kathrin Zopf, Kathrin R Frey, Tina Kienitz, Manfred Ventz, Britta Bauer, Marcus Quinkler
CONTEXT: Patients with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) are at a high risk of adrenal crisis (AC). Glucocorticoid sensitivity is at least partially genetically determined by polymorphisms of the glucocorticoid receptor (GR). OBJECTIVES: To determine if a number of intercurrent illnesses and AC are associated with the GR gene polymorphism BclI in patients with PAI and CAH. DESIGN AND PATIENTS: This prospective, longitudinal study over 37...
November 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28937294/hypertensive-crisis-in-pregnancy-due-to-a-metamorphosing-pheochromocytoma-with-postdelivery-cushing-s-syndrome
#14
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/28933807/recognizing-and-managing-adrenal-disorders-in-the-emergency-department-digest
#15
Amy Cutright, Stephen Ducey, Claudia L Barthold, Jeremy Kim
Primary and secondary adrenal insufficiency are underrecognized conditions among emergency department patients, affecting an estimated 10% to 20% of critically ill patients. The signs and symptoms of cortisol deficit can be nonspecific and wide-ranging, and identification and swift treatment with stress-dosing of hydrocortisone is vital to avoid life-threatening adrenal crisis. Laboratory evaluation focuses on identification of electrolyte abnormalities typical of adrenal insufficiency, and while additional testing may depend on the type and severity of symptoms, it should not delay corticosteroid replacement...
September 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28924487/a-novel-stop-mutation-p-gln22-of-dax1-nr0b1-results-in-late-onset-x-linked-adrenal-hypoplasia-congenita
#16
Judith Gerards, Michael M Ritter, Elke Kaminsky, Andreas Gal, Wolfgang Hoeppner, Marcus Quinkler
DAX1 (NR0B1) is an orphan nuclear receptor, which plays an important role in development and function of the adrenal glands and gonads. Mutations in DAX1 cause X-linked adrenal hypoplasia congenita (X-linked AHC), which is characterized by adrenal insufficiency (AI) and hypogonadotropic hypogonadism (HHG). Affected boys present with adrenal failure usually in childhood and, later in life, with delayed puberty. However, patients with a late-onset form of X-linked AHC have also been described in the past years...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28919626/addison-s-disease-a-diagnostic-dilemma
#17
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/28898882/hospitalisation-in-children-with-adrenal-insufficiency-and-hypopituitarism-is-there-a-differential-burden-between-boys-and-girls-and-between-age-groups
#18
R Louise Rushworth, Georgina L Chrisp, Benjamin Dean, Henrik Falhammar, David J Torpy
BACKGROUND/AIMS: To determine the burden of hospitalisation in children with adrenal insufficiency (AI)/hypopituitarism in Australia. METHODS: A retrospective study of Australian hospitalisation data. All admissions between 2001 and 2014 for patients aged 0-19 years with a principal diagnosis of AI/hypopituitarism were included. Denominator populations were extracted from national statistics datasets. RESULTS: There were 3,779 admissions for treatment of AI/hypopituitarism in patients aged 0-19 years, corresponding to an average admission rate of 48...
September 12, 2017: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/28893233/clinical-characteristics-of-adrenal-crisis-in-adult-population-with-and-without-predisposing-chronic-adrenal-insufficiency-a-retrospective-cohort-study
#19
Masahiro Iwasaku, Maki Shinzawa, Shiro Tanaka, Kimihiko Kimachi, Koji Kawakami
BACKGROUND: Adrenal crisis (AC) occurs in various clinical conditions but previous epidemiological studies in AC are limited to chronic adrenal insufficiency (AI) and sepsis. The aim of this study was to investigate characteristics of AC patients, including predisposing diseases and to describe candidate risk factors for AC such as comorbidities and glucocorticoid (GC) therapy. METHODS: We conducted a retrospective cohort study using a claims database on 7.4 million patients from 145 acute care hospitals between January 1, 2003 and April 30, 2014...
September 11, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28870780/mutational-analysis-of-rare-subtypes-of-congenital-adrenal-hyperplasia-in-a-highly-inbred-population
#20
Meshael M Alswailem, Ohoud S Alzahrani, Doha S Alhomaidah, Rahma Alasmari, Ebtesam Qasem, Avaniyapuram Kannan Murugan, Afaf Alsagheir, Imad Brema, Bassam Ben Abbas, Mohammed Almehthel, Ali Almeqbali, Ali S Alzahrani
CONTEXT: Apart from 21 Hydroxylase deficiency, other subtypes of congenital adrenal hyperplasia (CAH) are rare. We studied the clinical features and molecular genetics of a relatively large series of patients with CYP17A1, HSD3β2 and StAR deficiencies. PATIENTS AND METHODS: We studied 21 patients including 7 patients with CYP17A1, 10 patients with HSD3β2 and 4 patients with StAR deficiencies. For mutation detection, we isolated DNA from peripheral leucocytes, amplified genes of interest using polymerase chain reaction and directly sequenced the amplicons using Dideoxy Chain Termination method...
September 6, 2017: Molecular and Cellular Endocrinology
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