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Hypocortisolism

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https://www.readbyqxmd.com/read/28237543/hyper-and-hypocortisolism-in-bipolar-disorder-a-beneficial-influence-of-lithium-on-the-hpa-axis
#1
Martin Maripuu, Mikael Wikgren, Pontus Karling, Rolf Adolfsson, Karl-Fredrik Norrback
BACKGROUND: A hyperactive hypothalamic-pituitary-adrenal axis (HPA-axis) is a well-known phenomenon in bipolar disorder (BD). However, hypocortisolism has also been described and found associated with depression, low quality of life and cardiovascular risk factors in BD patients. Although the pathophysiology related to hypocortisolism in BD is largely unknown, hypocortisolism is associated with chronic stress exposure and after inducing an initial rise in cortisol long-term stress may result in a transition to hypocortisolism...
February 20, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28167370/maltreatment-and-diurnal-cortisol-regulation-a-meta-analysis
#2
Kristin Bernard, Allison Frost, Charles B Bennett, Oliver Lindhiem
Childhood maltreatment leads to a host of negative physical and mental health outcomes, with cortisol dysregulation implicated as a possible mechanism. Given inconsistencies across in the literature regarding the direction and magnitude of the association between maltreatment and diurnal cortisol regulation, the current meta-analysis of 27 studies aimed to examine the association between maltreatment and at least one of 3 indicators of diurnal cortisol regulation: wake-up cortisol levels, the cortisol awakening response (CAR), and/or the diurnal cortisol slope...
January 10, 2017: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/28104521/endoscopic-versus-microscopic-transsphenoidal-surgery-in-the-treatment-of-pituitary-adenoma-a-systematic-review-and-meta-analysis
#3
Aijun Li, Weisheng Liu, Peicheng Cao, Yuehua Zheng, Zhenfu Bu, Tao Zhou
BACKGROUND: Inconsistent findings have been reported regarding the efficacy and safety of endoscopic and microscopic transsphenoidal surgery for pituitary adenoma. This study aimed to assess the benefits and shortcomings of these surgical methods in patients with pituitary adenoma. METHODS: The electronic databases PubMed, EmBase, and the Cochrane Library were systematically searched, as well as proceedings of major meetings. Eligible studies with retrospective or prospective design that evaluated endoscopic versus microscopic methods in patients with pituitary adenoma were included...
January 16, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28098040/-hypocortisolism-associated-with-nephrotic-syndrome
#4
R H Westerdijk, B H R Wolffenbuttel, I P Kema, R S M E Wouters
BACKGROUND: With nephrotic syndrome, cortisol levels may be falsely lowered by loss of cortisol-binding globulin (CBG) in the urine. An incorrect diagnosis of adrenal insufficiency could therefore be made. CASE DESCRIPTION: We describe the case of a 52-year-old female with nephrotic syndrome that did not sufficiently respond to medication. Treatment management was complicated by symptomatic hypotension, which was thought to be caused by adrenal insufficiency. The cortisol levels in the blood were low and a clinical cause could not be identified...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28009336/hypocortisolism-and-preterm-birth
#5
S D Karakash, N Tschankoshvili, J Weedon, R M Schwartz, C Kirschbaum, H Minkoff
OBJECTIVE: We sought to determine whether hypocortisolism is associated with preterm birth, using hair cortisol as a marker of long term hypothalamic-pituitary-adrenal axis activity. STUDY DESIGN: In a prospective, matched, case-control study, 29 women who had a preterm birth at 24-36w5d gestation were compared to 29 women who delivered at term, matched for maternal age, gestational age, and ethnicity. Cases' samples were collected within 72 h of preterm birth and controls at the same gestational age as the corresponding case...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27855238/adrenal-crisis-secondary-to-bilateral-adrenal-haemorrhage-after-hemicolectomy
#6
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/27810852/pituitary-apoplexy-masquerading-as-functional-decline-in-an-older-person
#7
Nydia Camelia Rais, Reshma Aziz Merchant, Santhosh Kumar Seetharaman
We report the case of an older lady who was admitted to a tertiary teaching hospital with sub-acute functional decline of two months' duration, which was initially attributed to a concomitant urinary tract infection. Further investigations, however, revealed the diagnosis of pituitary apoplexy with central hypocortisolism. Subsequent treatment with physiological doses of steroids improved patient's function and overall well-being. This report adds to the sparse literature on pituitary apoplexy in the older adults and emphasizes the non-specific presentation of this clinical syndrome...
November 3, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27803375/pre-trilostane-and-three-hour-post-trilostane-cortisol-to-monitor-trilostane-therapy-in-dogs
#8
L Macfarlane, T Parkin, I Ramsey
It is recommended that trilostane therapy of canine hyperadrenocorticism is monitored using an ACTH stimulation test, however this has never been validated. Three cortisol concentrations (pre-trilostane, 3-hour posttrilostane and 1-hour post-ACTH stimulation) were compared to a clinical score obtained from an owner questionnaire. There were 110 sets of 3 cortisol measurements and questionnaires obtained from 67 trilostane treated dogs. Questionnaire results were used to classify each dog as well or unwell. Well dogs were then categorised as having excellent, moderate or poor hyperadrenocorticism control, using thresholds produced by 14 independent veterinarians...
December 10, 2016: Veterinary Record
https://www.readbyqxmd.com/read/27754735/acute-hormonal-findings-after-aneurysmal-subarachnoid-hemorrhage-report-from-a-single-center
#9
Riikka S K Takala, Riku Kiviranta, Klaus T Olkkola, Tero Vahlberg, Dan Laukka, Anna Kotkansalo, Melissa Rahi, Matti Sankinen, Jussi Posti, Ari Katila, Jaakko Rinne
PURPOSE: The aim was to assess anterior pituitary hormone levels during the acute phase of aneurysmal subarachnoid hemorrhage (aSAH) and analyze the possible association with the clinical condition and outcome. MATERIAL AND METHODS: Forty patients with aSAH whose aneurysm was secured by endovascular coiling were enrolled. Basal secretions of cortisol, testosterone, luteinizing hormone (LH), prolactin (PRL), and sex hormone binding globulin (SHBG) levels were measured up to 14 days after the incident...
October 18, 2016: Endocrine Research
https://www.readbyqxmd.com/read/27704605/granulomatous-and-lymphocytic-hypophysitis-are-they-immunologically-distinct
#10
COMPARATIVE STUDY
Shilpa Rao, Anita Mahadevan, Tanmoy Maiti, Manish Ranjan, Shivayogi Durgad Shwetha, Arimappamagan Arivazhagan, Jitender Saini
Hypophysitis includes three histopathologically distinct entities - granulomatous, lymphocytic and xanthomatous forms. Etiopathogenesis and the immunological differences among these is not well characterized. This study aims to explore the immunopathogenesis of granulomatous and lymphocytic forms of hypophysitis. Demographic, clinical, endocrine function and radiological features of 33 histologically confirmed cases of hypophysitis were reviewed. Immunophenotyping of inflammatory component was performed in 13/33 cases...
December 2016: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/27690690/dissociation-of-molecular-and-endocrine-circadian-rhythms-in-male-mice-lacking-bmal1-in-the-adrenal-cortex
#11
Rebecca Dumbell, Alexei Leliavski, Olga Matveeva, Christopher Blaum, Anthony H Tsang, Henrik Oster
The circadian rhythm of glucocorticoids affects diverse physiological systems, including stress responses and the coordination of rhythmic functions in peripheral and central tissues. Circadian clocks are considered to be important coordinators of glucocorticoid release and loss of the core clock component Brain and muscle Arnt-like protein-1 leads to ablation of behavioral and physiological rhythms, hypocortisolism, impaired ACTH, and behavioral stress responses. Transplantation and conditional clock gene knock-down studies in mice suggest an important role of local adrenocortical clock function in this context...
November 2016: Endocrinology
https://www.readbyqxmd.com/read/27605910/a-window-on-the-study-of-aversive-instrumental-learning-strains-performance-neuroendocrine-and-immunologic-systems
#12
Caroline C de Oliveira, Flávia V Gouveia, Marina C de Castro, Mayra A Kuroki, Lennon C T Dos Santos, Erich T Fonoff, Manoel J Teixeira, José P Otoch, Raquel C R Martinez
The avoidance response is present in pathological anxiety and interferes with normal daily functions. The aim of this article is to shed light on performance markers of active avoidance (AA) using two different rat strains, Sprague-Dawley (SD) and Wistar. Specifically, good and poor performers were evaluated regarding anxiety traits exhibited in the elevated plus maze (EPM) and corticosterone levels and motor activity in the open field test. In addition, the plasma levels of Interleukin-6 (IL-6), Interleukin-1Beta (IL-1beta), Nerve Growth Factor Beta (NGF-beta), Tumor Necrosis Factor-Alpha (TNF-alpha) and cytokine-induced neutrophil chemoattractant 1 (CINC-1) were compared in the good and poor performers to better understand the role of the immunologic system in aversive learning...
2016: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/27507414/-psychiatric-manifestations-due-to-abnormal-glucocorticoid-levels
#13
K M Lommerse, F N Dijkstra, A J P Boeke, E M W Eekhoff, G E Jacobs
This clinical case presentation describes the disease trajectory in two patients who presented with psychiatric symptoms as a result of abnormal serum glucocorticoid levels. One case involves a 58-year-old man with hypercortisolism, the other case concerns a 55-year-old woman with hypocortisolism. In both cases there was a considerable diagnostic delay in recognizing the underlying adrenal gland pathology. Abnormal glucocorticoid levels, caused by endocrine disorders, often results in psychiatric symptoms. Delay in diagnosis may have adverse consequences...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27500004/xanthomatous-hypophysitis-associated-with-autoimmune-disease-in-an-elderly-patient-a-rare-case-report
#14
Masahiro Oishi, Yasuhiko Hayashi, Issei Fukui, Daisuke Kita, Tadao Miyamori, Mitsutoshi Nakada
BACKGROUND: Xanthomatous hypophysitis (XH) is an extremely rare form of primary hypophysitis characterized by infiltration of the pituitary gland by mixed types of inflammatory cells, including foamy cells, plasma cells, and small mature lymphocytes. XH manifests as varying degrees of hypopituitarism. Although several previous reports have denied a possible contribution of autoimmune mechanism, the exact pathogenesis of XH remains unclear. CASE DESCRIPTION: We describe the case of a 72-year-old woman with a history of rheumatoid arthritis and Sjögren's syndrome who presented with panhypopituitarism and diabetes insipidus...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27468060/proopiomelanocortin-deficiency-treated-with-a-melanocortin-4-receptor-agonist
#15
Peter Kühnen, Karine Clément, Susanna Wiegand, Oliver Blankenstein, Keith Gottesdiener, Lea L Martini, Knut Mai, Ulrike Blume-Peytavi, Annette Grüters, Heiko Krude
Patients with rare defects in the gene encoding proopiomelanocortin (POMC) have extreme early-onset obesity, hyperphagia, hypopigmentation, and hypocortisolism, resulting from the lack of the proopiomelanocortin-derived peptides melanocyte-stimulating hormone and corticotropin. In such patients, adrenal insufficiency must be treated with hydrocortisone early in life. No effective pharmacologic treatments have been available for the hyperphagia and obesity that characterize the condition. In this investigator-initiated, open-label study, two patients with proopiomelanocortin deficiency were treated with setmelanotide, a new melanocortin-4 receptor agonist...
July 21, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27367307/relative-hypocortisolism-is-associated-with-obesity-and-the-metabolic-syndrome-in-recurrent-affective-disorders
#16
Martin Maripuu, Mikael Wikgren, Pontus Karling, Rolf Adolfsson, Karl-Fredrik Norrback
BACKGROUND: Cardiovascular disease (CVD) is one of the main causes of excess deaths in affective disorders. Affective disorders are associated with increased frequencies of CVD risk-factors such as obesity, dyslipidemia, and metabolic syndrome. Stress-induced chronic cortisol excess has been suggested to promote obesity and metabolic syndrome. Chronic stress with frequent or persisting hypothalamic-pituitary-adrenal-axis (HPA-axis) hyperactivity may, over time, lead to a state of low HPA-axis activity, also denoted hypocortisolism...
November 1, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27355580/pituitary-antibodies-in-an-adolescent-with-secondary-adrenal-insufficiency-and-turner-syndrome
#17
Allison J Pollock, Tasa S Seibert, Cristiana Salvatori, Patrizio Caturegli, David B Allen
BACKGROUND/AIMS: Autoimmune hypophysitis (AH) is a rare inflammatory disease of the pituitary gland causing varying degrees of hypopituitarism and/or sellar compression. Cranial MRI remains the best noninvasive tool to diagnose AH, although a diagnosis of certainty requires pituitary biopsy. The objective of this study was to assess the utility of detecting pituitary antibodies for the diagnosis of AH. METHODS: A 15-year-old female with Turner syndrome (TS), hypothyroidism, and ovarian failure presented acutely with hypocortisolism...
June 30, 2016: Hormone Research in Pædiatrics
https://www.readbyqxmd.com/read/27341314/new-diagnostic-criteria-for-subclinical-hypercortisolism-using-postsurgical-hypocortisolism-the-co-work-of-adrenal-research-study
#18
Seung Hun Lee, Kee-Ho Song, Jinju Kim, Sooyoun Park, Seong Hee Ahn, Hyeonmok Kim, Yoon Young Cho, Sunghwan Suh, Beom-Jun Kim, Jae Hyeon Kim, Jung-Min Koh
OBJECTIVE: There is no consensus on the biochemical diagnostic criteria for subclinical hypercortisolism (SH). Using parameters related to the hypothalamic-pituitary-adrenal axis, we aimed to develop a diagnostic model of SH for predicting postsurgical hypocortisolism and metabolic complications. DESIGN: Prospective and cross-sectional, observational, multicentre study in Korea. METHODS: After exclusion of overt Cushing's syndrome, adrenal incidentaloma (AI) patients who underwent unilateral adrenalectomy (n = 99) and AI patients (n = 843) were included...
January 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/27265913/ipilimumab-induced-autoimmune-hypophysitis-diagnostic-and-management-challenges-illustrated-by-a-clinical-case
#19
Pedro Marques, Ashley Grossman
Autoimmune hypophysitis has been described in patients on ipilimumab, a humanised monoclonal antibody increasingly used in the treatment of metastatic melanoma. A 67-year-old woman presented with severe fatigue, nausea and headaches following the third dose of ipilimumab, which was being given as treatment for metastatic melanoma (four administrations at three-weekly intervals). Hormonal evaluation confirmed hypocortisolism, with low gonadotrophins and a low thyroid-stimulating hormone with normal free T4 (she was on long-standing levothyroxine because of past surgery for a multinodular goitre)...
November 2015: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27262345/dysfunctional-stress-responses-in-chronic-pain
#20
REVIEW
Alain Woda, Pascale Picard, Frédéric Dutheil
Many dysfunctional and chronic pain conditions overlap. This review describes the different modes of chronic deregulation of the adaptive response to stress which may be a common factor for these conditions. Several types of dysfunction can be identified within the hypothalamo-pituitary-adrenal axis: basal hypercortisolism, hyper-reactivity, basal hypocortisolism and hypo-reactivity. Neuroactive steroid synthesis is another component of the adaptive response to stress. Dehydroepiandrosterone (DHEA) and its sulfated form DHEA-S, and progesterone and its derivatives are synthetized in cutaneous, nervous, and adipose cells...
September 2016: Psychoneuroendocrinology
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