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Hypocortisolism

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https://www.readbyqxmd.com/read/28609197/the-glu331del-mutation-in-the-cyp17a1-gene-causes-atypical-congenital-adrenal-hyperplasia-in-a-46-xx-female
#1
Giulia Lanzolla, Giuseppe Vancieri, Silvia Lanciotti, Federica Sangiuolo, Elisa Menegatti, Luca Federici, Costanzo Moretti, Francesco Brancati
17α-Hydroxylase deficiency is an uncommon type of congenital adrenal hyperplasia (CAH) caused by mutations in the CYP17A1 gene encoding both 17α-hydroxylase and 17,20-lyase, essential for sex steroids production. Main clinical features include lack of pubertal development, hypertension, and hypokalemia. We report the first case of a 46,XX female homozygote for the p.Glu331del mutation in the CYP17A1 gene showing an atypical clinical presentation. She was evaluated the first time for primary amenorrhea and delayed puberty in the presence of low levels of androgens, 17β-estradiol, serum cortisol, and high levels of progesterone and gonadotropins...
June 13, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28542739/afternoon-cortisol-provides-a-link-between-self-regulated-anger-and-peer-reported-aggression-in-typically-developing-children-in-the-school-context
#2
Eva Oberle, Kaitlyn McLachlan, Nicole L A Catherine, Ursula Brain, Kimberly A Schonert-Reichl, Joanne Weinberg, Tim F Oberlander
Aggression jeopardizes positive development in children and predicts social and academic maladjustment in school. The present study determined the relationships among anger dysregulation (a marker of emotion regulation), cortisol activity (a biomarker of stress), and peer-nominated aggression in typically developing children in their everyday classroom setting (N = 151, Mean age = 10.86, SD =.74). Salivary cortisol was collected at 09:15, 11:45, and 14:45 hr across 4 consecutive days. Children provided self-reports of anger regulation; peers reported proactive and reactive aggressive behaviors...
May 22, 2017: Developmental Psychobiology
https://www.readbyqxmd.com/read/28537422/mindfulness-based-stress-reduction-program-on-chronic-low-back-pain-a-study-investigating-the-impact-on-endocrine-physical-and-psychologic-functioning
#3
Rita B Ardito, Piero Stanley Pirro, Tania S Re, Isabella Bonapace, Valentino Menardo, Emanuela Bruno, Laura Gianotti
OBJECTIVE: To explore the impact of the Mindfulness-Based Stress Reduction (MBSR) program on pain severity and endocrine, physical, and psychologic functioning in patients with chronic low-back pain (CLBP). METHODS: A total of 28 participants were enrolled in the study between January and June 2014; 17 participants were sequentially sampled for an 8-week MBSR program, and 11 were placed on a waitlist control group. Pain severity, quality of life (QOL), global psychologic functioning, and depression were assessed at baseline, at the end of treatment, and 4-5 months post-treatment for both groups...
May 24, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28469865/a-case-of-congestive-heart-failure-caused-by-secondary-hypocortisolism
#4
Fukuko Nagura, Satoshi Kodera, Naoki Hayakawa, Syunichi Kushida, Junji Kanda
Congestive heart failure caused by secondary hypocortisolism is rare but clinically significant, because its appropriate treatment is effective. Severe hyponatremia with indefinite complaint resembling depression or persisting fever despite antibiotics may be important for establishing this diagnosis.
May 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28267148/elevated-hair-cortisol-concentrations-in-recently-fled-asylum-seekers-in-comparison-to-permanently-settled-immigrants-and-non-immigrants
#5
R Mewes, H Reich, N Skoluda, F Seele, U M Nater
Recently fled asylum seekers generally live in stressful conditions. Their residency status is mostly insecure and, similar to other immigrants, they experience stress due to acculturation. Moreover, they often suffer from traumatization and posttraumatic stress disorder (PTSD). All of these factors can result in chronic maladaptive biological stress responses in terms of hyper- or hypocortisolism and, ultimately, illness. We believe the current study is the first to compare hair cortisol concentration (HCC) of recently fled asylum seekers with PTSD to those without PTSD, and to compare HCC of asylum seekers to HCC of permanently settled immigrants and non-immigrant individuals...
March 7, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28237543/hyper-and-hypocortisolism-in-bipolar-disorder-a-beneficial-influence-of-lithium-on-the-hpa-axis
#6
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
#7
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
#8
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 a retrospective or prospective design that evaluated endoscopic versus microscopic methods in patients with pituitary adenoma were included...
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28098040/-hypocortisolism-associated-with-nephrotic-syndrome
#9
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
#10
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
#11
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
#12
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...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/27803375/pre-trilostane-and-three-hour-post-trilostane-cortisol-to-monitor-trilostane-therapy-in-dogs
#13
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
#14
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...
May 2017: Endocrine Research
https://www.readbyqxmd.com/read/27704605/granulomatous-and-lymphocytic-hypophysitis-are-they-immunologically-distinct
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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