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https://www.readbyqxmd.com/read/28093870/acute-management-of-autoimmune-toxicity-in-cancer-patients-on-immunotherapy-common-toxicities-and-the-approach-for-the-emergency-physician
#1
Anna J Lomax, Catriona McNeil
When a patient receiving anti-cancer treatment presents acutely unwell, an understanding of associated side effects of their therapy is critical. This review will discuss the approach to patients receiving anti-cancer treatment with immunotherapy presenting with autoimmune toxicities in the emergency setting. These toxicities are commonly referred to as immune-related adverse events (irAE). IrAE might consist of, but are not limited to, dermatologic, gastrointestinal (diarrhoea, colitis), hepatic, endocrine (thyroid dysfunction, hypophysitis, adrenal crisis), renal, ocular and pulmonary toxicity...
January 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28088216/immunohistochemical-features-of-giant-cell-ependymoma-of-the-filum-terminale-with-unusual-clinical-and-radiological-presentation
#2
Fernando Candanedo-Gonzalez, Cindy Sharon Ortiz-Arce, Samuel Rosales-Perez, Ana Lilia Remirez-Castellanos, Candelaria Cordova-Uscanga, Armando Gamboa-Dominguez
BACKGROUND: Giant cell ependymoma of the filum terminale is a rare variant, generally manifested as a well-circunscribed intradural mass with an indolent biological behavior. CASE PRESENTATION: We describe the case of a 48-year-old Mexican female who non-relevant past medical history, that developed a GCE of the filum terminale. Magnetic resonance imaging and computed tomography revealed the presence of an intra-axial tumor extending from L3 to L5 with extra-medullary invasion...
January 14, 2017: Diagnostic Pathology
https://www.readbyqxmd.com/read/28068878/long-term-control-of-hypercortisolism-by-vandetanib-in-a-medullary-thyroid-carcinoma-with-a-somatic-ret-mutation
#3
Anne-Cécile Paepegaey, Beatrix Cochand-Priollet, Estelle Louiset, Pierre Olivier Sarfati, Marco Alifano, Nelly Burnichon, Marie Bienvenu-Perrard, Najiba Lahlou, Léopoldine Bricaire, Lionel Groussin
CONTEXT: Medullary thyroid carcinomas (MTCs) complicated by ectopic Cushing's syndrome have a poor prognosis, partially due to the difficulties to control hypercortisolism by adrenal blocking drugs. Recent reports (including the initial follow-up of this patient) have suggested that tyrosine kinase inhibitors (TKIs) may be a therapeutic option due to an antisecretory action on ACTH. However, there is a lack of long-term follow-up studies. CASE DESCRIPTION: We report the case of a 58 year-old man with a MTC-related Cushing's syndrome resistant to a combination of several anticortisolic drugs...
January 9, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28008293/hormonal-and-echocardiographic-abnormalities-in-adult-patients-with-sickle-cell-anemia-in-bahrain
#4
Taysir S Garadah, Ahmed A Jaradat, Mohammed E Alalawi, Adla B Hassan
BACKGROUND: Adrenal, thyroid, and parathyroid gland hormonal changes are recognized in children with homozygous (HbSS) sickle-cell anemia (SCA), but are not clear in adult patients with SCA. AIM: To assess the metabolic and endocrine abnormalities in adult patients with SCA and evaluate left ventricular (LV) systolic and diastolic functions compared with patients with no SCA and further study the relationship between serum levels of cortisol, free thyroxine (T4), and testosterone with serum ferritin...
2016: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28008098/b-type-natriuretic-peptide-increases-cortisol-and-catecholamine-concentrations-in-healthy-subjects
#5
Gabriele Grimm, Michael Resl, Birgit B Heinisch, Martin Hülsmann, Anton Luger, Martin Clodi, Greisa Vila
B-type natriuretic peptide (BNP) is a hormone released by the heart in response to volume load and exerts natriuretic properties. It is clinically used as a diagnostic and prognostic biomarker, and investigated as a pharmacological agent in the therapy of heart failure. Here we investigate the changes in pituitary, adrenal and thyroid hormones in response to BNP administration in a randomized single-blinded cross-over study conducted in ten healthy men aged 21-29 years. Participants received in two study sessions a continuous intravenous infusion during four hours (once placebo and once three pmol/kg/min BNP) and remained in supine position throughout the study...
December 22, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28004764/sheehan-syndrome
#6
Züleyha Karaca, Bashir A Laway, Hatice S Dokmetas, Hulusi Atmaca, Fahrettin Kelestimur
Sheehan syndrome or postpartum hypopituitarism is a condition characterized by hypopituitarism due to necrosis of the pituitary gland. The initial insult is caused by massive postpartum haemorrhage (PPH), leading to impaired blood supply to the pituitary gland, which has become enlarged during pregnancy. Small sella turcica size, vasospasms (caused by PPH) and/or thrombosis (associated with pregnancy or coagulation disorders) are predisposing factors; autoimmunity might be involved in the progressive worsening of pituitary functions...
December 22, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27994341/anesthetic-management-of-clinically-silent-familial-pheochromocytoma-with-men-2a-a-report-of-four-cases
#7
Shipra Aggarwal, Vandana Talwar, Pooja Virmani, Suniti Kale
Familial pheochromocytomas are commonly associated with multiple endocrine neoplasia type 2 (MEN 2) syndrome. Majority of the patients present with normal clinical and biochemical parameters in the preoperative period, the incidence of hypertension being only 50 %. Even though patients may be clinically asymptomatic, surveillance and proper preoperative evaluation is important, as surgery for associated tumors may precipitate a hypertensive crisis and result in severe complications. A family of 19 members, of which 12 were positive for MEN 2A syndrome, presented to our hospital...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27992012/conduct-protocol-in-emergency-acute-adrenal-insufficiency
#8
Adil Bachir Fares, Rômulo Augusto Dos Santos
Introduction: Acute adrenal insufficiency or addisonian crisis is a rare comorbidity in emergency; however, if not properly diagnosed and treated, it may progress unfavorably. Objective: To alert all health professionals about the diagnosis and correct treatment of this complication. Method: We performed an extensive search of the medical literature using specific search tools, retrieving 20 articles on the topic. Results: Addisonian crisis is a difficult diagnosis due to the unspecificity of its signs and symptoms...
November 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27956115/future-perspectives-in-adult-stem-cell-turnover-implications-for-endocrine-physiology-and-disease
#9
Clara V Alvarez, Fernando Oroz-Gonjar, Montserrat Garcia-Lavandeira
No abstract text is available yet for this article.
December 9, 2016: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/27943004/carney-complex-a-familial-lentiginosis-predisposing-to-a-variety-of-tumors
#10
REVIEW
Constantine A Stratakis
Carney complex is a familial lentiginosis syndrome; these disorders cover a wide phenotypic spectrum ranging from a benign inherited predisposition to develop cutaneous spots not associated with systemic disease to associations with several syndromes. Carney complex is caused by PRKAR1A mutations and perturbations of the cyclic AMP-dependent protein kinase (PKA) signaling pathway. In addition to the cutaneous findings, the main tumors associated with Carney complex are endocrine: 1) primary pigmented nodular adrenocortical disease, a bilateral adrenal hyperplasia leading to Cushing syndrome; 2) growth-hormone secreting pituitary adenoma or pituitary somatotropic hyperplasia leading to acromegaly; 3) thyroid and gonadal tumors, including a predisposition to thyroid cancer...
September 2016: Reviews in Endocrine & Metabolic Disorders
https://www.readbyqxmd.com/read/27922495/toxic-and-endocrine-myopathies
#11
Hans D Katzberg, Charles D Kassardjian
PURPOSE OF REVIEW: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies. RECENT FINDINGS: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27906859/recent-advances-in-nuclear-medicine-in-endocrine-oncology
#12
Markus Luster, Andreas Pfestroff, Frederik A Verburg
PURPOSE OF REVIEW: The purpose is to review recent advances concerning the role of nuclear medicine in endocrine oncology. RECENT FINDINGS: For I therapy of thyroid cancer a thyrotropin (TSH) more than 30 mU/l has for many years been deemed a condition sine qua non. However, new data show that patients with lower TSH levels at the time of ablation have the same rate of successful ablation as those with TSH more than 30 mU/l.I-124 combined integrated positron emission tomography and computed X-ray tomography was shown to be highly accurate in predicting findings on posttherapy radioiodine scanning and was shown to have a high prognostic power...
January 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/27896436/risk-factors-for-complications-after-adrenalectomy-results-from-a-comprehensive-national-database
#13
Lo Hallin Thompson, Erik Nordenström, Martin Almquist, Helene Jacobsson, Anders Bergenfelz
PURPOSE: Most knowledge regarding outcome after adrenal surgery stems from retrospective studies reported by highly specialized centres. The aim of this study was to report a national experience of adrenalectomy with particular attention to predictive factors for postoperative complications, conversion from endoscopic to open surgery and length of hospital stay. METHODS: Adrenalectomies reported in the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery (SQRTPA) 2009-2014 were included...
November 28, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27891401/premature-ovarian-failure-an-association-with-autoimmune-diseases
#14
Ayesha, Vandana Jha, Deepti Goswami
INTRODUCTION: Premature Ovarian Failure (POF) is the cessation of ovarian function before the age of 40 years. POF is reported to be associated with autoimmune diseases in 20-30% of cases. AIM: Patients presenting with idiopathic POF were screened for the presence of autoimmune disorders. MATERIALS AND METHODS: Twenty patients with idiopathic POF were included in the study. Baseline investigation in all subjects included fasting serum FSH, LH, E2, progesterone, free T3, free T4, Thyroid-Stimulating Hormone (TSH) and Anti-Thyroperoxidase (anti-TPO) antibodies, testosterone and Dehydroepiandrosterone (DHEAS) levels...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27885217/lymphocytic-adrenal-medullitis-and-lymphocytic-thyroiditis-in-a-laboratory-beagle-dog
#15
Takuya Doi, Yuki Tomonari, Kazufumi Kawasako, Naoaki Yamada, Minoru Tsuchitani
Lymphocytic adrenal medullitis characterized by inflammation and atrophy in the medulla of the bilateral adrenal glands was observed in an 18-month-old male laboratory beagle dog. It might be that the present lymphocytic adrenal medullitis is an autoimmune-mediated disease as the histological characteristics are consistent with an autoimmune pathogenesis. However, the actual cause remains unclear as the existence of serum autoantibodies against the adrenal medulla could not be confirmed. Although this dog also contracted lymphocytic thyroiditis along with serum thyroglobulin autoantibodies, indicating that the thyroiditis occurred with an autoimmune basis; the relation between the adrenal medullitis and thyroiditis is unknown...
November 24, 2016: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/27882133/effects-of-forced-swimming-stress-on-thyroid-function-pituitary-thyroid-stimulating-hormone-and-hypothalamus-thyrotropin-releasing-hormone-expression-in-adrenalectomy-wistar-rats
#16
Qiuyan Sun, Aihua Liu, Yanan Ma, Anyi Wang, Xinhong Guo, Weiping Teng, Yaqiu Jiang
In order to study the impact that is imposed on the hypothalamic-pituitary-thyroid (HPT) axis of adrenalectomy male Wistar rats by stress caused by swimming, the blood level of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH), the expression of TSHβ mRNA at the pituitary and thyrotropin releasing hormone (TRH) expression at the paraventricular nucleus (PVN) were measured. A total of 50 male Wistar rats of 6-8 weeks of age and with an average weight of 190-210 grams were randomly divided into the following two groups: The surgical (without adrenal glands) and non-surgical (adrenalectomy) group...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27872133/thyroid-metastasis-from-lung-adenocarcinoma-with-eml4-alk-rearrangement
#17
Hironori Kawamoto, Yugo Kaneko, Kai Ryu, Kazuyoshi Kuwano
Thyroid metastases from lung cancer are very rare. A woman aged 42 years with a tumour in the lower lobe of the right lung was diagnosed as having lung adenocarcinoma positive for echinoderm microtubule-associated proteinlike 4-anaplastic lymphoma kinase. Positron emission tomography demonstrated fluorodeoxyglucose accumulation in the lower lobe of the right lung, the right thyroid lobe and both adrenal glands. We performed fine-needle aspiration biopsy (FNAB) and used reverse transcriptase-PCR (RT-PCR) to diagnose the patient as having metastatic lung adenocarcinoma to the thyroid gland...
November 21, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27864805/endocrine-hypertension-a-practical-approach
#18
REVIEW
Joseph M Pappachan, Harit N Buch
Elevated blood pressure resulting from few endocrine disorders (endocrine hypertension) accounts for a high proportion of cases of secondary hypertension. Although some features may be suggestive, many cases of endocrine hypertension remain silent until worked up for the disease. A majority of cases result from primary aldosteronism. Other conditions that can cause endocrine hypertension are: congenital adrenal hyperplasia, Liddle syndrome, pheochromocytomas, Cushing's syndrome, acromegaly, thyroid diseases, primary hyperparathyroidism and iatrogenic hormone manipulation...
November 19, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27857512/respiratory-manifestations-in-endocrine-diseases
#19
REVIEW
Codruţa Lencu, Teodora Alexescu, Mirela Petrulea, Monica Lencu
The control mechanisms of respiration as a vital function are complex: voluntary - cortical, and involuntary - metabolic, neural, emotional and endocrine. Hormones and hypothalamic neuropeptides (that act as neurotrasmitters and neuromodulators in the central nervous system) play a role in the regulation of respiration and in bronchopulmonary morphology. This article presents respiratory manifestations in adult endocrine diseases that evolve with hormone deficit or hypersecretion. In hyperthyroidism, patients develop ventilation disorders, obstructive and central sleep apnea, and pleural collection...
2016: Clujul Medical (1957)
https://www.readbyqxmd.com/read/27822452/multiple-endocrine-neoplasia-similar-to-human-subtype-2a-in-a-dog-medullary-thyroid-carcinoma-bilateral-pheochromocytoma-and-parathyroid-adenoma
#20
E A Soler Arias, V A Castillo, R H Trigo, M E Caneda Aristarain
Human multiple endocrine neoplasia subtype 2A (MEN 2A) is characterized by medullary thyroid carcinoma, pheochromocytoma and parathyroid hyperplasia or adenoma in the same individual. In this report, a case of a female Rottweiler with medullary thyroid carcinoma, bilateral pheochromocytoma and parathyroid adenoma was described. Clinical manifestations of muscle weakness, polydipsia, polyuria, diarrhea and weight loss were observed. Two adrenal neoplasms were identified incidentally by ultrasonography, and tumor in the left thyroid lobe was identified by palpation...
2016: Open veterinary journal
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