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Secondary Adrenal Insufficiency

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https://www.readbyqxmd.com/read/29929552/anterior-hypopituitarism-in-a-patient-with-amyloidosis-secondary-to-crohn-s-disease-a-case-report
#1
Natacha Verbeke, Nathalie Pirson, Arnaud Devresse, Raluca Furnica, Thierry Duprez, Dominique Maiter
BACKGROUND: Amyloid infiltration of endocrine glands has been reported, mostly in the thyroid, pancreas, adrenals, and testes, but affected patients do not frequently exhibit overt endocrine insufficiency. Here we report the case of a patient with complete anterior hypopituitarism probably due to a known systemic amyloidosis. CASE PRESENTATION: Our male Caucasian patient was diagnosed with Crohn's disease at the age of 22 years. At the age of 37, he developed secondary renal amyloidosis, which resulted in end-stage renal failure...
June 22, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29928263/prolactin-producing-pituitary-carcinoma-hypopituitarism-and-graves-disease-report-of-a-challenging-case-and-literature-review
#2
Rita Bettencourt-Silva, Josué Pereira, Sandra Belo, Daniela Magalhães, Joana Queirós, Davide Carvalho
Introduction: The diagnosis of pituitary carcinoma is very rare, requires the evidence of metastatic disease, and has a poor overall survival. Malignant prolactinoma frequently requires dopamine agonist therapy, pituitary surgery, radiotherapy, and even chemotherapy. Case description: A 19-year-old female presented with galactorrhea, primary amenorrhea, and left hemianopsia. Complementary study detected hyperprolactinemia and a pituitary macroadenoma with cavernous sinus invasion and suprasellar growth...
2018: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29905835/glucocorticoids-and-bone-consequences-of-endogenous-and-exogenous-excess-and-replacement-therapy
#3
Rowan S Hardy, Hong Zhou, Markus J Seibel, Mark S Cooper
Osteoporosis associated with long-term glucocorticoid therapy remains a common and serious bone disease. In addition, in recent years it has become clear that more subtle states of endogenous glucocorticoid excess may have a major impact on bone health. Adverse effects can be seen with mild systemic glucocorticoid excess but there is also evidence of tissue-specific regulation of glucocorticoid action within bone as a mechanism of disease. This review article will examine a) the role of endogenous glucocorticoids in normal bone physiology, b) the skeletal effects of endogenous glucocorticoid excess in the context of endocrine conditions such as Cushing's disease/syndrome and autonomous cortisol secretion (subclinical Cushing's syndrome), and c) the actions of therapeutic (exogenous) glucocorticoids on bone...
June 13, 2018: Endocrine Reviews
https://www.readbyqxmd.com/read/29904615/acute-pericarditis-as-a-presentation-of-adrenal-insufficiency
#4
Sukesh Manthri, Sindhura Bandaru, Abdisamad Ibrahim, Chaitanya K Mamillapalli
Acute pericarditis as a presenting sign of adrenal insufficiency is rarely reported. We present a rare case that highlights pericarditis as a clinical presentation of secondary adrenal insufficiency later complicated by cardiac tamponade. A 44-year-old lady who presented to the hospital with a one-day history of pleuritic chest pain and shortness of breath. In the emergency room, she had a blood pressure of 70/35 mmHg. Laboratory evaluation revealed white blood cell count of 16.08 k/cumm with neutrophilia, normal renal function and elevated troponin (0...
April 13, 2018: Curēus
https://www.readbyqxmd.com/read/29895525/the-hypothalamic-pituitary-adrenal-axis-in-childhood-cancer-survivors
#5
Christina Wei, Elizabeth Crowne
Endocrine abnormalities are common among childhood cancer survivors. Abnormalities of the hypothalamic-pituitary-adrenal axis (HPAA) are the least common, but the consequences are severe if missed. Patients with tumours located and /or had surgery performed near the hypothalamic-pituitary region and those treated with an accumulative cranial radiotherapy dose of over 30 Gy are most at risk of adrenocorticotrophic hormone (ACTH) deficiency. Primary adrenal insufficiency may occur in patients with tumours located in or involving one or both adrenals...
June 12, 2018: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29894991/metabolic-complications-in-adrenal-insufficiency
#6
Grethe A Ueland, Eystein S Husebye
Pharmacological glucocorticoid treatment is associated with adverse metabolic consequences such as hypertension, overweight, reduced glucose tolerance, diabetes mellitus and ultimately increased mortality in cardiovascular disease. Here we review the evidence of detrimental effects of hormone replacement therapy in adrenal insufficiency (AI). Registry studies indicate increased cardiovascular mortality, hypertension, diabetes, and dyslipidemia in both primary and secondary AI, but when cohorts with carefully characterized patients are studied the picture is less clear, and recently patients with primary AI was reported to have less hypertension and lower body mass index than controls...
2018: Frontiers of Hormone Research
https://www.readbyqxmd.com/read/29875974/-chronic-adrenal-insufficiency-an-underestimated-cause-of-chronic-fatigue
#7
Marie-Pierrette Ntyonga-Pono
Chronic adrenal insufficiency is regarded as a rare disease in its primary stage. However, secondary adrenal insufficiency, which essentially occurs after stopping corticosteroids, is more frequent, ranging from 4.2% to 60%, depending on the pathology treated, but it is often unrecognized. We report the case of a 66 year old female patient with a history of chronic fatigue for more than 2 years. The patient consulted several clinicians but symptoms were wrongly attributed to a depressive disorder rather than to adrenal corticotropic adrenal insufficiency...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29875912/relative-adrenal-insufficiency-in-adults-with-sickle-cell-disease
#8
Eugene Sobngwi, Noel Désirée Mbango, Eric Vounsia Balti, Francoise Ngo Sack, Vicky Ama Moor, Jean-Claude Mbanya
Rheological modifications observed in sickle cell anemia are associated with ischemic complications that can cause target organ functional impairment. The objective was to investigate adrenal function of adult patients with sickle cell disease. In this cross-sectional study conducted in a tertiary referral hospital of the capital city of Cameroon, we enrolled ten crisis-free adult patients with sickle cell disease (SCD) and ten age- and sex-matched healthy individuals. We assessed adrenal function by testing basal cortisol levels and 60 min after tetracosactide (Synacthen® ) injection using immuno-chemiluminescence method...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29791007/should-all-patients-with-adrenal-insufficiency-or-a-subgroup-of-patients-with-pre-diabetes-be-treated-with-dual-release-hydrocortisone
#9
Roberta Giordano
Guarnotta et al. compare the effects of dual-release (DR) hydrocortisone 36 months' treatment in 13 patients with primary adrenal insufficiency and 36 with secondary adrenal insufficiency, compared to conventional glucocorticoid treatment. A retrospective evaluation was conducted on the effects of 36 months of DR hydrocortisone therapy on visceral adiposity, insulin secretion and insulin sensitivity. Forty-nine patients with adrenal insufficiency were recruited. This article is protected by copyright. All rights reserved...
May 23, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29750931/relative-adrenal-insufficiency-is-associated-with-prolonged-postoperative-hemodynamic-instability
#10
Amine Mazine, Ismail Bouhout, Nadim Saydy, Louis-Mathieu Stevens, Maude Gagné-Loranger, Frédéric Vanden Eynden, Daniel Parent, Yoan Lamarche, Denis Bouchard
BACKGROUND: We assessed the hypothesis that a significant proportion of patients undergoing cardiac surgery suffer from postoperative relative adrenal insufficiency (RAI), and that this puts them at higher risk of persistent hemodynamic instability. METHODS: A prospective study included 135 patients who underwent cardiac surgery using cardiopulmonary bypass between July 2006 and December 2007. Adrenal function was assessed 36 hours after surgery using a 1 μg cosyntropin (ACTH) stimulation test...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29748231/management-of-endocrine-disease-differential-diagnosis-investigation-and-therapy-of-bilateral-adrenal-incidentalomas
#11
Isabelle Bourdeau, Nada El Ghorayeb, Nadia Gagnon, Andre Lacroix
The investigation and management of unilateral adrenal incidentalomas have been extensively considered in the last decades. While bilateral adrenal incidentalomas represent about 15 percent of adrenal incidentalomas, they have been less frequently discussed. The differential diagnosis of bilateral incidentalomas includes metastasis, primary bilateral macronodular adrenal hyperplasia (BMAH) and bilateral cortical adenomas. Les frequent etiologies are bilateral pheochromocytomas, congenital adrenal hyperplasia, Cushing's disease or ectopic ACTH secretion with secondary bilateral adrenal hyperplasia, primary malignancies, myelolipomas, infections or hemorrhage...
May 10, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29742971/insufficiency-of-the-zona-glomerulosa-of-the-adrenal-cortex-and-progressive-kidney-insufficiency-following-unilateral-adrenalectomy-case-report-and-discussion
#12
Joanna Kanarek-Kucner, Adrian Stefański, Rufus Barraclough, Tomasz Gorycki, Jacek Wolf, Krzysztof Narkiewicz, Michał Hoffmann
BACKGROUND: Primary aldosteronism (PA) is the most common cause of secondary hypertension and bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenoma (APA) seem to be the most common causes of PA. Unilateral adrenalectomy (UA) is the preferred treatment for APA, although the benefits are still difficult to assess. CASE REPORT: We present a case report of a 69-year old man with a 30 year history of hypertension and probably long-standing PA due to APA, with typical organ complications...
May 9, 2018: Blood Pressure
https://www.readbyqxmd.com/read/29730618/role-of-sampling-times-and-serum-cortisol-cut-off-concentrations-on-the-routine-assessment-of-adrenal-function-using-the-standard-cosyntropin-test-in-an-academic-hospital-from-spain-a-retrospective-chart-review
#13
Andrés E Ortiz-Flores, Elisa Santacruz, Lucía Jiménez-Mendiguchia, Ana García-Cano, Lia Nattero-Chávez, Héctor F Escobar-Morreale, Manuel Luque-Ramírez
OBJECTIVES: Aiming to validate the use of a single poststimulus sampling protocol for cosyntropin test short standard high-dose test (SST) in our institution, our primary objectives were (1) to determine the concordance between 30 and 60 min serum cortisol (SC) measurements during SST; and (2) to evaluate the diagnostic agreement between both sampling times when using classic or assay-specific and sex-specific SC cut-off values. The secondary objectives included (1) estimating the specificity and positive predictive value of 30 and 60 min sampling times while considering the suspected origin of adrenal insufficiency (AI); and (2) obtaining assay-specific cut-off values for SC after SST in a group of subjects with normal hypothalamic-pituitary-adrenal (HPA) axis...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29682773/mortality-data-from-the-european-adrenal-insufficiency-registry-patient-characterization-and-associations
#14
Marcus Quinkler, Bertil Ekman, Pinggao Zhang, Andrea M Isidori, Robert D Murray
OBJECTIVE: Mortality from primary and secondary adrenal insufficiency (AI; PAI and SAI, respectively) is 2-3-fold higher than in the general population. Mortality relates to cardiovascular disease, acute adrenal crisis (AC), cancer and infections; however, there has been little further characterization of patients who have died. DESIGN/METHODS: We analysed real-world data from 2034 patients (801 PAI, 1233 SAI) in the European Adrenal Insufficiency Registry (EU-AIR; NCT01661387)...
July 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29662328/hyporeninemic-hypoaldosteronism-in-a-patient-with-diabetes-mellitus-an-unforgettable-case-report
#15
Naziha Chelaghma, Samson O Oyibo
A 58-year-old man presented with a 3-year history of chronic and intermittent hyperkalemia requiring recurrent attendances to the emergency department for urgent treatment. His medical history included secondary diabetes mellitus following a bout of acute pancreatitis and a previous splenectomy for a spontaneous splenic rupture. He also had a history of prolonged use of non-steroidal anti-inflammatory drugs for back pain and painful neuropathy. He was not on any medication or diet that would cause a raised serum potassium level and his renal function was normal...
2018: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29658671/-a-case-of-insulinoma-complicated-with-secondary-adrenal-insufficiency
#16
Yao Li, Hui Chen
A middle-aged male patient with recurrent hypoglycemia was diagnosed as insulinoma according to the symptoms and the laboratory tests. Laboratory tests also showed low cortisol and adrenocortico-tropic hormone (ACTH) levels, therefore adrenal insufficiency was diagnosed and hydrocortisone was given. The hormone replacement therapy was terminated after surgery, and ACTH and cortisol levels returned to normal.
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/29563965/avoiding-diagnostic-errors-in-psychosomatic-medicine-a-case-series-study
#17
Atsuko Koyama, Yoichi Ohtake, Kanae Yasuda, Kiyohiro Sakai, Ryo Sakamoto, Hiromichi Matsuoka, Hirokuni Okumi, Toshiko Yasuda
Background: Non-organic lesions or diseases of unknown origin are sometimes misdiagnosed as "psychogenic" disorders or "psychosomatic" diseases. For the quality of life and safety of patients, recent attention has focused on diagnostic error. The aim of this study was to clarify the factors that affected misdiagnoses in psychosomatic medicine by examining typical cases and to explore strategies that reduce diagnostic errors. Case presentation: The study period was from January 2001 to August 2017...
2018: BioPsychoSocial Medicine
https://www.readbyqxmd.com/read/29546743/secondary-adrenal-insufficiency-in-pregnancy-any-differences
#18
Stephan Petersenn
Secondary adrenal insufficiency may pose specific challenges during pregnancy. The interpretation of diagnostic tests is hindered by physiological adaptations of the HPA axis. Due the relevant increases in CBG, measurement of salivary cortisol may be preferable, but lacks sufficiently established cut-offs both for early-morning evaluation and during dynamic testing. Hydrocortisone should be used for replacement to avoid overexposure of the fetus, with dose adjustments according to clinical judgement. To account for increased free cortisol levels during the course of pregnancy, hydrocortisone may be increased by 5-7...
March 15, 2018: Minerva Endocrinologica
https://www.readbyqxmd.com/read/29525066/-diffuse-hypertrichosis-revealing-non-classical-congenital-adrenal-hyperplasia
#19
C Berthin, P Sibilia, J Martins-Hericher, A Donzeau, L Martin
BACKGROUND: Non-classical congenital adrenal hyperplasia (NC-CAH) is a recessive autosomal disease caused by a deficiency of adrenal steroidogenesis enzymes. It must be distinguished from classical CAH, either simple virilising or salt-wasting, diagnosed during the neonatal period and responsible for potentially lethal disorders of sexual differentiation. NC-CAH presents a simpler and less specific clinical picture. Herein, we present two cases comprising twin girls consulting for diffuse hypertrichosis...
April 2018: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/29508432/systematic-review-adrenal-insufficiency-secondary-to-swallowed-topical-corticosteroids-in-eosinophilic-oesophagitis
#20
REVIEW
H Philpott, M K Dougherty, C C Reed, M Caldwell, D Kirk, D J Torpy, E S Dellon
BACKGROUND: Swallowed topical corticosteroids are prescribed for eosinophilic oesophagitis (EoE), but there is a theoretical risk of adrenal insufficiency from their use. AIMS: To determine if the use of topical corticosteroids to treat EoE is associated with the development of adrenal insufficiency. METHOD: We conducted a systematic review of the published literature from January 1, 1950 to April 1, 2017 using Pubmed, Embase, Web of Science and Cochrane Central...
April 2018: Alimentary Pharmacology & Therapeutics
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