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Secondary Adrenal Insufficiency

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https://www.readbyqxmd.com/read/29662328/hyporeninemic-hypoaldosteronism-in-a-patient-with-diabetes-mellitus-an-unforgettable-case-report
#1
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
#2
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
#3
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
#4
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
#5
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...
March 7, 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
#6
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...
March 5, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29488089/pheochromocytoma-diagnosed-during-pregnancy-lessons-learned-from-a-series-of-ten-patients
#7
G Donatini, J L Kraimps, C Caillard, E Mirallie, F Pierre, Loïc De Calan, Hamy Antoine, O Larin, O Tovkay, S Cherenko
BACKGROUND: Pheochromocytoma (PHEO) in pregnancy is a life-threatening condition. Its management is challenging with regards to the timing and type of surgery. METHODS: A retrospective review of the management of ten patients diagnosed with pheochromocytoma during pregnancy was performed. Data were collected on the initial diagnostic workup, symptoms, treatment, and follow-up. RESULTS: PHEO was diagnosed in ten patients who were between the 10th and the 29th weeks of pregnancy...
February 27, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29447799/iatrogenic-cushing-s-syndrome-and-adrenal-insufficiency-in-infants-on-intranasal-dexamethasone-drops-for-nasal-obstruction-case-series-and-literature-review
#8
REVIEW
Rohan R Joshi, Alison Maresh
The use of intranasal steroid drops for nasal obstruction in infants is common practice and can prevent more invasive surgical procedures; however, it is not without complication. We describe 2 cases of iatrogenic Cushing's secondary to nasal steroids in infants with nasal obstruction, discuss the etiology of this unusual complication, and review previous literature reports. While reporting in the literature is sparse, these cases highlight the risk of development of adrenal insufficiency with usage of nasal steroid drops in infants as well as the need for close monitoring of administration and tapering of the drops...
February 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29442094/a-potential-side-effect-of-oral-topical-steroids-central-serous-chorioretinopathy
#9
Saranya George, Anita Balan
Topical corticosteroids are some of the most common drugs used in oral medicine for treating atrophic and erosive lesions that affect the mucosa. Adverse effects of these drugs include oral candidiasis with associated burning mouth and hypogeusia, hypersensitive reactions to the drug, and inhibition of the hypothalamic-pituitary-adrenal axis and secondary adrenal insufficiency. The ocular side effects of oral topical steroids are less documented. This short communication describes a case of central serous retinopathy that developed following administration of oral topical steroid...
January 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/29376554/evaluation-of-the-frequency-of-adrenal-crises-and-preventive-measures-in-patients-with-primary-and-secondary-adrenal-insufficiency-in-switzerland
#10
Antje Notter, Stefan Jenni, Emanuel Christ
AIMS OF THE STUDY: Adrenal insufficiency is a dangerous clinical condition, leading to significant morbidity or mortality in situations with inadequate glucocorticoid replacement treatment. We aimed to assess preventive measures in adrenal insufficiency and the incidence and risk factors of adrenal crisis, as well as to test the patients' knowledge about their disease. METHODS: All patients in May and June 2016 and December 2016 and January 2017 with primary (17...
January 29, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29375882/idiopathic-intracranial-hypertension-as-a-presenting-sign-of-adrenal-insufficiency
#11
Sandra Shenouda, Khaled Al-Farawi, Jenna Dolan, Susan L Flesher
Idiopathic intracranial hypertension is a diagnosis of exclusion defined by elevated intracranial pressure without mass lesions or hydrocephalus. Causes of idiopathic intracranial hypertension include obesity, vitamin derangements, antibiotics, corticosteroids, and autoimmune disorders. Cushing's disease and Addison's disease have been associated with idiopathic intracranial hypertension. Secondary adrenal insufficiency following withdrawal of inhaled corticosteroids has been found to be a relatively common phenomenon...
2018: SAGE open medical case reports
https://www.readbyqxmd.com/read/29368442/improved-insulin-sensitivity-and-secretion-in-pre-diabetic-patients-with-adrenal-insufficiency-on-dual-release-hydrocortisone-treatment-a-36-month-retrospective-analysis
#12
Valentina Guarnotta, Alessandro Ciresi, Giuseppe Pillitteri, Carla Giordano
OBJECTIVE: Dual-release hydrocortisone (DR-HC) provides physiological cortisol exposure, leading to an improvement of anthropometric and metabolic parameters. The aim of the study was to evaluate the effects of DR-HC on insulin secretion and sensitivity and cardio metabolic risk, indirectly expressed by the visceral adiposity index (VAI). DESIGN AND PATIENTS: Retrospective analysis of 49 patients, 13 with primary and 36 with secondary adrenal insufficiency (AI) respectively, on conventional glucocorticoid treatment at baseline and switched to DR-HC for 36 months...
January 25, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29367875/myotonic-dystrophy-type-1-with-diabetes-mellitus-mixed-hypogonadism-and-adrenal-insufficiency
#13
Ken Takeshima, Hiroyuki Ariyasu, Tatsuya Ishibashi, Shintaro Kawai, Shinsuke Uraki, Jinsoo Koh, Hidefumi Ito, Takashi Akamizu
Myotonic dystrophy type 1 (DM1) is an autosomal dominant multisystem disease affecting muscles, the eyes and the endocrine organs. Diabetes mellitus and primary hypogonadism are endocrine manifestations typically seen in patients with DM1. Abnormalities of hypothalamic-pituitary-adrenal (HPA) axis have also been reported in some DM1 patients. We present a case of DM1 with a rare combination of multiple endocrinopathies; diabetes mellitus, a combined form of primary and secondary hypogonadism, and dysfunction of the HPA axis...
2018: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/29362269/plenadrema-effect-of-dual-release-versus-conventional-hydrocortisone-on-fatigue-measured-by-ecological-momentary-assessments-a-study-protocol-for-an-open-label-switch-pilot-study
#14
Victor Brun Boesen, Thea Christoffersen, Torquil Watt, Stina Willemoes Borresen, Marianne Klose, Ulla Feldt-Rasmussen
INTRODUCTION: Patients with adrenal insufficiency have impaired health-related quality of life (QoL). The dual-release hydrocortisone preparation, Plenadren, has been developed to mimic the physiological cortisol release more closely than conventional hydrocortisone treatment. Plenadren has been shown to improve QoL, in particular fatigue, in patients with primary adrenal insufficiency. However, the effect has not been investigated in patients with secondary adrenal insufficiency; furthermore, no study has taken the diurnal variation of fatigue into account...
January 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29344425/a-case-of-psychosis-in-a-patient-with-secondary-adrenal-insufficiency-a-possible-etiological-role-of-a-hypocortisolemic-induced-increase-in-proinflammatory-cytokines
#15
David R Spiegel, Aaron B Nelson, David C Lieb, Alexander M Pattison, Justin Smith, Patrice Zigrossi, Erin Godbout
Adrenal insufficiency is divided into three types based on the etiology of its development. In primary adrenal insufficiency, pathology resides in end-organ failure at the level of the adrenal cortex, while in secondary and tertiary adrenal insufficiency, impairment rests in the pituitary gland and hypothalamus, respectively. Regardless of etiology, adrenal insufficiency results in a hypocortisolemic condition. While the relationship between neuropsychiatric symptoms, especially psychosis, and hypercortisolemia has been extensively documented, the development of hypocortisolemia-induced psychosis is less common...
September 2017: Innovations in Clinical Neuroscience
https://www.readbyqxmd.com/read/29344035/hypercalcaemic-pancreatitis-adrenal-insufficiency-autoimmune-thyroiditis-and-diabetes-mellitus-in-a-girl-with-probable-sarcoidosis
#16
Devi Dayal, Olivia Pepper, Renuka Ramakrishnan, Eileen Baildam, Poonam Dharmaraj, Gavin Cleary, Liza McCann, Clare Pain, Senthil Senniappan
Introduction: Sarcoidosis is a multisystemic granulomatous disease with diverse and often non-specific symptoms during childhood. The clinical manifestations sometimes include endocrinopathies related to sarcoid infiltration of various endocrine organs, but more commonly due to the associated autoimmune endocrine disorders. There are only a few reports of multiple autoimmune and non-autoimmune endocrine problems occurring simultaneously in patients with sarcoidosis. We report a girl with probable sarcoidosis who also had Hashimoto's thyroiditis, Type 1 diabetes (T1D) and secondary adrenal insufficiency...
October 2017: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29338844/sfe-sfedp-adrenal-insufficiency-french-consensus-introduction-and-handbook
#17
Yves Reznik, Pascal Barat, Jérôme Bertherat, Claire Bouvattier, Frédéric Castinetti, Olivier Chabre, Philippe Chanson, Christine Cortet, Brigitte Delemer, Bernard Goichot, Damien Gruson, Laurence Guignat, Emmanuelle Proust-Lemoine, Marie-Laure Raffin Sanson, Rachel Reynaud, Dinane Samara Boustani, Dominique Simon, Antoine Tabarin, Delphine Zenaty
The French endocrinology society (SFE) and the French pediatric endocrinology society (DFSDP) have drawn up recommendations for the management of primary and secondary adrenal insufficiency in the adult and child, based on an analysis of the literature by 19 experts in 6 work-groups. A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms except hyperpigmentation which is observed in primary adrenal insufficiency. Diagnosis rely on plasma cortisol and ACTH measurement at 8am and/or the cortisol increase after synacthen administration...
February 2018: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29259830/iatrogenic-cushing-s-syndrome-with-subsequent-adrenal-insufficiency-in-a-patient-with-psoriasis-vulgaris-using-topical-steroids
#18
Suzan Demir Pektas, Gursoy Dogan, Nese Cinar
Iatrogenic Cushing's syndrome (ICS) is usually related to prolonged and/or high-dose oral or parenteral steroid use. Psoriasis vulgaris (PV) is chronic inflammatory disease and characterized by periods of attack and remission. Topical steroid (TS) is the first choice of treatment for localized and mild PV. The development of systemic side effects of the steroids is usually not observed after TS application. But the risk of developing ICS still exists. In the literature, there are a few adult cases who developed ICS and subsequent adrenal insufficiency associated with TS...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29233815/dual-release-hydrocortisone-treatment-glycometabolic-profile-and-health-related-quality-of-life
#19
L M Mongioì, R A Condorelli, S La Vignera, A E Calogero
OBJECTIVE: Adrenal insufficiency (AI) is a chronic condition associated with increased mortality and morbidity. The treatment of AI in the last years has been object of important changes due to the development of a dual-release preparation of hydrocortisone. It differs from previous therapeutic strategy as it contemplates a once-daily tablet that allows more closely mimicking the physiological circadian cortisol rhythm. The aim of the study was to evaluate the effects of dual-release hydrocortisone treatment on the glycometabolic profile and health-related quality of life of patients with AI...
January 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29229498/effect-of-once-daily-modified-release-hydrocortisone-versus-standard-glucocorticoid-therapy-on-metabolism-and-innate-immunity-in-patients-with-adrenal-insufficiency-dream-a-single-blind-randomised-controlled-trial
#20
Andrea M Isidori, Mary Anna Venneri, Chiara Graziadio, Chiara Simeoli, Daniela Fiore, Valeria Hasenmajer, Emilia Sbardella, Daniele Gianfrilli, Carlotta Pozza, Patrizio Pasqualetti, Stefania Morrone, Angela Santoni, Fabio Naro, Annamaria Colao, Rosario Pivonello, Andrea Lenzi
BACKGROUND: Conventional treatment of patients with adrenal insufficiency involves administration of glucocorticoids multiple times a day and has been associated with weight gain and metabolic impairment. The optimal glucocorticoid replacement therapy for these patients is highly debated because of the scarcity of evidence from randomised trials. We aimed to establish whether the timing and pharmacokinetics of glucocorticoid replacement therapy affect the metabolism and immune system of patients with adrenal insufficiency...
March 2018: Lancet Diabetes & Endocrinology
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