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Secondary Adrenal Insufficiency

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https://www.readbyqxmd.com/read/29442094/a-potential-side-effect-of-oral-topical-steroids-central-serous-chorioretinopathy
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
January 12, 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
#10
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
#11
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
#12
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...
December 8, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29223281/human-studies-on-hypothalamo-pituitary-adrenal-hpa-axis
#13
REVIEW
Kamani Liyanarachchi, Richard Ross, Miguel Debono
The daily rhythm of the hypothalamo-pituitary-adrenal (HPA) axis is regulated by the central clock in the suprachiasmatic nucleus. Cortisol, a glucocorticoid, acts as a secondary messenger between the central clock and the peripheral tissues. Changes in clock time, as seen in shift workers, alters the HPA axis and results in metabolic disturbances associated with ill health. Depression, anorexia nervosa and obstructive sleep apnoea, are associated with cortisol rhythm phase shifts and increased cortisol exposure...
October 2017: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/29220613/fully-automated-pipetting-sorting-system-for-different-morphological-phenotypes-of-zebrafish-embryos
#14
Helmut Breitwieser, Thomas Dickmeis, Marcel Vogt, Marco Ferg, Christian Pylatiuk
Systems biology methods, such as transcriptomics and metabolomics, require large numbers of small model organisms, such as zebrafish embryos. Manual separation of mutant embryos from wild-type embryos is a tedious and time-consuming task that is prone to errors, especially if there are variable phenotypes of a mutant. Here we describe a zebrafish embryo sorting system with two cameras and image processing based on template-matching algorithms. In order to evaluate the system, zebrafish rx3 mutants that lack eyes due to a patterning defect in brain development were separated from their wild-type siblings...
December 1, 2017: SLAS Technology
https://www.readbyqxmd.com/read/29184808/recovery-of-steroid-induced-adrenal-insufficiency
#15
REVIEW
Areej K Younes, Noor K Younes
Secondary adrenal insufficiency can result from insufficient stimulation of the adrenal glands due to inadequate secretion or synthesis of adrenocorticotropic hormone (ACTH). This can be caused by hypopituitarism, central nervous system injury (tumors, radiation, and surgery) or long-term glucocorticoid therapy. Glucocorticoids were introduced in the 1950s, and have been used for their anti-inflammatory and other pharmacological effects, and also as replacement therapy for adrenal insufficiency. However, chronic glucocorticoid use may lead to suppression of the hypothalamic pituitary adrenal axis through negative feedback...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29182204/-long-qt-syndrome-and-polymorphic-ventricular-tachycardia-due-to-hypopituitarism-report-of-one-case
#16
José Miguel García-Castro, Antonia García-Martín, Emilio Guirao-Arrabal, Pedro Luis Carrillo-Alascio
Symptoms of hypopituitarism are usually chronic and nonspecific, but rarely the disease can have acute and life threatening manifestations. We report a 53 years old female with a pituitary adenoma that was admitted to our hospital because of syncope. The electrocardiogram showed sinus bradycardia with a prolonged QT interval. Frequent runs of non-sustained polymorphic ventricular tachycardia were noted on telemetry. The patient had a history of severe acute headaches in the previous days and laboratory tests revealed severe secondary hypothyroidism, adrenal insufficiency and a decrease in pituitary hormones...
July 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/29174931/group%C3%A2-1-epidemiology-of-primary-and-secondary-adrenal-insufficiency-prevalence-and-incidence-acute-adrenal-insufficiency-long-term-morbidity-and-mortality
#17
Olivier Chabre, Bernard Goichot, Delphine Zenaty, Jérôme Bertherat
The prevalence of primary adrenal insufficiency is estimated at between 82-144/million, with auto-immunity being the most common cause in adults and genetic causes, especially enzyme defects, being the most common cause in children. The prevalence of secondary adrenal deficiency is estimated to be between 150-280/million. The most frequent occurrence is believed to be corticosteroid-induced insufficiency, despite the incidence of clinically relevant deficiency after cessation of glucocorticoid treatment being widely debated...
November 23, 2017: Annales D'endocrinologie
https://www.readbyqxmd.com/read/29151505/isolated-adrenocorticotropin-deficiency-due-to-nivolumab-induced-hypophysitis-in-a-patient-with-advanced-lung-adenocarcinoma-a-case-report-and-literature-review
#18
Nobumasa Ohara, Kazumasa Ohashi, Toshiya Fujisaki, Chiyumi Oda, Yohei Ikeda, Yuichiro Yoneoka, Takehisa Hashimoto, Go Hasegawa, Kazuo Suzuki, Toshinori Takada
A 63-year-old Japanese woman with advanced lung adenocarcinoma developed isolated adrenocorticotropin deficiency caused by immune checkpoint inhibitor (ICI)-related hypophysitis following 8 months of nivolumab therapy. Prompt corticosteroid replacement therapy effectively relieved her secondary adrenal insufficiency symptoms and allowed her to pursue nivolumab therapy, which had been effective for the control of lung adenocarcinoma. Human leukocyte antigen (HLA) typing revealed the presence of the DRB1*04:05-DQA1*03:03-DQB1*04:01 haplotype, which is associated with susceptibility to autoimmune polyglandular syndrome with pituitary disorder in the Japanese population...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29147134/the-clinical-course-after-glucocorticoid-treatment-in-patients-with-inflammatory-bowel-disease-is-linked-to-suppression-of-the-hypothalamic-pituitary-adrenal-axis-a-retrospective-observational-study
#19
Aghil Ibrahim, Per Dahlqvist, Tommy Olsson, David Lundgren, Mårten Werner, Ole B Suhr, Pontus Karling
Background: Adrenal insufficiency (AI) secondary to treatment with glucocorticoids (GCs) is common in patients with inflammatory bowel disease (IBD), but little is known about the relationship between AI and the clinical course in IBD. The aim of the study was to compare the clinical course in IBD patients with normal adrenal function versus patients with subnormal adrenal function. Methods: A retrospective observational study on 63 patients with IBD who had performed a low-dose short Synacthen test (LDSST) (1 μg) immediately (1-7 days) after a standard course of GCs...
November 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/29118985/acute-development-of-cushing-syndrome-in-an-hiv-infected-child-on-atazanavir-ritonavir-based-antiretroviral-therapy
#20
Gueorgui Dubrocq, Andrea Estrada, Shannon Kelly, Natella Rakhmanina
An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain...
2017: Endocrinology, Diabetes & Metabolism Case Reports
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