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Acute secondary adrenal crisis

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https://www.readbyqxmd.com/read/27855238/adrenal-crisis-secondary-to-bilateral-adrenal-haemorrhage-after-hemicolectomy
#1
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/27729064/histopathological-analysis-of-spontaneous-large-necrosis-of-adrenal-pheochromocytoma-manifested-as-acute-attacks-of-alternating-hypertension-and-hypotension-a-case-report
#2
Nobumasa Ohara, Yasuyuki Uemura, Naomi Mezaki, Keita Kimura, Masanori Kaneko, Hirohiko Kuwano, Katsuya Ebe, Toshio Fujita, Takeshi Komeyama, Hiroyuki Usuda, Yuto Yamazaki, Takashi Maekawa, Hironobu Sasano, Kenzo Kaneko, Kyuzi Kamoi
BACKGROUND: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. Hypertension secondary to pheochromocytoma is often paroxysmal, and patients occasionally present with sudden attacks of alternating hypertension and hypotension. Spontaneous, extensive necrosis within the tumor that is associated with catecholamine crisis is an infrequent complication of adrenal pheochromocytoma, but its pathogenesis remains unclear. CASE PRESENTATION: A 69-year-old Japanese man developed acute-onset episodic headaches, palpitations, and chest pains...
October 12, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27583208/fatal-purpura-fulminans-and-waterhouse-friderichsen-syndrome-from-fulminant-streptococcus-pneumoniae-sepsis-in-an-asplenic-young-adult
#3
Andrew J Hale, Mary LaSalvia, James E Kirby, Allison Kimball, Rachel Baden
Asplenic patients are at increased risk for sepsis and fulminant infection. Sepsis in these patients is typically secondary to encapsulated bacteria, with Streptococcus pneumoniae being the most frequent pathogen. Rare complications of severe sepsis include purpura fulminans and bilateral adrenal hemorrhage (Waterhouse-Friderichsen syndrome). We present the case of a 36-year-old woman, healthy except for splenectomy years prior for idiopathic thrombocytopenic purpura treatment, who presented with fever. Upon presentation to our hospital, three hours after symptoms onset, she had purpura fulminans and shock...
2016: IDCases
https://www.readbyqxmd.com/read/27016277/-adrenal-insufficiency-of-the-adult
#4
C Jublanc, E Bruckert
Adrenal insufficiency is a rare but life-threatening disorder. Clinical manifestations include fatigue, weight loss, gastrointestinal manifestations and skin hyperpigmentation, the latter being specific of primary adrenal failure. Because of non-specific clinical features of this rare disorder, diagnosis can be delayed and adrenal failure be revealed by an acute crisis. Adrenal insufficiency can be primary (Addison disease), most frequently autoimmune, or secondary, resulting from long term administration of exogenous glucocorticoids or more rarely from pituitary disorders...
March 22, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/26816449/takotsubo-cardiomyopathy-in-a-patient-with-pituitary-adenoma-and-secondary-adrenal-insufficiency
#5
Georgene Singh, Ari Manickam, Manikandan Sethuraman, Ramesh Chandra Rathod
We describe a case of Takotsubo cardiomyopathy in a case of pituitary macroadenoma in acute adrenal crisis. A 48-year-old man presented with acute onset altered sensorium, vomiting, and gasping. On admission, he was unresponsive and hemodynamically unstable. He was intubated and ventilated and resuscitated with fluids and inotropes. The biochemical evaluation revealed hyponatremia, hyperkalemia, and hypocortisolism. Hyponatremia was corrected with 3% hypertonic saline. Contrast enhanced computed tomography (CT) scan of the brain revealed a sellar-suprasellar mass with hypothalamic extension with no evidence of pituitary apoplexy...
December 2015: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26717337/hypertensive-emergency-due-to-pheochromocytoma-crisis-complicated-with-refractory-hemodynamic-collapse
#6
Mert İlker Hayıroğlu, Özlem Yıldırımtürk, Mehmet Bozbay, Mehmet Eren, Seçkin Pehlivanoğlu
Hypertensive emergency usually appears in older patients with previous recurrent episodes, and is among the most frequent admissions to emergency departments. A 29-year-old woman was referred to our clinic with the diagnosis of hypertensive emergency. The patient complained of severe headache, dyspnea, palpitation, diaphoresis, and confusion due to hypertensive encephalopathy. Her blood pressure was 250/150 mmHg on admission. At the referral hospital, the patient had undergone cranial CT because of her confused state and this excluded acute cerebral hemorrhage...
December 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/26583075/primary-adrenal-failure-due-to-antiphospholipid-syndrome
#7
Murat Sahin, Ayten Oguz, Dilek Tuzun, Serife Nur Boysan, Bülent Mese, Hatice Sahin, Kamile Gul
Background. Antiphospholipid syndrome (APS) characterized by thrombosis and abortus may rarely cause primary adrenal failure. Case Presentations. A 34-year-old male presented with hypotension, hypoglycemia, hyperpigmentation on his skin and oral mucosa, scars on both legs, and loss of consciousness. In laboratory examinations, hyponatremia (135 mmol/L), hyperpotassemia (6 mmol/L), and thrombocytopenia (83 K/µL) were determined. Cortisol (1.91 µg/dL) and adrenocorticotropic (550 pg/mL) hormone levels were also evaluated...
2015: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/26512333/a-vicious-cycle-of-acute-catecholamine-cardiomyopathy-and-circulatory-collapse-secondary-to-pheochromocytoma
#8
Olufisayo Otusanya, Harmeen Goraya, Priyanka Iyer, Kristen Landi, Amit Tibb, Pavlos Msaouel
Acute catecholamine cardiomyopathy is an uncommon, life-threatening manifestation of pheochromocytoma. The massive release of catecholamines from the adrenal medulla and their toxic effects on the coronary vessels and the cardiac myocytes play a significant role in the pathogenesis of cardiomyopathy in patients with pheochromocytoma. Severe manifestations, such as acute catecholamine cardiomyopathy, may be the initial presentation, especially in unsuspected and untreated pheochromocytoma cases. The clinical course of catecholamine-induced cardiomyopathy is unpredictable as patients may rapidly deteriorate into circulatory collapse and multisystem crisis...
October 2015: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/26488344/acute-psychosis-in-the-course-of-treatment-of-acute-adrenal-crisis-with-hydrocortisone-in-the-patient-with-secondary-adrenal-insufficiency-a-case-study
#9
Jan Brykalski, Lucyna Papierska, Maria Załuska
OBJECTIVES: Presentation of the risk of psychosis induced by the treatment of adrenal crisis with high doses of hydrocortisone. METHODS: A case analysis in the context of the literature. RESULTS: There are reported psychoses in the patients with adrenal hypofunction and hyperfunction. Psychoses following implementation of substitution with small doses of corticosteroids due to adrenal insufficiency were also observed. The hypereactivity of the glucocorticoid receptor is supposed mechanism...
2015: Psychiatria Polska
https://www.readbyqxmd.com/read/26113981/adrenal-insufficiency-in-a-child-following-unilateral-excision-of-a-dual-hormone-secreting-phaeochromocytoma
#10
Annika Sjoeholm, Cassandra Li, Chaey Leem, Aiden Lee, Maria P Stack, Paul L Hofman, Benjamin J Wheeler
UNLABELLED: Phaeochromocytomas are a rare clinical entity, with dual hormone-secreting lesions particularly uncommon, seen in <1%. ACTH is the most common hormone co-produced, and is potentially lethal if not diagnosed. We present the case of a previously well 10-year-old boy, who presented acutely with a hypertensive crisis and was found to have a unilateral, non-syndromic phaeochromocytoma. Medical stabilization of his hypertension was challenging, and took 3 weeks to achieve, before proceeding to unilateral adrenalectomy...
2015: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/25539346/acute-hypertensive-crisis-secondary-to-pheochromocytoma-during-elective-cosmetic-surgery
#11
EDITORIAL
Michael J Frederick, Amy S Colwell
No abstract text is available yet for this article.
January 2015: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/25437659/post-operative-bilateral-adrenal-haemorrhage-a-case-report
#12
R E McNicol, A Bradley, J Griffin, G Duncan, C A Eriksen, G J K Guthrie
INTRODUCTION: Bilateral adrenal haemorrhage is a rare, but serious, illness carrying an estimated 15% mortality.(1,2) The majority of cases occur in patients with acute, stressful illness, however the exact mechanism underlying adrenal haemorrhage remains unclear. This medical emergency carries significant diagnostic difficulty(4) with non-specific clinical symptoms and variations in electrolyte abnormalities. Timely treatment is important as it prevents both the acute and long-term sequelae of adrenal failure...
2014: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/24965226/bartter-syndrome-type-3-in-an-elderly-complicated-with-adrenocorticotropin-deficiency
#13
Eri Tamagawa, Hidefumi Inaba, Takayuki Ota, Hiroyuki Ariyasu, Hiromichi Kawashima, Hisao Wakasaki, Hiroto Furuta, Masahiro Nishi, Taisei Nakao, Hiroshi Kaito, Kazumoto Iijima, Koichi Nakanishi, Norishige Yoshikawa, Takashi Akamizu
Bartter syndrome (BS) is a disorder with normotensive hypokalemic alkalosis and hyperreninemic hyperaldosteronemia. BS affects infants or early childhood. Patients with BS type 3 harbor mutation in CLCNKB, Cl channel Kb. Gitelman syndrome (GS) is a disorder in childhood, with mutation in SLC12A3. Isolated adrenocorticotropin deficiency (IAD) causes secondary adrenal insufficiency. Neither elderly cases, nor cases with IAD were previously reported in BS. A 72-year-old man was admitted with acute adrenal crisis...
2014: Endocrine Journal
https://www.readbyqxmd.com/read/24115716/a-young-man-with-a-dizzy-spell-and-acute-abdominal-pain
#14
Hassan Mohamed Saeed Elasha, Farees Anjum, Mussa H Almalki
Isolated adrenocorticotropic hormone (ACTH) deficiency is a rare cause of secondary adrenal insufficiency and its presentation with adrenal crisis is rather rare. Acute adrenal insufficiency (adrenal crisis) can be an elusive diagnosis, particularly in previously undiagnosed patients. As in this patient, the presentation of adrenal crisis with acute abdominal pain was misdiagnosed as an acute surgical abdomen, leading to a delay in the diagnosis and in the initiation of life saving treatment.
October 2013: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/23853620/acute-myocardial-infarction-secondary-to-catecholamine-release-owing-to-cocaine-abuse-and-pheochromocytoma-crisis
#15
Efren Martinez-Quintana, Ricardo Jaimes-Vivas, Javiel Cuba-Herrera, Beatriz Saiz-Udaeta, Fayna Rodríguez-Gonzalez, Maria Soledad Martinez-Martin
Most pheochromocytomas are not suspected clinically while a high percentage of them are curable with surgery. We present the case of an adult cocaine-addicted male patient with an underlying pheochromocytoma and repeated myocardial infarctions. Computed tomography showed a left round adrenal mass, also high 24-hour urine levels of catecholamines and metanephrines were detected from urinalysis. The patient was given alpha and beta blockers, moreover a laparoscopic left adrenalectomy was performed. Cocaine can block the reuptake of noradrenaline, leading to increasing its concentration and consequently its effects as well, and induce local or diffuse coronary vasoconstriction in normal coronary artery segments per se, cocaine can also trigger pheochromocytoma crisis, and therefore, cardiac complications such as myocardial infarction due to these additive effects are intended to occur...
2013: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/23282274/-acute-myocardial-infarction-due-to-pheochromocytoma
#16
Iraís Cristal Ortiz-Vázquez, Marco Antonio Ramos-García, Gerardo Maza-Juárez, Juan Marcelino Clavellina-Rosas, Alejandra Moreno-Vázquez, Moisés Calderón-Abbo
BACKGROUND: pheochromocytoma is a neuroendocrine tumor that secretes high levels of catecholamines and it is able to exert serious cardiovascular effects. The cardiac involvement is the most frequent, with reported conditions such as transient myocardial dysfunction, acute coronary syndrome and ventricular arrhythmias. CLINICAL CASE: we reported a 36 year-old woman without cardiovascular history. She presented with an adrenergic crisis after surgery leading to acute heart failure and acute myocardial infarction...
September 2012: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/22975403/-hypotension-from-endocrine-origin
#17
REVIEW
Marie-Christine Vantyghem, Claire Douillard, Anne-Sophie Balavoine
Hypotension is defined by a low blood pressure either permanently or only in upright posture (orthostatic hypotension). In contrast to hypertension, there is no threshold defining hypotension. The occurrence of symptoms for systolic and diastolic measurements respectively below 90 and 60 mm Hg establishes the diagnosis. Every acute hypotensive event should suggest shock, adrenal failure or an iatrogenic cause. Chronic hypotension from endocrine origin may be linked to adrenal failure from adrenal or central origin, isolated hypoaldosteronism, pseudohypoaldosteronism, pheochromocytoma, neuro-endocrine tumors (carcinoïd syndrome) or diabetic dysautonomia...
November 2012: La Presse Médicale
https://www.readbyqxmd.com/read/21225386/postoperative-adrenal-crisis-in-an-adolescent-with-loeys-dietz-syndrome-and-undiagnosed-adrenoleukodystrophy
#18
Ami M Kuisle, Stefanie Gauguet, Lawrence I Karlin, Andrew Dauber, Mary Ellen McCann
PURPOSE: We present an unusual case involving an adolescent who experienced cardiovascular collapse postoperatively. He had more than one rare life-threatening genetic disorder, and herein we review the anesthetic management of a patient with Loeys-Dietz syndrome (LDS) and adrenoleukodystrophy. CLINICAL FEATURES: A 12-yr-old male (41.5 kg, American Society of Anesthesiologists' physical status III) with LDS, a connective tissue disorder, underwent posterior spinal fusion for spondylolisthesis...
April 2011: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/20862350/lost-in-the-mist-acute-adrenal-crisis-following-intranasal-fluticasone-propionate-overuse
#19
Arturo Loaiza-Bonilla, Tollin Sullivan, Ryan Kendall Harris
Introduction. Acute adrenal crisis in relation to nasal steroid overuse has been reported very scantly in English medical literature and remains an underdiagnosed condition. Case presentation. A 55 year-old male presented with altered mental status, retrograde amnesia, fluid refractory hypotension, abdominal pain, fever, and chest pain. Physical examination revealed amnesia, bradypsychia, tachycardia, decreased muscle tone and hyporeflexia. Overuse of nasal steroid was suspected by history. Random early morning cortisol level was < 0...
2010: Case Reports in Medicine
https://www.readbyqxmd.com/read/20814595/acute-adrenal-crisis-in-an-asthmatic-child-treated-with-inhaled-fluticasone-proprionate
#20
Angela H Santiago, Susan Ratzan
Adrenal suppression secondary to prolonged inhaled corticosteroid use is usually limited to biochemical abnormalities, with no obvious clinical effects. Acute adrenal crisis is much rarer event but has been reported with increasing frequency. We report a case of a 7-year-old asthmatic child who presented with an acute history of lethargy after a respiratory infection. He was maintained on 220 mug/day of fluticasone propionate for several years. Initial evaluation revealed severe adrenal suppression, with undetectable cortisol levels and minimal response after stimulation with ACTH...
2010: International Journal of Pediatric Endocrinology
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