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https://www.readbyqxmd.com/read/28642733/a-case-of-pulmonary-carcinoid-tumor-with-a-superimposed-aspergilloma-presenting-as-a-covert-ectopic-adrenocorticotropic-hormone-syndrome
#1
Kyoung Jin Kim, Ji Hee Yu, Nan Hee Kim, Young Hye Kim, Young Sik Kim, Ji A Seo
Ectopic adrenocorticotropic hormone (ACTH) syndrome is a challenging diagnosis only responsible for approximately 10% of Cushing syndrome cases. It has been associated with a variety of benign and malignant tumors including a carcinoid tumor accompanied by aspergilloma in our case that was significantly difficult to be detected. We report a patient over 70 years old with uncontrolled hypertension and hypokalemia presenting with generalized edema. Laboratory results revealed ACTH-dependent Cushing syndrome, but imaging studies did not show any discrete lesions secreting ACTH...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28642375/acquired-resistance-to-corticotropin-therapy-in-nephrotic-syndrome-role-of-de-novo-neutralizing-antibody
#2
Pei Wang, Yan Zhang, Yu Wang, Andrew S Brem, Zhangsuo Liu, Rujun Gong
There is increasing evidence supporting the use of corticotropin as an alternative treatment of refractory proteinuric glomerulopathies. The efficacy of short-acting corticotropin, however, remains unknown and was tested here in an adolescent with steroid-dependent nephrotic syndrome caused by minimal change disease. After developing Cushing syndrome and recently being afflicted with severe cellulitis, the patient was weaned off all immunosuppressants, including corticosteroids. This resulted in a relapse of generalized anasarca, associated with massive proteinuria and hypoalbuminemia...
June 22, 2017: Pediatrics
https://www.readbyqxmd.com/read/28639924/cushing-syndrome-diagnostic-workup-and-imaging-features-with-clinical-and-pathologic-correlation
#3
Nicolaus A Wagner-Bartak, Ali Baiomy, Mouhammed Amir Habra, Shalini V Mukhi, Ajaykumar C Morani, Brinda R Korivi, Steven G Waguespack, Khaled M Elsayes
OBJECTIVE: Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent. CONCLUSION: Cushing disease, which is caused by a pituitary adenoma, is the most common cause of ACTH-dependent CS for which pituitary MRI can be diagnostic, with bilateral inferior petrosal sinus sampling useful in equivocal cases...
July 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28639759/-diabetes-mellitus-secondary-to-an-endocrine-pathology-when-to-think-about-it
#4
Nathalie Rouiller, François R Jornayvaz
An endocrine disease can be associated with glucose intolerance or diabetes mellitus, and the latter can falsely be considered as type 2 diabetes. Glycemic imbalance can be a direct or indirect consequence of excessive hormone production. Endocrine diseases such as acromegaly, Cushing's syndrome and pheochromocytoma can increase glucose production and cause insulin resistance. Hyperthyroidism, hyperaldosteronism, glucagonoma and somatostatinoma lead to hyperglycemia by other physiopathological mechanisms detailed in this article...
May 31, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28638307/rectal-metyrapone-for-treatment-of-hypercortisolism-in-an-infant-with-mccune-albright-syndrome
#5
Kate Verbeeten, Stasia Hadjiyannakis, Melody Cameron, Jaime McDonald
Infantile Cushing syndrome is an infrequent yet potentially fatal manifestation of McCune-Albright syndrome, for which there are few safe treatments available. Ketoconazole is limited by potential hepatotoxicity in this population. Metyrapone may be an effective treatment, but it may not be tolerated when given orally. An infant with McCune-Albright syndrome presented with severe Cushing syndrome. Oral metyrapone resulted in feeding refusal, and ketoconazole caused an increase in liver enzymes; however, she was successfully treated with metyrapone given rectally...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28637948/in-the-overnight-dexamethasone-suppression-test-1-0-mg-loading-is-superior-to-0-5-mg-loading-for-diagnosing-subclinical-adrenal-cushing-s-syndrome-based-on-plasma-dexamethasone-levels-determined-using-liquid-chromatography-tandem-mass-spectrometry
#6
Yosuke Sasaki, Takuyuki Katabami, Shiko Asai, Hisashi Fukuda, Yasushi Tanaka
The low-dose dexamethasone suppression test (DST) is one of the commonly used initial tests for endogenous Cushing's syndrome (CS). However, there are two loading dose regimens (0.5-mg and 1-mg), which may cause some confusion in daily practice in Japan; furthermore, there are no reports regarding whether 0.5-mg DST is a better loading dose for detecting adrenal subclinical CS (SCS) based on the plasma dexamethasone (DEX) levels. Therefore, the aims of this study were (a) to develop a novel assay to measure DEX by using liquid chromatography tandem-mass spectrometry (LC-MS/MS) and (b) to compare between the 0...
June 21, 2017: Endocrine Journal
https://www.readbyqxmd.com/read/28627121/cushing-s-syndrome-caused-by-use-of-synthetic-ocular-steroid
#7
A Üstyol, F Kökali, N Duru, M A Duman, M Elevli
WHAT IS KNOWN AND OBJECTIVE: Cases of Cushing's syndrome (CS) following ocular steroid use have been reported in recent years, albeit rarely. CASE DESCRIPTION: We report a case of iatrogenic CS in a child induced by fluorometholone-containing eyedrops. Our patient was referred to our endocrinology clinic due to rapid weight gain. His history revealed that 1.5 months previously he had been started on fluorometholone eyedrops. WHAT IS NEW AND CONCLUSION: To the best of our knowledge, no cases of CS have been reported following ocular fluorometholone use...
June 18, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28626929/successful-liver-transplantation-for-non-resectable-desmoplastic-nested-spindle-cell-tumor-complicated-by-cushing-s-syndrome
#8
Sarah Tehseen, Louis Rapkin, Erwin Schemankewitz, Joseph F Magliocca, Rene Romero
Desmoplastic spindle cell tumors of liver are rare tumors of low malignant potential characterized by well-demarcated nests of spindle and epithelioid cells in a dense desmoplastic stroma. While surgery remains the definitive treatment, there have been reports of tumor recurrence locally and metastasis which respond poorly to chemotherapy. Hepatic transplant has been attempted in cases of recurrence or large size of primary tumor. Long-term follow-up and imaging surveillance are required as these tumors have shown a tendency for recurrence many years after initial therapy...
June 18, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28626863/prolactin-correction-for-adequacy-of-petrosal-sinus-cannulation-may-diminish-diagnostic-accuracy-in-cushing-s-disease
#9
Sunita Mc De Sousa, Ann I McCormack, Shaun McGrath, David J Torpy
OBJECTIVE: Petrosal venous prolactin concentrations have been promoted to improve the diagnostic accuracy of inferior petrosal sinus sampling (IPSS), beyond that achieved with ACTH measurement alone, in diagnosing a pituitary ACTH source, and determining corticotrophinoma side (L/R). Our objective was to assess the effect of using prolactin to confirm adequacy of petrosal cannulation in a cohort of patients with ACTH-dependent Cushing's syndrome. DESIGN: Retrospective cohort study...
June 19, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28623531/elevated-serum-beta-d-glucan-with-pseudomonas-aspergillus-and-a-partially-acid-fast-organism-in-respiratory-cultures-a-case-of-hickam-s-dictum-over-occam-s-razor
#10
Salman Khan, Camille Hamula, Meenakshi Rana, Timothy Sullivan, Dallas Dunn, Pinki Patel, Aaron Mishkin, Shirish Huprikar
We describe a case of a man with ectopic Cushing's syndrome, elevated serum beta-D-glucan, and respiratory cultures with Pseudomonas, Aspergillus, and a partially acid-fast organism. Our case highlights challenges in diagnosis and management of coinfection in an immunocompromised host.
June 16, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28614036/an-individualized-approach-to-the-evaluation-of-cushing-syndrome
#11
Susmeeta T Sharma
Cushing syndrome (CS) is caused by chronic exposure to excess glucocorticoids. Early recognition and treatment of hypercortisolemia can lead to decreased morbidity and mortality. The diagnosis of CS and thereafter, establishing the cause can often be difficult, especially in patients with mild and cyclic hypercortisolism. Surgical excision of the cause of excess glucocorticoids is the optimal treatment for CS. Medical therapy (steroidogenesis inhibitors, medications that decrease adrenocorticotropic hormone [ACTH] levels or glucocorticoid antagonists) and pituitary radiotherapy may be needed as adjunctive treatment modalities in patients with residual, recurrent or metastatic disease, in preparation for surgery, or when surgery is contraindicated...
June 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28614007/ectopic-cushing-s-syndrome-a-ten-year-experience-from-a-tertiary-care-centre-in-southern-india
#12
Samantha Sathyakumar, Thomas Vizhalil Paul, Hesargatta Shyamsunder Asha, Birla Roy Gnanamuthu, M J Paul, Deepak Thomas Abraham, Simon Rajaratnam, Nihal Thomas
OBJECTIVE: Ectopic ACTH secretion is a less common cause of Cushing's syndrome, and is seen in 5 to 10% of cases with endogenous hypercortisolemia. We hereby describe our experience of patients with ectopic ACTH syndrome, who have been managed over the past 10 years at a tertiary care centre in Southern India. METHODS: The inpatient and outpatient records of patients from 2006 to 2015 were retrospectively reviewed. The clinical features, clinical history, biochemical values, imaging features which included radiological findings and PET scans, management, details of follow-up and outcomes were documented...
June 14, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28614003/biochemical-control-during-long-term-follow-up-of-230-adult-patients-with-cushing-s-disease-a-multi-center-retrospective-study
#13
Eliza B Geer, Ismat Shafiq, Murray B Gordon, Vivien Bonert, Alejandro Ayala, Ronald S Swerdloff, Laurence Katznelson, Yelena Lalazar, Ekaterina Manuylova, Karen J Pulaski-Liebert, John D Carmichael, Zeina Hannoush, Vijaya Surampudi, Michael S Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P Neary, Beverly Mk Biller
OBJECTIVES: Cushing's disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately-treated CD is associated with significant morbidity and elevated mortality. Multi-center data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. METHODS: Eight pituitary centers in 4 US regions participated in this multi-center retrospective chart review study...
June 14, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28607927/depression-and-anxiety-scores-are-associated-with-amygdala-volume-in-cushing-s-syndrome-preliminary-study
#14
Alicia Santos, Esther Granell, Beatriz Gómez-Ansón, Iris Crespo, Patricia Pires, Yolanda Vives-Gilabert, Elena Valassi, Susan M Webb, Eugenia Resmini
INTRODUCTION: Cushing's syndrome (CS) has repeatedly been associated with hippocampal volume reductions, while little information is available on the amygdala, another structure rich in glucocorticoid receptors. The aim of the study was to analyze amygdala volume in patients with CS and its relationship with anxiety, depression, and hormone levels. MATERIAL AND METHODS: 39 CS patients (16 active and 23 patients in remission) and 39 healthy controls matched for age, sex, and education level completed anxiety (STAI) and depression tests (BDI-II) and underwent a 3 Tesla brain MRI and endocrine testing...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28603831/cushing-syndrome-revealing-thymic-carcinoid-tumor
#15
Ibtissem Oueslati, Karima Khiari, Nadia Khessairi, Emna Elfeleh, Najla Bchir, Néjib Ben Abdallah
No abstract text is available yet for this article.
August 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28603512/using-person-fit-statistics-to-detect-outliers-in-survey-research
#16
John M Felt, Ruben Castaneda, Jitske Tiemensma, Sarah Depaoli
Context: When working with health-related questionnaires, outlier detection is important. However, traditional methods of outlier detection (e.g., boxplots) can miss participants with "atypical" responses to the questions that otherwise have similar total (subscale) scores. In addition to detecting outliers, it can be of clinical importance to determine the reason for the outlier status or "atypical" response. Objective: The aim of the current study was to illustrate how to derive person fit statistics for outlier detection through a statistical method examining person fit with a health-based questionnaire...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28599697/paraneoplastic-cushing-syndrome-due-to-wilm-s-tumor
#17
Mahwish Faizan, Jaida Manzoor, Muhammad Saleem, Saadia Anwar, Qaiser Mehmood, Ambreen Hameed, Agha Shabbir Ali
Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to neoplasm. Paraneoplastic syndromes may be the first or the most prominent manifestations of cancer. Wilm's tumor is the most frequent pediatric renal malignancy and usually presents with abdominal mass. Unusual presentations like acquired von Willebrand disease, sudden death due to pulmonary embolism and Cushing syndrome have been described in the literature. Cushing syndrome, as the presenting symptom of a malignant renal tumor in children, is a very rare entity...
May 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28594137/increased-adipocyte-size-macrophage-infiltration-and-adverse-local-adipokine-profile-in-perirenal-fat-in-cushing-s-syndrome
#18
Sean H P P Roerink, Margreet A E M Wagenmakers, Johan F Langenhuijsen, Dov B Ballak, Hanne M M Rooijackers, Frank C d'Ancona, François M van Dielen, Jan W A Smit, Theo S Plantinga, Romana T Netea-Maier, Ad R M M Hermus
OBJECTIVE: To analyze changes in fat cell size, macrophage infiltration, and local adipose tissue adipokine profiles in different fat depots in patients with active Cushing's syndrome. METHODS: Subcutaneous (SC) and perirenal (PR) adipose tissue of 10 patients with Cushing's syndrome was compared to adipose tissue of 10 gender-, age-, and BMI-matched controls with regard to adipocyte size determined by digital image analysis on hematoxylin and eosin stainings, macrophage infiltration determined by digital image analysis on CD68 stainings, and adipose tissue leptin and adiponectin levels using fluorescent bead immunoassays and ELISA techniques...
June 8, 2017: Obesity
https://www.readbyqxmd.com/read/28593924/influence-of-age-gender-and-body-mass-index-on-late-night-salivary-cortisol-in-healthy-adults
#19
Sabrina Coelli, Camila Bergonsi Farias, Ariana Aguiar Soares, Gabriele Martins Crescente, Vânia Naomi Hirakata, Luiza Barboza Souza, Mauro Antônio Czepielewski, Joíza Lins Camargo, Sandra Pinho Silveiro
BACKGROUND: Late-night salivary cortisol (LNSC) is one of the most reliable tests to screen for endogenous Cushing syndrome. This test is simple, inexpensive and noninvasive and has high sensitivity and specificity. The aim of our study was to analyze the putative influence of age, gender and body mass index (BMI) on LNSC levels in a healthy population. METHODS: Cross-sectional study conducted in healthy adults. Midnight saliva samples were collected at home. Participants refrained from teeth brushing, eating or drinking for 2 h prior to collection...
May 5, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28590513/diagnostic-accuracy-of-increased-urinary-cortisol-cortisone-ratio-to-differentiate-acth-dependent-cushing-s-syndrome
#20
Filippo Ceccato, Laura Trementino, Mattia Barbot, Giorgia Antonelli, Mario Plebani, Luca Denaro, Daniela Regazzo, Federico Rea, Anna Chiara Frigo, Carolina Concettoni, Marco Boscaro, Giorgio Arnaldi, Carla Scaroni
BACKGROUND AND AIM: Differential diagnosis between Cushing's Disease (CD) and Ectopic ACTH Syndrome (EAS) may be a pitfall for endocrinologists. The increasing use in clinical practice of chromatography and mass spectrometry improves the measurement of urinary free cortisol (UFF) and cortisone (UFE). We have recently observed that cortisol to cortisone ratio (FEr) was higher in a small series of EAS; in this paper we collected a larger number of ACTH-dependent CS to study the role of FEr to characterize the source of corticotropin secretion...
June 7, 2017: Clinical Endocrinology
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