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Curr Opin Endocrinol Diabetes Obes 2019 Mar 11. Epub 2019 Mar 11.

Department of Endocrinology and Diabetes, Indiana University School of Medicine, Indiana, USA.

Purpose Of Review: Despite the declaration of an opioid epidemic, opioid use remains prevalent. Side-effects of chronic opioid use continue to be problematic. Opioid-induced endocrinopathies have been well documented, yet opioid-induced adrenal insufficiency (OIAI) remains underappreciated. Read More

Pediatr Emerg Care 2019 Mar 7. Epub 2019 Mar 7.

Background: Congenital adrenal hyperplasia is an autossomic recessive condition. The most common mutation is in the CYP21A2 gene situated in chromosome 6, leading to a 21-hydroxylase deficiency. Clinical presentation ranges from light hyperandrogenism to potentially fatal adrenal salt-losing crisis. Read More

J Pharm Pract 2019 Mar 10:897190019834771. Epub 2019 Mar 10.

1 Pharmacy Department, Indiana University Health Methodist Hospital, Indianapolis, IN, USA.

Endocrine emergencies are frequent in critically ill patients and may be the cause of admission or can be secondary to other critical illness. The ability to anticipate endocrine abnormalities such as adrenal excess or , hypothyroidism, can mitigate their duration and severity. Hyperglycemic crisis may trigger hospital and intensive care unit (ICU) admission and may be life threatening. Read More

J Clin Endocrinol Metab 2019 Mar 7. Epub 2019 Mar 7.

Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Germany.

Context: Unilateral adrenalectomy has been proposed in selected patients with primary bilateral macronodular adrenocortical hyperplasia (PBMAH), but its long-term outcome is unclear.

Objective: The aim of this study was to analyze long-term clinical and biochemical outcome of unilateral adrenalectomy versus bilateral adrenalectomy in patients with PBMAH in comparison to outcome of cortisol-producing adenoma (CPA) treated by unilateral adrenalectomy.

Design: Retrospective observational study in three German and one Italian academic tertiary care center. Read More

J Investig Med 2019 Feb 28. Epub 2019 Feb 28.

Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA.

Adrenal insufficiency (AI) remains a significant cause of morbidity and mortality in children with 1 in 200 episodes of adrenal crisis resulting in death. The goal of this working group of the Pediatric Endocrine Society Drug and Therapeutics Committee was to raise awareness on the importance of early recognition of AI, to advocate for the availability of hydrocortisone sodium succinate (HSS) on emergency medical service (EMS) ambulances or allow EMS personnel to administer patient's HSS home supply to avoid delay in administration of life-saving stress dosing, and to provide guidance on the emergency management of children in adrenal crisis. Currently, hydrocortisone, or an equivalent synthetic glucocorticoid, is not available on most ambulances for emergency stress dose administration by EMS personnel to a child in adrenal crisis. Read More

Eur J Pediatr 2019 Feb 26. Epub 2019 Feb 26.

Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel.

The aim of the study was to assess the epidemiology and risk factors of adrenal crises (AC) in children with adrenal insufficiency (AI). Children diagnosed with AI between 1990 and 2017 at four Israeli pediatric endocrinology units were studied. Demographic and clinical data were retrieved retrospectively from their files. Read More

BMJ Case Rep 2019 Feb 19;12(2). Epub 2019 Feb 19.

Chemical Pathology, New Cross Hospital, Wolverhampton, UK.

Herbal remedies adulterated with glucocorticoids can cause Cushing's syndrome. We report a severe presentation of a 'herbal remedy' adulterated with glucocorticoids; causing a potentially fatal adrenal crisis precipitated by acute illness. Investigations were consistent with adrenal suppression and confirmed, after tablet analysis, to be due to a 'herbal remedy' containing synthetic betamethasone/dexamethasone. Read More

Ital J Pediatr 2019 Feb 6;45(1):23. Epub 2019 Feb 6.

University of Trieste, Piazzale Europa, 1, 34127, Trieste, Italy.

Background: Primary adrenal insufficiency (PAI) in children is an uncommon but severe condition which can be either inherited or acquired. It consists in clinical manifestation of defective production or ineffective action of endogenous glucocorticoids; deficiency in mineralocorticoids and adrenal androgens may coexist. Diagnosis of PAI in children and young people can be challenging; while adrenal crisis (acute decompensation) is a life-threatening condition, with patient presenting with characteristic features of hypoglycemia, hypotension, collapse and coma, chronic adrenal insufficiency may present with vague and non-specific symptoms, making the diagnosis more difficult. Read More

Vestn Otorinolaringol 2018 ;83(6):27-30

Department of Diseases of Ear, Throat, and Nose, Rostov State Medical University, Ministry of Health of the Russian Federation, Rostov-on-Don, Russia, 344022.

The objective of the present study was to elucidate the dynamics of the hormonal status of the adrenal glands in the patients suffering from Menière's disease in its different clinical forms. We examined a total of 26 patients at the age from 29 to 47 years presenting with this condition. All the patients were divided into two groups depending on the character of the disease. Read More

Endocrine 2019 Mar 4;63(3):407-421. Epub 2019 Feb 4.

Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia.

Purpose: 3β-hydroxysteroid dehydrogenase type 2 deficiency (3βHSD2D) is a very rare variant of congenital adrenal hyperplasia (CAH) causing less than 0.5% of all CAH. The aim was to review the literature. Read More

BMJ Case Rep 2019 Jan 29;12(1). Epub 2019 Jan 29.

Department of Paediatrics, Barking Havering and Redbridge University Hospitals NHS Trust, Romford, UK.

We report a case of a 10-day-old male infant who presented to the emergency department with severe electrolyte imbalance and life-threatening arrhythmia. The parents reported a 3-day history of poor feeding and lethargy. On examination, he was bradycardic (heart rate of 65 beats/min) with signs of dehydration. Read More

Clin Pediatr (Phila) 2019 Apr 29;58(4):406-412. Epub 2019 Jan 29.

1 University of Virginia, Charlottesville, VA, USA.

Our objective was to assess the risk of adrenal insufficiency (AI) with short-term use of low- to moderate-potency topical corticosteroids (TCS) for treatment of atopic dermatitis. Our systematic literature search revealed 9 studies (n = 371) that evaluated AI using adrenocorticotropic hormone stimulation testing, with measures of serum cortisol levels at baseline and following at least 2 weeks of TCS application. Biochemical AI was defined by a stimulated cortisol level of ≤18. Read More

J Postgrad Med 2019 Jan-Mar;65(1):44-46

Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

We report a 49-year-old woman who presented with a hypertensive crisis and acute heart failure and reduced left ventricular systolic function. An abdominal ultrasonography revealed a huge lobulated heterogeneous mass at the lower pole of the right kidney and a mass over the left suprarenal area, which were further delineated by magnetic resonance imaging. The patient underwent laparoscopic right radical nephrectomy and left adrenalectomy. Read More

Clin Endocrinol (Oxf) 2019 Apr 10;90(4):534-541. Epub 2019 Feb 10.

Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Objective: Detailed studies of Addison's disease resulting from disseminated adrenal histoplasmosis (AH) are not available. We describe the presentation and prognosis of AH and cortisol status before and after antifungal therapy.

Design: Single-centre retrospective hospital-based study of 40 consecutive adults with AH [39 males; age (mean ± SD) 53 ± 11 years] was conducted between 2006 and 2018. Read More

Am J Surg 2019 Jan 3. Epub 2019 Jan 3.

Division of Surgical Oncology, Oregon Health & Science University, United States. Electronic address:

Background: Patients with carcinoid tumors are at risk for profound intraoperative hypotension known as carcinoid crisis, which catecholamines are traditionally believed to trigger. However, data supporting this are lacking.

Methods: Anesthesia records were retrospectively reviewed for carcinoid patients treated with vasopressors. Read More

Cardiol Res 2018 Dec 7;9(6):378-380. Epub 2018 Dec 7.

University of Kansas School of Medicine-Wichita, 1010 N Kansas, Wichita, KS 67214, USA.

Takotsubo cardiomyopathy is a form of reversible cardiomyopathy. It is usually due to sudden emotional or physical stress. It is associated with excessive sympathetic stimulation and catecholamine release. Read More

Eur J Nucl Med Mol Imaging 2019 Jan 7. Epub 2019 Jan 7.

Department of Radiology, Nuclear Medicine Section, University of Minnesota, Minneapolis, MN, USA.

Saudi Med J 2019 Jan;40(1):87-92

Unit of Pediatric Endocrinology and Diabetes, Maternity and Children Hospital, Dammam, Kingdom of Saudi Arabia. E-mail.

We are presenting a monozygotic twin brothers presented at different ages with different presentations. Twin-A presented at age of 18 days with salt losing crisis. Investigations revealed high plasma renin with low-normal aldosterone. Read More

J Neuromuscul Dis 2019 ;6(1):31-41

Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA.

Long-term glucocorticoid therapy has improved outcomes in patients with Duchenne muscular dystrophy. However, the recommended glucocorticoid dosage suppresses the hypothalamic-pituitary-adrenal axis, leading to adrenal insufficiency that may develop during severe illness, trauma or surgery, and after discontinuation of glucocorticoid therapy. The purpose of this review is to highlight the risk of adrenal insufficiency in this patient population, and provide practical recommendations for management of adrenal insufficiency, glucocorticoid withdrawal, and adrenal function testing. Read More

J Med Case Rep 2019 Jan 5;13(1). Epub 2019 Jan 5.

Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa, Tokyo, 142-8555, Japan.

Background: There are several reports of pheochromocytoma crisis triggered by systemic glucocorticoid administration. However, pheochromocytoma crisis after intra-articular glucocorticoid administration has been rarely reported.

Case Presentation: A 45-year-old Japanese man presented to our hospital with a sudden, severe headache. Read More

Case Rep Endocrinol 2018 22;2018:2359205. Epub 2018 Nov 22.

Pediatric Endocrinology, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, 111 Plain Street, 3rd Floor, Providence, RI 02903, USA.

Introduction: Thyroid hormone is known to accelerate glucocorticoid turnover. In a thyrotoxic state, individuals with adrenal insufficiency are unable to increase endogenous cortisol production to compensate for increased turnover, placing them at risk for symptoms of glucocorticoid deficiency and adrenal crisis. In patients with salt-wasting congenital adrenal hyperplasia (SW-CAH), hyperandrogenemia is a measurable reflection of relative glucocorticoid insufficiency. Read More

World Neurosurg 2018 Dec 20. Epub 2018 Dec 20.

Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA; Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA. Electronic address:

Background: Although reducing 30-day hospital readmissions is now a priority in neurosurgical quality improvement, postoperative emergency room (ER) visits have remained poorly understood, in particular, in populations with limited access to outpatient care. After endoscopic transsphenoidal surgery, the unique pathologic entities treated can engender a variety of surgical and metabolic complications-often dangerous, delayed, and nonspecific in presentation. We sought to characterize the causes and timing of ER visits-with or without readmission-in a socioeconomically disadvantaged population. Read More

Medicine (Baltimore) 2018 Dec;97(51):e13885

Department of Oncology, Second Affiliated Hospital of Suzhou University, Suzhou.

To evaluate the feasibility, local control, and survival after computed tomography (CT)-guided cryoablation for adrenal metastases.This study included 31 consecutive patients with adrenal metastases who were treated by CT-guided cryoablation in our center from July 2011 to October 2017. The technical success rate, local progression rate, local progression-free survival (LPFS), systemic progression-free survival (SPFS), and overall survival were assessed. Read More

Exp Clin Endocrinol Diabetes 2019 Feb 18;127(2-03):165-175. Epub 2018 Dec 18.

Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.

Addison's disease - the traditional term for primary adrenal insufficiency (PAI) - is defined as the clinical manifestation of chronic glucocorticoid- and/or mineralocorticoid deficiency due to failure of the adrenal cortex which may result in an adrenal crisis with potentially life-threatening consequences. Even though efficient and safe pharmaceutical preparations for the substitution of endogenous gluco- and mineralocorticoids are established in therapy, the mortality in patients with PAI is still increased and the health-related quality of life (HRQoL) is often reduced.PAI is a rare disease but recent data report an increasing prevalence. Read More

Pediatr Hematol Oncol 2018 Aug - Sep;35(5-6):355-361. Epub 2018 Nov 20.

a Department of Pediatrics , Ehime University Graduate School of Medicine , Ehime , Japan.

Although outcomes for infant leukemia have improved recently, transient adrenal insufficiency is commonly observed during treatment, especially after glucocorticoid administration. We identified three infants with acute leukemia who suffered from prolonged adrenal insufficiency requiring long-term (from 15 to 66 months) hydrocortisone replacement. All infants showed life-threatening symptoms associated with adrenal crisis after viral infections or other stress. Read More

CEN Case Rep 2018 Nov 19. Epub 2018 Nov 19.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.

A 57-year-old woman with pre-dialysis chronic kidney disease (CKD) was hospitalized because of fever and fatigue. On admission, increased inflammatory response and pyuria with bacteriuria were observed. Pyelonephritis was successfully treated with antibiotics, whereas her fatigue continued and she developed progressive hypercalcemia and hyponatremia; serum sodium level, 116 mEq/L and corrected serum calcium level, 13. Read More

BMJ Case Rep 2018 Nov 8;2018. Epub 2018 Nov 8.

Department of Diabetes and Endocrinology, Royal Glamorgan Hospital, Llantrisant, UK.

A 30-year-old woman with polyglandular autoimmune type 2 syndrome was found collapsed at home with a cardiac arrest, which required direct current cardioversion. On admission, she was hypothermic, hypotensive and bradycardic. Initial biochemical investigations were consistent with a pre-renal acute kidney injury, metabolic acidosis and a possible sepsis. Read More

BMC Endocr Disord 2018 Nov 6;18(1):78. Epub 2018 Nov 6.

Department of Endocrinology, Shenzhen Children's Hospital, 7019# Yitian Road, Futian District, Shenzhen, 518038, Guangdong Province, China.

Background: Congenital lipoid adrenal hyperplasia (CLAH) is an extremely rare and the most severe form of congenital adrenal hyperplasia. Typical features include disorder of sex development, early-onset adrenal crisis and enlarged adrenal glands with fatty accumulation.

Case Presentation: We report a case of CLAH caused by mutations in the steroidogenic acute regulatory protein (StAR) gene. Read More

BMC Anesthesiol 2018 Nov 6;18(1):158. Epub 2018 Nov 6.

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, 200 First Street SW, Rochester, MN, 55905, USA.

Background: Surgical manipulation of pheochromocytomas and paragangliomas (PPGLs) may induce large hemodynamic oscillations due to catecholamine release. Little is known regarding hemodynamic instability during percutaneous ablation of PPGLs. We examined intraprocedural hemodynamic variability and postoperative complications related to percutaneous ablation of extra-adrenal metastases of PPGL. Read More

Hosp Pediatr 2018 Nov;8(11):693-698

Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

Objectives: Immunizations provide important protection from serious childhood illnesses. Infant chronic lung disease (CLD) is a serious complication of prematurity and predisposes premature infants to respiratory morbidity, rehospitalization, and mortality. This high-risk group is especially vulnerable to infections, such as invasive pneumococcal disease, influenza, and bronchiolitis. Read More

Case Rep Endocrinol 2018 25;2018:2091257. Epub 2018 Sep 25.

Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.

Studies on genome-wide transcription patterns have shown that many genetic alterations implicated in pheochromocytoma-paraganglioma (P-PGL) syndromes cluster in a common cellular pathway leading to aberrant activation of molecular response to hypoxia in normoxic conditions (the pseudohypoxia hypothesis). Several cases of P-PGL have been reported in patients with cyanotic congenital heart disease (CCHD). Patients affected with CCHD have an increased likelihood of P-PGL compared to those affected with noncyanotic congenital heart disease. Read More

Endokrynol Pol 2018 Oct 23. Epub 2018 Oct 23.

Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center, Belgrade, Serbia; Medical Faculty, University of Belgrade, Belgrade, Serbia.

Pheochromocytomas and sympathetic paragangliomas are rare catecholamine-secreting tumors and represent very rare causes of intracerebral hemorrhage in young, with only few cases reported. A 32-year-old man presented to our emergency department because of sudden onset of severe headache. He had a six months history of paroxysmal headache, palpitations and sweating. Read More

Wilderness Environ Med 2018 Dec 8;29(4):504-507. Epub 2018 Oct 8.

Department of Internal Medicine, Trichy SRM Medical College Hospital and Research Center, Irungalur, Trichy, India (Prof Thirumalaikolundusubramanian).

Snakebite envenomation is an important public health problem in tropical countries. We report a case of bilateral adrenal hemorrhage in a 28-y-old man with Russell's viper bite that occurred in the Sathyamangalam forest range in the Indian state of Tamil Nadu. In this case, a combination of early bite recognition, hospital-based supportive care, corticosteroid therapy, and timely administration of polyvalent antivenom resulted in a favorable clinical outcome. Read More

J Clin Endocrinol Metab 2018 Nov;103(11):4324-4331

Pediatric Endocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts.

Context: Adrenoleukodystrophy (ALD) is a peroxisomal disorder associated with neurologic decompensation and adrenal insufficiency. Newborn screening for ALD has recently been implemented in five states with plans to expand to all 50 states in the United States. Adrenal insufficiency ultimately develops in most males with ALD, but the earliest age of onset is not well established. Read More

Clin Kidney J 2018 Oct 30;11(5):691-693. Epub 2018 Jan 30.

Department of Pediatrics, Division of Endocrinology, Washington University, St. Louis, MO, USA.

Posaconazole is an antifungal therapy reported to cause incident hypertension. Hypokalemia is also a known side effect. The combination of hypertension and hypokalemia suggests mineralocorticoid excess. Read More

Sci Rep 2018 Sep 28;8(1):14542. Epub 2018 Sep 28.

Department of Anatomy and Cell Science, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan.

Bilateral adrenalectomy forces the patient to undergo glucocorticoid replacement therapy and bear a lifetime risk of adrenal crisis. Adrenal autotransplantation is considered useful to avoid adrenal crisis and glucocorticoid replacement therapy. However, the basic process of regeneration in adrenal autografts is poorly understood. Read More

World J Surg 2019 Feb;43(2):527-533

Department of Medicine, Division of Endocrinology and Metabolism, University of Pittsburgh, Pittsburgh, PA, USA.

Background: Management of patients with bilateral adrenal masses and ACTH-independent Cushing's syndrome (AICS) is challenging, as bilateral adrenalectomy can lead to steroid dependence and lifelong risk of adrenal crisis. Adrenal venous sampling (AVS) has been previously reported to facilitate lateralization for guiding adrenalectomy. The aim of the current study was to investigate the utility of AVS using protocol from study by Young et al. Read More

Medicina (B Aires) 2018;78 Suppl 2:82-87

Hospital de Niños Dr. Luis Calvo Mackenna, Santiago, Chile. E-mail:

Autoimmune diseases of the peripheral nervous system are common in pediatrics. Guillain-Barré syndrome, juvenile myasthenia gravis, and juvenile dermatomyositis are the most important. Their common pathogenesis involves the action of specific autoantibodies which are frequently triggered by viral or bacterial infection. Read More

Endocr J 2018 Dec 8;65(12):1155-1159. Epub 2018 Sep 8.

Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa 920-8640, Japan.

A 45-year-old male suddenly experienced left-flank abdominal pain. Echocardiography revealed akinesis of the 'takotsubo cardiomyopathy' type. He experienced a sudden haemodynamic collapse (blood pressure, 324/154 mmHg; pulse rate, 180 beats/min) during emergency cardiac catheterisation. Read More

Scott Med J 2018 Aug 30:36933018789312. Epub 2018 Aug 30.

2 Consultant Infectious Diseases Physician, Infectious Diseases Unit, Penang General Hospital, Penang, Malaysia.

We report a 72-year-old patient who presented with an ulcerated palatal mass, weight loss and adrenal insufficiency. Repeated biopsies from the mass revealed actinomycosis with no features of malignancy, while computed tomography scanning revealed a left maxillary sinus mass with invasive features and bilateral large adrenal masses. Blood and urine investigations showed adrenal insufficiency. Read More

Cureus 2018 Jun 18;10(6):e2833. Epub 2018 Jun 18.

Emergency Medicine/ Medical Simulation, Mayo Clinic, Jacksonville, USA.

Introduction The widespread use of corticosteroids for treatment of inflammatory conditions has resulted in the need to promptly recognize drug-induced adrenal insufficiency. This scenario was inspired by an actual case and aims to enhance critical thinking. Our case is unique as we use a case-based format with written tests to track progress. Read More

J Pediatr Urol 2018 Oct 23;14(5):417.e1-417.e5. Epub 2018 Jul 23.

Division of Pediatric Urology, Riley Hospital for Children at IU Health, IN, USA.

Purpose: The parental decision-making process regarding female genital restoration surgery (FGRS) for girls with congenital adrenal hyperplasia (CAH) is controversial and poorly understood. The aim of the study aim was to evaluate parental concerns related to their child's future and parental plans about disclosure prior to FGRS.

Materials And Methods: The authors performed an online survey of consecutive parents presenting at a tertiary referral center for consultation regarding FGRS for their daughter with CAH before 3 years of age (2016-2018). Read More

Case Rep Endocrinol 2018 15;2018:4073536. Epub 2018 Jul 15.

Division of General Surgery, McGill University Health Centre, Montréal, QC, Canada.

Pheochromocytomas are rare adrenal neoplasms characterized by excess secretion of catecholamines. We describe the case of a 65-year-old man, known for hypertension, with no family history of hereditary pheochromocytoma syndromes. He reported a two-year history of flushing, systolic blood pressure surges to 200 mmHg, headaches, tremors, and syncope. Read More

Saudi Med J 2018 Aug;39(8):829-833

Department of Internal Medicine, King Fahad Military Medical Complex, Dhahran, Kingdom of Saudi Arabia. E-mail.

A 43-year-old man with Hashimoto's thyroiditis and previous thromboembolic events treated with warfarin for 6 months, presented with right flank pain accompanied with vomiting, dizziness, and altered mental status 2 weeks after discontinuation of warfarin. His clinical examination findings were unremarkable. Routine blood work showed lymphopenia, thrombocytopenia, and hypoosmolar hyponatremia. Read More

Int J Surg Case Rep 2018 1;50:111-115. Epub 2018 Aug 1.

Department of Pathology, College of Health Sciences, University of Zimbabwe. Electronic address:

Introduction: Pheochromocytomas are catecholamine producing tumours which arise from chromaffin cells within the adrenal medulla. Patients with these tumours commonly present with a triad of headache, palpitations and hypertension.

Case Presentation: We present a case of a 37-year-old male patient who presented with dull left sided abdominal pain and discomfort for 6 weeks. Read More

Cureus 2018 Jun 6;10(6):e2752. Epub 2018 Jun 6.

Internal Medicine, Yale New Haven Health at Bridgeport Hospital, Bridgeport, USA.

Brugada syndrome (BrS) is an inherited channelopathy disease, caused by genetic changes in transmembrane ion channels. It has an increased risk of sudden cardiac death (SCD) in the absence of a structural heart disease. We report a case in which the presenting electrocardiogram (EKG) exhibited a type 1 Brugada-like pattern during an adrenal crisis with transformation into a type 2 Brugada-like pattern as the crisis improved. Read More

J Med Case Rep 2018 Aug 10;12(1):217. Epub 2018 Aug 10.

University Paediatric Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.

Background: Smith-Lemli-Opitz syndrome is a rare autosomal recessive disorder of cholesterol biosynthesis which is characterized by multiple congenital malformations and global developmental delay. Here we report the case of a 3-year-old, previously undiagnosed, child with Smith-Lemli-Opitz syndrome presenting with acute adrenal crisis, which is an extremely rare and atypical presentation of this disease.

Case Presentation: A 3-year-old Sri Lankan Sinhalese boy without evidence of infection presented with circulatory collapse. Read More

Clin Endocrinol (Oxf) 2018 Nov 24;89(5):577-585. Epub 2018 Sep 24.

School of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.

Objective: Episodes of acute adrenal insufficiency (AI)/adrenal crises (AC) are a serious consequence of congenital adrenal hyperplasia (CAH). This study aimed to assess morbidity from acute illness in CAH and identify factors associated with use of IV hydrocortisone, admission and diagnosis of an AC.

Method: An audit of acute illness presentations among children with CAH to paediatric hospitals in New South Wales, Australia, between 2000 and 2015. Read More

Endocr Pract 2018 08 7;24(8):746-755. Epub 2018 Aug 7.

In 1855, Thomas Addison described an illness now known as Addison disease (AD) caused by damage to the adrenal cortex and manifesting in weakness, weight loss, hypotension, gastrointestinal disturbances, and brownish pigmentation of the skin and mucous membranes. Corticosteroid supplementation, corticotropin (adrenocorticotropic hormone [ACTH] of medicinal use) test, and anti-adrenal auto-antibodies (AA) have come into use in the 100 years since Addison's death. Following the methodological innovations, 4 disorders which share impaired response to corticotropin in common have been discovered (i. Read More