1,700 results match your criteria Adrenal Crisis


Paediatric population pharmacokinetic modelling to assess hydrocortisone replacement dosing regimens in young children.

Eur J Endocrinol 2020 Jul 1. Epub 2020 Jul 1.

C Kloft, Department of Clinical Pharmacy and Biochemistry, Freie Universität Berlin Institute of Pharmacy, Berlin, 12169, Germany.

Context: Accurate hydrocortisone dosing in children with adrenal insufficiency is important to avoid the risks of over and under treatment including iatrogenic Cushing`s syndrome and adrenal crisis.

Objective: To establish a population pharmacokinetic model of hydrocortisone in children and use this to refine hydrocortisone replacement regimens.

Design And Methods: Pharmacokinetic study of hydrocortisone granules, available in 0. Read More

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http://dx.doi.org/10.1530/EJE-20-0231DOI Listing

Incidence of Adrenal Insufficiency and Cushing's Syndrome After Long-Term Epidural Steroid Injections Over Six Months or Longer: A Preliminary Study.

J Pain Res 2020 24;13:1505-1514. Epub 2020 Jun 24.

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Purpose: Endocrinological complications of an epidural steroid injection (ESI) are rare but dangerous. Nevertheless, despite the associated risks, repeated long-term ESIs are indispensable in some clinical situations. However, only a few reports to date have assessed the safety of this procedure. Read More

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http://dx.doi.org/10.2147/JPR.S252278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321692PMC

Avascular necrosis of the femoral head due to low-dose corticosteroid used in a patient with panhypopituitarism: A case report and literature review.

Jt Dis Relat Surg 2020 18;31(2):390-394. Epub 2020 Jun 18.

Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Kliniği, 06110 Dışkapı, Ankara, Türkiye.

Osteonecrosis, commonly known as avascular necrosis (AVN) of bone, is one of the universally recognized side effects of high-dose steroids and commonly involves femur head leading to significant morbidity. However, the development of AVN in the femoral head due to low-dose oral corticosteroid therapy in a short time is a rare occurrence. Management by stopping corticosteroid treatment can be challenging in many cases due to the adrenal crisis. Read More

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http://dx.doi.org/10.5606/ehc.2020.72773DOI Listing

Standardised patient education in adrenal insufficiency: a prospective multi-centre evaluation.

Eur J Endocrinol 2020 Aug;183(2):119-127

Endocrinology and Diabetes Unit, Department of Medicine I, University Hospital Wuerzburg, Wuerzburg, Germany.

Objective: Patients with adrenal insufficiency (AI) suffer from impaired quality of life and are at risk of adrenal crisis (AC) despite established replacement therapy. Patient education is regarded an important measure for prevention of AC and improvement of AI management. A standardized education programme was elaborated for patients with chronic AI in Germany. Read More

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http://dx.doi.org/10.1530/EJE-20-0181DOI Listing

Adrenal crises in older patients.

Lancet Diabetes Endocrinol 2020 07;8(7):628-639

Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. Electronic address:

Adrenal crises are severe manifestations of adrenal insufficiency that result in hospital admission and incur a risk of cardiovascular events, acute renal injury, and death. Evidence from population-based studies indicate that adults older than 60 years have the highest adrenal insufficiency incidence, contribute to the highest number of adrenal crises, and have the highest age-specific incidence of adrenal crisis, which doubles between the age groups of 60-69 years and 80 years or older. Older patients might be more susceptible to adrenal crises because of a higher prevalence of comorbidities and a consequently higher risk of acute illness. Read More

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http://dx.doi.org/10.1016/S2213-8587(20)30122-4DOI Listing

Adrenal Insufficiency and Glucocorticoid Use During the COVID-19 Pandemic.

Clinics (Sao Paulo) 2020 12;75:e2022. Epub 2020 Jun 12.

Unidade de Suprarrenal & Unidade de Endocrinologia do Desenvolvimento, Laboratorio de Hormonios e Genetica Molecular (LIM/42), Servico de Endocrinologia e Metabologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.

The coronavirus disease 2019 (COVID-19) is an emerging pandemic challenge. Acute respiratory distress syndrome (ARDS) in COVID-19 is characterized by a severe cytokine storm. Patients undergoing glucocorticoid (GC) replacement therapy for adrenal insufficiency (AI) represent a highly vulnerable group that could develop severe complications due to the SARS-CoV-2 infection. Read More

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http://dx.doi.org/10.6061/clinics/2020/e2022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279638PMC

A case of pheochromocytoma presenting with cardiac manifestation: case report.

BMC Pediatr 2020 Jun 17;20(1):299. Epub 2020 Jun 17.

Cardiovascular Research Center, Shahid Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Pheochromocytomas are rare tumors originating in chromaffin cells which predominantly are located in adrenal glands. Sustained or paroxysmal hypertension (HT) is the most frequent sign of pheochromocytoma. In some cases, it is associated with the classic triad including episodic headaches, sudoresis, and tachycardia; however, we present a case of pheochromocytoma with first presentation of cardiomyopathy. Read More

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http://dx.doi.org/10.1186/s12887-020-02197-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298960PMC

Microwave Ablation of Adrenal Tumors in Patients With Continuous Intra-Arterial Blood Pressure Monitoring Without Prior Alpha-Adrenergic Blockade: Safety and Efficacy.

Cardiovasc Intervent Radiol 2020 Jun 11. Epub 2020 Jun 11.

Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792, USA.

Purpose: Evaluate the safety and efficacy of adrenal microwave ablation performed with continuous intra-arterial blood pressure monitoring (IABPM) and without alpha-adrenergic blockade (AAB) as pretreatment.

Material And Methods: A single-center, retrospective review of all percutaneous adrenal microwave ablation performed between 2011 and 2018. Microwave ablation was completed on 11 patients, with a total of 15 adrenal tumors with a mean size of 3. Read More

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http://dx.doi.org/10.1007/s00270-020-02547-wDOI Listing

RECURRENT INVASIVE DUCTAL BREAST CARCINOMA PRESENTING AS PRIMARY ADRENAL INSUFFICIENCY WITH ADRENAL CRISIS.

AACE Clin Case Rep 2020 Mar-Apr;6(2):e50-e53. Epub 2020 Mar 4.

Objective: We report the first case of recurrent ductal breast carcinoma presenting as primary adrenal insufficiency.

Methods: We describe a patient who developed a recurrence of invasive ductal breast carcinoma which went undetected until the patient presented with fulminant adrenal crisis. We describe here an overview of the clinical presentation, work-up, diagnosis, and treatment of adrenal crisis. Read More

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http://dx.doi.org/10.4158/ACCR-2019-0331DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282154PMC

Familial Mediterranean Fever Complicated by a Triad of Adrenal Crisis: Amyloid Goiter and Cardiac Amyloidosis.

Case Rep Rheumatol 2020 19;2020:7865291. Epub 2020 May 19.

Medicine Department, Ahli Hospital, Hebron, Palestine, Israel.

Background: FMF is a common disease in the Mediterranean populations and may be complicated by AA amyloidosis. The coexistence of adrenal and thyroid amyloidosis in AA amyloidosis secondary to familial Mediterranean fever (FMF) is an extremely rare reported condition. We presented a previously unreported triad of adrenal, thyroid, and cardiac amyloidosis secondary to FMF. Read More

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http://dx.doi.org/10.1155/2020/7865291DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256690PMC

Disseminated histoplasmosis in India presenting as addisonian crisis with epiglottis involvement.

IDCases 2020 28;21:e00844. Epub 2020 May 28.

Department of Gastroenterology, Sir Gangaram Hospital, New Delhi, India.

Histoplasmosis is caused by . Like most fungal infections, histoplasmosis is common in immunocompromised patients. In immunocompetent patient, infection is generally asymptomatic and rarely turns into a disseminated form. Read More

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http://dx.doi.org/10.1016/j.idcr.2020.e00844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267723PMC

Bright side of biologics uncovered the dark side of long-term topical steroids: A psoriatic patient treated with biologics developed severe adrenal crisis.

J Dermatol 2020 Jun 3. Epub 2020 Jun 3.

Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

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http://dx.doi.org/10.1111/1346-8138.15419DOI Listing

Neurohormones in the Pathophysiology of Vasovagal Syncope in Adults.

Front Cardiovasc Med 2020 6;7:76. Epub 2020 May 6.

Cardiovascular Division, Department of Medicine, Cardiac Arrhythmia and Syncope Center, University of Minnesota Medical School, Minneapolis, MN, United States.

Vasovagal syncope (VVS) is the most common cause of syncope across all age groups. Nonetheless, despite its clinical importance and considerable research effort over many years, the pathophysiology of VVS remains incompletely understood. In this regard, numerous studies have been undertaken in an attempt to improve insight into the evolution of VVS episodes and many of these studies have examined neurohormonal changes that occur during the progression of VVS events primarily using the head-up tilt table testing model. Read More

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http://dx.doi.org/10.3389/fcvm.2020.00076DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232538PMC

Low-dose ACTH test for evaluation of hypothalamus-pituitary-adrenal axis preoperatively and 3-month follow-up in non-functioning pituitary adenomas.

J Endocrinol Invest 2020 May 20. Epub 2020 May 20.

Division of Endocrinology and Diabetes, Medanta-The Medicity, Gurugram, Haryana, India.

Background: Peri-operative glucocorticoids are routinely administered to patients undergoing trans-sphenoidal surgery for non-functional pituitary adenomas (NFPA) irrespective of hypothalamus-pituitary-adrenal (HPA) axis status.

Purpose: Evaluation of HPA axis before and 12 weeks after endoscopic trans-sphenoidal adenomectomy (E-TSA) utilizing low-dose (1 μg) ACTH stimulation test (LDACTH) to determine the need for glucocorticoid administration in patients with NFPA. We also determined the factors that can predict occurrence of hypocortisolism at 12 weeks after surgery. Read More

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http://dx.doi.org/10.1007/s40618-020-01292-8DOI Listing

Current Management and Outcome of Pregnancies in Women With Adrenal Insufficiency: Experience from a Multicenter Survey.

J Clin Endocrinol Metab 2020 Aug;105(8)

Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland.

Context: Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due to the rarity of the disease and lack of evidence-based recommendations to guide glucocorticoid and mineralocorticoid dosage adjustment.

Objective: Multicenter survey on current clinical approaches in managing AI during pregnancy.

Design: Retrospective anonymized data collection from 19 international centers from 2013 to 2019. Read More

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http://dx.doi.org/10.1210/clinem/dgaa266DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320831PMC

When a crisis hits: bilateral adrenal haemorrhage - a case report.

Clin Med (Lond) 2020 Mar;20(Suppl 2):s40

Oxford University Hospitals NHS Trust, Oxford, UK.

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http://dx.doi.org/10.7861/clinmed.20-2-s40DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243557PMC

Acute illness in patients with concomitant Addison's disease and type 1 diabetes mellitus: Increased incidence of hypoglycaemia and adrenal crises.

Clin Endocrinol (Oxf) 2020 May 12. Epub 2020 May 12.

School of Medicine, Sydney, The University of Notre Dame, Sydney, NSW, Australia.

Background: Patients with Addison's disease (AD) and comorbid type 1 diabetes mellitus (T1DM) are at increased risk of certain acute metabolic disorders relative to patients with one of these conditions only. The reasons for this are unknown.

Methods: All attendances for acute illness by AD patients at the emergency department of a Sydney hospital between 2000 and 2017 were reviewed. Read More

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http://dx.doi.org/10.1111/cen.14219DOI Listing
May 2020
3.457 Impact Factor

Endocrine components of newborn screening.

Authors:
Melissa Russell

Curr Probl Pediatr Adolesc Health Care 2020 Mar 6;50(3):100772. Epub 2020 May 6.

Eastern Virginia Medical School, Division of Pediatric Endocrinology, Children's Hospital of The King's Daughters, Children's Specialty Group, PLLC, Norfolk, VA, United States. Electronic address:

The process of screening newborns for congenital disorders is important for the early detection and treatment of multiple medical conditions. Congenital hypothyroidism and congenital adrenal hyperplasia are two endocrine disorders evaluated on all newborn screens. Early treatment of these conditions can prevent intellectual disability and life-threatening adrenal crisis. Read More

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http://dx.doi.org/10.1016/j.cppeds.2020.100772DOI Listing

[Endocrine Dysfunction Associated with Immune Checkpoint Blockade].

Authors:
Shintaro Iwama

Gan To Kagaku Ryoho 2020 Feb;47(2):203-206

Dept. of Endocrinology and Diabetes, Nagoya University Hospital.

Immune checkpoint inhibitors(ICIs)have been widely used in patients with advanced malignancies. However, these drugs can cause immune-related adverse events(irAEs)in several organs, including lung, skin, gastrointestinal tract, liver, nerve, muscle, and endocrine organs. Endocrine irAEs include hypopituitarism, primary adrenal insufficiency, thyroid dysfunction, hypoparathyroidism, and type 1 diabetes mellitus, which can result in life-threatening consequences, such as adrenal crisis, thyroid storm, severe hypocalcemia, and diabetic ketoacidosis. Read More

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February 2020

ENDOCRINOLOGY IN THE TIME OF COVID-19: Management of adrenal insufficiency.

Eur J Endocrinol 2020 Jul;183(1):G25-G32

Department of Diabetes and Endocrinology, University College London Hospitals NHS Foundation Trust, London, UK.

We provide guidance on prevention of adrenal crisis during the global COVID-19 crisis, a time with frequently restricted access to the usual level of healthcare. Patients with adrenal insufficiency are at an increased risk of infection, which may be complicated by developing an adrenal crisis; however, there is currently no evidence that adrenal insufficiency patients are more likely to develop a severe course of disease. We highlight the need for education (sick day rules, stringent social distancing rules), equipment (sufficient glucocorticoid supplies, steroid emergency self-injection kit) and empowerment (steroid emergency card, COVID-19 guidelines) to prevent adrenal crises. Read More

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http://dx.doi.org/10.1530/EJE-20-0361DOI Listing

A case report and literature review: Identification of a novel AIRE gene mutation associated with Autoimmune Polyendocrine Syndrome Type 1 in East Asians.

Medicine (Baltimore) 2020 May;99(18):e20000

Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun, China.

Rationale: Autoimmune polyendocrine syndrome type 1 (APS-1), also referred as the autoimmune polyendocrinopathy candidiasis-ectodermal dystrophy (APECED), is a rare autosomal inherited disease predominantly among Caucasians from Northern Europe. This syndrome is very rare in East Asian population.

Patients Concerns: Here, we describe a case of a 15-year-old Chinese boy admitted due to a 1-month history of intermittent fatigue, nausea, vomiting, and diarrhea. Read More

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http://dx.doi.org/10.1097/MD.0000000000020000DOI Listing

Significant barriers to diagnosis and management of adrenal insufficiency in Africa.

Endocr Connect 2020 May;9(5):445-456

Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa.

Background: The burden and management of primary adrenal insufficiency (PAI) in Africa have not been well documented. We aimed to identify specific disease characteristics, patient demographics, and patterns of clinical management in established PAI in Africa.

Methods: An online survey of physicians' experience relating to PAI. Read More

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http://dx.doi.org/10.1530/EC-20-0129DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274557PMC

Managing COVID-19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid-sparing Immunosuppression.

Pharmacotherapy 2020 06 26;40(6):517-524. Epub 2020 May 26.

Department of Pharmacy Services, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA.

Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome virus (SARS-CoV-2) has become a global health care crisis. The Centers for Disease Control and Prevention (CDC) lists immunocompromised patients, including those requiring immunosuppression following renal transplantation, as high risk for severe disease from SARS-CoV-2. Treatment for other viral infections in renal transplant recipients often includes a reduction in immunosuppression; however, no current guidelines are available recommending the optimal approach to managing immunosuppression in the patients who are infected with SARS-CoV-2. Read More

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http://dx.doi.org/10.1002/phar.2410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267490PMC

Congenital Adrenal Hyperplasia with Salt Wasting Crisis: A Case Report.

JNMA J Nepal Med Assoc 2020 Jan;58(221):56-58

Department of Pediatrics, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.

Congenital Adrenal Hyperplasia is a group of autosomal recessive disorders due to deficiencies of enzymes involved in steroidogenesis. The most common form is a 21-hydroxylase deficiency which can be classical or non-classical. The severe form also called Classical Congenital Adrenal Hyperplasia is usually detected after birth to infant period. Read More

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January 2020

Current status of potential therapeutic candidates for the COVID-19 crisis.

Brain Behav Immun 2020 07 22;87:59-73. Epub 2020 Apr 22.

Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chiba 260-8670, Japan. Electronic address:

As of April 15, 2020, the ongoing coronavirus disease 2019 (COVID-2019) pandemic has swept through 213 countries and infected more than 1,870,000 individuals, posing an unprecedented threat to international health and the economy. There is currently no specific treatment available for patients with COVID-19 infection. The lessons learned from past management of respiratory viral infections have provided insights into treating COVID-19. Read More

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http://dx.doi.org/10.1016/j.bbi.2020.04.046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175848PMC
July 2020
5.889 Impact Factor

Pericardial Effusion as an Initial Presentation of Panhypopituitarism.

Eur J Case Rep Intern Med 2020 24;7(4):001478. Epub 2020 Feb 24.

Department of Internal Medicine, Hospital Garcia de Orta, Almada, Portugal.

Pericardial effusion has a broad spectrum of clinical presentation, ranging from an incidental finding on imaging to a potentially fatal emergency such as pericardial tamponade, the most severe presentation. The authors present a case of a middle-aged male hospitalized due to shortness of breath. Initial work-up was positive for massive pericardial effusion with haemodynamic compromise. Read More

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http://dx.doi.org/10.12890/2020_001478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162561PMC
February 2020

A pictorial review of non-traumatic adrenergic crisis.

Emerg Radiol 2020 Apr 16. Epub 2020 Apr 16.

Ohio State University Wexner Medical Center, Columbus, OH, USA.

Non-traumatic adrenal crisis is a rare but critical diagnosis to make in emergency settings due to grave consequences. Various pathologies can present as acute crisis, such as spectrum of endocrine imbalance, ranging from catecholamine excess in pheochromocytomas to acute adrenal insufficiency related to glandular dysfunction. Critical manifestations may be due to structural causes related to adrenal hemorrhage, especially when they are bilateral. Read More

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http://dx.doi.org/10.1007/s10140-020-01777-2DOI Listing

MANAGEMENT OF ENDOCRINE DISEASE Disease burden and treatment challenges in patients with both Addison's disease and type 1 diabetes mellitus.

Eur J Endocrinol 2020 Jul;183(1):R1-R11

Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Concurrent type 1 diabetes (T1D) and Addison's disease (AD) is a rare combination of diseases and, in approximately one third of these patients, it is also combined with an autoimmune thyroid disease. Recently, it was shown that patients with both T1D and AD have a higher risk of premature death compared to patients with T1D alone, the most common causes of death being due to diabetic complications and cardiovascular disease. These patients receiving replacement therapies with both insulin and glucocorticoids face an increased risk of hypo- and hyperglycemia and diabetic ketoacidosis and have a higher risk of adrenal crisis than patients with AD alone. Read More

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http://dx.doi.org/10.1530/EJE-20-0052DOI Listing

A Rare Presentation of Possible Disseminated Histoplasmosis with Adrenal Insufficiency Leading to Adrenal Crisis in an Immunocompetent Adult: A Case Report.

Case Rep Med 2020 17;2020:8506746. Epub 2020 Mar 17.

Department of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

Histoplasmosis is caused by , and commonly it causes an asymptomatic illness. Although is the commonest organism to infect adrenal glands, disseminated histoplasmosis in an immune-competent host leading to adrenal insufficiency is rare in current literature. Here, we report a case of possible disseminated histoplasmosis leading to adrenal crisis in a young Asian immunocompetent male. Read More

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http://dx.doi.org/10.1155/2020/8506746DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103037PMC

An analysis of early morning acth levels in the first case of pembrolizumab-induced adrenalitis as a delayed immune-related event (dire) - case study.

Wiad Lek 2020 ;73(2):396-400

Department Of Internal Medicine Ii, Division Of Gastroenterology, Thuringia Clinic "Georgius Agricola", Saalfeld/Saale, Germany.

Objective: The aim: The levels of adrenocorticotrophic hormone (ACTH) are elevated in primary adrenal failure (Addison's disease) with a peak in the early morning hours. This also occurs under hydrocortisone replacement therapy due to the unphysiological substitution regime. The aim was to study ACTH levels under two different replacement regimens. Read More

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Treatment of the adult growth hormone deficiency syndrome with growth hormone: What are the implications for other hormone replacement therapies for hypopituitarism?

Growth Horm IGF Res 2020 Jun 23;52:101316. Epub 2020 Mar 23.

Medical Service, VA Palo Alto Health Care System and Stanford University, Palo Alto, CA 94301, United States of America. Electronic address:

When initiating growth hormone replacement therapy, it is important to consider a patient's other pituitary hormone replacement medications, as adjustments are often necessary. Growth hormone therapy can increase the metabolism of hydrocortisone or endogenous cortisol, unmasking borderline ACTH deficiency and leading to the development of adrenal insufficiency and adrenal crisis. In addition, growth hormone can enhance the metabolism of thyroxine to triiodothyronine, uncovering borderline TSH deficiency. Read More

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http://dx.doi.org/10.1016/j.ghir.2020.101316DOI Listing

Glucocorticoid replacement regimens for treating congenital adrenal hyperplasia.

Cochrane Database Syst Rev 2020 03 19;3:CD012517. Epub 2020 Mar 19.

University of Liverpool, Alder Hey Children's NHS Foundation Trust, Department of Women's and Children's Health, Eaton Road, Liverpool, Merseyside, UK, L12 2AP.

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive condition which leads to glucocorticoid deficiency and is the most common cause of adrenal insufficiency in children. In over 90% of cases, 21-hydroxylase enzyme deficiency is found which is caused by mutations in the 21-hydroxylase gene. Managing individuals with CAH due to 21-hydroxylase deficiency involves replacing glucocorticoids with oral glucocorticoids (including prednisolone and hydrocortisone), suppressing adrenocorticotrophic hormones and replacing mineralocorticoids to prevent salt wasting. Read More

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http://dx.doi.org/10.1002/14651858.CD012517.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081382PMC

A rare serious case of retroperitoneal paraganglioma misdiagnosed as duodenal gastrointestinal stromal tumor: a case report.

BMC Surg 2020 Mar 16;20(1):49. Epub 2020 Mar 16.

Department of Histopathology, Albassel Hospital, Tartous, Syrian Arab Republic.

Background: Pheochromocytoma (PCC) and Paraganglioma (PGL) are rare neuroendocrine neoplasms. These tumors harbour disastrous consequences during surgery due to catecholamine hypersecretion if they are undiagnosed or prepared inadequately preoperatively.

Case Presentation: A 41- year- old lady presented with mild left flank discomfort. Read More

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http://dx.doi.org/10.1186/s12893-020-00712-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7077140PMC

Prevention of Adrenal Crisis: Cortisol Responses to Major Stress Compared to Stress Dose Hydrocortisone Delivery.

J Clin Endocrinol Metab 2020 Jul;105(7)

Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.

Context: Patients with adrenal insufficiency require increased hydrocortisone cover during major stress to avoid a life-threatening adrenal crisis. However, current treatment recommendations are not evidence-based.

Objective: To identify the most appropriate mode of hydrocortisone delivery in patients with adrenal insufficiency who are exposed to major stress. Read More

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http://dx.doi.org/10.1210/clinem/dgaa133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241266PMC

Spectrum of Current Management of Pediatric Pulmonary Hypertensive Crisis.

Crit Care Explor 2019 Aug 9;1(8):e0037. Epub 2019 Aug 9.

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

Pulmonary hypertension is a growing pediatric problem and children may present with pulmonary hypertensive crisis-a life-threatening emergency requiring acute interventions. The aim of this study was to characterize the broad spectrum of care provided in North American PICUs for children who present with pulmonary hypertensive crisis.

Design: Electronic cross-sectional survey. Read More

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http://dx.doi.org/10.1097/CCE.0000000000000037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063944PMC

Phenylethanolamine -methyltransferase gene polymorphisms associate with crisis pain in sickle cell disease patients.

Pharmacogenomics 2020 03 12;21(4):269-278. Epub 2020 Mar 12.

Department of Biopharmaceutical Sciences, University of Illinois at Chicago College of Pharmacy, Chicago, IL 60607, USA.

Phenylethanolamine methyltransferase (PNMT) catalyzes the conversion of sympathetic neurotransmitter norepinephrine to epinephrine. We examined the association of polymorphisms with acute and chronic pain in sickle cell disease (SCD). Utilization of emergency care owing to painful crisis was used as a marker for acute pain in 131 patients with SCD. Read More

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http://dx.doi.org/10.2217/pgs-2019-0096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202258PMC

Undiagnosed Pheochromocytoma Presenting as a Pancreatic Tumor: A Case Report.

Open Med (Wars) 2020 20;15:103-106. Epub 2020 Feb 20.

Department of General, Endocrinological and Vascular Surgery, Medical University of Warsaw, Warsaw 02-097 Poland.

Pheochromocytoma is a rare catecholamine-producing tumor of the adrenal gland. Patients with known pheochromocytoma undergoing surgery require preoperative treatment with alpha-blockers to reduce the risk of intraoperative complications related to catecholamine release. If undiagnosed, pheochromocytoma can lead to life-threatening surgical complications. Read More

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http://dx.doi.org/10.1515/med-2020-0015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053398PMC
February 2020

Safety of percutaneous ultrasound-guided fine-needle aspiration of adrenal lesions in dogs: Perception of the procedure by radiologists and presentation of 50 cases.

J Vet Intern Med 2020 Mar 11;34(2):626-635. Epub 2020 Mar 11.

Department of Veterinary Medical Science, Alma Mater Studiorum, University of Bologna, Bologna, Italy.

Background: Percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) of adrenal gland lesions is controversial in veterinary medicine.

Objective: To evaluate the frequency and radiologists' perception of the risk of the procedure as well as determining the incidence of complications.

Methods: Retrospective study. Read More

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http://dx.doi.org/10.1111/jvim.15743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096638PMC

The management of glucocorticoid deficiency: Current and future perspectives.

Clin Chim Acta 2020 Jun 5;505:148-159. Epub 2020 Mar 5.

Academic Department of Endocrinology, Beaumont Hospital/RCSI, Dublin, Ireland. Electronic address:

Glucocorticoid deficiency is the clinical state characterised by inadequate cortisol production. It may occur due to the primary failure of the adrenal cortex or to lack of stimulation of the adrenal cortex by adrenocorticotropic hormone. The aim of treatment of glucocorticoid deficiency is to mimic the normal physiological secretion of cortisol, in order to normalise quality of life and reverse pathological sequelae. Read More

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http://dx.doi.org/10.1016/j.cca.2020.03.006DOI Listing

Tako-tsubo Syndrome as First Manifestation in a Case of Pheochromocytoma Developed From a Non-functional Adrenal Incidentaloma.

Front Endocrinol (Lausanne) 2020 14;11:51. Epub 2020 Feb 14.

Section of Endocrinology, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.

Pheochromocytoma is a catecholamine secreting tumor that, in extremely rare cases, may develop over time from a non-functional adrenal adenoma. Catecholamine excess can lead to a kind of cardiomyopathy similar to that seen in tako-tsubo syndrome (TTS). A 69 years old female with a history of type 2 diabetes, hypertension, and a non-functional right adrenal adenoma diagnosed 3 years earlier was referred to our center for further investigations. Read More

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http://dx.doi.org/10.3389/fendo.2020.00051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7033429PMC
February 2020

Autoimmune polyglandular syndrome type II with co-manifestation of Addison's and Graves' disease in a 15-year-old boy: case report and literature review.

J Pediatr Endocrinol Metab 2020 Apr;33(4):575-578

Catholic Childrens Hospital Wilhelmstift, Department of Paediatrics, Hamburg, Germany.

Background Autoimmune polyglandular syndrome type II (APS II) is defined as the combination of autoimmune adrenal insufficiency and autoimmune thyroid disease (AITD) and/or type I diabetes mellitus (T1DM) in the same patient. Case presentation A 15-year-old boy had a history of weight loss, nausea and vomiting, headache, restlessness, and tanned skin. He was diagnosed with Graves' disease. Read More

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http://dx.doi.org/10.1515/jpem-2019-0506DOI Listing

Management of Immune-Related Endocrinopathies in Anticancer Treatment with Checkpoint Inhibitors.

Klin Onkol 2020 ;33(1):15-19

Modern immunotherapy with checkpoint inhibitors has become the backbone treatment for many cancers. However, it is often accompanied by immune-related side effects, which may differ depending on the nature of the treatment. The frequency of adverse reactions increases with the number of patients receiving immunotherapy. Read More

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http://dx.doi.org/10.14735/amko202015DOI Listing
January 2020

Allgrove Syndrome: A Report of New Pathological Variants in the AAAS Gene.

Cornea 2020 Jun;39(6):782-783

Department of Ophthalmology, Centre Hospitalier Universaite Sainte-Justine, Montreal, QC, Canada.

Purpose: To report 2 novel variants in the AAAS gene consistent with the diagnosis of Allgrove syndrome.

Methods: A 12-year-old girl was referred to our clinic for progressive bilateral decrease in visual acuity. She was known for achalasia that had been surgically treated at a very early age. Read More

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http://dx.doi.org/10.1097/ICO.0000000000002287DOI Listing

Impact of glucocorticoid supplementation on reducing perioperative complications in patients on long-term glucocorticoid medication: A propensity score analysis using a nationwide inpatient database.

Am J Surg 2020 Feb 3. Epub 2020 Feb 3.

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Background: Perioperative glucocorticoid supplementation has been suggested as a potentially effective precaution against perioperative adrenal crisis in patients on long-term glucocorticoid medication.

Methods: This retrospective cohort study used a national inpatient database in Japan. We included patients who underwent general surgery and those who received long-term glucocorticoid medication before surgery. Read More

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http://dx.doi.org/10.1016/j.amjsurg.2020.01.051DOI Listing
February 2020

New Insights and Methods in the Approach to Thalassemia Major: The Lesson From the Case of Adrenal Insufficiency.

Front Mol Biosci 2019 29;6:162. Epub 2020 Jan 29.

Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy.

Thalassemia Major (TM) is a complex pathology that needs a highly skilled approach. Endocrine comorbidities are nowadays the most important complications, including hypogonadism, hypothyroidism, diabetes mellitus, and bone diseases. Recent works stated that there could be a relevant prevalence of adrenal insufficiency (AI) present in TM, and this fact may become crucial, especially in case of major stressful events. Read More

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http://dx.doi.org/10.3389/fmolb.2019.00162DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000370PMC
January 2020

Autoimmune Addison's disease.

Best Pract Res Clin Endocrinol Metab 2020 Jan 30;34(1):101379. Epub 2020 Jan 30.

Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine, University of Perugia, Perugia, Italy. Electronic address:

Primary adrenal insufficiency (PAI) occurs in 1/5000-1/7000 individuals in the general population. Autoimmune Addison's disease (AAD) is the major cause of PAI and is a major component of autoimmune polyendocrine syndrome type 1 (APS1) and type 2 (APS2). Presence of 21-hydroxylase autoantibodies (21OHAb) identifies subjects with ongoing clinical or pre-clinical adrenal autoimmunity. Read More

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http://dx.doi.org/10.1016/j.beem.2020.101379DOI Listing
January 2020

Adrenal insufficiency: Physiology, clinical presentation and diagnostic challenges.

Clin Chim Acta 2020 Jun 7;505:78-91. Epub 2020 Feb 7.

Academic Department of Endocrinology, Beaumont Hospital, Dublin 9, Ireland; Royal College of Surgeons in Ireland, 123 St Stephens' Green, Dublin 2, Ireland. Electronic address:

Adrenal insufficiency (AI) is a serious condition, which can arise from pathology affecting the adrenal gland itself (primary adrenal insufficiency, PAI), hypothalamic or pituitary pathology (secondary adrenal insufficiency, SAI), or as a result of suppression of the hypothalamic-pituitaryadrenal (HPA) axis by exogenous glucocorticoid therapy (tertiary adrenal insufficiency, TAI). AI is associated with an increase in morbidity and mortality and a reduction in quality of life. In addition, the most common cause of PAI, autoimmune adrenalitis, may be associated with a variety of other autoimmune disorders. Read More

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http://dx.doi.org/10.1016/j.cca.2020.01.029DOI Listing

Spontaneous fertility and variable spectrum of reproductive phenotype in a family with adult-onset X-linked adrenal insufficiency harboring a novel DAX-1/NR0B1 mutation.

BMC Endocr Disord 2020 Feb 6;20(1):21. Epub 2020 Feb 6.

Department of Medicine, Division of Endocrinology, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, Universidade Federal de São Paulo, Rua Pedro de Toledo 669, Sao Paulo, SP, 04039-032, Brazil.

Background: Adrenal hypoplasia congenita (AHC) is an X-linked disorder that affects the adrenal cortex and hypothalamus-pituitary-gonadal axis (HPG), leading to primary adrenocortical insufficiency (PAI) and hypogonadotropic hypogonadism. AHC is caused by a mutation in the DAX-1 gene (NR0B1). More commonly, this disease is characterized by early-onset PAI, with symptoms in the first months of life. Read More

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http://dx.doi.org/10.1186/s12902-020-0500-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7006140PMC
February 2020

Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency: Guidelines from the Association of Anaesthetists, the Royal College of Physicians and the Society for Endocrinology UK.

Anaesthesia 2020 05 3;75(5):654-663. Epub 2020 Feb 3.

Department of Intensive Care Medicine, King's College Hospital, Co-Chair, Working Party on behalf of the Association of Anaesthetists, London, UK.

These guidelines aim to ensure that patients with adrenal insufficiency are identified and adequately supplemented with glucocorticoids during the peri-operative period. There are two major categories of adrenal insufficiency. Primary adrenal insufficiency is due to diseases of the adrenal gland (failure of the hormone-producing gland), and secondary adrenal insufficiency is due to deficient adrenocorticotropin hormone secretion by the pituitary gland, or deficient corticotropin-releasing hormone secretion by the hypothalamus (failure of the regulatory centres). Read More

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http://dx.doi.org/10.1111/anae.14963DOI Listing

Vomiting and Cardiac Arrest in a 10-Year-Old Girl.

Pediatr Emerg Care 2020 Feb 1. Epub 2020 Feb 1.

From the Department of Pediatrics, McMaster University.

Primary adrenal insufficiency is a potentially life-threatening condition that provides a diagnostic challenge because many patients have months to years of insidious symptomatology. Adrenal crisis is the extreme acute manifestation of primary adrenal insufficiency, presenting with any, or all, of severe weakness, altered mental status, hypotension, and rarely cardiorespiratory arrest. Primary adrenal insufficiency should be considered in patients with clinical features of glucocorticoid and/or mineralocorticoid deficiency. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001957DOI Listing
February 2020