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    517 results match your criteria Adrenal Insufficiency & Adrenal Crisis

    1 OF 11

    [Recommendations for the diagnosis and treatment of classic forms of 21-hydroxylase-deficient congenital adrenal hyperplasia].
    An Pediatr (Barc) 2017 Feb 1. Epub 2017 Feb 1.
    Hospital Clínico Universitario Virgen Arrixaca, Murcia, España.
    Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is an autosomal recessive disorder caused by mutations in the CYP21A2 gene. Cortisol and aldosterone synthesis are impaired in the classic forms (adrenal insufficiency and salt-wasting crisis). Females affected are virilised at birth, and are at risk for genital ambiguity. Read More

    Clinical features and practice patterns of treatment for adrenal crisis: a nationwide cross-sectional study in Japan.
    Eur J Endocrinol 2017 Mar;176(3):329-337
    Department of General MedicineNational Defense Medical College, Tokorozawa, Saitama, Japan.
    Context: Adrenal crisis is an endocrine emergency that requires prompt diagnosis and treatment. However, the clinical features and practice patterns of treatment for adrenal crisis are not completely understood.

    Objective: To investigate patient characteristics, comorbidities and treatments of adrenal crisis. Read More

    Adrenal crises: perspectives and research directions.
    Endocrine 2017 Feb 19;55(2):336-345. Epub 2016 Dec 19.
    Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.
    Adrenal crises are life-threatening complications of adrenal insufficiency. These events have an estimated incidence of between 5 and 10  adrenal crises/100 patient years and are responsible for some of the increased morbidity and excess mortality experienced by patients with adrenal insufficiency. Treatment involves urgent administration of IV/IM hydrocortisone and IV fluids. Read More

    Conduct protocol in emergency: Acute adrenal insufficiency.
    Rev Assoc Med Bras (1992) 2016 Nov;62(8):728-734
    Degree in Endocrinology and Metabology from Sociedade Brasileira de Endocrinologia e Metabologia (SBEM). Assistant Physician at the Internal Medicine Service of Hospital de Base. Researcher at Centro Integrado de Pesquisa (CIP), Hospital de Base, São José do Rio Preto. Endocrinology Coordinator of the Specialties Outpatient Clinic (AME), São José do Rio Preto, SP, Brazil.
    Introduction:: Acute adrenal insufficiency or addisonian crisis is a rare comorbidity in emergency; however, if not properly diagnosed and treated, it may progress unfavorably.

    Objective:: To alert all health professionals about the diagnosis and correct treatment of this complication.

    Method:: We performed an extensive search of the medical literature using specific search tools, retrieving 20 articles on the topic. Read More

    [Adrenal Insufficiency].
    Dtsch Med Wochenschr 2016 Nov 30;141(24):1740-1742. Epub 2016 Nov 30.
    Even under established replacement therapy, chronic adrenal insufficiency is associated with an impairment in daily life activities and a higher number of sick-days. In patients with individually adjusted glucocorticoid doses (avoiding over-replacement) the frequency of glucocorticoid side effects is low. Besides the standard treatment with conventional hydrocortisone, new formulas aiming at more adjusted physiological circadian cortisol profiles or improved individual dosing have been evaluated in recent clinical trials. Read More

    Rifampicin-induced adrenal crisis in a patient with tuberculosis: a therapeutic challenge.
    BMJ Case Rep 2016 Nov 29;2016. Epub 2016 Nov 29.
    Department of Respiratory Medicine, Tameside General Hospital, Ashton-under-Lyne, UK.
    A 55-year-old Indian man presented with productive cough and a large left pleural effusion. Pleural fluid culture grew Mycobacterium tuberculosis, and he was started on antituberculosis therapy. One week later, the patient presented to hospital with drowsiness, dehydration and hypotension. Read More

    Adrenal crisis secondary to bilateral adrenal haemorrhage after hemicolectomy.
    Endocrinol Diabetes Metab Case Rep 2016 25;2016. Epub 2016 Oct 25.
    Department of Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia; The University of Sydney, Sydney, Australia.
    : 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. Read More

    MANAGEMENT OF ENDOCRINE DISEASE: Regenerative therapies in autoimmune Addison's disease.
    Eur J Endocrinol 2017 Mar 3;176(3):R123-R135. Epub 2016 Nov 3.
    Institute of Genetic MedicineInternational Centre for Life, Centre Parkway, Newcastle upon Tyne, UK.
    The treatment for autoimmune Addison's disease (AAD) has remained virtually unchanged in the last 60 years. Most patients have symptoms that are relatively well controlled with exogenous steroid replacement, but there may be persistent symptoms, recurrent adrenal crisis and poor quality of life, despite good compliance with optimal current treatments. Treatment with conventional exogenous steroid therapy is also associated with premature mortality, increased cardiovascular risk and complications related to excessive steroid replacement. Read More

    Adrenal crisis while on high-dose steroid treatment: what rheumatologist should consider?
    Rheumatol Int 2016 Nov 1. Epub 2016 Nov 1.
    Division of Rheumatology, Department of Internal Medicine, School of Medicine, Eskişehir Osmangazi University, 26480, Eskişehir, Turkey.
    Steroid treatment is commonly recommended for autoimmune disorders in rheumatology practice. While adrenal crisis may occur upon existence of an inducing factor in patients with known or unknown adrenal insufficiency as well as in those with a suppressed hypothalamic-pituitary-adrenal (HPA) axis due to chronic steroid use, addisonian crisis rarely develops in patients on supraphysiological doses of steroid and, when emerged, it might be very difficult to recognize. Here, we present a patient who developed adrenal crisis while receiving high-dose methylprednisolone treatment due to retroperitoneal fibrosis and we also discuss possible mechanisms with a brief literature review. Read More

    Delayed diagnosis with autoimmune polyglandular syndrome type 2 causing acute adrenal crisis: A case report.
    Medicine (Baltimore) 2016 Oct;95(42):e5062
    Key laboratory of Endocrinology, Ministry of Health, Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
    Background: Autoimmune polyglandular syndrome type 2 (APS-2), also known as Schmidt's syndrome, is an uncommon disorder characterized by the coexistence of Addison's disease with thyroid autoimmune disease and/or type 1 diabetes mellitus. Addison's disease as the obligatory component is potentially life-threatening. Unfortunately, the delayed diagnosis of Addison's disease is common owing to its rarity and the nonspecific clinical manifestation. Read More

    NFKB2 mutation in common variable immunodeficiency and isolated adrenocorticotropic hormone deficiency: A case report and review of literature.
    Medicine (Baltimore) 2016 Oct;95(40):e5081
    aDepartment of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health bDepartment of Internal Medicine cDepartment of Pediatrics dDepartment of Infectious Diseases eDepartment of Dermatology, Peking Union Medical College Hospital, Beijing, P.R. China.
    Background: Common variable immunodeficiency (CVID) with central adrenal insufficiency is a recently defined clinical syndrome caused by mutations in the nuclear factor kappa-B subunit 2 (NFKB2) gene. We present the first case of NFKB2 mutation in Asian population.

    Methods And Results: An 18-year-old Chinese female with adrenocorticotropic hormone (ACTH) deficiency was admitted due to adrenal crisis and pneumonia. Read More

    Alacrima as a Harbinger of Adrenal Insufficiency in a Child with Allgrove (AAA) Syndrome.
    Am J Case Rep 2016 Oct 4;17:703-706. Epub 2016 Oct 4.
    Department of Genetics, New York Methodist Hospital, Brooklyn, NY, USA.
    BACKGROUND Allgrove syndrome, or triple "A" syndrome (3A syndrome), is a rare autosomal recessive syndrome with variable phenotype, and an estimated prevalence of 1 per 1,000,000 individuals. Patients usually display the triad of achalasia, alacrima, and adrenocorticotropin (ACTH) insensitive adrenal insufficiency, though the presentation is inconsistent. CASE REPORT Here, the authors report a case of Allgrove syndrome in a pediatric patient with delayed diagnosis in order to raise awareness of this potentially fatal disease as a differential diagnosis of alacrima. Read More

    Endocr Pract 2017 Jan 15;23(1):17-31. Epub 2016 Sep 15.
    Objective: Various glucocorticoid (GC) regimens have been used in the treatment of patients with adrenal insufficiency, yet the differences between such regimens on health outcomes are unclear. We performed a systematic review and meta-analysis to compare the effects of GC regimens on quality of life (QoL), bone density, incidence of adrenal crisis, and death. In pediatric studies, we also searched for final adult height. Read More

    Triple A to triple S: From diagnosis, to anesthetic management of Allgrove syndrome.
    J Clin Anesth 2016 Sep 29;33:141-3. Epub 2016 Apr 29.
    Department of Anaesthesiology and Critical Care, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
    Introduction: Allgrove syndrome (AS) is a rare autosomal recessive disorder characterized by achalasia cardia, alacrimia, and adrenocorticotropic hormone-resistant adrenal insufficiency which is sometimes associated with autonomic dysfunction. It has also been referred to as the triple A syndrome in view of the cardinal symptoms described above. First described by Allgrove et al in 1978, the disorder usually presents mostly during the first decade of life. Read More

    Darkened skin, vomiting, and salt cravings in a teenager · Dx?
    J Fam Pract 2016 Jun;65(6):E1-3
    Phoenix Children's Hospital, AZ, USA. Email:
    Acute adrenal insufficiency crisis usually occurs after a prolonged period of nonspecific complaints due to a loss of both glucocorticoids and mineralocorticoids; by the time overt symptoms occur, 90% of the adrenal gland may be destroyed. Patients (such as ours) may present with symptoms such as abdominal pain, weakness, vomiting, fever, and decreased responsiveness. Read More

    X-linked Congenital Adrenal Hypoplasia with a Novel NR0B1/DAX Gene Mutation.
    Indian Pediatr 2016 Jun;53(6):529-31
    Department of Endocrinology, Princess Margaret Hospital,; #School of Paediatrics and Child Health, The University of Western Australia; and $Genetic Services of Western Australia, Princess Margaret Hospital and King Edward Memorial Hospital; Perth, Australia. Correspondence to: Dr Mary B Abraham, Department of Endocrinology and Diabetes, Princess Margaret Hospital, Perth, Australia.
    Background: The etiology of primary adrenal insufficiency has implications for further management of the condition.

    Case Characteristics: A 5-year-old boy presented in adrenal crisis with glucocorticoid and mineralocorticoid deficiency.

    Observation: Investigations confirmed primary adrenal insufficiency and ruled out the common etiologies. Read More

    Diagnosis and treatment of adrenal insufficiency including adrenal crisis: a Japan Endocrine Society clinical practice guideline [Opinion].
    Endocr J 2016 Sep 24;63(9):765-784. Epub 2016 Jun 24.
    Department of Endocrinology and Diabetes Mellitus, Faculty of Medicine, Fukuoka University, Fukuoa 814-0180, Japan.
    This clinical practice guideline of the diagnosis and treatment of adrenal insufficiency (AI) including adrenal crisis was produced on behalf of the Japan Endocrine Society. This evidence-based guideline was developed by a committee including all authors, and was reviewed by a subcommittee of the Japan Endocrine Society. The Japanese version has already been published, and the essential points have been summarized in this English language version. Read More

    Abdominal Distension and Vascular Collapse.
    J Miss State Med Assoc 2016 Apr;57(4):113-5
    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Read More

    Primary Adrenal Insufficiency Misdiagnosed as Hypothyroidism in a Patient with Polyglandular Syndrome.
    N Am J Med Sci 2016 May;8(5):226-8
    Department of Internal Medicine, Bassett Medical Center, Columbia University College of Physicians and Surgeons, New York, USA.
    Context: Autoimmune polyglandular syndrome is a rare condition that causes a variety of clinical symptoms due to autoimmune processes involving multiple endocrine organs. Its vague presentation can cause missed or delayed treatment for adrenal insufficiency, resulting in a life-threatening adrenal crisis.

    Case Report: A 21-yr-old man presented with lethargy, hypotension, hyponatremia, hypoglycemia, and an elevated thyroid-stimulating hormone level. Read More

    Adrenal Insufficiency Therapy: How to Keep the Balance between Good Quality of Life and Low Risk for Long-Term Side Effects?
    Front Horm Res 2016 23;46:196-210. Epub 2016 May 23.
    Glucocorticoid treatment in adrenal insufficiency remains a challenge since many patients complain of fatigue, reduced health-related quality of life and working ability. Moreover, there is a fear of increased mortality and morbidity related to adrenal crises and chronic overexposure to glucocorticoids. In order to counter these negative effects on daily life and future health, recent recommendations speak for lower replacement doses and administration forms that attempt to mimic the circadian variation in cortisol. Read More

    Quality of Life and Life Expectancy in Patients with Adrenal Insufficiency: What Is True and What Is Urban Myth?
    Front Horm Res 2016 17;46:171-83. Epub 2016 May 17.
    For a long time it has been assumed that patients with chronic adrenal insufficiency under established replacement therapy have a normal life expectancy and a normal everyday life. Recent studies now indicate both an impairment of quality of life (QoL) with a negative impact on daily life and increased mortality in a significant number of patients. The clinical presentation of patients varies considerably. Read More

    Secondary Adrenal Insufficiency: Where Is It Hidden and What Does It Look Like?
    Front Horm Res 2016 17;46:159-70. Epub 2016 May 17.
    Adrenal failure secondary to hypothalamic-pituitary disease is a common although underestimated and underdiagnosed condition, with serious consequences. Corticotropin deficiency can be isolated or more frequently occur in association with other pituitary hormones deficiencies. The most frequent endogenous cause of secondary adrenal insufficiency (SAI) is a tumor of the hypothalamic-pituitary region, usually associated with panhypopituitarism secondary to tumor growth or to its treatment with surgery or irradiation. Read More

    Delayed Diagnosis of Graves' Thyrotoxicoisis Presenting as Recurrent Adrenal Crisis in Primary Adrenal Insufficiency.
    J Clin Diagn Res 2016 Apr 1;10(4):OD20-2. Epub 2016 Apr 1.
    Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College , Vellore, Tamil Nadu, India .
    Adrenal crisis is a potential life threatening complication. The common causes of adrenal crisis are infections, surgical stress and abrupt cessation of steroid medications. Endocrine causes like Graves' disease with thyrotoxicosis is one of the less common causes of an adrenal crisis. Read More

    Pathologe 2016 May;37(3):238-44
    Institute für Pathologie und Neuropathologie der Universität Hamburg, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Deutschland.
    Inflammation of the adrenal glands is caused by autoimmunopathies or infections and can induce adrenal insufficiency. Autoimmune lymphocytic adrenalitis is often combined with other autoimmune diseases and the most frequent cause of Addison's disease; however, it only becomes clinically apparent when more than 90 % of the adrenal cortex has been destroyed. Histological features are characterized by lymphoplasmacytic inflammation leading to an increased destruction of adrenocortical tissue but less severe courses can also occur. Read More

    Self-management support in patients with adrenal insufficiency.
    Clin Endocrinol (Oxf) 2016 Oct 26;85(4):652-9. Epub 2016 Apr 26.
    Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, The Netherlands.
    Objective: Patient education is an important intervention to prevent an adrenal crisis in patients with adrenal insufficiency. The objective of this study was to assess the knowledge of adjusting the dose of glucocorticoids in special circumstances in patients with adrenal insufficiency who had previously been educated on this topic. In patients with insufficient knowledge, we tried to identify the underlying causes and care needs. Read More

    Diagnosis and management of pediatric adrenal insufficiency.
    World J Pediatr 2016 Aug 8;12(3):261-74. Epub 2016 Apr 8.
    Growth-Development and Pediatric Endocrine Unit, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey.
    Background: Adrenal insufficiency (AI) is a wellknown cause of potentially life-threatening disorders. Defects at each level of the hypothalamic-pituitary-adrenal axis can impair adrenal function, leading to varying degrees of glucocorticoid (GC) deficiency. Iatrogenic AI induced by exogenous GCs is the most common cause of AI. Read More

    [Adrenal insufficiency of the adult].
    Rev Med Interne 2016 Dec 22;37(12):820-826. Epub 2016 Mar 22.
    Service d'endocrinologie-métabolisme, Institut E3M, hôpital Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75013 Paris, France.
    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. Read More

    Acute adrenal insufficiency: an aide-memoire of the critical importance of its recognition and prevention.
    Intern Med J 2016 Mar;46(3):356-9
    Department of Endocrinology, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia.
    Adrenal crisis is a life-threatening emergency that causes significant excess mortality in patients with adrenal insufficiency. Delayed recognition by medical staff of an impending adrenal crisis and failure to give timely hydrocortisone therapy within the emergency department continue to be commonly encountered, even in metropolitan teaching hospitals. Within the authors' institutions, several cases of poorly handled adrenal crises have occurred over the last 2 years. Read More

    Hospital Admission Patterns in Children with CAH: Admission Rates and Adrenal Crises Decline with Age.
    Int J Endocrinol 2016 6;2016:5748264. Epub 2016 Jan 6.
    Endocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, North Terrace, Adelaide, SA 5000, Australia.
    Objective. To examine patterns of hospitalisation for acute medical conditions in children with congenital adrenal hyperplasia (CAH). Design. Read More

    Takotsubo cardiomyopathy in a patient with pituitary adenoma and secondary adrenal insufficiency.
    Indian J Crit Care Med 2015 Dec;19(12):731-4
    Department of Anaesthesiology, Sri Chitra Tirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
    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. Read More

    Reduction in daily hydrocortisone dose improves bone health in primary adrenal insufficiency.
    Eur J Endocrinol 2016 Apr 25;174(4):531-8. Epub 2016 Jan 25.
    Department of Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyEndocrine and Diabetes UnitDepartment of Medicine I, University Hospital, University of Würzburg, Würzburg, GermanyAdrenal Steroid GroupANZAC Research Institute, Concord Repatriation General Hospital, Hospital Road, Concord Hospital, Concord, New South Wales 2139, AustraliaEndokrinologikumBerlin, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany Department of Clinical EndocrinologyCharité Campus Mitte, Charité University Medicine Berlin, Berlin, GermanyEndocrine and Diabetes UnitDepartment of Medicine I, University Hospital, University of Würzburg, Würzburg, GermanyAdrenal Steroid GroupANZAC Research Institute, Concord Repatriation General Hospital, Hospital Road, Concord Hospital, Concord, New South Wales 2139, AustraliaEndokrinologikumBerlin, GermanyEndocrinology in CharlottenburgStuttgarter Platz 1, 10627 Berlin, Germany
    Objective: Individuals with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) receive life-long glucocorticoid (GC) replacement therapy. Current daily GC doses are still higher than the reported adrenal cortisol production rate. This GC excess could result in long-term morbidities such as osteoporosis. Read More

    Latent polyglandular autoimmune syndrome type 2 case diagnosed during a shock manifestation.
    Gynecol Endocrinol 2016 Jul 25;32(7):521-3. Epub 2016 Jan 25.
    d Department of Nuclear Medicine , Hatay Antakya State Hospital , Hatay , Turkey.
    There are many types of polyglandular autoimmune syndrome (PAS). PAS type 2 is the most common type among adults. For PAS type 2 (PAS-2) diagnosis, detection of Addison's disease with autoimmune thyroid disease and/or type 1 diabetes mellitus are required. Read More

    Endocr Pract 2016 May 20;22(5):595-601. Epub 2016 Jan 20.
    Objective: Craniopharyngiomas (CPs) are benign brain tumors presenting frequently in childhood and are treated by surgery with or without radiotherapy. About 50% of cured patients suffer from eating disorders and obesity due to hypothalamic damage, as well as hypopituitarism, necessitating subsequent hormone substitution therapy. Gastric bypass surgery has been reported to be an efficient treatment strategy for morbid hypothalamic obesity. Read More

    Adrenal Function Testing Following Hormone Therapy for Infantile Spasms: Case Series and Review of Literature.
    Front Neurol 2015 8;6:259. Epub 2015 Dec 8.
    Department of Pediatrics, Division of Pediatric Endocrinology, Nationwide Children's Hospital, The Ohio State University , Columbus, OH , USA.
    Prednisolone and adrenocorticotropic hormone (ACTH) are "hormone" therapies for infantile spasms. There is limited data on the occurrence of decreased adrenal reserve or signs of clinical adrenal insufficiency after hormone therapy. This is a retrospective medical record review of patients referred to our Infantile Spasms Program. Read More

    Glucocorticoid therapy for adrenal insufficiency: nonadherence, concerns and dissatisfaction with information.
    Clin Endocrinol (Oxf) 2016 May 15;84(5):664-71. Epub 2016 Feb 15.
    Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.
    Objective: Appropriate self-management of glucocorticoid therapy (GC) is crucial for patients with adrenal insufficiency (AI). We aimed to describe patients' self-reported nonadherence to GC, evaluate perceived doubts about need for GC, concerns about adverse effects, and dissatisfaction with information received about GC.

    Design: Cross-sectional survey. Read More

    Primary Adrenal Failure due to Antiphospholipid Syndrome.
    Case Rep Endocrinol 2015 22;2015:161497. Epub 2015 Oct 22.
    Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey.
    Background. Antiphospholipid syndrome (APS) characterized by thrombosis and abortus may rarely cause primary adrenal failure. Case Presentations. Read More

    Children with classic congenital adrenal hyperplasia experience salt loss and hypoglycemia: evaluation of adrenal crises during the first 6 years of life.
    Eur J Endocrinol 2016 Feb 12;174(2):177-86. Epub 2015 Nov 12.
    Bavarian Health and Food Safety AuthorityVeterinärstr.2, D-85762 Oberschleißheim, GermanyDepartment of PediatricsUniversity of Erlangen-Nürnberg, Erlangen, GermanyDepartment of PediatricsLudwig-Maximilians-University Munich (LMU), Munich, GermanyDepartment of PediatricsTechnical University Munich (TUM), Munich, GermanyDepartment of PediatricsKlinikum Wels-Grieskirchen, Wels, Austria Bavarian Health and Food Safety AuthorityVeterinärstr.2, D-85762 Oberschleißheim, GermanyDepartment of PediatricsUniversity of Erlangen-Nürnberg, Erlangen, GermanyDepartment of PediatricsLudwig-Maximilians-University Munich (LMU), Munich, GermanyDepartment of PediatricsTechnical University Munich (TUM), Munich, GermanyDepartment of PediatricsKlinikum Wels-Grieskirchen, Wels, Austria.
    Objective: To evaluate adrenal crises after the start of treatment up to the age of 6 years in children with classic congenital adrenal hyperplasia (CAH).

    Design: Analysis of data extracted from a population-based prospective long-term follow-up study of children detected in neonatal screening.

    Methods: Data of 102 Bavarian children with classic CAH due to 21-hydroxylase deficiency were analyzed, using parental questionnaires and medical reports. Read More

    Adrenal Hypoplasia Congenita: A Rare Cause of Primary Adrenal Insufficiency and Hypogonadotropic Hypogonadism.
    Pediatr Rep 2015 Sep 28;7(3):5936. Epub 2015 Sep 28.
    Endocrinology Unit, Pediatrics Department, Hospital Santa Maria , Lisboa, Portugal.
    Primary adrenal insufficiency is defined by the impaired synthesis of adrenocortical hormones due to an intrinsic disease of the adrenal cortex. Determining its etiology is crucial to allow adequate long-term management and genetic counseling. We report the case of a male adolescent that presented in the neonatal period with adrenal crisis and received replacement therapy for primary adrenal insufficiency. Read More

    Acute psychosis in the course of treatment of acute adrenal crisis with hydrocortisone in the patient with secondary adrenal insufficiency - a case study.
    Psychiatr Pol 2015 ;49(4):673-81
    Kliniczny Oddział Psychiatryczny i IV Klinika Psychiatrii IPiN w Szpitalu Bielańskim w Warszawie.
    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. Read More

    Budesonide-related adrenal insufficiency.
    BMJ Case Rep 2015 Oct 1;2015. Epub 2015 Oct 1.
    Department of Internal Medicine, VU Medical Centre, Amsterdam, Noord Holland, The Netherlands.
    Iatrogenic adrenal insufficiency is a potential harmful side effect of treatment with corticosteroids. It manifests itself when an insufficient cortisol response to biological stress leads to an Addisonian crisis: a life-threatening situation. We describe a case of a patient who developed an Addisonian crisis after inappropriate discontinuation of budesonide (a topical steroid used in Crohn's disease) treatment. Read More

    Diffusion MRI features of acute encephalopathy due to stopping steroid medication abruptly in congenital adrenal hyperplasia.
    Ann Indian Acad Neurol 2015 Jul-Sep;18(3):342-4
    Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
    Congenital adrenal hyperplasia (CAH) is characterized by adrenal steroid biosynthesis defect. Steroid replacement therapy should be performed regularly in these patients. Adrenal crisis may be present in acute stress due to increased cortisol requirements or in steroid deficiency due to stopping steroid medication abruptly. Read More

    Adrenal Crisis: Still a Deadly Event in the 21st Century.
    Am J Med 2016 Mar 9;129(3):339.e1-9. Epub 2015 Sep 9.
    Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
    Adrenal crisis is a life-threatening medical emergency, associated with a high mortality unless it is appropriately recognized and early treatment is rendered. Despite it being a treatable condition for almost 70 years, failure of adequate preventive measures or delayed treatment has often led to unnecessary deaths. Gastrointestinal illness is the most common precipitant for an adrenal crisis. Read More

    An overview of the nursing issues involved in caring for a child with adrenal insufficiency.
    Nurs Child Young People 2015 Sep;27(7):28-36
    King's College London.
    Adrenal insufficiency is an endocrine condition defined as the inadequate production or action of glucocorticoids, principally a steroid hormone called cortisol. While rare in childhood, it carries the risk of adrenal crisis in the event of a child becoming unwell as a result of intercurrent illness, injury or surgery. Children's nurses must be vigilant in caring for a child with adrenal insufficiency and have a clear understanding and awareness of the principles of emergency management at home and in hospital. Read More

    Traumatic panhypopituitarism resulting in acute adrenal crisis.
    J Trauma Acute Care Surg 2015 Sep;79(3):484-9
    From the Departments of Surgery (P.B.H., C.J.M., L.S.Y., A.M.A.), and Endocrinology (A.A), Medical College of Georgia (A.J.C.), Georgia Regents University, Augusta, Georgia.
    Pituitary function plays an integral role in the physiologic response to traumatic injury. A significant proportion of trauma patients develop partial pituitary insufficiency. While isolated deficiencies of individual pituitary hormones are common, there are few reports in the literature of traumatic pan-pituitary failure with deficiency of all major pituitary hormones. Read More

    Adrenal suppression in patients taking inhaled glucocorticoids is highly prevalent and management can be guided by morning cortisol.
    Eur J Endocrinol 2015 Nov 20;173(5):633-42. Epub 2015 Aug 20.
    Oxford Centre for Diabetes Endocrinology and Metabolism (OCDEM)NIHR Biomedical Research Centre, Churchill Hospital, University of Oxford, Headington, Oxford OX3 7LJ, UKCentre for EndocrinologyDiabetes and Metabolism, University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UKDepartment of EndocrinologyFaculty of Medicine and Psychology, St Andrea Hospital, Sapienza University of Rome, Rome, ItalyDepartments of BiochemistryHealth InformaticsQueen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2TH, UKDepartment of EndocrinologyUniversity of Leeds, Leeds, UK
    Context: Up to 3% of US and UK populations are prescribed glucocorticoids (GC). Suppression of the hypothalamo-pituitary-adrenal axis with the potential risk of adrenal crisis is a recognized complication of therapy. The 250 μg short Synacthen stimulation test (SST) is the most commonly used dynamic assessment to diagnose adrenal insufficiency. Read More

    Addison's disease in a patient with hypothyroidism: autoimmune polyglandular syndrome type 2.
    BMJ Case Rep 2015 Aug 3;2015. Epub 2015 Aug 3.
    Tauranga Hospital, Tauranga, Bay of Plenty, New Zealand.
    A 57-year-old Caucasian woman with known autoimmune hypothyroidism diagnosed in 2006 presented to hospital with flu-like symptoms and circulatory collapse. She reported weight loss and gradual increase in her skin pigmentation over a 1-year period. Aggressive fluid resuscitation was instituted. Read More

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