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    539 results match your criteria Adrenal Insufficiency & Adrenal Crisis

    1 OF 11

    Recognizing and managing adrenal disorders in the emergency department
    Emerg Med Pract 2017 09;19(9):1-24
    Assistant Professor of Emergency Medicine, Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE
    Primary and secondary adrenal insufficiency are underrecognized conditions among emergency department patients, affecting an estimated 10% to 20% of critically ill patients. The signs and symptoms of cortisol deficit can be nonspecific and wide-ranging, and identification and swift treatment with stress-dosing of hydrocortisone is vital to avoid life-threatening adrenal crisis. Laboratory evaluation focuses on identification of electrolyte abnormalities typical of adrenal insufficiency, and while additional testing may depend on the type and severity of symptoms, it should not delay corticosteroid replacement. Read More

    [Adrenal crisis].
    Internist (Berl) 2017 Aug 16. Epub 2017 Aug 16.
    Medizinische Klinik und Poliklinik, Schwerpunkt Endokrinologie und Diabetologie, Universitätsklinikum Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Deutschland.
    Patients with chronic adrenal insufficiency suffer from reduced quality of life and increased mortality. An association between mortality and adrenal crisis is assumed. The frequency of adrenal crisis is about 8/100 patient years. Read More

    Exploration of knowledge and understanding in patients with primary adrenal insufficiency: a mixed methods study.
    BMC Endocr Disord 2017 Aug 1;17(1):47. Epub 2017 Aug 1.
    School of Nursing, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, West Midlands, B15 2TT, UK.
    Background: Primary adrenal insufficiency (PAI) is a rare and severe condition requiring lifelong steroid replacement. During acute illness or stressful events, it is important to appropriately adjust glucocorticoid dose; failure to do so may lead to an adrenal crisis. The aim of the study was to explore patients PAI knowledge and understanding of the condition, steroid replacement adjustment during acute illness or stress and provided education. Read More

    Adrenal crisis in metastatic breast cancer.
    BMJ Case Rep 2017 Jul 6;2017. Epub 2017 Jul 6.
    Interne I: Internistische Onkologie, Hämatologie u. Gastroenterologie, Ordensklinikum Linz Krankenhaus d. Barmherzigen Schwestern Linz Betriebs GmbH, Linz, Austria.
    A female patient with oestrogen receptor-positive and human epidermal growth factor receptor 2 (HER2)-positive invasive lobular breast cancer presented with progressive disease on CT scan. Some days after initiation of antineoplastic chemotherapy and anti-HER2 targeted antibody therapy, the patient presented with profuse diarrhoea, neutropaenia, nausea and weakness. Although Clostridium difficile was rapidly tackled as a causative agent of gastrointestinal complaints, clinical situation did not markedly improve despite proper antimicrobial treatment. Read More

    The Key to Adrenal Insufficiency Education: Repetition, Repetition, Repetition.
    Pediatr Endocrinol Rev 2017 Jun;14(Suppl 2):448-453
    Organic Acid Research Section (OARS) of the Medical Genomics and Metabolic Genetics Branch (MGMGB) National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
    Described more than 150 years ago by Thomas Addison, adrenal gland dysfunction, while treatable, remains a clinically significant and potentially fatal disease. Vague and non-specific symptomatology can delay diagnosis of adrenal insufficiency and lead to adrenal crisis. Affected individuals may delay self-management due to knowledge deficits or lack of required therapies. Read More

    Adrenal insufficiency - recognition and management.
    Clin Med (Lond) 2017 Jun;17(3):258-262
    Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
    Adrenal insufficiency is characterised by inadequate -glucocorticoid production owing to destruction of the adrenal cortex or lack of adrenocorticotropic hormone stimulation. In primary adrenal insufficiency, lack of mineralocorticoids is also a feature. Patients can present with an insidious onset of symptoms, or acutely in adrenal crisis, which requires prompt recognition and treatment. Read More

    Endocrine Emergencies With Neurologic Manifestations.
    Continuum (Minneap Minn) 2017 Jun;23(3, Neurology of Systemic Disease):778-801
    Purpose Of Review: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities.

    Recent Findings: To identify the optimal management of endocrine emergencies, using formal clinical diagnostic criteria and grading scales such as those recently proposed for pituitary apoplexy will be beneficial in future prospective studies. Read More

    Thyrotoxicosis leading to adrenal crises reveals primary bilateral adrenal lymphoma.
    Endocrinol Diabetes Metab Case Rep 2017 16;2017. Epub 2017 May 16.
    Anatomopathology Department, Hospital de Egas Moniz C.H.L.O.-E.P.E, LisbonPortugal.
    Primary adrenal lymphoma is a rare malignancy. It frequently presents bilaterally and with symptoms of adrenal insufficiency. Amiodarone may induce secondary organ dysfunction, and thyrotoxicosis develops in 15% of cases. Read More

    A case report of pedigree of a homozygous mutation of the steroidogenic acute regulatory protein causing lipoid congenital adrenal hyperplasia.
    Medicine (Baltimore) 2017 May;96(21):e6994
    aDepartment of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Key Laboratory of Health and Family Planning Commission, Beijing, China bThe Key Laboratory of Genome Sciences and Information, Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing, China.
    Rationale: Lipoid congenital adrenal hyperplasia (LCAH) is extremely rare, but is the most fatal form of congenital adrenal hyperplasia resulting from mutations in the steroidogenic acute regulatory protein (STAR) gene. LCAH arises from severe defects in the conversion of cholesterol to pregnenolone, the precursor of all steroids.

    Patient Concerns: A case was reported that an 11-month-old Chinese girl who presented with a sex development disorder and hyponatremia. Read More

    Quality of compounded hydrocortisone capsules used in the treatment of children.
    Eur J Endocrinol 2017 Aug 16;177(2):239-242. Epub 2017 May 16.
    Institute for Experimental Paediatric EndocrinologyCharité Berlin, Berlin, Germany
    Objectives: Due to the lack of paediatric-licensed formulations, children are often treated with individualized pharmacy-compounded adult medication. An international web-based survey about the types of medication in children with adrenal insufficiency (AI) revealed that the majority of paediatric physicians are using pharmacy-compounded medication to treat children with AI. Observations of loss of therapy control in children with congenital adrenal hyperplasia with compounded hydrocortisone capsules and regained control after prescribing a new hydrocortisone batch led to this 'real world' evaluation of pharmacy-compounded paediatric hydrocortisone capsules. Read More

    Autoimmune polyendocrine syndrome type 1 in an Indian cohort: a longitudinal study.
    Endocr Connect 2017 Jul 26;6(5):289-296. Epub 2017 Apr 26.
    Departments of EndocrinologySanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
    Objective: Autoimmune polyendocrine syndrome type 1 (APS1) is a rare autosomal recessive disorder characterized by progressive organ-specific autoimmunity. There is scant information on APS1 in ethnic groups other than European Caucasians. We studied clinical aspects and autoimmune regulator (AIRE) gene mutations in a cohort of Indian APS1 patients. Read More

    A Complex Interplay: Cognitive Behavioural Therapy for Severe Health Anxiety in Addison's Disease to Reduce Emergency Department Admissions.
    Behav Cogn Psychother 2017 Jul 9;45(4):419-426. Epub 2017 Apr 9.
    Department of Psychology,University of Bath,Bath,UK.
    Background: Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. Read More

    [A clinical analysis of 123 cases of primary empty sella].
    Zhonghua Nei Ke Za Zhi 2017 Apr;56(4):268-272
    Department of Endocrinology and Metabolism, General Hospital of Tianjin Medical University, Tianjin 300052, China.
    Objective: This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES). Methods: The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied. Results: (1) The average age of the 123 (male 43, female 80) PES patients was (59. Read More

    Symptomatic adrenal suppression among children in Canada.
    Arch Dis Child 2017 Apr 9;102(4):338-339. Epub 2016 Nov 9.
    Department of Pediatrics (Endocrinology), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
    Background: Adrenal suppression (AS) is an under-recognised side effect of glucocorticoid (GC) use. AS may go undetected until a physiological stress precipitates an adrenal crisis. The incidence of AS has not been established. Read More

    Clinical Characteristics of Patients with Adrenal Insufficiency in a General Hospital.
    Endocrinol Metab (Seoul) 2017 Mar 19;32(1):83-89. Epub 2017 Jan 19.
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
    Background: Adrenal insufficiency (AI) is a life-threatening disorder caused by the deficiency of adrenal steroid hormones. This retrospective cross-sectional study investigated the characteristics of patients with AI in Korea.

    Methods: All consecutive patients with suspected AI who received care at a tertiary referral center in Korea in 2014 and underwent adrenocorticotropic hormone stimulation or insulin-tolerance testing were identified through a review of medical charts. Read More

    Nivolumab induced myxedema crisis.
    J Immunother Cancer 2017 21;5:13. Epub 2017 Feb 21.
    Department of Hematology/Oncology, St. John Hospital and Medical Center, 19229 Mack Ave Suite 23 Grosse Pointe Woods, Detroit, 48236 Michigan USA.
    Background: Nivolumab is an anti-programmed cell death (anti-PD-1) monoclonal antibody that is approved by Food and Drug Administration for treatment of metastatic non-small cell lung cancer, metastatic melanoma, relapsed Hodgkin lymphoma and advanced renal cell cancer. We report a rare case of myxedema crisis induced by nivolumab in a patient with metastatic squamous cell carcinoma of lung.

    Case Presentation: Fifty three-year old woman with metastatic squamous cell carcinoma currently on treatment with nivolumab presented with diffuse facial and tongue swelling, slurred speech, depressed mentation, fatigue and weakness. Read More

    Septo-optic dysplasia/de Morsier's syndrome.
    Saudi J Anaesth 2017 Jan-Mar;11(1):106-107
    Department of Anesthesia, São João Hospital Centre, Porto, Portugal; Department of Anesthesia, Medical Faculty, Oporto University, Porto, Portugal.
    Septo-optic dysplasia (SOD)/de Morsier's syndrome is characterized by optic nerve hypoplasia, pituitary endocrine dysfunction, and midline brain abnormalities. Hypopituitarism, hypothyroidism, hypogonadism, and adrenal insufficiency can lead to severe hypoglycemia, adrenal crisis, seizures, and sudden death. Anesthetic management of SOD was associated with high perioperative mortality. Read More

    [Recommendations for the diagnosis and treatment of classic forms of 21-hydroxylase-deficient congenital adrenal hyperplasia].
    An Pediatr (Barc) 2017 Aug 1;87(2):116.e1-116.e10. 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 2017 Apr 1;37(4):657-662. 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

    GLUCOCORTICOID REPLACEMENT REGIMENS IN CHRONIC ADRENAL INSUFFICIENCY: A SYSTEMATIC REVIEW AND META-ANALYSIS.
    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

    [Adrenalitis].
    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

    Acute reversible cardiomyopathy and heart failure in a child with acute adrenal crisis.
    Paediatr Int Child Health 2017 May 29;37(2):148-151. Epub 2016 Jan 29.
    b Divisions of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine , Ankara University , Ankara , Turkey.
    Acute adrenal crisis is a life-threatening disorder. Cardiovascular complications of the condition are usually limited to hypovolaemic hypotension and shock. An acute reversible cardiomyopathy and heart failure in association with acute adrenal crisis is rarely reported, particularly in children. Read More

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