Search our Database of Scientific Publications and Authors

I’m looking for a

    586 results match your criteria Adrenal Insufficiency & Adrenal Crisis

    1 OF 12

    Adrenal crisis in a 14-year-old boy 12 years after hematopoietic stem cell transplantation.
    Endocrinol Diabetes Metab Case Rep 2018 6;2018. Epub 2018 Jun 6.
    Divisions of Pediatric Endocrinology, Department of Pediatric and Adolescent Medicine, University Hospital of Erlangen, Erlangen, Germany.
    We report on a boy of Albanian descent with the history of juvenile myelomonocytic leukemia (JMML). JMML was diagnosed at the age of 17 months and treated by hematopoietic stem cell transplantation (HSCT). At the age of 14. Read More

    Evaluation of Hypothalamic-Pituitary-Adrenal Axis Suppression following Cutaneous Use of Topical Corticosteroids in Children: A Meta-Analysis.
    Horm Res Paediatr 2018 Jun 13:1-8. Epub 2018 Jun 13.
    Department of Pediatrics, Division of Endocrinology, University of Virginia, Charlottesville, Virginia, USA.
    Background/aims: A meta-analysis was performed to determine the likelihood of hypothalamic-pituitary-adrenal (HPA) axis suppression following short-term cutaneous treatment of atopic dermatitis with topical corticosteroids (TCS) in pediatric patients.

    Methods: All published pediatric clinical trials evaluating TCS use with pre- and post-treatment HPA axis assessment by cosyntropin stimulation testing were included.

    Results: Of 128 eligible trials, 12 were selected for meta-analysis with a total of 522 participants. Read More

    Relative adrenal insufficiency in adults with sickle cell disease.
    Pan Afr Med J 2018 12;29:30. Epub 2018 Jan 12.
    Department of Internal Medicine, Endocrine and Diabetes Unit, Yaoundé Central Hospital, Yaoundé, Cameroon.
    Rheological modifications observed in sickle cell anemia are associated with ischemic complications that can cause target organ functional impairment. The objective was to investigate adrenal function of adult patients with sickle cell disease. In this cross-sectional study conducted in a tertiary referral hospital of the capital city of Cameroon, we enrolled ten crisis-free adult patients with sickle cell disease (SCD) and ten age- and sex-matched healthy individuals. Read More

    Adrenal Crises in Children: Perspectives and Research Directions.
    Horm Res Paediatr 2018 Jun 6:1-11. Epub 2018 Jun 6.
    Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.
    Adrenal crises (AC) are life-threatening physiological disturbances that occur at a rate of 5-10/100 patient years in patients with adrenal insufficiency (AI). Despite their seriousness, there is a paucity of information on the epidemiology of AC events in the paediatric population specifically, as most investigations have focused on AI and ACs in adults. Improved surveillance of AC-related morbidity and mortality should improve the delineation of AC risk overall and among different subgroups of paediatric patients with AI. Read More

    Acute adrenal crisis and mortality in adrenal insufficiency: Still a concern in 2018!
    Ann Endocrinol (Paris) 2018 Jun 30;79(3):164-166. Epub 2018 Apr 30.
    Department of medicine I, endocrinology and diabetology, Würzburg University Hospital, Oberdürrbacher street, 6, 97080 Würzburg, Germany. Electronic address:
    Despite established replacement therapy, mortality in patients suffering from chronic adrenal insufficiency is increasing. This may be partly explained by the fact that lack of adrenal stress hormones impairs the body's capacity to deal adequately with stress situations, resulting in life-threatening adrenal crises. Since many such situations are of rapid onset, concepts that allow for quick response to emergencies are particularly important. Read More

    Mortality data from the European Adrenal Insufficiency Registry-Patient characterization and associations.
    Clin Endocrinol (Oxf) 2018 Jul 22;89(1):30-35. Epub 2018 Apr 22.
    Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK.
    Objective: Mortality from primary and secondary adrenal insufficiency (AI; PAI and SAI, respectively) is 2-3-fold higher than in the general population. Mortality relates to cardiovascular disease, acute adrenal crisis (AC), cancer and infections; however, there has been little further characterization of patients who have died.

    Design/methods: We analysed real-world data from 2034 patients (801 PAI, 1233 SAI) in the European Adrenal Insufficiency Registry (EU-AIR; NCT01661387). Read More

    Treatment of Addison's disease during pregnancy.
    Endocrinol Diabetes Metab Case Rep 2018 12;2018. Epub 2018 Apr 12.
    Endocrinology, Diabetes and Metabolism Department, Coimbra Hospital and University Center, Coimbra, Portugal.
    Addison's disease, or primary adrenocortical insufficiency, is a long-term, potentially severe, rare endocrine disorder. In pregnancy, it is even rarer. We report the case of a 30-year-old pregnant patient with Addison's disease, referred to Obstetrics-Endocrinology specialty consult at 14 weeks gestation. Read More

    Management of adrenal emergencies in educated patients with adrenal insufficiency-A prospective study.
    Clin Endocrinol (Oxf) 2018 Jul 24;89(1):22-29. Epub 2018 Apr 24.
    Department of Medicine I, Endocrinology and Diabetes Unit, University Hospital Wuerzburg, Wuerzburg, Germany.
    Objective: To evaluate the management of adrenal emergencies (AE) requiring parenteral glucocorticoid (GC) treatment in patients with chronic adrenal insufficiency (AI).

    Design: Prospective, multicentre, questionnaire-based study.

    Patients And Measurements: Participating patients (n = 150) with chronic AI were provided with a questionnaire on the management of emergency situations, which had to be completed and sent back in case of an AE. Read More

    Therapeutic patient education in adrenal insufficiency.
    Ann Endocrinol (Paris) 2018 Jun 29;79(3):167-173. Epub 2018 Mar 29.
    Service des maladies endocriniennes et métaboliques, hôpital Cochin, CHU Paris-centre, centre de référence des maladies rares de la surrénale, 75014 Paris, France. Electronic address:
    It is essential to encourage patient autonomy in the management of their illness, and notably their participation in treatment education programs; specific programs target avoidance or early preventive treatment of acute adrenal insufficiency, which is a life-threatening complication. Therapeutic patient education is recommended by the two international consensus statements on the management of primary adrenal insufficiency and the French consensus on adrenal insufficiency. Although there is no common international reference framework to date, the objective of the French consensus was to provide a frame of reference to facilitate the development of therapeutic education for patients with adrenal insufficiency. Read More

    Longitudinal Assessment of Illnesses, Stress Dosing, and Illness Sequelae in Patients With Congenital Adrenal Hyperplasia.
    J Clin Endocrinol Metab 2018 Jun;103(6):2336-2345
    National Institutes of Health Clinical Center, Bethesda, Maryland.
    Context: Patients with congenital adrenal hyperplasia (CAH) are at risk for life-threatening adrenal crises. Management of illness episodes aims to prevent adrenal crises.

    Objective: We evaluated rates of illnesses and associated factors in patients with CAH followed prospectively and receiving repeated glucocorticoid stress dosing education. Read More

    A rare cause of primary adrenal insufficiency due to a homozygous Arg188Cys mutation in the gene.
    Endocrinol Diabetes Metab Case Rep 2018 21;2018. Epub 2018 Mar 21.
    Pediatric Endocrinology, Diabetology and Metabolism, Bern University Children's Hospital and Department of BioMedical Research, University of Bern, Bern, Switzerland.
    Steroidogenic acute regulatory protein () is a key protein for the intracellular transport of cholesterol to the mitochondrium in endocrine organs (e.g. adrenal gland, ovaries, testes) and essential for the synthesis of all steroid hormones. Read More

    [Addisonian Crisis - Risk Assessment and Appropriate Treatment].
    Dtsch Med Wochenschr 2018 Mar 15;143(6):392-396. Epub 2018 Mar 15.
    An adrenal crisis (Addisonian crisis) is an acute life-threatening complication of adrenal insufficiency. It occurs when hydrocortisone demand is not met by supplementation in the context of an infection - often gastrointestinal, fever, trauma, acute psychological or physical stress. Symptoms of weakness, nausea, muscle/joint pain and drowsiness may develop out of robust health within few hours. Read More

    Acute Primary Adrenal Insufficiency after Hip Replacement in a Patient with Acute Intermittent Porphyria.
    Case Rep Endocrinol 2018 4;2018:2353172. Epub 2018 Jan 4.
    Division of Endocrinology, Diabetology and Metabolism, Santa Croce e Carle Hospital, Via M. Coppino 26, 12100 Cuneo, Italy.
    Adrenal insufficiency is a potentially life-threatening condition when it occurs acutely, as in adrenal hemorrhage. Generally it is not reversible and requires chronic replacement therapy. Acute intermittent porphyria (AIP) is a rare genetic disease characterized by alterations in heme biosynthesis that result in accumulation of precursors in tissues. Read More

    Adrenal insufficiency, steroid sick day rules and the paediatric endocrine nurse.
    Nurs Child Young People 2018 Mar;30(2):26-31
    Oxford University Hospitals NHS Foundation Trust, Oxford, England.
    Clinical governance processes are important for improving patient care. Patients with adrenal insufficiency are at significant risk if they have an adrenal crisis and require steroid therapy. Families should receive education on managing illness or stress, that is, steroid sick day rules. Read More

    GLUCOCORTICOID-INDUCED ADRENAL INSUFFICIENCY: A STUDY OF THE INCIDENCE IN HOSPITAL PATIENTS AND A REVIEW OF PERI-OPERATIVE MANAGEMENT.
    Endocr Pract 2018 May 2;24(5):437-445. Epub 2018 Mar 2.
    Objective: Glucocorticoid (GC) pharmacotherapy is an effective treatment for a range of diseases, but exposure can suppress the hypothalamic-pituitary-adrenal axis, leading to glucocorticoid-induced adrenal insufficiency (GC-AI) in some patients. However, the incidence of diagnosed GC-AI and the associated health burden, including the incidence of adrenal crises (ACs), are unknown. Although GC-AI treatment is based on well-established principles, there are no agreed protocols regarding the peri-operative management of exposed patients. Read More

    Primary adrenal insufficiency due to hereditary apolipoprotein AI amyloidosis: endocrine involvement beyond hypogonadism.
    Amyloid 2018 Feb 15:1-4. Epub 2018 Feb 15.
    a Department of Endocrinology and Nutrition , Hospital Clínic , Barcelona , Spain.
    Several mutations in the gene encoding apolipoprotein AI (apoAI) have been described as a cause of familial amyloidosis. Individuals with apoAI-derived (AApoAI) amyloidosis frequently manifest with liver, kidney, laryngeal, skin and myocardial involvement. Although primary hypogonadism (PH) is considered almost pathognomonic of this disease, until now, primary adrenal insufficiency (PAI) has not been described as a common clinical feature. Read More

    Evaluation of the frequency of adrenal crises and preventive measures in patients with primary and secondary adrenal insufficiency in Switzerland.
    Swiss Med Wkly 2018 01 29;148:w14586. Epub 2018 Jan 29.
    Division of Diabetology, Endocrinology and Metabolism, University Hospital of Bern, Inselspital, Switzerland / Division of Endocrinology, Diabetology and Metabolism, University Hospital of Basel, Switzerland.
    Aims Of The Study: Adrenal insufficiency is a dangerous clinical condition, leading to significant morbidity or mortality in situations with inadequate glucocorticoid replacement treatment. We aimed to assess preventive measures in adrenal insufficiency and the incidence and risk factors of adrenal crisis, as well as to test the patients' knowledge about their disease.

    Methods: All patients in May and June 2016 and December 2016 and January 2017 with primary (17. Read More

    Extent of surgery for phaeochromocytomas in the genomic era.
    Br J Surg 2018 Jan;105(2):e84-e98
    Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
    Background: Germline mutations are present in 20-30 per cent of patients with phaeochromocytoma. For patients who develop bilateral disease, complete removal of both adrenal glands (total adrenalectomy) will result in lifelong adrenal insufficiency with an increased risk of death from adrenal crisis. Unilateral/bilateral adrenal-sparing surgery (subtotal adrenalectomy) offers preservation of cortical function and independence from steroids, but leaves the adrenal medulla in situ and thus at risk of developing new and possibly malignant disease. Read More

    SFE/SFEDP adrenal insufficiency French consensus: Introduction and handbook.
    Ann Endocrinol (Paris) 2018 Feb 12;79(1):1-22. Epub 2018 Jan 12.
    Service d'endocrinologie diabétologie pédiatrique, hôpital Robert-Debré, centre de référence des maladies endocriniennes rares de la croissance et du développement, université Paris Diderot, Assistance publique-Hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France.
    The French endocrinology society (SFE) and the French pediatric endocrinology society (DFSDP) have drawn up recommendations for the management of primary and secondary adrenal insufficiency in the adult and child, based on an analysis of the literature by 19 experts in 6 work-groups. A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms except hyperpigmentation which is observed in primary adrenal insufficiency. Diagnosis rely on plasma cortisol and ACTH measurement at 8am and/or the cortisol increase after synacthen administration. Read More

    Improved medical-alert ID ownership and utilization in youth with congenital adrenal hyperplasia following a parent educational intervention.
    J Pediatr Endocrinol Metab 2018 Jan;31(2):213-219
    Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA.
    Background: Classical congenital adrenal hyperplasia (CAH) is a potentially life-threatening condition, and adrenal crisis is a major cause of morbidity and mortality in affected children. Medical-alert identification (ID) could prevent complications of adrenal crisis by identifying the need for time-sensitive, critical treatment. Our objectives were to evaluate usage of medical-alert IDs by CAH youth, ownership and awareness of IDs amongst their parents, and the effect of an in-clinic educational intervention on ID utilization. Read More

    Isolated unilateral adrenal gland hemorrhage following motor vehicle collision: a case report and review of the literature.
    J Med Case Rep 2017 Dec 26;11(1):358. Epub 2017 Dec 26.
    Department of General Surgery, Henry Ford Wyandotte Hospital, 2333 Biddle Ave, Wyandotte, MI, 48192, USA.
    Background: Adrenal gland trauma is a rare condition that typically stems from blunt force trauma, and is associated with multiple organ injuries. Alternatively, isolated adrenal gland trauma is extremely rare, accounting for only 1.5 to 4% of all adrenal trauma cases. Read More

    Stress-Dosed Glucocorticoids and Mineralocorticoids Before Intensive Endurance Exercise in Primary Adrenal Insufficiency.
    Clin J Sport Med 2017 Dec 19. Epub 2017 Dec 19.
    Endocrinology and Metabolism, Wake Forest University, Winston-Salem, NC.
    Patients with primary adrenal insufficiency (PAI) require increased doses of glucocorticoids and mineralocorticoids during stressors, such as surgery, trauma, and sepsis. Although current guidelines exist for dose adjustments in these situations, there is no accepted dosing regimen for patients with PAI participating in intensive endurance exercise. Given the extensive physiologic stress of events, such as marathons, triathlons, and similar events, it is likely that a "stress-dose" of adrenal replacement therapy will not only prevent adrenal crisis, but also improve performance. Read More

    Polyendocrinopathy Resulting From Pembrolizumab in a Patient With a Malignant Melanoma.
    J Endocr Soc 2017 Jun 28;1(6):646-649. Epub 2017 Apr 28.
    Department of Endocrinology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, 75014 Paris, France.
    Introduction: Checkpoint inhibitors have significantly improved the prognosis of patients with advanced melanoma. These cancer immunotherapy drugs have specific endocrine autoimmune toxicity. We describe a case of an adrenal insufficiency secondary to pembrolizumab, an anti-programmed cell death-1 monoclonal antibody. Read More

    Evaluation of Evidence of Adrenal Insufficiency in Trials of Normocortisolemic Patients Treated With Mifepristone.
    J Endocr Soc 2017 Apr 21;1(4):237-246. Epub 2017 Feb 21.
    Corcept Therapeutics, Menlo Park, California 94025.
    Context: Adrenal insufficiency (AI) is an important medical concern for clinicians when normocortisolemia is achieved during treatment of endogenous Cushing syndrome (CS).

    Objective: To examine symptoms of potential AI in a large population of normocortisolemic patients without CS treated with mifepristone, a glucocorticoid receptor antagonist indicated for the treatment of patients with CS.

    Methods: We conducted a pooled safety analysis of five phase 3, placebo-controlled clinical trials of normocortisolemic adults without CS but diagnosed with psychotic depression (n = 1460). Read More

    MANAGEMENT OF ENDOCRINE DISEASE: Fertility, pregnancy and lactation in women with adrenal insufficiency.
    Eur J Endocrinol 2018 Feb 30;178(2):R45-R53. Epub 2017 Nov 30.
    Klinik für EndokrinologieDiabetologie und Klinische Ernährung, UniversitätsSpital Zürich, Zürich, Switzerland
    With the introduction of hormonal substitution therapy in the 1950s, adrenal insufficiency (AI) has been turned into a manageable disease in pregnant women. In fact, in the light of glucocorticoid replacement therapy and improved obstetric care, it is realistic to expect good maternal and fetal outcomes in patients with AI. However, there are still a number of challenges such as establishing the diagnosis of AI in pregnant women and optimizing the treatment of AI and related comorbidities prior to as well as during pregnancy. Read More

    Group 6. Modalities and frequency of monitoring of patients with adrenal insufficiency. Patient education.
    Ann Endocrinol (Paris) 2017 Dec 1;78(6):544-558. Epub 2017 Dec 1.
    Service d'endocrinologie diabétologie pédiatrique, hôpital Robert-Debré, université Paris-Diderot, centre de référence des maladies endocriniennes rares de la croissance et du développement, Assistance publique-hôpitaux de Paris, 48, boulevard Sérurier, 75019 Paris, France.
    Patients with adrenal insufficiency require regular, specialised monitoring in order to optimise their replacement therapy, to detect signs of under- and over-dosage, and to examine for possible associated disorders (auto-immune disorders in the case of auto-immune primary adrenal insufficiency either isolated or as part of auto-immune polyendocrinopathy syndrome type 1; illnesses with underlying monogenic causes). The transition period between adolescence and adulthood represents an added risk of a breakdown in monitoring which requires particular attention from medical teams and coordination between adult and pediatric medical teams. It is essential to encourage patient autonomy in the management of their illness, notably their participation in treatment education programs, in particular programs that target avoidance of, or early treatment of acute adrenal insufficiency. Read More

    Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality.
    Ann Endocrinol (Paris) 2017 Dec 27;78(6):490-494. Epub 2017 Nov 27.
    Service des maladies endocriniennes et métaboliques, hôpital Cochin, CHU Paris Centre, 75014 Paris, France.
    The prevalence of primary adrenal insufficiency is estimated at between 82-144/million, with auto-immunity being the most common cause in adults and genetic causes, especially enzyme defects, being the most common cause in children. The prevalence of secondary adrenal deficiency is estimated to be between 150-280/million. The most frequent occurrence is believed to be corticosteroid-induced insufficiency, despite the incidence of clinically relevant deficiency after cessation of glucocorticoid treatment being widely debated. Read More

    Group 5: Acute adrenal insufficiency in adults and pediatric patients.
    Ann Endocrinol (Paris) 2017 Dec 23;78(6):535-543. Epub 2017 Nov 23.
    Service d'endocrinologie et des maladies de la reproduction, hôpital de Bicêtre, hôpitaux universitaires Paris-Sud, AP-HP, 94275 Le Kremlin-Bicêtre, France; Inserm 1185, faculté médecine Paris-Sud, université Paris-Sud, université Paris-Saclay, 94276 Le Kremlin-Bicêtre, France.

    Acute development of Cushing syndrome in an HIV-infected child on atazanavir/ritonavir based antiretroviral therapy.
    Endocrinol Diabetes Metab Case Rep 2017 28;2017. Epub 2017 Oct 28.
    Divisions of Infectious Diseases.
    An 11-year-old male with perinatally acquired human immune deficiency virus (HIV) infection on antiretroviral regimen, which included abacavir plus lamivudine (Epzicom), didanosine, ritonavir and atazanavir presented with bilateral axillary striae, increased appetite, fatigue, facial swelling and acute weight gain. Two months prior to presentation, the patient had received a diagnostic and therapeutic intra-articular triamcinolone injection in the knee for pain relief and subsequently became progressively swollen in the face, developed striae bilaterally at the axillae, experienced increased appetite, fatigue and an 8 pound weight gain. During the endocrine workup, suspicion for adrenal insufficiency prompted 24-h urine collection for free cortisol, which was found to be undetectable (below LLQ of 1. Read More

    Acute-Onset Panhypopituitarism Nearly Missed by Initial Cosyntropin Testing.
    Case Rep Crit Care 2017 3;2017:7931438. Epub 2017 Oct 3.
    Medical University Clinic, Kantonsspital Aarau, Aarau, Switzerland.
    Introduction: Diagnosis of adrenal crisis and panhypopituitarism in patients with septic shock is difficult but crucial for outcome.

    Case: A 66-year-old woman with metastasized breast cancer presented to the ED with respiratory insufficiency and septic shock after a 2-day history of the flu. After transfer to the ICU, corticosteroids were started in addition to antibiotics, as the patient was vasopressor-nonresponsive. Read More

    Clues for early detection of autoimmune Addison's disease - myths and realities.
    J Intern Med 2018 Feb 3;283(2):190-199. Epub 2017 Nov 3.
    Department of Clinical Medicine, University of Bergen, Bergen, Norway.
    Background: Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce.

    Objective: Perform a retrospective audit of patient records with the aim of identifying biochemical markers for early diagnosis of AAD. Read More

    Primary adrenal insufficiency in adult population: a Portuguese Multicentre Study by the Adrenal Tumours Study Group.
    Endocr Connect 2017 Nov 31;6(8):935-942. Epub 2017 Oct 31.
    Department of EndocrinologyHospital de Braga, Braga, Portugal.
    Introduction: Primary adrenal insufficiency (PAI) is a rare but severe and potentially life-threatening condition. No previous studies have characterized Portuguese patients with PAI.

    Aims: To characterize the clinical presentation, diagnostic workup, treatment and follow-up of Portuguese patients with confirmed PAI. Read More

    Adrenal Insufficiency in Pediatric Eosinophilic Esophagitis Patients Treated with Swallowed Topical Steroids.
    Pediatr Allergy Immunol Pulmonol 2017 Sep;30(3):135-140
    Gastrointestinal Eosinophilic Diseases Program, University of Colorado School of Medicine, Aurora, Colorado.
    Swallowed topical steroids (STS) are the only effective pharmacological therapy for eosinophilic esophagitis (EoE). Thus far, studies of small populations of EoE patients have reported conflicting results in relation to adrenal insufficiency (AI). We sought to measure AI in a clinical setting in children taking STS for EoE. Read More

    Adrenal crisis and autoimmune polyglandular syndromes.
    Proc (Bayl Univ Med Cent) 2017 Oct;30(4):427-428
    Department of Internal Medicine (Freeland) and Division of Pulmonary and Critical Care Medicine (Tsai-Nguyen, Pan, Mora), Baylor University Medical Center at Dallas; and the Texas A&M Health Science Center College of Medicine (Lueking).
    We report a 67-year-old woman who presented with adrenal crisis as a manifestation of autoimmune polyglandular syndrome 2, a polygenic disorder characterized by concurrent primary adrenal insufficiency and either autoimmune thyroid disease or type 1 diabetes mellitus. Read More

    I polymorphism of the glucocorticoid receptor and adrenal crisis in primary adrenal insufficiency.
    Endocr Connect 2017 Nov 27;6(8):685-691. Epub 2017 Sep 27.
    Endocrinology in CharlottenburgBerlin, Germany
    Context: Patients with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) are at a high risk of adrenal crisis (AC). Glucocorticoid sensitivity is at least partially genetically determined by polymorphisms of the glucocorticoid receptor (GR).

    Objectives: To determine if a number of intercurrent illnesses and AC are associated with the GR gene polymorphism I in patients with PAI and CAH. Read More

    Recognizing and managing adrenal disorders in the emergency department [digest].
    Emerg Med Pract 2017 Sep 22;19(9 Suppl Points & Pearls):S1-S2. Epub 2017 Sep 22.
    Emergency Physician, St. David's South Austin Medical Center, Austin, TX.
    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

    A novel stop mutation (p.(Gln22*)) of DAX1 (NR0B1) results in late-onset X-linked adrenal hypoplasia congenita.
    Endocrinol Diabetes Metab Case Rep 2017 4;2017. Epub 2017 Sep 4.
    Endocrinology in Charlottenburg.
    DAX1 (NR0B1) is an orphan nuclear receptor, which plays an important role in development and function of the adrenal glands and gonads. Mutations in DAX1 cause X-linked adrenal hypoplasia congenita (X-linked AHC), which is characterized by adrenal insufficiency (AI) and hypogonadotropic hypogonadism (HHG). Affected boys present with adrenal failure usually in childhood and, later in life, with delayed puberty. Read More

    Addison's Disease: A Diagnostic Dilemma.
    Mymensingh Med J 2017 Jul;26(3):671-675
    Dr Shireen Afroz, Professor, Department of Pediatric Nephrology, Bangladesh Institute of Child Health & Dhaka Shishu (Children) Hospital, Sher-e-bangla Nagar Dhaka, Bangladesh; E-mail:
    Adrenal insufficiency is a rare disease, but is life threatening when overlooked. Addison's disease may be an acquired form of adrenal insufficiency due to the destruction or dysfunction of the adrenal cortex. It affects both glucocorticoid and mineralocorticoid function. Read More

    Hospitalisation in Children with Adrenal Insufficiency and Hypopituitarism: Is There a Differential Burden between Boys and Girls and between Age Groups?
    Horm Res Paediatr 2017 12;88(5):339-346. Epub 2017 Sep 12.
    Endocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia.
    Background/aims: To determine the burden of hospitalisation in children with adrenal insufficiency (AI)/hypopituitarism in Australia.

    Methods: A retrospective study of Australian hospitalisation data. All admissions between 2001 and 2014 for patients aged 0-19 years with a principal diagnosis of AI/hypopituitarism were included. Read More

    Clinical characteristics of adrenal crisis in adult population with and without predisposing chronic adrenal insufficiency: a retrospective cohort study.
    BMC Endocr Disord 2017 Sep 11;17(1):58. Epub 2017 Sep 11.
    Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
    Background: Adrenal crisis (AC) occurs in various clinical conditions but previous epidemiological studies in AC are limited to chronic adrenal insufficiency (AI) and sepsis. The aim of this study was to investigate characteristics of AC patients, including predisposing diseases and to describe candidate risk factors for AC such as comorbidities and glucocorticoid (GC) therapy.

    Methods: We conducted a retrospective cohort study using a claims database on 7. Read More

    An analysis of the relationship between serum cortisol and serum sodium in routine clinical patients.
    Pract Lab Med 2017 Aug 13;8:30-33. Epub 2017 Apr 13.
    Blood Sciences, Leeds General Infirmary, Leeds, UK.
    Objectives: Adrenal insufficiency is an uncommon cause of hyponatraemia that should not be overlooked due to the severe consequences of an Addisonian crisis. Using the laboratory database of a large teaching hospital, we have explored the relationship between serum sodium and serum cortisol, and have estimated the frequency of hypoadrenalism in severely hyponatraemic patients.

    Design And Methods: Data were gathered over a 23 month period from the Laboratory Information Management System at the Leeds Teaching Hospitals NHS Trust for instances where serum sodium and cortisol had been measured on a single sample. Read More

    Recognizing and managing adrenal disorders in the emergency department
    Emerg Med Pract 2017 09 1;19(9):1-24. Epub 2017 Sep 1.
    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 Oct;58(10):1037-1041
    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

    1 OF 12