762 results match your criteria Adrenal Insufficiency and Adrenal Crisis


Clinical Characteristics, Management, and Potential Biomarkers of Endocrine Dysfunction Induced by Immune Checkpoint Inhibitors.

Endocrinol Metab (Seoul) 2021 Apr 27;36(2):312-321. Epub 2021 Apr 27.

Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.

Immune-related adverse events (irAEs) affecting the endocrine glands are among the most frequent irAEs induced by immune checkpoint inhibitors (ICIs) and include hypopituitarism, primary adrenal insufficiency, thyrotoxicosis, hypothyroidism, hypoparathyroidism, and type 1 diabetes mellitus. Since the incidence and clinical features of endocrine irAEs vary according to the ICI used, it is important to understand the characteristics of these irAEs and to manage each one appropriately. Since some endocrine irAEs, including adrenal crisis and diabetic ketoacidosis, are potentially life-threatening, predicting the risk of endocrine irAEs before their onset is critical. Read More

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Interaction between hypotension and age on adrenal crisis diagnosis.

Endocrinol Diabetes Metab 2021 04 2;4(2):e00205. Epub 2020 Dec 2.

Endocrine and Metabolic Unit Royal Adelaide Hospital and University of Adelaide Adelaide SA Australia.

Objective: To determine whether adrenal crisis (AC) identification may be affected by the definition of hypotension.

Context: Delays in AC diagnosis can result in adverse outcomes. AC-related cardiovascular compromise may vary according to baseline blood pressure and may be associated with delayed AC detection in some patients. Read More

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Death Due to Adrenal Crisis: Case Report and a Review of the Forensic Literature.

Am J Forensic Med Pathol 2021 Apr 7. Epub 2021 Apr 7.

From the Department of Pathology, State University of New York, Syracuse, NY.

Abstract: Adrenal crisis is a life-threatening manifestation of acute adrenal insufficiency. One of the most important underlying causes is Addison disease (primary adrenal insufficiency).A 42-year-old White woman with a medical history of Addison disease on chronic steroid therapy was admitted to the emergency department due to sustained episodes of cardiopulmonary arrest. Read More

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Association of Slipped Capital Femoral Epiphysis With Panhypopituitarism Due to Pituitary Macroadenoma: A Case Report.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:2324709621999956

University of Alabama at Birmingham, AL, USA.

Slipped capital femoral epiphysis (SCFE) commonly occurs in overweight or obese adolescents, but can also be associated with endocrine disorders including hypothyroidism, pituitary tumors, and growth hormone deficiency. In this article, we present a case of panhypopituitarism that initially presented with SCFE. A 16-year-old male presented with right SCFE. Read More

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Investigation of the Hypothalamo-pituitary-adrenal (HPA) axis: a contemporary synthesis.

Rev Endocr Metab Disord 2021 Jun 26;22(2):179-204. Epub 2021 Mar 26.

Department of Endocrinology, Yeditepe University, Medical School, Istanbul, Turkey.

The hypothalamo-pituitary-adrenal (HPA) axis is one of the main components of the stress system. Maintenance of normal physiological events, which include stress responses to internal or external stimuli in the body, depends on appropriate HPA axis function. In the case of severe cortisol deficiency, especially when there is a triggering factor, the patient may develop a life-threatening adrenal crisis which may result in death unless early diagnosis and adequate treatment are carried out. Read More

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Adrenal insufficiency.

Nat Rev Dis Primers 2021 03 11;7(1):19. Epub 2021 Mar 11.

Endocrinology in Charlottenburg, Berlin, Germany.

Adrenal insufficiency (AI) is a condition characterized by an absolute or relative deficiency of adrenal cortisol production. Primary AI (PAI) is rare and is caused by direct adrenal failure. Secondary AI (SAI) is more frequent and is caused by diseases affecting the pituitary, whereas in tertiary AI (TAI), the hypothalamus is affected. Read More

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A systematic review of adrenal insufficiency among patients with pulmonary tuberculosis in Sub-Saharan Africa.

Int J Mycobacteriol 2021 Jan-Mar;10(1):1-7

Department of Medicine, University College Hospital, Ibadan, Nigeria.

Introduction: Tuberculosis (TB) is a disease of public health importance globally. The incidence of pulmonary TB is rising in sub-Saharan Africa. Bilateral adrenal destruction and the use of medications such as rifampicin are possible mechanisms by which TB cause adrenal insufficiency. Read More

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Use of medical identification jewellery in children and young adults with adrenal insufficiency in Australia.

Endocrine 2021 Mar 11. Epub 2021 Mar 11.

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

Purpose: Patients with adrenal insufficiency (AI) are at risk of life-threatening illness. Medical jewellery is recommended for emergencies, but its uptake is unknown. This study assessed the use of medical jewellery among Australian AI patients aged 25 years and under. Read More

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Therapy options for adrenal insufficiency and recommendations for the management of adrenal crisis.

Endocrine 2021 Mar 4;71(3):586-594. Epub 2021 Mar 4.

Medizinische Klinik IV, Klinikum der Universität München, Munich, Germany.

Adrenal insufficiency (AI) is a life-threatening condition requiring life-long glucocorticoid (GC) substitution therapy, as well as stress adaptation to prevent adrenal crises. The number of individuals with primary and secondary adrenal insufficiency in Europe is estimated to be 20-50/100.000. Read More

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Venoarterial extracorporeal membrane oxygenation as bridge to effective treatment in a 19-year-old woman with acute adrenal crisis: a case report.

Eur Heart J Case Rep 2021 Feb 20;5(2):ytab031. Epub 2021 Feb 20.

Intensive Care Unit, Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Marchioninistraße 15, 81377 Munich, Germany.

Background: Adrenal crisis is an acute life-threatening exacerbation of the Addison's disease or primary adrenal insufficiency (PAI) and is associated with a high mortality rate. It can be the first manifestation of adrenal insufficiency and is caused by a critical lack of glucocorticoids.

Case Summary: Here, we report the case of a 19-year-old woman presenting to the emergency room with unspecific symptoms, i. Read More

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February 2021

Long-term corticosteroid use, adrenal insufficiency and the need for steroid-sparing treatment in adult severe asthma.

J Intern Med 2021 Feb 17. Epub 2021 Feb 17.

Royal Brompton Hospital, London, UK.

Secondary adrenal insufficiency (AI) occurs as the result of any process that disrupts normal hypothalamic and/or anterior pituitary function and causes a decrease in the secretion of steroid hormones from the adrenal cortex. The most common cause of secondary AI is exogenous corticosteroid therapy administered at supraphysiologic dosages for ≥ 1 month. AI caused by oral corticosteroids (OCS) is not well-recognized or commonly diagnosed but is often associated with reduced well-being and can be life-threatening in the event of an adrenal crisis. Read More

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February 2021

Increased mortality risk in patients with primary and secondary adrenal insufficiency.

J Clin Endocrinol Metab 2021 Feb 17. Epub 2021 Feb 17.

Department of Metabolic Medicine, St. Mary's Hospital, Imperial College NHS trust, London, UK.

Context: Mortality data in patients with adrenal insufficiency are inconsistent, possibly due to temporal and geographical differences between patients and their reference populations.

Objective: To compare mortality risk and causes of death in adrenal insufficiency with an individually-matched reference population.

Design: Retrospective cohort study. Read More

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February 2021

Immune Checkpoint Inhibitor-Induced Adrenalitis and Primary Adrenal Insufficiency: Systematic Review and Optimal Management.

Endocr Pract 2021 Feb 16;27(2):165-169. Epub 2020 Dec 16.

Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. Electronic address:

Objective: Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte antigen 4 or programmed death 1 and its ligand (programmed death ligand 1) have been approved for the treatment of a variety of cancers. However, ICI therapy is associated with a risk of immune-related adverse events. In this study, we reviewed reported cases of adrenalitis and primary adrenal insufficiency (PAI)-rare but lethal endocrine immune-related adverse events-in patients who underwent ICI therapy. Read More

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February 2021

Acute illness in children with secondary adrenal insufficiency.

Clin Endocrinol (Oxf) 2021 Feb 5. Epub 2021 Feb 5.

Endocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, Adelaide, SA, Australia.

Objective And Background: Secondary adrenal insufficiency (SAI) is a rare condition in childhood which can be associated with high levels of morbidity in some patients. The causes of increased levels of illness are not well defined and warrant further investigation.

Methods: A retrospective cohort of patients with SAI was constructed by examining records of all attendances for acute illness by SAI patients at the emergency department of the two specialist paediatric hospitals in Sydney, Australia between 2004 and 2016. Read More

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February 2021

Typical and reverse Takotsubo syndromes as initial manifestations of consecutive Addisonian crises in a 38-year-old patient: the heart has its reasons!

BMJ Case Rep 2021 Jan 28;14(1). Epub 2021 Jan 28.

Division of Cardiology, Royal University Hospital, Saskatoon, Saskatchewan, Canada

We report an interesting case of a 38-year-old woman presenting with reverse Takotsubo syndrome (TTS) secondary to an Addisonian crisis, her second such episode. A few years prior, she had presented with typical TTS in the setting of Addisonian crisis; diagnostic work-up revealing Auto-Immune Polyglandular Syndrome Type II (APS II). We believe this to be the first case report of typical and variant phenotypes of TTS in a patient with APS II. Read More

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January 2021

Takotsubo cardiomyopathy associated with adrenal insufficiency in the context of long-term steroid use mimicking acute coronary syndrome.

BMJ Case Rep 2021 Jan 25;14(1). Epub 2021 Jan 25.

Cardiology Department, St George's Hospital, London, UK.

Takotsubo cardiomyopathy (TCMP) is an important, though under-recognised, syndrome which mimics acute coronary syndrome (ACS) presenting with similar clinical, biochemical and ECG features. A 68-year-old man was referred as ACS for emergency coronary angiography; however, a history of lethargy, weight loss and electrolyte abnormalities prompted further investigations. Angiography was postponed, adrenal insufficiency confirmed and steroid replacement commenced. Read More

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January 2021

Adrenal insufficiency.

Lancet 2021 Feb 20;397(10274):613-629. Epub 2021 Jan 20.

Department of Clinical Science and KG Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway; Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Center of Molecular Medicine, and Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.

Adrenal insufficiency can arise from a primary adrenal disorder, secondary to adrenocorticotropic hormone deficiency, or by suppression of adrenocorticotropic hormone by exogenous glucocorticoid or opioid medications. Hallmark clinical features are unintentional weight loss, anorexia, postural hypotension, profound fatigue, muscle and abdominal pain, and hyponatraemia. Additionally, patients with primary adrenal insufficiency usually develop skin hyperpigmentation and crave salt. Read More

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February 2021

Adrenal Crisis May Occur Even In Patients With Asymptomatic Covid-19.

Endocr Pract 2020 Aug;26(8):929-930

Department of Endocrinology, La Conception Hospital, 147 Boulevard Baille, 13005 Marseille, France.. Electronic address:

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Adverse Effects of Ramadan Fasting in a Girl with Salt-Losing Congenital Adrenal Hyperplasia.

Case Rep Endocrinol 2020 29;2020:6688927. Epub 2020 Dec 29.

Department of Pediatrics, Children' Hospital "Vittore Buzzi", Milan, Italy.

Objective: Congenital adrenal hyperplasia (CAH) is the most common cause of adrenal insufficiency in pediatrics. Chronic glucocorticoid replacement is the mainstay of treatment in the classic forms of CAH, and mineralocorticoid replacement therapy is mandatory in the salt-wasting form. Fasting is a mild stressor, which can expose to dehydration, hypotension, hypoglycemia, and acute adrenal crisis in patients with adrenal insufficiency. Read More

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December 2020

Towards novel treatments for adrenal diseases: Cell- and gene therapy-based approaches.

Mol Cell Endocrinol 2021 03 14;524:111160. Epub 2021 Jan 14.

Centre for Endocrinology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK. Electronic address:

Adrenal insufficiency, the inability to produce adequate levels of corticosteroids, is a multi-causal disease that requires lifelong daily hormone replacement. Nevertheless, this cannot replace the physiological demand for steroids which are secreted following a circadian rhythm and vary in periods of stress; the consequences of under- or over-replacement include adrenal crisis and metabolic disturbances, respectively. Although clinical research has focused on enhancing the effectiveness/reducing side effects of current treatment modalities, only small improvements are deemed possible; thus, alternative solutions are urgently needed. Read More

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Perioperative glucocorticoid management based on current evidence.

Authors:
Kwon Hui Seo

Anesth Pain Med (Seoul) 2021 Jan 15;16(1):8-15. Epub 2021 Jan 15.

Department of Anesthesiology and Pain Medicine, Hallym University Sacred Heart Hospital, Hallym University School of Medicine, Anyang, Korea.

Glucocorticoid preparations, adreno-cortical steroids, with strong anti-inflammatory and immunosuppressive effects, are widely used for treating various diseases. The number of patients exposed to steroid therapy prior to surgery is increasing. When these patients present for surgery, the anesthesiologist must decide whether to administer perioperative steroid supplementation. Read More

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January 2021

Bilateral adrenal hemorrhage after colectomy for perforated diverticulitis: A case report.

Int J Surg Case Rep 2021 Jan 17;78:336-339. Epub 2020 Dec 17.

Division of Colon and Rectal Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.

Introduction: Bilateral adrenal hemorrhage can lead to acute adrenal insufficiency. This is a rare complication in the post-operative setting, and we present a case in which it developed after a colectomy for perforated diverticulitis.

Presentation Of Case: The patient is a 65-year-old female who presented with abdominal pain, nausea, emesis, and hematochezia, and CT scan showing sigmoid diverticulitis with peri-sigmoid abscess. Read More

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January 2021

Diagnosing and managing adrenal crisis in pregnancy: A case report.

Case Rep Womens Health 2021 Jan 10;29:e00278. Epub 2020 Dec 10.

Walter Reed National Military Medical Center, Department of Obstetrics & Gynecology, United States of America.

Background: The diagnosis of adrenal insufficiency in pregnancy is relatively rare. Further, making this diagnosis can be challenging as many of the symptoms overlap with normal symptoms of pregnancy. Given the potential for severe maternal and fetal morbidity and mortality, early recognition and prompt comprehensive treatment are critical. Read More

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January 2021

Bilateral adrenal haemorrhage complicated by sepsis, coagulopathy, influenza A and adrenal crisis.

BMJ Case Rep 2020 Dec 28;13(12). Epub 2020 Dec 28.

Radiology, Aberdeen Royal Infirmary, Aberdeen, UK.

Bilateral adrenal haemorrhage is a rare and often fatal condition that most commonly occurs under conditions of severe physiological stress. We describe a 33-year-old male patient with ulcerative colitis who presented with acute worsening epigastric pain, vomiting and raised inflammatory markers. Initial differentials included gastritis and peptic ulceration. Read More

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December 2020

Evaluating tertiary adrenal insufficiency in rheumatology patients on long-term systemic glucocorticoid treatment.

Clin Endocrinol (Oxf) 2021 Mar 11;94(3):361-370. Epub 2021 Jan 11.

Leeds Centre for Diabetes and Endocrinology, Leeds Teaching Hospitals Trust, Leeds, UK.

Objective: Patients with rheumatic diseases are often treated with prolonged, high-dose systemic glucocorticoids which can cause hypothalamic-pituitary-adrenal (HPA) axis suppression and development of tertiary adrenal insufficiency. Adrenal insufficiency carries the risk of serious, potentially life-threatening adrenal crisis. Our study evaluated the prevalence, characteristics and recovery of patients with underlying rheumatology conditions who had received prolonged glucocorticoid treatment. Read More

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[Assessment of autoantibodies against 21-hydroxylase in the diagnosis of primary autoimmune adrenal insufficiency].

Probl Endokrinol (Mosk) 2020 Jun 10;65(6):466-473. Epub 2020 Jun 10.

Endocrinology Research centre.

Primary adrenal insufficiency is manifested by a deficiency of adrenal cortex hormones and can lead to a life-threatening condition. Early diagnosis is key to patient survival. Auto-antibodies to one of the adrenal steroidogenesis enzymes, 21-hydroxylase, are an immunological marker of autoimmune adrenal insufficiency. Read More

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Pituitary stalk interruption syndrome: A rare case report and literature review.

Medicine (Baltimore) 2020 Dec;99(50):e23266

Department of Endocrinology.

Rationale: Pituitary stalk interruption syndrome (PSIS) is a congenital pituitary anatomical defect. It is characterized by the triad of thin or interrupted pituitary stalk, absent or ectopic posterior lobe, and hypoplastic or aplastic anterior lobe. Moreover, this condition is considered rare. Read More

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December 2020

A New Presentation: Aphallia, Vesicoureteral Reflux, Rectovesical Fistula, and Adrenal Insufficiency.

Case Rep Pediatr 2020 23;2020:8826520. Epub 2020 Nov 23.

Pediatric B Department-Mother-Child Pole, Mohammed VI University Hospital, Marrakesh, Morocco.

Aphallia or penile agenesis is a rare congenital malformation with an estimated incidence rate of 1 in 10 to 30 million births. More than half of aphallia cases have associated anomalies including caudal axis, cardiovascular, genitourinary, and gastrointestinal anomalies. The penile agenesis associated with adrenal insufficiency has never been reported in an infant. Read More

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November 2020

Nonvirilized Genitalia in 3 Female Newborns With the Salt-Wasting Congenital Adrenal Hyperplasia Phenotype.

J Endocr Soc 2021 Jan 5;5(1):bvaa169. Epub 2020 Nov 5.

Division of Endocrinology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, a form of primary adrenal insufficiency characterized by impaired cortisol secretion and elevated androgen production, is the leading cause of atypical genitalia in the female newborn. Females with classic CAH, either salt-wasting or simple-virilizing form, usually present at birth with atypical genitalia ranging from clitoromegaly to male-appearing genitalia, due to in utero to elevated androgens (androstenedione and testosterone). Females with mild nonclassic CAH usually present with typical genitalia. Read More

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January 2021