630 results match your criteria Adrenal Insufficiency and Adrenal Crisis


Impact of underlying chronic adrenal insufficiency on clinical course of hospitalized patients with adrenal crisis: A nationwide cohort study.

Eur J Intern Med 2019 Apr 9. Epub 2019 Apr 9.

Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Japan. Electronic address:

Background: Chronic adrenal insufficiency (AI) is an established risk factor for adrenal crisis (AC). However, the proportion of patients with newly diagnosed chronic AI during admission for AC is unclear.

Methods: This retrospective cohort study used a Japanese claims database involving 7. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S09536205193010
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http://dx.doi.org/10.1016/j.ejim.2019.04.001DOI Listing
April 2019
4 Reads

The use of Medical Identification Jewellery in Adults with Adrenal Insufficiency in Australia.

Clin Endocrinol (Oxf) 2019 Apr 9. Epub 2019 Apr 9.

Endocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia.

Objective: Hydrocortisone stress dosing during illness can prevent adrenal crises (AC) in patients with adrenal insufficiency (AI). When patients cannot communicate, medical identification jewellery may facilitate parenteral hydrocortisone provision but patient adoption rates are not known.

Design: A cross-sectional analysis of Australian medical identification jewellery subscription data. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1111/cen.13985
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http://dx.doi.org/10.1111/cen.13985DOI Listing
April 2019
4 Reads

Jaundice and anaemia as presenting features of an incomplete autoimmune polyglandular syndrome type II.

BMJ Case Rep 2019 Apr 8;12(4). Epub 2019 Apr 8.

Department of General Medicine, R.G. Kar Medical College and Hospital, Kolkata, India.

The coexistence of adrenal failure with either autoimmune thyroid disease and/or type 1 diabetes is defined as autoimmune polyglandular syndrome (APS) type 2 or Schmidt's syndrome. Vitiligo, hypergonadotropic hypogonadism, chronic autoimmune hepatitis, alopecia, pernicious anaemia and seronegative arthritis may also be present. We present a case of 45-year-old Indian man with progressive jaundice and asthenia for 3 months. Read More

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http://dx.doi.org/10.1136/bcr-2018-228490DOI Listing
April 2019
1 Read

Emergency treatment of adrenal crisis with prednisone suppositories: a bioequivalence study in female patients with Addison's disease.

Endocr Connect 2019 Apr;8(4):425-434

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

Objective Patients with adrenal insufficiency (AI) need to adapt their glucocorticoid replacement under stressful conditions to prevent adrenal crisis (AC). Prednisone (PN) suppositories are used for emergency treatment. Pharmacokinetics of 100 mg PN suppositories after vaginal or rectal administration was evaluated. Read More

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http://dx.doi.org/10.1530/EC-19-0024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454300PMC
April 2019
6 Reads

Opioid induced adrenal insufficiency: what is new?

Authors:
Diane Donegan

Curr Opin Endocrinol Diabetes Obes 2019 Mar 11. Epub 2019 Mar 11.

Department of Endocrinology and Diabetes, Indiana University School of Medicine, Indiana, USA.

Purpose Of Review: Despite the declaration of an opioid epidemic, opioid use remains prevalent. Side-effects of chronic opioid use continue to be problematic. Opioid-induced endocrinopathies have been well documented, yet opioid-induced adrenal insufficiency (OIAI) remains underappreciated. Read More

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http://dx.doi.org/10.1097/MED.0000000000000474DOI Listing
March 2019
4 Reads

Management of Endocrine Emergencies in the ICU.

Authors:
Judith Jacobi

J Pharm Pract 2019 Mar 10:897190019834771. Epub 2019 Mar 10.

1 Pharmacy Department, Indiana University Health Methodist Hospital, Indianapolis, IN, USA.

Endocrine emergencies are frequent in critically ill patients and may be the cause of admission or can be secondary to other critical illness. The ability to anticipate endocrine abnormalities such as adrenal excess or , hypothyroidism, can mitigate their duration and severity. Hyperglycemic crisis may trigger hospital and intensive care unit (ICU) admission and may be life threatening. Read More

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http://dx.doi.org/10.1177/0897190019834771DOI Listing
March 2019
1 Read

Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings.

J Investig Med 2019 Feb 28. Epub 2019 Feb 28.

Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA.

Adrenal insufficiency (AI) remains a significant cause of morbidity and mortality in children with 1 in 200 episodes of adrenal crisis resulting in death. The goal of this working group of the Pediatric Endocrine Society Drug and Therapeutics Committee was to raise awareness on the importance of early recognition of AI, to advocate for the availability of hydrocortisone sodium succinate (HSS) on emergency medical service (EMS) ambulances or allow EMS personnel to administer patient's HSS home supply to avoid delay in administration of life-saving stress dosing, and to provide guidance on the emergency management of children in adrenal crisis. Currently, hydrocortisone, or an equivalent synthetic glucocorticoid, is not available on most ambulances for emergency stress dose administration by EMS personnel to a child in adrenal crisis. Read More

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http://dx.doi.org/10.1136/jim-2019-000999DOI Listing
February 2019
3 Reads

Adrenal crises in children with adrenal insufficiency: epidemiology and risk factors.

Eur J Pediatr 2019 May 26;178(5):731-738. Epub 2019 Feb 26.

Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children's Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel.

The aim of the study was to assess the epidemiology and risk factors of adrenal crises (AC) in children with adrenal insufficiency (AI). Children diagnosed with AI between 1990 and 2017 at four Israeli pediatric endocrinology units were studied. Demographic and clinical data were retrieved retrospectively from their files. Read More

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http://dx.doi.org/10.1007/s00431-019-03348-1DOI Listing
May 2019
4 Reads

SIADH versus adrenal insufficiency: a life-threatening misdiagnosis.

Ital J Pediatr 2019 Feb 6;45(1):23. Epub 2019 Feb 6.

University of Trieste, Piazzale Europa, 1, 34127, Trieste, Italy.

Background: Primary adrenal insufficiency (PAI) in children is an uncommon but severe condition which can be either inherited or acquired. It consists in clinical manifestation of defective production or ineffective action of endogenous glucocorticoids; deficiency in mineralocorticoids and adrenal androgens may coexist. Diagnosis of PAI in children and young people can be challenging; while adrenal crisis (acute decompensation) is a life-threatening condition, with patient presenting with characteristic features of hypoglycemia, hypotension, collapse and coma, chronic adrenal insufficiency may present with vague and non-specific symptoms, making the diagnosis more difficult. Read More

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http://dx.doi.org/10.1186/s13052-019-0614-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366080PMC
February 2019
11 Reads

Low Risk of Adrenal Insufficiency After Use of Low- to Moderate-Potency Topical Corticosteroids for Children With Atopic Dermatitis.

Clin Pediatr (Phila) 2019 Apr 29;58(4):406-412. Epub 2019 Jan 29.

1 University of Virginia, Charlottesville, VA, USA.

Our objective was to assess the risk of adrenal insufficiency (AI) with short-term use of low- to moderate-potency topical corticosteroids (TCS) for treatment of atopic dermatitis. Our systematic literature search revealed 9 studies (n = 371) that evaluated AI using adrenocorticotropic hormone stimulation testing, with measures of serum cortisol levels at baseline and following at least 2 weeks of TCS application. Biochemical AI was defined by a stimulated cortisol level of ≤18. Read More

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http://dx.doi.org/10.1177/0009922818825154DOI Listing
April 2019
4 Reads

Clinical outcomes and cortical reserve in adrenal histoplasmosis-A retrospective follow-up study of 40 patients.

Clin Endocrinol (Oxf) 2019 Apr 10;90(4):534-541. Epub 2019 Feb 10.

Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Objective: Detailed studies of Addison's disease resulting from disseminated adrenal histoplasmosis (AH) are not available. We describe the presentation and prognosis of AH and cortisol status before and after antifungal therapy.

Design: Single-centre retrospective hospital-based study of 40 consecutive adults with AH [39 males; age (mean ± SD) 53 ± 11 years] was conducted between 2006 and 2018. Read More

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http://doi.wiley.com/10.1111/cen.13935
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http://dx.doi.org/10.1111/cen.13935DOI Listing
April 2019
13 Reads

Adrenal hypoplasia congenita in identical twins.

Saudi Med J 2019 Jan;40(1):87-92

Unit of Pediatric Endocrinology and Diabetes, Maternity and Children Hospital, Dammam, Kingdom of Saudi Arabia. E-mail.

We are presenting a monozygotic twin brothers presented at different ages with different presentations. Twin-A presented at age of 18 days with salt losing crisis. Investigations revealed high plasma renin with low-normal aldosterone. Read More

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http://dx.doi.org/10.15537/smj.2019.1.23337DOI Listing
January 2019
3 Reads

Management of Adrenal Insufficiency Risk After Long-term Systemic Glucocorticoid Therapy in Duchenne Muscular Dystrophy: Clinical Practice Recommendations.

J Neuromuscul Dis 2019 ;6(1):31-41

Department of Pediatrics, Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado, USA.

Long-term glucocorticoid therapy has improved outcomes in patients with Duchenne muscular dystrophy. However, the recommended glucocorticoid dosage suppresses the hypothalamic-pituitary-adrenal axis, leading to adrenal insufficiency that may develop during severe illness, trauma or surgery, and after discontinuation of glucocorticoid therapy. The purpose of this review is to highlight the risk of adrenal insufficiency in this patient population, and provide practical recommendations for management of adrenal insufficiency, glucocorticoid withdrawal, and adrenal function testing. Read More

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https://www.medra.org/servlet/aliasResolver?alias=iospress&a
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http://dx.doi.org/10.3233/JND-180346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398538PMC
January 2019
16 Reads

Graves' Thyrotoxicosis Leading to Adrenal Decompensation and Hyperandrogenemia in a Pediatric Patient with Salt-Wasting Congenital Adrenal Hyperplasia.

Case Rep Endocrinol 2018 22;2018:2359205. Epub 2018 Nov 22.

Pediatric Endocrinology, Rhode Island Hospital/The Warren Alpert Medical School of Brown University, 111 Plain Street, 3rd Floor, Providence, RI 02903, USA.

Introduction: Thyroid hormone is known to accelerate glucocorticoid turnover. In a thyrotoxic state, individuals with adrenal insufficiency are unable to increase endogenous cortisol production to compensate for increased turnover, placing them at risk for symptoms of glucocorticoid deficiency and adrenal crisis. In patients with salt-wasting congenital adrenal hyperplasia (SW-CAH), hyperandrogenemia is a measurable reflection of relative glucocorticoid insufficiency. Read More

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http://dx.doi.org/10.1155/2018/2359205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282132PMC
November 2018
3 Reads

An Update on Addison's Disease.

Exp Clin Endocrinol Diabetes 2019 Feb 18;127(2-03):165-175. Epub 2018 Dec 18.

Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.

Addison's disease - the traditional term for primary adrenal insufficiency (PAI) - is defined as the clinical manifestation of chronic glucocorticoid- and/or mineralocorticoid deficiency due to failure of the adrenal cortex which may result in an adrenal crisis with potentially life-threatening consequences. Even though efficient and safe pharmaceutical preparations for the substitution of endogenous gluco- and mineralocorticoids are established in therapy, the mortality in patients with PAI is still increased and the health-related quality of life (HRQoL) is often reduced.PAI is a rare disease but recent data report an increasing prevalence. Read More

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http://dx.doi.org/10.1055/a-0804-2715DOI Listing
February 2019
21 Reads
1.760 Impact Factor

Prolonged adrenal insufficiency after high-dose glucocorticoid in infants with leukemia.

Pediatr Hematol Oncol 2018 Aug - Sep;35(5-6):355-361. Epub 2018 Nov 20.

a Department of Pediatrics , Ehime University Graduate School of Medicine , Ehime , Japan.

Although outcomes for infant leukemia have improved recently, transient adrenal insufficiency is commonly observed during treatment, especially after glucocorticoid administration. We identified three infants with acute leukemia who suffered from prolonged adrenal insufficiency requiring long-term (from 15 to 66 months) hydrocortisone replacement. All infants showed life-threatening symptoms associated with adrenal crisis after viral infections or other stress. Read More

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https://www.tandfonline.com/doi/full/10.1080/08880018.2018.1
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http://dx.doi.org/10.1080/08880018.2018.1539148DOI Listing
March 2019
31 Reads

Adrenal crisis presented as acute onset of hypercalcemia and hyponatremia triggered by acute pyelonephritis in a patient with partial hypopituitarism and pre-dialysis chronic kidney disease.

CEN Case Rep 2019 May 19;8(2):83-88. Epub 2018 Nov 19.

Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.

A 57-year-old woman with pre-dialysis chronic kidney disease (CKD) was hospitalized because of fever and fatigue. On admission, increased inflammatory response and pyuria with bacteriuria were observed. Pyelonephritis was successfully treated with antibiotics, whereas her fatigue continued and she developed progressive hypercalcemia and hyponatremia; serum sodium level, 116 mEq/L and corrected serum calcium level, 13. Read More

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http://link.springer.com/10.1007/s13730-018-0371-9
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http://dx.doi.org/10.1007/s13730-018-0371-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450993PMC
May 2019
32 Reads

Polyglandular endocrine emergency: lessons from a patient, which a book cannot teach.

BMJ Case Rep 2018 Nov 8;2018. Epub 2018 Nov 8.

Department of Diabetes and Endocrinology, Royal Glamorgan Hospital, Llantrisant, UK.

A 30-year-old woman with polyglandular autoimmune type 2 syndrome was found collapsed at home with a cardiac arrest, which required direct current cardioversion. On admission, she was hypothermic, hypotensive and bradycardic. Initial biochemical investigations were consistent with a pre-renal acute kidney injury, metabolic acidosis and a possible sepsis. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2018-22650
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http://dx.doi.org/10.1136/bcr-2018-226503DOI Listing
November 2018
26 Reads

Increasing Immunization Rates in Infants with Severe Chronic Lung Disease: A Quality Improvement Initiative.

Hosp Pediatr 2018 Nov;8(11):693-698

Division of Neonatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

Objectives: Immunizations provide important protection from serious childhood illnesses. Infant chronic lung disease (CLD) is a serious complication of prematurity and predisposes premature infants to respiratory morbidity, rehospitalization, and mortality. This high-risk group is especially vulnerable to infections, such as invasive pneumococcal disease, influenza, and bronchiolitis. Read More

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http://dx.doi.org/10.1542/hpeds.2018-0046DOI Listing
November 2018
22 Reads

Adrenoleukodystrophy: Guidance for Adrenal Surveillance in Males Identified by Newborn Screen.

J Clin Endocrinol Metab 2018 Nov;103(11):4324-4331

Pediatric Endocrine Unit, Massachusetts General Hospital for Children and Harvard Medical School, Boston, Massachusetts.

Context: Adrenoleukodystrophy (ALD) is a peroxisomal disorder associated with neurologic decompensation and adrenal insufficiency. Newborn screening for ALD has recently been implemented in five states with plans to expand to all 50 states in the United States. Adrenal insufficiency ultimately develops in most males with ALD, but the earliest age of onset is not well established. Read More

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https://academic.oup.com/jcem/advance-article/doi/10.1210/jc
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http://dx.doi.org/10.1210/jc.2018-00920DOI Listing
November 2018
13 Reads

Masking and misleading: concomitant actinomycosis and B-cell lymphoma - a case report and review of literature.

Scott Med J 2018 Aug 30:36933018789312. Epub 2018 Aug 30.

2 Consultant Infectious Diseases Physician, Infectious Diseases Unit, Penang General Hospital, Penang, Malaysia.

We report a 72-year-old patient who presented with an ulcerated palatal mass, weight loss and adrenal insufficiency. Repeated biopsies from the mass revealed actinomycosis with no features of malignancy, while computed tomography scanning revealed a left maxillary sinus mass with invasive features and bilateral large adrenal masses. Blood and urine investigations showed adrenal insufficiency. Read More

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http://dx.doi.org/10.1177/0036933018789312DOI Listing
August 2018
7 Reads

A Sarcoidosis Patient Presents with Adrenal Insufficiency: A Standardized Patient Scenario for Medical Students and Residents.

Cureus 2018 Jun 18;10(6):e2833. Epub 2018 Jun 18.

Emergency Medicine/ Medical Simulation, Mayo Clinic, Jacksonville, USA.

Introduction The widespread use of corticosteroids for treatment of inflammatory conditions has resulted in the need to promptly recognize drug-induced adrenal insufficiency. This scenario was inspired by an actual case and aims to enhance critical thinking. Our case is unique as we use a case-based format with written tests to track progress. Read More

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http://dx.doi.org/10.7759/cureus.2833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101462PMC
June 2018
22 Reads

A Case of Brugada Pattern Associated with Adrenal Insufficiency.

Cureus 2018 Jun 6;10(6):e2752. Epub 2018 Jun 6.

Internal Medicine, Yale New Haven Health at Bridgeport Hospital, Bridgeport, USA.

Brugada syndrome (BrS) is an inherited channelopathy disease, caused by genetic changes in transmembrane ion channels. It has an increased risk of sudden cardiac death (SCD) in the absence of a structural heart disease. We report a case in which the presenting electrocardiogram (EKG) exhibited a type 1 Brugada-like pattern during an adrenal crisis with transformation into a type 2 Brugada-like pattern as the crisis improved. Read More

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http://dx.doi.org/10.7759/cureus.2752DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080736PMC
June 2018
5 Reads

Smith-Lemli-Opitz syndrome presenting as acute adrenal crisis in a child: a case report.

J Med Case Rep 2018 Aug 10;12(1):217. Epub 2018 Aug 10.

University Paediatric Unit, Colombo North Teaching Hospital, Ragama, Sri Lanka.

Background: Smith-Lemli-Opitz syndrome is a rare autosomal recessive disorder of cholesterol biosynthesis which is characterized by multiple congenital malformations and global developmental delay. Here we report the case of a 3-year-old, previously undiagnosed, child with Smith-Lemli-Opitz syndrome presenting with acute adrenal crisis, which is an extremely rare and atypical presentation of this disease.

Case Presentation: A 3-year-old Sri Lankan Sinhalese boy without evidence of infection presented with circulatory collapse. Read More

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http://dx.doi.org/10.1186/s13256-018-1738-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085650PMC
August 2018
2 Reads

Variations in the management of acute illness in children with congenital adrenal hyperplasia: An audit of three paediatric hospitals.

Clin Endocrinol (Oxf) 2018 Nov 24;89(5):577-585. Epub 2018 Sep 24.

School of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia.

Objective: Episodes of acute adrenal insufficiency (AI)/adrenal crises (AC) are a serious consequence of congenital adrenal hyperplasia (CAH). This study aimed to assess morbidity from acute illness in CAH and identify factors associated with use of IV hydrocortisone, admission and diagnosis of an AC.

Method: An audit of acute illness presentations among children with CAH to paediatric hospitals in New South Wales, Australia, between 2000 and 2015. Read More

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http://dx.doi.org/10.1111/cen.13826DOI Listing
November 2018
28 Reads
3.460 Impact Factor

Latent Adrenal Insufficiency: Concept, Clues to Detection, and Diagnosis.

Endocr Pract 2018 08 7;24(8):746-755. Epub 2018 Aug 7.

In 1855, Thomas Addison described an illness now known as Addison disease (AD) caused by damage to the adrenal cortex and manifesting in weakness, weight loss, hypotension, gastrointestinal disturbances, and brownish pigmentation of the skin and mucous membranes. Corticosteroid supplementation, corticotropin (adrenocorticotropic hormone [ACTH] of medicinal use) test, and anti-adrenal auto-antibodies (AA) have come into use in the 100 years since Addison's death. Following the methodological innovations, 4 disorders which share impaired response to corticotropin in common have been discovered (i. Read More

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http://dx.doi.org/10.4158/EP-2018-0114DOI Listing
August 2018
6 Reads

Tuberculous Adrenal Abscess Presenting as Adrenal Insufficiency in a 4-Year-Old Boy.

J Trop Pediatr 2018 Jul 27. Epub 2018 Jul 27.

Division of Pediatric Endocrinology, Bai Jerbai Wadia Hospital for Children, Mumbai, India.

We describe the case of a 4.8-year-old boy who presented with adrenal crisis. The advent of symptoms of adrenal insufficiency in the patient was at around 2 years of age. Read More

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http://dx.doi.org/10.1093/tropej/fmy046DOI Listing
July 2018
6 Reads
0.860 Impact Factor

Acute Adrenal Insufficiency in the Perioperative Period: A Case Report.

A A Pract 2019 Feb;12(3):63-65

From the Department of Anesthesiology & Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.

Acute adrenal insufficiency is a rare but potentially life-threatening event during the perioperative period. The usual manifestations of an acute adrenal crisis can mimic common postoperative complications and a high index of suspicion is required for the diagnosis. Early diagnosis and prompt treatment can be lifesaving. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000846DOI Listing
February 2019
23 Reads

[The 464th case: sudden convulsion and coma in a patient with acute leukemia].

Zhonghua Nei Ke Za Zhi 2018 Jul;57(7):539-541

Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China.

A 46-year-old female patient was diagnosed as mixed phenotype acute leukemia with chief complaints of intermittent gingival swelling and bleeding for 1 week. The induction chemotherapy was not effective. During the second course chemotherapy, the patient had sudden convulsion and coma. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0578-1426.2018.07.017DOI Listing
July 2018
6 Reads

Heterozygous mutations in the cholesterol side-chain cleavage enzyme gene (CYP11A1) can cause transient adrenal insufficiency and life-threatening failure to thrive.

Hormones (Athens) 2018 Sep 11;17(3):419-421. Epub 2018 Jul 11.

Division of Pediatric Endocrinology, Third Department of Pediatrics, Attikon University Hospital, Haidari, Athens, Greece.

The first and rate-limited step of steroidogenesis in all steroidogenic tissues is the conversion of cholesterol to pregnenolone, catalysed by P450scc side-chain cleavage enzyme (CYP11A1 gene-SCC). SCC deficiency has been characterised as an autosomal recessive disorder, although it may also be inherited as an autosomal dominant trait in humans. Here, we describe a family of three members carrying the same novel heterozygous CYP11A1 mutation, a c. Read More

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http://dx.doi.org/10.1007/s42000-018-0048-yDOI Listing
September 2018
12 Reads

Adrenal Insufficiency in Young Children: a Mixed Methods Study of Parents' Experiences.

J Genet Couns 2018 Dec 7;27(6):1447-1458. Epub 2018 Jul 7.

Genetic Alliance UK, 49-51 East Road, London, N1 6AH, UK.

Research into adrenal insufficiency (AI) and congenital adrenal hyperplasia (CAH) in children has focused largely on clinical consequences for patients; and until recently, the wider experience of the condition from the perspective of other family members has been neglected. In a mixed methods study, we captured the experiences of parents of young children affected by AI/CAH, including their views on the psychosocial impact of living with and managing the condition. Semi-structured interviews were carried out in the UK and an online survey was developed, translated and disseminated through support groups (UK and the Netherlands) and outpatient endocrinology clinics (Germany). Read More

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http://dx.doi.org/10.1007/s10897-018-0278-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6209050PMC
December 2018
5 Reads

Study of adrenal function in patients with tuberculosis.

Indian J Tuberc 2018 Jul 7;65(3):241-245. Epub 2017 Oct 7.

Professor and Head, Department of Biochemistry, Sri Guru Ram Das Institute of Medical Sciences & Research, Vallah, Amritsar, India.

Background: Although subclinical adrenal insufficiency has been documented in tuberculosis but it has been neglected in mainstream management of TB due to inconclusive data on its prevalence in TB. The fact that adrenal insufficiency may result not only in poor general condition of the patient but also sudden death due to adrenal crisis, makes it all the more important to address this issue seriously. In this non-randomized interventional study comprising of 100 cases of TB, our aim was to assess the adreno-cortical functions in patients with pulmonary TB (50 cases) and extra-pulmonary TB (50 cases) in an attempt to determine if there is any compromise of adrenal function. Read More

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http://dx.doi.org/10.1016/j.ijtb.2017.08.033DOI Listing
July 2018
21 Reads

[CME: Adrenal Insufficiency].

Authors:
Stefan Fischli

Praxis (Bern 1994) 2018 Jun;107(13):717-725

1 Abteilung Endokrinologie, Diabetologie und Klinische Ernährung, Departement Innere Medizin, Luzerner Kantonsspital.

CME: Adrenal Insufficiency Abstract. Patients suffering from adrenal insufficiency (AI) often present with unspecific symptoms. Therefore, the diagnosis of AI, a potential life-threatening condition, can be missed. Read More

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http://dx.doi.org/10.1024/1661-8157/a002982DOI Listing
June 2018
15 Reads

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

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http://dx.doi.org/10.1530/EDM-18-0034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993059PMC
June 2018
14 Reads

[Canine hypoadrenocorticism - an update on pathogenesis, diagnosis and treatment].

Tierarztl Prax Ausg K Kleintiere Heimtiere 2018 Jun 13;46(3):163-175. Epub 2018 Jun 13.

Canine hypoadrenocorticism (HoAC) results from a loss of functional adrenal cortex, the most common etiology of which is an immune-mediated destruction leading to an inadequate production of glucocorticoids and mineralocorticoids. The term "atypical" HoAC is used for a subgroup of dogs with either an isolated glucocorticoid deficiency or a combined glucocorticoid and mineralocorticoid deficiency but normal electrolytes. Dogs with HoAC can present with a large variety of clinical signs, ranging from shaking, weakness, and mild gastrointestinal signs to seizures, hypovolemic shock, and collapse. Read More

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http://www.thieme-connect.de/DOI/DOI?10.15654/TPK-180351
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http://dx.doi.org/10.15654/TPK-180351DOI Listing
June 2018
13 Reads

Evaluation of Hypothalamic-Pituitary-Adrenal Axis Suppression following Cutaneous Use of Topical Corticosteroids in Children: A Meta-Analysis.

Horm Res Paediatr 2018 13;89(6):389-396. 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

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http://dx.doi.org/10.1159/000489125DOI Listing
November 2018
32 Reads

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

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http://dx.doi.org/10.11604/pamj.2018.29.30.6025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987076PMC
June 2018
27 Reads

Adrenal Crises in Children: Perspectives and Research Directions.

Horm Res Paediatr 2018 6;89(5):341-351. 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

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http://dx.doi.org/10.1159/000481660DOI Listing
October 2018
17 Reads
1.713 Impact Factor

Acute adrenal crisis and mortality in adrenal insufficiency: Still a concern in 2018!

Authors:
Stefanie Hahner

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

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http://dx.doi.org/10.1016/j.ando.2018.04.015DOI Listing
June 2018
31 Reads

[Delayed diagnosis of adrenal crisis].

Ugeskr Laeger 2018 Apr;180(15)

Adrenal crisis is a life-threatening emergency with excess mortality of patients with adrenal insufficiency. This case report is about delayed diagnosis of a patient with unknown primary adrenal insufficiency, reduced consciousness and shock. Read More

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April 2018
1 Read

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

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http://dx.doi.org/10.1111/cen.13609DOI Listing
July 2018
19 Reads

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

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http://dx.doi.org/10.1530/EDM-17-0179DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5900459PMC
April 2018
7 Reads

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

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http://dx.doi.org/10.1111/cen.13608DOI Listing
July 2018
22 Reads

Therapeutic patient education in adrenal insufficiency.

Authors:
Laurence Guignat

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

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http://dx.doi.org/10.1016/j.ando.2018.03.002DOI Listing
June 2018
5 Reads

Longitudinal Assessment of Illnesses, Stress Dosing, and Illness Sequelae in Patients With Congenital Adrenal Hyperplasia.

J Clin Endocrinol Metab 2018 06;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

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http://dx.doi.org/10.1210/jc.2018-00208DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276663PMC
June 2018
21 Reads
6.210 Impact Factor

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

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http://dx.doi.org/10.1530/EDM-18-0003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5863243PMC
March 2018
5 Reads

[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

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http://dx.doi.org/10.1055/s-0043-111729DOI Listing
March 2018
7 Reads

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

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http://dx.doi.org/10.1155/2018/2353172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5817294PMC
January 2018
27 Reads