844 results match your criteria Adrenal Insufficiency and Adrenal Crisis


Adrenal crises in adolescents and young adults.

Endocrine 2022 May 18. Epub 2022 May 18.

Department of Endocrinology, Karolinska University Hospital, SE-17176, Stockholm, Sweden.

Purpose: Review the literature concerning adrenal insufficiency (AI) and adrenal crisis (AC) in adolescents and young adults.

Methods: Searches of PubMed identifying relevant reports up to March 2022.

Results: AI is rare disorder that requires lifelong glucocorticoid replacement therapy and is associated with substantial morbidity and occasional mortality among adolescents and young adults. Read More

View Article and Full-Text PDF

Management Of Acute Adrenal Insufficiency Related Adverse Events In Children With Congenital Adrenal Hyperplasia - Results Of An International Survey Of Specialist Centres.

Horm Res Paediatr 2022 May 13. Epub 2022 May 13.

Introduction There is wide variation in reported rates of acute adrenal insufficiency (AI) related adverse events (sick day episodes and adrenal crises) between centres. This study aimed to evaluate the level of consensus on criteria considered essential for defining and managing these events in children with Congenital Adrenal Hyperplasia. Methods Active users of the International Congenital Adrenal Hyperplasia & International Disorders of Sex Development (I-CAH/I-DSD) Registries (n=66), non-active users of I-CAH/I-DSD (n=35) and the EuRRECa e-Reporting Registry (n=10) were approached to complete an online survey. Read More

View Article and Full-Text PDF

Interventions for the prevention of adrenal crisis in adults with primary adrenal insufficiency: a systematic review.

Eur J Endocrinol 2022 May 1. Epub 2022 May 1.

D Carrick-Sen, School of Nursing, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland.

Objective: The incidence of adrenal crisis remains high, particularly for people with primary adrenal insufficiency, despite the introduction of behavioural interventions. The present study aimed to identify and evaluate available evidence of interventions aiming to prevent adrenal crisis in primary adrenal insufficiency.

Design: Systematic review of literature and theoretical mapping. Read More

View Article and Full-Text PDF

Adrenal insufficiency.

J Clin Pathol 2022 May 9. Epub 2022 May 9.

Clinical Biochemistry, Bedfordshire Hospitals NHS Foundation Trust, Bedford, UK.

Adrenal insufficiency (AI), first described by Thomas Addison in 1855, is characterised by inadequate hormonal production by the adrenal gland, which could either be primary, due to destruction of the adrenal cortex, or secondary/tertiary, due to lack of adrenocorticotropic hormone or its stimulation by corticotropin-releasing hormone. This was an invariably fatal condition in Addison's days with most patients dying within a few years of diagnosis. However, discovery of cortisone in the 1940s not only improved the life expectancy of these patients but also had a dramatic effect on their overall quality of life. Read More

View Article and Full-Text PDF

Susceptibility to Adrenal Crisis Is Associated With Differences in Cortisol Excretion in Patients With Secondary Adrenal Insufficiency.

Front Endocrinol (Lausanne) 2022 20;13:849188. Epub 2022 Apr 20.

Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Objective: To compare cortisol pharmacokinetics and pharmacodynamics mapped through several glucocorticoid sensitive pathways in patients on hydrocortisone substitution with or without an adrenal crisis.

Design: A analysis of a previously conducted randomized controlled trial in patients with secondary adrenal insufficiency examining the effects of 2 weight-adjusted hydrocortisone doses.

Methods: Comparisons were primarily made on a hydrocortisone dose of 0. Read More

View Article and Full-Text PDF

Adrenal crisis secondary to Covid-19 vaccination in patient with hypopituitarism.

AACE Clin Case Rep 2022 Apr 25. Epub 2022 Apr 25.

Division of Endocrinology-Diabetes and Metabolism, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston 07039, New Jersey.

Background/objective: Adrenal crisis (AC) is an acute life-threatening condition that can occur in patients with primary or secondary adrenal insufficiency who are already on glucocorticoid replacement therapy or can be a first presentation of adrenal insufficiency. Vaccination with Tdap, influenza and pneumococcal vaccine has been reported as a cause of AC. Our objective is to present a case of AC precipitated by COVID-19 mRNA vaccination in patient with hypopituitarism. Read More

View Article and Full-Text PDF

A Study of Adrenocortical Function in Patients with Pulmonary Tuberculosis and its Response to Anti Tubercular Therapy(ATT).

Authors:
Brunda K

J Assoc Physicians India 2022 Apr;70(4):11-12

Mandya Institute of Medical Sciences, Mandya, Karnataka.

Tuberculosis may lead to adrenal insufficiency by direct glandular involvement, by extra glandular infection or as a by-product of Anti tuberculous therapy. Subclinical adrenal insufficiency becomes important in stressful situation which require increased release of ACTH to meet heightened metabolic demands. Our objective was to determine the adrenal reserve in patients with pulmonary tuberculosis and to determine the effect of ATT on adrenal function. Read More

View Article and Full-Text PDF

Critical illness-induced corticosteroid insufficiency: what it is not and what it could be.

J Clin Endocrinol Metab 2022 Mar 31. Epub 2022 Mar 31.

Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven University, Belgium.

Critical illnesses are hallmarked by increased systemic cortisol availability, a vital part of the stress response. Acute stress may trigger a life-threatening adrenal crisis when a disease of the hypothalamic-pituitary-adrenal (HPA)-axis is present and not adequately treated with stress doses of hydrocortisone. Stress doses of hydrocortisone are also used to reduce high vasopressor need in patients suffering from septic shock, in the absence of adrenal insufficiency. Read More

View Article and Full-Text PDF

Monitoring for and Management of Endocrine Dysfunction in Adrenoleukodystrophy.

Int J Neonatal Screen 2022 Mar 2;8(1). Epub 2022 Mar 2.

Division of Pediatric Endocrinology and Diabetes, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467, USA.

Adrenoleukodystrophy (ALD) is a peroxisomal disorder affecting the nervous system, adrenal cortical function, and testicular function. Newborn screening for ALD has the potential to identify patients at high risk for life-threatening adrenal crisis and cerebral ALD. The current understanding of the natural history of endocrine dysfunction is limited. Read More

View Article and Full-Text PDF

Approach to the patient with glucocorticoid-induced adrenal insufficiency.

J Clin Endocrinol Metab 2022 Mar 18. Epub 2022 Mar 18.

Department of Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Glucocorticoid-induced adrenal insufficiency is caused by exogenous glucocorticoid suppression of the hypothalamic-pituitary-adrenal axis and is the most prevalent form of adrenal insufficiency. The condition is important to diagnose given the risk of life-threatening adrenal crisis and impact on patients' quality of life. The diagnosis is made with a stimulation test such as the ACTH-test. Read More

View Article and Full-Text PDF

Adrenal Insufficiency: Investigating Prevalence and Healthcare Utilization Using Administrative Data.

J Endocr Soc 2022 Apr 9;6(4):bvab184. Epub 2021 Dec 9.

Office of Lifelong Learning & the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, AB, Canada.

Context: Adrenal insufficiency (AI) is an uncommon, life-threatening disorder requiring lifelong treatment with steroid therapy and special attention to prevent adrenal crisis. Little is known about the prevalence of AI in Canada or healthcare utilization rates by these patients.

Objective: We aimed to assess the prevalence and healthcare burden of AI in Alberta, Canada. Read More

View Article and Full-Text PDF

Current Approach for Diagnosis and Treatment of Adrenal Tuberculosis-Our Experience and Review of Literature.

Surg J (N Y) 2022 Jan 3;8(1):e92-e97. Epub 2022 Mar 3.

Department of Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Addison's disease was first described by Thomas Addison in 1855. He demonstrated the destruction of bilateral adrenal gland by tuberculosis (TB) in six patients. Since then, the incidence of TB has declined in the Western world, but in developing countries, it is still the most common cause of adrenal insufficiency. Read More

View Article and Full-Text PDF
January 2022

[Emergency card, emergency medication, and information leaflet for the prevention and treatment of adrenal crisis (Addison crisis): an Austrian consensus document].

J Klin Endokrinol Stoffwechs 2022 2;15(1):5-27. Epub 2022 Mar 2.

St. Anna Kinderspital, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Wien, Wien, Österreich.

A central goal of the adrenal insufficiency management is the prevention of acute adrenal insufficiency (also known as adrenal crisis or Addison crisis). This consensus document was generated in order to achieve better implementation and harmonization of measures for the prevention and treatment of acute adrenal insufficiency in Austria. The following measures are generally recommended for all patients with adrenal insufficiency and are outlined in this manuscript: (1) Provision of a "steroid emergency card" and possibly also a medical alert bracelet or necklace (or similar identification). Read More

View Article and Full-Text PDF

Disseminated tuberculosis associated with autoimmune haemolytic anaemia and adrenal deficiency: a rare association.

BMJ Case Rep 2022 Mar 4;15(3). Epub 2022 Mar 4.

Department of Pathology, Rajagiri Hospital, Aluva, Kerala, India.

Tuberculosis (TB) is one of the greatest masqueraders in medical practice and can have manifestations involving any organ or organ systems of the body. The presentation of disseminated TB can range from typical features like fever, weight loss and fatigue to protean manifestations. We share the case of an elderly man who presented to us with weight loss, anaemia, weakness and lymphadenopathy involving thoracic and intraabdominal locations. Read More

View Article and Full-Text PDF

Cardiac tamponade as a presentation of primary adrenal insufficiency.

BMJ Case Rep 2022 Mar 4;15(3). Epub 2022 Mar 4.

Musgrove Park Hospital, Taunton, UK.

Cardiac tamponade is an important and severe consequence of pericardial effusion. Patients with haemodynamically significant pericardial effusions present with signs and symptoms relating to the degree of their impaired cardiac function. Although autoimmune disease is a recognised cause of pericardial effusion, cardiac tamponade as a clinical presentation of primary adrenal insufficiency (PAI) is infrequently reported. Read More

View Article and Full-Text PDF

The ISAQ Score Does Not Predict Adrenal Crisis in Patients with Primary Adrenal Insufficiency.

Exp Clin Endocrinol Diabetes 2022 Mar 3. Epub 2022 Mar 3.

Endocrinology in Charlottenburg, Berlin, Germany.

Objective: This study aimed to investigate the ability of the immune system assessment questionnaire (ISAQ) to predict adrenal crisis (AC) and infectious events in patients with primary adrenal insufficiency (PAI).

Design: This was a prospective single-centre study over three years.

Methods: Patients answered the ISAQ at baseline and were seen every 4-6 months in the endocrine outpatient clinic. Read More

View Article and Full-Text PDF

[Hypoxic and hypoglycemic brain damage as a result of an adrenal cortex crisis-An important differential diagnosis in cases of unspecific symptoms].

Anaesthesist 2022 Feb 28. Epub 2022 Feb 28.

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland.

Acute adrenal cortex insufficiency is a rare disease, which is hard to diagnose because of its diffuse symptoms. Symptoms, such as general weakness, nausea or vomiting, fatigue, hyponatremia, hyperkalemia, hypoglycemia and pronounced hypotension up to shock can be crucial in the diagnosis of an adrenal cortex crisis. The underlying disease of adrenal cortex insufficiency is also characterized by not always obvious symptoms, which are differently expressed depending on whether it is the primary or secondary type. Read More

View Article and Full-Text PDF
February 2022

Adrenal Crisis Secondary to Small Bowel Obstruction Caused by a Bezoar.

Cureus 2022 Jan 22;14(1):e21498. Epub 2022 Jan 22.

Department of Anesthesiology, Intensive Care and Emergency, Centro Hospitalar e Universitário do Porto, Porto, PRT.

Bezoars are aggregates of undigested materials that accumulate in the gastrointestinal lumen. They are a rare cause of small bowel obstruction and are mostly diagnosed in patients with small bowel disease. Patients with panhypopituitarism are more susceptible to developing metabolic and haemodynamic instability, particularly during perioperative period. Read More

View Article and Full-Text PDF
January 2022

Perioperative Management of a Patient With Cushing Disease.

J Endocr Soc 2022 Mar 28;6(3):bvac010. Epub 2022 Jan 28.

Departments of Medicine (Endocrinology, Diabetes and Clinical Nutrition) and Neurological Surgery, and Pituitary Center, Oregon Health & Science University, Portland, Oregon 97239, USA.

Patients with Cushing disease (CD) may present with both chronic and acute perioperative complications that necessitate multidisciplinary care. This review highlights several objectives for these patients before and after transsphenoidal surgery. Preoperative management includes treatment of electrolyte disturbances, cardiovascular comorbidities, prediabetes/diabetes, as well as prophylactic consideration(s) for thromboembolism and infection(s). Read More

View Article and Full-Text PDF

Systemic Manifestation of Miliary Tuberculosis in Patient With Advanced Diabetic Retinopathy Presenting With Electrolyte Imbalance, Seizures, and Adrenal Insufficiency.

Cureus 2022 Jan 9;14(1):e21047. Epub 2022 Jan 9.

Internal Medicine/Diabetes and Endocrinology, Barking, Havering and Redbridge University Hospitals NHS Trust, London, GBR.

Extra-pulmonary manifestations of tuberculosis can have diverse presentations depending on the affected organs. In this case report, we describe a case of a 50-year-old man of South Asian origin who presented with acute adrenal crisis on a background of undiagnosed miliary tuberculosis. Imaging after repeated episodes of adrenal crisis and seizures revealed bilaterally enlarged adrenals and cerebral tuberculomas, suggesting adrenal and central nervous system involvement. Read More

View Article and Full-Text PDF
January 2022

[Adrenal gland diseases: Addison's Disease].

Dtsch Med Wochenschr 2022 Jan 31;147(3):98-106. Epub 2022 Jan 31.

Addison's disease typically results from the autoimmune destruction of the adrenal cortex and requires lifelong replacement with glucocorticoids and mineralocorticoids. Main symptoms are non-specific and, therefore, often overlooked or misleading. Patients are frequently not diagnosed until experiencing a life-threatening adrenal crisis. Read More

View Article and Full-Text PDF
January 2022

Pediatric Adrenal Insufficiency: Challenges and Solutions.

Ther Clin Risk Manag 2022 11;18:47-60. Epub 2022 Jan 11.

Department of Pediatrics, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.

Adrenal insufficiency is an insidious diagnosis that can be initially misdiagnosed as other life-threatening endocrine conditions, as well as sepsis, metabolic disorders, or cardiovascular disease. In newborns, cortisol deficiency causes delayed bile acid synthesis and transport maturation, determining prolonged cholestatic jaundice. Subclinical adrenal insufficiency is a particular challenge for a pediatric endocrinologist, representing the preclinical stage of acute adrenal insufficiency. Read More

View Article and Full-Text PDF
January 2022

Frequently Asked Questions in Patients With Adrenal Insufficiency in the Time of COVID-19.

Front Endocrinol (Lausanne) 2021 24;12:805647. Epub 2021 Dec 24.

Endocrine Disease Unit, University-Hospital of Padova, Padova, Italy.

Adrenal insufficiency (AI) is a life-threatening disorder, with increased morbidity and mortality, especially in case of an acute illness that can increase the requirement of cortisol. A novel infectious disease, termed Coronavirus Disease 2019 (COVID-19), appeared in 2020. Therefore, AI patients are experiencing a novel challenge: the risk of infection. Read More

View Article and Full-Text PDF
January 2022

Risk assessment, diagnosis, and treatment of cancer treatment-related adrenal insufficiency.

Expert Rev Endocrinol Metab 2022 Jan 3;17(1):21-33. Epub 2022 Jan 3.

Royal Adelaide Hospital, Endocrine and Metabolic Unit Adelaide, Adelaide, Australia.

Introduction: Adrenal insufficiency (AI) is an easily treatable, potentially life-threatening condition, which is increasingly recognized in malignancy. The recent introduction of immune checkpoint inhibitors, in particular, and increasing use of tyrosine kinase inhibitors have increased the frequency of AI in patients with malignancy. A review is therefore warranted to summarize current knowledge on the topic and guide safe clinical practices. Read More

View Article and Full-Text PDF
January 2022

Addison's Disease Presenting as Acute Renal Failure and Hyperkalemic Paralysis: A Rare Presentation.

Case Rep Endocrinol 2021 22;2021:3103011. Epub 2021 Dec 22.

Division of Nephrology and Hypertension, Maimonides Medical Center, Brooklyn, NY 11219, USA.

Hyperkalemic paralysis in the setting of acute renal failure can lead to a missed or delayed diagnosis of adrenal insufficiency as the raised potassium can be attributed to the renal failure. Acute kidney injury as the presenting manifestation in an adrenal crisis due to Addison's disease has been rarely reported in the literature. Here, we present the case of a young 37-year-old male who came with hyperkalemic paralysis and acute renal failure needing emergent hemodialysis. Read More

View Article and Full-Text PDF
December 2021

Adrenal Insufficiency at the Time of COVID-19: A Retrospective Study in Patients Referring to a Tertiary Center.

J Clin Endocrinol Metab 2021 03;106(3):e1354-e1361

Endocrinology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.

Context: Coronavirus disease 2019 (COVID-19) represents a global health emergency, and infected patients with chronic diseases often present with a severe impairment. Adrenal insufficiency (AI) is supposed to be associated with an increased infection risk, which could trigger an adrenal crisis.

Objective: Our primary aim was to evaluate the incidence of COVID-19 symptoms and complications in AI patients. Read More

View Article and Full-Text PDF

Bilateral adrenal masses due to tuberculosis: how to diagnose without extra-adrenal tuberculosis.

Endocrinol Diabetes Metab Case Rep 2021 Dec 1;2021. Epub 2021 Dec 1.

Department of Endocrinology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Summary: Primary adrenal insufficiency is a rare disease and can masquerade as other conditions; therefore, it is sometimes incorrectly diagnosed. Herein, we reported the case of a 39-year-old Vietnamese male with primary adrenal insufficiency due to bilateral adrenal tuberculosis. The patient presented to the emergency room with acute adrenal crisis and a 3-day history of nausea, vomiting, epigastric pain, and diarrhoea with a background of 6 months of fatigue, weight loss, and anorexia. Read More

View Article and Full-Text PDF
December 2021

An autopsy case of unexpected death due to Addison's disease caused by adrenal tuberculosis.

Eur J Med Res 2021 Dec 4;26(1):137. Epub 2021 Dec 4.

Department of Pathology, Tianjin Medical University, No.22 Qixiangtai Road, Heping District, Tianjin, 300070, PR China.

Background: Adrenal tuberculosis is difficult to diagnose due to non-specific symptom. Unexpected death due to adrenal insufficiency after trauma surgery is rare.

Case Presentation: A 45-year-old man, who was admitted to hospital because of trauma to the right hand, died unexpectedly on the 13th day after replantation of amputated fingers. Read More

View Article and Full-Text PDF
December 2021

[New aspects of glucocorticoid substitution in adrenal insufficiency].

Internist (Berl) 2022 Jan 3;63(1):12-17. Epub 2021 Dec 3.

Medizinische Klinik 1 - Schwerpunkt Endokrinologie, Diabetes und Stoffwechsel, Universitätsklinikum Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Deutschland.

Background: Appropriate glucocorticoid dose adjustment in specific situations significantly impacts quality of life and performance of patients with adrenal insufficiency. It is also pivotal for the prevention of adrenal crisis.

Objectives: Improving medical care for patients with adrenal insufficiency. Read More

View Article and Full-Text PDF
January 2022

Adrenal Crisis Presenting as Recurrent Encephalopathy Mimicking Autoimmune, Infectious Encephalitis, and Common Variable Immune Deficiency: A Case Report.

Neurologist 2021 Nov 30. Epub 2021 Nov 30.

Departments of Neurology Radiology and Imaging Sciences, University of Utah George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT.

Introduction: Adrenal crisis can present with life-threatening complications and mimic autoimmune or infectious encephalitis, and common variable immune deficiency (CVID). The literature regarding the neurological complications of adrenal crisis is limited and focuses on patients who present with hypotension and electrolyte abnormalities.

Case Report: A 30-year-old man presented 3 times to our hospital with encephalopathy, fever, and left sided weakness with a history of multiple autoimmune diseases and prior hospitalizations for encephalopathy. Read More

View Article and Full-Text PDF
November 2021