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    Coagulation Profile in Patients with Different Etiologies for Cushing Syndrome: A Prospective Observational Study.
    Horm Metab Res 2017 Feb 22. Epub 2017 Feb 22.
    Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
    Previous studies reported a higher prevalence of venous-thromboembolic events among patients with Cushing disease (CD) compared to those with ACTH-independent Cushing syndrome (CS) from adrenal sources. The objective of the current study was to evaluate the coagulation profile of patients with CS from different etiologies. A prospective observational study was conducted at a clinical research center. Read More

    Ambulatory Arterial Stiffness Indexes in Cushing's Syndrome.
    Horm Metab Res 2017 Feb 22. Epub 2017 Feb 22.
    Department of Medicine-DIMED, University of Padova, Padova, Italy.
    Long-standing exposure to endogenous cortisol excess is associated with high cardiovascular risk. The aim of our study was to investigate arterial stiffness, which has been recognized as an independent predictor of adverse cardiovascular outcome, in a group of patients with Cushing's syndrome. Twenty-four patients with Cushing's syndrome (3 males, mean age 49±13 years; 20 pituitary-dependent Cushing's disease and 4 adrenal adenoma) underwent 24-h ambulatory blood pressure monitoring (ABPM) and evaluation of cardiovascular risk factors. Read More

    J Clin Res Pediatr Endocrinol 2017 Feb 20. Epub 2017 Feb 20.
    Objective: Melanocortin-4 receptor (MC4R) mutations are the most common known cause of monogenic obesity but there is limited data regarding MC4R mutations in Turkish subjects. To determine the prevalence of MC4R mutations in a group of Turkish morbid obese children and adolescents.

    Methods: MC4R was sequenced in 47 consecutive morbidly obese children and adolescents (28 girls and 19 boys, aged 1-18 years) who presented during a 1-year period. Read More

    Study of awareness of adrenal disorders among interns and postgraduate students of Hamidia Hospital, Bhopal.
    Indian J Endocrinol Metab 2017 Jan-Feb;21(1):251-254
    Department of Medicine, Gandhi Medical College, Bhopal, Madhya Pradesh, India.
    Introduction: Adrenal disorders could be a life-threatening emergency, hence requires immediate therapeutic management. For this awareness regarding its diagnosis, management, and treatment is prime important.

    Aims And Objective: To study the awareness of adrenal disorders among interns and postgraduates students of Hamidia Hospital, Bhopal. Read More

    Mycophenolate Mofetil Combined With Prednisone Versus Full-Dose Prednisone in IgA Nephropathy With Active Proliferative Lesions: A Randomized Controlled Trial.
    Am J Kidney Dis 2017 Feb 15. Epub 2017 Feb 15.
    National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China. Electronic address:
    Background: Observational studies suggest that patients with immunoglobulin A nephropathy (IgAN) with active proliferative lesions show a good response to immunosuppressive treatment.

    Study Design: Multicenter, prospective, randomized, controlled trial.

    Setting & Participants: 176 patients with IgAN with active proliferative lesions (cellular and fibrocellular crescents, endocapillary hypercellularity, or necrosis), proteinuria with protein excretion ≥ 1. Read More

    Hair cortisol in the evaluation of Cushing syndrome.
    Endocrine 2017 Feb 13. Epub 2017 Feb 13.
    Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, 20892, USA.
    Purpose: Hair cortisol evaluation has been used to help detect patients with suspected Cushing syndrome. Our goal was to correlate segmental hair cortisol with biochemical testing in patients with Cushing syndrome and controls. This study was a prospective analysis of hair cortisol in confirmed Cushing syndrome cases over 16 months. Read More

    Appearance of a thymic mass after treatment of Cushing's syndrome.
    Asian Cardiovasc Thorac Ann 2017 Feb 19;25(2):150-153. Epub 2016 Dec 19.
    1 Internal Medicine Unit, University Hospital of Sassari, Sassari, Italy.
    A 23-year-old woman was referred to our center with hirsutism, acne, weight gain, weakness, and irregular menses. Laboratory tests revealed increased levels of cortisol and sex hormones, and reduced adrenocorticotropic hormone levels. The patient underwent a right adrenalectomy. Read More

    DIAGNOSIS OF ENDOCRINE DISEASE: Differentiation of Pathologic/Neoplastic Hypercortisolism (Cushing Syndrome) from Physiologic/Non-neoplastic Hypercortisolism (formerly known as Pseudo-Cushing Syndrome).
    Eur J Endocrinol 2017 Feb 8. Epub 2017 Feb 8.
    H Raff, Endocrine Research Lab, Aurora St. Luke's Medical Center, Milwaukee, 53215, United States
    Endogenous hypercortisolism (Cushing syndrome) usually implies the presence of a pathologic condition caused by either an ACTH-secreting neoplasm or autonomous cortisol secretion from a benign or malignant adrenal neoplasm. However, sustained or intermittent hypercortisolism may also accompany many medical disorders that stimulate physiologic/non-neoplastic activation of the HPA axis (formerly known as pseudo-Cushing syndrome); these two entities may share indistinguishable clinical and biochemical features. A thorough history and physical examination is often the best (and sometimes only) way to exclude pathologic/neoplastic hypercortisolism. Read More

    Romiplostim therapy as a second-line treatment before splenectomy for refractory immune thrombocytopenia in a cirrhotic patient with iatrogenic Cushing syndrome secondary to corticosteroids.
    Clin Case Rep 2017 Feb 23;5(2):159-163. Epub 2017 Jan 23.
    Gastroenterology Service Hepatitis and Liver Transplant Unit IDIBELL Hospital Universitari de Bellvitge Feixa Llarga s/n L'Hospitalet de Llobregat 08907 Barcelona Spain.
    Our case report discusses the usefulness of administering romiplostim as a second-line treatment before splenectomy in a cirrhotic patient with immune thrombocytopenia who developed corticosteroid-induced Cushing's syndrome. Corticosteroids were tapered and consequently withdrawn. The patient made a full recovery postsplenectomy. Read More

    Adrenocortical neoplasms in adulthood and childhood: distinct presentation. Review of the clinical, pathological, and imaging characteristics.
    J Pediatr Endocrinol Metab 2017 Feb 7. Epub 2017 Feb 7.
    Adrenocortical tumors (ACT) in adulthood and childhood vary in clinical, histopathological, molecular, prognostic, and imaging aspects. ACT are relatively common in adults, as adenomas are often found incidentally on imaging. ACT are rare in children, though they have a significantly higher prevalence in the south and southeast regions of Brazil. Read More

    An Unlikely Cause of Hypokalemia.
    J Emerg Med 2017 Jan 28. Epub 2017 Jan 28.
    Temple University Hospital, Philadelphia, Pennsylvania.
    Background: Hypokalemia is a common clinical disorder caused by a variety of different mechanisms. Although the most common causes are diuretic use and gastrointestinal losses, elevated cortisol levels can also cause hypokalemia through its effects on the renin-angiotensin-aldosterone system. Cushing's syndrome refers to this general state of hypercortisolemia, which often manifests with symptoms of generalized weakness, high blood pressure, diabetes mellitus, menstrual disorders, and psychiatric changes. Read More

    Ectopic Cushing syndrome in small cell lung cancer: A case report and literature review.
    Thorac Cancer 2016 Nov 8. Epub 2016 Nov 8.
    Department of Thoracic Medical Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China.
    Small cell lung cancer (SCLC) is a neuroendocrine tumor with the potential to secrete various peptides or hormones that can lead to paraneoplastic syndromes, such as Ectopic Cushing syndrome (ECS). Because of the aggressive nature of the syndrome and its atypical features, ECS in small-cell lung cancer is difficult to diagnose and has a poor prognosis. We report a case of a 74-year-old male patient who presented with severe hypokalemia, proximal muscle weakness, peripheral edema, metabolic alkalosis, and worsening hyperglycemia. Read More

    Cushing's syndrome mutant PKA(L)(205R) exhibits altered substrate specificity.
    FEBS Lett 2017 Feb 3;591(3):459-467. Epub 2017 Feb 3.
    Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, USA.
    The PKA(L)(205R) hotspot mutation has been implicated in Cushing's syndrome through hyperactive gain-of-function PKA signaling; however, its influence on substrate specificity has not been investigated. Here, we employ the Proteomic Peptide Library (ProPeL) approach to create high-resolution models for PKA(WT) and PKA(L)(205R) substrate specificity. We reveal that the L205R mutation reduces canonical hydrophobic preference at the substrate P + 1 position, and increases acidic preference in downstream positions. Read More

    Source of Ectopic ACTH Secretion Easily Identified by 68Ga DOTANOC PET/CT.
    Clin Nucl Med 2017 Jan 16. Epub 2017 Jan 16.
    From the Nuclear Medicine Division, Groote Schuur Hospital/University of Cape Town, Cape Town, South Africa.
    Malignant tumors account for most sources of ectopic ACTH Cushing syndrome (EA-CS). Early localization of the source and complete removal can be curative and also prevent metastasis. Diagnostic CT is known to perform better than PET/CT (low dose) in characterizing lung pathologies. Read More

    Characterizing and predicting the Nelson-Salassa syndrome.
    J Neurosurg 2017 Jan 13:1-11. Epub 2017 Jan 13.
    Department of Neurologic Surgery, and.
    OBJECTIVE Nelson-Salassa syndrome (NSS) is a rare consequence of bilateral adrenalectomy (ADX) for refractory hypercortisolism due to Cushing disease (CD). Although classically defined by rapid growth of a large, invasive, adrenocorticotropin hormone (ACTH)-secreting pituitary tumor after bilateral ADX that causes cutaneous hyperpigmentation, visual disturbance, and high levels of ACTH, clinical experience suggests more variability. METHODS The authors conducted a retrospective chart review of all patients 18 years and older with a history of bilateral ADX for CD, adequate pituitary MRI, and at least 2 years of clinical follow-up. Read More

    Avascular Necrosis of the Hips With Increased Activity on 68Ga-DOTATATE PET/CT.
    Clin Nucl Med 2017 Mar;42(3):214-215
    From the *Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center (CC), Bethesda; †PET Department, Clinical Center, National Institutes of Health (NIH), Bethesda, MD; ‡Department of Radiology, Medical School, University of Crete, Crete, Greece; and §Center for Research in Computer Vision (CRCV), Electrical and Computer Science Department, University of Central Florida (UCF), Orlando, FL.
    Prolonged exposure to cortisol is one of the major causes of avascular bone necrosis (AVN). We report on a case of a woman with Cushing syndrome attributed to ectopic adrenocorticotropic hormone-secreting tumor who was evaluated with whole-body PET/CT study using Ga-DOTATATE. The scan showed increased activity by both femoral heads, corresponding to the margins of bilateral AVN seen on MRI. Read More

    Adrenocorticotropic hormone levels before treatment predict recurrence of Cushing's disease.
    J Formos Med Assoc 2016 Oct 28. Epub 2016 Oct 28.
    Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan; Center of Anti-aging and Health Consultation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address:
    Background/purpose: Cushing's disease (CD) is the most common cause of endogenous Cushing's syndrome. Transsphenoidal surgery (TSS) is the first choice of treatment. Predicting prognosis after treatment can benefit further strategies of management, but currently there is no convenient predictor. Read More

    The Recovery of Hypothalamic-Pituitary-Adrenal Axis Is Rapid in Subclinical Cushing Syndrome.
    Endocrinol Metab (Seoul) 2016 Dec;31(4):592-597
    Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
    Background: In subclinical Cushing syndrome (SC), it is assumed that glucocorticoid production is insufficient to cause a clinically recognizable syndrome. Differences in hormonal levels or recovery time of the hypothalamic-pituitary-adrenocortical (HPA) axis after adrenalectomy between patients with overt Cushing syndrome (OC) and SC remain unknown.

    Methods: Thirty-six patients (10 with OC and 26 with SC) with adrenal Cushing syndrome who underwent adrenalectomy from 2004 to 2014 were reviewed retrospectively. Read More

    Choroidal and Retinal Abnormalities by Optical Coherence Tomography in Endogenous Cushing's Syndrome.
    Front Endocrinol (Lausanne) 2016 9;7:154. Epub 2016 Dec 9.
    Department of Endocrinology, University of São Paulo Medical School , São Paulo, São Paulo , Brazil.
    Context: Cortisol has been suggested as a risk factor for choroidal thickening, which may lead to retinal changes.

    Objective: To compare choroidal thickness measurements using optical coherence tomography (OCT) in patients with endogenous active Cushing's syndrome (CS) and to evaluate the occurrence of retinal abnormalities in the same group of patients.

    Design: Cross-sectional study. Read More

    Hypertension: The role of biochemistry in the diagnosis and management.
    Clin Chim Acta 2017 Feb 19;465:131-143. Epub 2016 Dec 19.
    Dept. of Clinical Biochemistry & Diagnostic Endocrinology, Mater Misericordiae University Hospital, Dublin, Ireland.
    Hypertension is defined as a persistently elevated blood pressure ≥140/90mmHg. It is an important treatable risk factor for cardiovascular disease, with a high prevalence in the general population. The most common cause, essential hypertension, is a widespread disease - however, secondary hypertension is under investigated and under diagnosed. Read More

    Endoscopic Endonasal Surgery for Remission of Cushing Disease Caused by Ectopic Intracavernous Macroadenoma: Case Report and Literature Review.
    World Neurosurg 2017 Feb 18;98:870.e5-870.e10. Epub 2016 Dec 18.
    Department of Otolaryngology, University of Louisville, Louisville, Kentucky, USA.
    Background: Complete surgical resection of an adrenocorticotropic hormone (ACTH)-secreting pituitary adenoma is the gold standard of treatment of Cushing disease. Ectopic location of these adenomas is an extremely rare condition that may compromise the diagnosis and surgical success. We present the first case of an ectopic intracavernous ACTH-secreting macroadenoma totally resected with endoscopic endonasal surgery (EES). Read More

    Clinical characteristics of adrenal tumors in children: a retrospective review of a 15-year single-center experience.
    Int Urol Nephrol 2017 Mar 17;49(3):381-385. Epub 2016 Dec 17.
    Department of Pediatric Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
    Objective: Adrenal tumors are rare in children. The aim of this study is to review and analyze clinical data on the diagnosis and management of adrenal tumors in children.

    Methods: Between 2001 and 2015, 48 pediatric patients (<14 years old) admitted to our institute with adrenal tumors were reviewed. Read More

    Prevention and management of glucocorticoid-induced side effects: A comprehensive review: Gastrointestinal and endocrinologic side effects.
    J Am Acad Dermatol 2017 Jan;76(1):11-16
    Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address:
    Part 2 of this 4-part continuing medical education series continues with a discussion of the prevention and management of gastrointestinal side effects associated with corticosteroid use, including peptic ulcer disease, gastrointestinal bleeding, and pancreatitis, followed by a review of corticosteroid-related endocrinologic side effects, such as diabetes, adrenal suppression, and Cushing syndrome. Read More

    Diagnosis of Cushing's disease in a patient with consistently normal urinary free cortisol levels: a case report.
    Clin Case Rep 2016 Dec 9;4(12):1181-1183. Epub 2016 Nov 9.
    Seattle Pituitary Center Swedish Neuroscience Institute Seattle Washington USA.
    The urinary free cortisol (UFC) test is widely used for the screening of Cushing's syndrome. This case study illustrates the potential failure of the UFC test to correctly diagnose Cushing's disease (CD), indicating that the use of other complementary tests may be necessary to diagnose this disease in some cases. Read More

    Hypokalemia associated with a solitary pulmonary nodule: A case report.
    Medicine (Baltimore) 2016 Dec;95(50):e5046
    aDepartment of Internal Medicine bEndocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
    Background: Differential diagnosis of hypokalemia and adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome often presents challenging in endocrinology and requires careful clinical, biochemical, radiological, and pathological investigations. Hypokalemia is a common abnormality and systematic approach is required to avoid delays in diagnosis of important underlying causes.

    Case Summary & Conclusion: A 49-year-old woman presented with moderate hypokalemia. Read More

    Outcome and prognostic factors in high-risk childhood adrenocortical carcinomas: A report from the European Cooperative Study Group on Pediatric Rare Tumors (EXPeRT).
    Pediatr Blood Cancer 2016 Dec 13. Epub 2016 Dec 13.
    Department of Pediatric, Adolescent, Young Adult Oncology, French Pediatric Rare Tumor group (groupe Fracture), Institut Curie, Paris, France.
    Objectives: The aim of this retrospective international analysis was to evaluate the role of risk factors in pediatric patients with adrenocortical carcinoma (ACC) observed in European countries (2000-2013) in an attempt to identify factors associated with poor prognosis.

    Procedures: Data were retrieved from databases of Germany, France, Poland, and Italy, which form the European Cooperative Study Group on Pediatric Rare Tumors (EXPeRT). Patients were less than 18 years old, with at least one of the following tumor-related risk factors: metastases, volume more than 200 cm(3) , Cushing syndrome, vascular or regional lymph node invasion, initial biopsy, or incomplete excision. Read More

    Carney complex: A familial lentiginosis predisposing to a variety of tumors.
    Rev Endocr Metab Disord 2016 Sep;17(3):367-371
    Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Building 10, Room East 1330, CRC, 10 Center Dr. MSC1862, Bethesda, MD, 20892-1862, USA.
    Carney complex is a familial lentiginosis syndrome; these disorders cover a wide phenotypic spectrum ranging from a benign inherited predisposition to develop cutaneous spots not associated with systemic disease to associations with several syndromes. Carney complex is caused by PRKAR1A mutations and perturbations of the cyclic AMP-dependent protein kinase (PKA) signaling pathway. In addition to the cutaneous findings, the main tumors associated with Carney complex are endocrine: 1) primary pigmented nodular adrenocortical disease, a bilateral adrenal hyperplasia leading to Cushing syndrome; 2) growth-hormone secreting pituitary adenoma or pituitary somatotropic hyperplasia leading to acromegaly; 3) thyroid and gonadal tumors, including a predisposition to thyroid cancer. Read More

    Endocrinology Update: Hirsutism.
    FP Essent 2016 Dec;451:17-24
    University of Michigan Medical School Ypsilanti Health Center, 200 Arnet Suite 200, Ypsilanti, MI 48198.
    Hirsutism is defined as excessive terminal hair growth, such as coarse sexual or secondary hair, that typically appears in a male growth pattern in androgen-dependent areas of the female body. It can occur in men and women. Common etiologies include polycystic ovary syndrome, idiopathic hyperandrogenemia, idiopathic hirsutism, adrenal hyperplasia due to 21-hydroxylase deficiency, androgen-secreting tumors, iatrogenic hirsutism, acromegaly, Cushing syndrome, hyperprolactinemia, and hypo- or hyperthyroidism. Read More

    E2F1-mediated human POMC expression in ectopic Cushing's syndrome.
    Endocr Relat Cancer 2016 Nov 7;23(11):857-870. Epub 2016 Oct 7.
    Pituitary CenterCedars-Sinai Medical Center, Los Angeles, California, USA
    Cushing's syndrome is caused by excessive adrenocorticotropic hormone (ACTH) secretion derived from pituitary corticotroph tumors (Cushing disease) or from non-pituitary tumors (ectopic Cushing's syndrome). Hypercortisolemic features of ectopic Cushing's syndrome are severe, and no definitive treatment for paraneoplastic ACTH excess is available. We aimed to identify subcellular therapeutic targets by elucidating transcriptional regulation of the human ACTH precursor POMC (proopiomelanocortin) and ACTH production in non-pituitary tumor cells and in cell lines derived from patients with ectopic Cushing's syndrome. Read More

    Affective alterations in patients with Cushing's syndrome in remission are associated with decreased BDNF and cortisone levels.
    Eur J Endocrinol 2017 Feb;176(2):221-231
    Endocrinology/Medicine DepartmentHospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
    Objective: Affective alterations and poorer quality of life often persist in patients with Cushing's syndrome (CS) in remission. Brain-derived neurotrophic factor (BDNF) regulates the hypothalamic-pituitary-adrenal axis (HPA) and is highly expressed in brain areas controlling mood and response to stress. Our aims were to assess affective alterations after long-term remission of CS and evaluate whether they are associated with serum BDNF, salivary cortisol (SalF) and/or cortisone (SalE) concentrations. Read More

    Increased prevalence of obstructive sleep apnea in patients with Cushing's syndrome compared with weight- and age-matched controls.
    Eur J Endocrinol 2017 Mar 8;176(3):267-272. Epub 2016 Dec 8.
    Departments of Endocrinology and Metabolism
    Objective: Diabetes mellitus and obesity are well-known risk factors associated with obstructive sleep apnea (OSA). Cushing's syndrome (CS) is also characterized by obesity and diabetes mellitus. However, the association between CS and OSA remains unclear. Read More

    Adrenalectomy for Cushing's syndrome: do's and don'ts.
    J Med Life 2016 Oct-Dec;9(4):334-341
    "I. Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; Department of Endocrinology, Clinical County Hospital, Cluj-Napoca, Romania.
    Aim. To present specific aspects of adrenalectomy for Cushing's syndrome (CS) by introducing well established aspects ("do's") and less known aspects ("don'ts"). Material and Method. Read More

    Toxic and Endocrine Myopathies.
    Continuum (Minneap Minn) 2016 Dec;22(6, Muscle and Neuromuscular Junction Disorders):1815-1828
    Purpose Of Review: This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies.

    Recent Findings: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy. Recently proposed mechanisms of injury in patients with critical illness myopathy include inhibition of protein synthesis, mitochondrial dysfunction, disruption of the ubiquitin-proteasome system, oxidative stress, and disruption of intramuscular calcium homeostasis, which can cause a myosin-loss myopathy. Read More

    Successful percutaneous CT-guided microwave ablation of adrenal gland for ectopic Cushing syndrome.
    Clin Imaging 2017 Mar - Apr;42:93-95. Epub 2016 Nov 29.
    London Health Sciences Centre - Victoria Hospital, Western University - Department of Medical Imaging, 800 Commissioners Road East, London, Ontario N6A 5W9, Canada.
    Adrenocorticotropic hormone production by pancreatic neuroendocrine tumor (PNET) is rare and results in hyperstimulation of the adrenal gland to produce ectopic Cushing syndrome. Our case showcases the safety and effectiveness of percutaneous CT-guided microwave ablation of the adrenal gland in a 49-year-old female with PNET and hepatic metastases who presented with ectopic Cushing syndrome despite surgical resection of the primary pancreatic tumor and left adrenal gland. Prior to ablation, the right adrenal gland measured 4. Read More

    Adrenal Cushing syndrome with detectable ACTH from an unexpected source.
    BMJ Case Rep 2016 Nov 30;2016. Epub 2016 Nov 30.
    Department of Endocrine Surgery, Weill Cornell Medicine-NYP/Lower Manhattan Hospital, New York, New York, USA.
    Mixed corticomedullary adrenal tumours (MCMT) are rare. We describe the second reported case of a male patient presenting with hypertension and Cushing syndrome with MCMT. A man aged 48 years presented with hypertension and signs of Cushing syndrome. Read More

    [Adrenocortical oncocytoma presenting as Cushing´s syndrome in pregnancy with spontaneous postpartum uterine rupture].
    Ceska Gynekol 2016 ;81(3):228-232
    Objective: The description of rare case of the Cushings syndrome in pregnancy resulting in the spontaneous rupture of uterus.

    Designs: A case report.

    Setting: Department of Gynecology and Obstetrics, 1st Medical Faculty of Charles University and Hospital Na Bulovce. Read More

    Cushing syndrome in a child due to pro-opiomelanocortin (POMC) secretion from a yolk sac tumor.
    Eur J Endocrinol 2017 Feb 22;176(2):K1-K7. Epub 2016 Nov 22.
    Department of EndocrinologyGreat Ormond Street Hospital for Children, London, UK
    Context: Pituitary microadenomas and adrenal tumours are the most common causes for endogenous Cushing syndrome (CS) in children.

    Case Description: We describe a two-year old girl with Cushing syndrome due to ectopic pro-opiomelanocortin (POMC) production from an abdominal yolk sac tumor. Cortisol concentrations were elevated but adrenocorticotropic hormone (ACTH) concentrations were equivocal. Read More

    Cushing Syndrome in Carney Complex: Clinical, Pathologic, and Molecular Genetic Findings in the 17 Affected Mayo Clinic Patients.
    Am J Surg Pathol 2017 Feb;41(2):171-181
    *Department of Internal Medicine †Division of Endocrinology, Diabetes, Metabolism and Nutrition §Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN ‡Section on Endocrinology and Genetics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
    Carney complex (CNC) is a rare dominantly inherited multiorgan tumoral disorder that includes Cushing syndrome (CS). To establish the Mayo Clinic experience with the CS component, including its clinical, laboratory, and pathologic findings, we performed a retrospective search of the patient and pathologic databases of Mayo Clinic in Rochester, MN, for patients with CNC and clinical or laboratory findings of CS. Thirty-seven patients with CNC were identified. Read More

    Flushing in (neuro)endocrinology.
    Rev Endocr Metab Disord 2016 Sep;17(3):373-380
    Division of Endocrinology, University of Mississippi Medical Center, Jackson, MS, USA.
    Cutaneous flushing is a common presenting complaint in endocrine disorders. The pathophysiology of flushing involves changes in cutaneous blood flow triggered by multiple intrinsic factors that are either related to physiology or disease. Flushing can be divided into episodic or persistent causes. Read More

    Outcome of adrenalectomy for subclinical hypercortisolism and Cushing syndrome.
    Surgery 2017 Jan 16;161(1):264-271. Epub 2016 Nov 16.
    UO Chirurgia Endocrina e Metabolica, Università Cattolica del Sacro Cuore, Rome, Italy.
    Background: We compared operative and metabolic outcomes in patients with subclinical Cushing syndrome and Cushing syndrome caused by unilateral adrenal lesion, aiming to clarify the role of glucocorticoid replacement treatment in patients with subclinical Cushing syndrome after adrenalectomy.

    Methods: The medical records of all the patients who underwent unilateral adrenalectomy for subclinical Cushing syndrome or Cushing syndrome were reviewed. Diagnostic criteria for subclinical Cushing syndrome were a pathologic dexamethasone suppression test plus 2 additional criteria. Read More

    Resistant Hypertension.
    Adv Exp Med Biol 2016 Nov 19. Epub 2016 Nov 19.
    Lankenau Medical Center, Lancaster Avenue, Suite 130, Wynnewood, PA, USA, 19096.
    Conservatively, ten million people in the USA alone may suffer from RH and may be similarly prevalent elsewhere. Given the strong linear correlation between hypertension and cardiovascular outcomes, better control is paramount. We favor a multi-pronged approach. Read More

    The genomic landscape of balanced cytogenetic abnormalities associated with human congenital anomalies.
    Nat Genet 2017 Jan 14;49(1):36-45. Epub 2016 Nov 14.
    Molecular Neurogenetics Unit, Center for Human Genetic Research, Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA.
    Despite the clinical significance of balanced chromosomal abnormalities (BCAs), their characterization has largely been restricted to cytogenetic resolution. We explored the landscape of BCAs at nucleotide resolution in 273 subjects with a spectrum of congenital anomalies. Whole-genome sequencing revised 93% of karyotypes and demonstrated complexity that was cryptic to karyotyping in 21% of BCAs, highlighting the limitations of conventional cytogenetic approaches. Read More

    Mediastinal Lipomatosis with Dyslipidemia: Cause of Dyspnea.
    J Assoc Physicians India 2016 Nov;64(11):88-89
    Asstt. Professor, Dept. of Medicine, SMS Medical College, Jaipur, Rajasthan.
    We report a case who presented to us with dyspnea and was found to have ML in the absence of steroid use, diabetes, Cushing syndrome and obesity. This case provides an important differential diagnosis in a patient presenting with dyspnea widened mediastinum and cardiomegaly. This is probably among very few cases of ML with dyslipidemia. Read More

    Hydrocephalus associated with childhood nonaccidental head trauma.
    Neurosurg Focus 2016 Nov;41(5):E8
    The Cushing Neuroscience Institute and Department of Neurosurgery, Hofstra Northwell School of Medicine at Cohen Children's Medical Center and Northwell Health System, Manhasset, New York; and.
    OBJECTIVE The incidence of posttraumatic ventriculomegaly (PTV) and shunt-dependent hydrocephalus after nonaccidental head trauma (NAHT) is unknown. In the present study, the authors assessed the timing of PTV development, the relationship between PTV and decompressive craniectomy (DC), and whether PTV necessitated placement of a permanent shunt. Also, NAHT/PTV cases were categorized into a temporal profile of delay in admission and evaluated for association with outcomes at discharge. Read More

    A Cushing's syndrome patient's severe insomnia and morning blood pressure surge both improved after her left adrenal tumor resection.
    Blood Press Monit 2016 Dec;21(6):361-365
    aKotake Hospital, Kotake bIizuka Municipal Hospital, Iizuka, Fukuoka cDivision of Hypertension, Clinical Research Institute, National Hospital Organization Kyushu Medical Center dDivision of Pathology, Clinical Research Institute, National Hospital Organization Kyushu Medical Center eSteel Memorial Yawata Hospital, Kitakyushu, Fukuoka fDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
    Underlying mechanisms of the elevated risks of hypertension and cardiovascular disease (CVD) in Cushing's syndrome (CS) are unclear. We treated an adult woman with CS because of a cortisol-secreting adrenal tumor. After tumor resection, the 24-h blood pressure (BP) level improved from 156/91 to 131/84 mmHg; the morning BP surprisingly improved from 174/98 to 127/93 mmHg, although we reduced her antihypertensive medication. Read More

    Design, synthesis, and evaluation of (2S,4R)-Ketoconazole sulfonamide analogs as potential treatments for Metabolic Syndrome.
    Bioorg Med Chem Lett 2016 Dec 10;26(23):5825-5829. Epub 2016 Oct 10.
    GVK Biosciences Private Limited, Plot 28A, IDA Nacharam, Hyderabad 500076, India.
    Metabolic Syndrome, also referred to as 'Syndrome X' or 'Insulin Resistance Syndrome,' remains a major, unmet medical need despite over 30years of intense effort. Recent research suggests that there may be a causal link between this condition and abnormal glucocorticoid processing. Specifically, dysregulation of the hypothalamic-pituitary-adrenocortical (HPA) axis leads to increased systemic cortisol concentrations. Read More

    [Hypertension etiological work up: Hormonological assessment always before imaging?]
    Presse Med 2016 Oct 31;45(10):871-876. Epub 2016 Aug 31.
    CHU Rangueil, pôle cardiovasculaire et métabolique, service de thérapeutique et HTA, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
    The purpose is to consider the practical management of etiological work up in hypertension, beyond national or international recommendations, leading to consider the prior practice of hormonal assays or renal, renovascular or adrenal imaging. The ease of access to imaging, difficulties to meet the requirements to obtain reliable hormonal assays explain the use of first-line imaging in clinical practice. The renal and adrenal CT angiography provides diagnostic orientation without allowing a formal conclusion. Read More

    Treatment-related neuroendocrine prostate cancer resulting in Cushing's syndrome.
    Int J Urol 2016 Dec 21;23(12):1038-1041. Epub 2016 Oct 21.
    Department of Medicine, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA.
    Here we present, to the best of our knowledge, the first case of a paraneoplastic Cushing's syndrome (hypercortisolism) resulting from treatment-related neuroendocrine prostate cancer - a highly aggressive and difficult disease to treat. A 51-year-old man was started on androgen deprivation therapy after presenting with metastatic prostate cancer, characterized by diffuse osseous metastasis. Shortly thereafter, he developed progressive disease with biopsy proven neuroendocrine prostate cancer as well as symptoms of increased skin pigmentation, hypokalemia, hypertension, hyperglycemia and profound weakness, consistent with ectopic Cushing's syndrome. Read More

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