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Clinical profile of adrenoleukodysrophyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract X-linked Adrenoleukodystrophy (ALD) is the most common of the peroxisomal disorder and is associated with functional defect of the very long chain fatty acid (VLCFA) oxidation leading to the accumulation of VLCFA in the white matter and adrenal cortex. Retrospective evaluation of medical records of ALD patients were carried out. In all the 5 patients the duration of the symptoms varied from 1–7 years. Most of them presented with Addisonian crisis (4/5) and hyperpigmentation (5/5), white half of them (3/5) had neurological symptoms. All patients had biochemical evidence of the adrenal insufficiency...
Source: Indian Journal of Pediatrics - November 11, 2009 Category: Pediatrics Tags: Indian Journal of Pediatrics Source Type: journals

Megestrol: Adrenal insufficiency in an elderly patient: case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Reactions)
Source: Reactions - November 11, 2009 Category: Drugs & Pharmacology Tags: Short communication Source Type: journals

Long-Term Safety of Recombinant Human Growth Hormone in Children.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: After more than 20 yr, leukemia, a major safety issue initially believed associated with GH, has not been confirmed, but other signals, including risk of second malignancies in patients previously treated with irradiation, have been detected or confirmed through the NCGS. These data further clarify the events associated with rhGH and, although confirming a favorable overall safety profile, they also highlight specific populations at potential risk. PMID: 19906787 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - November 11, 2009 Category: Endocrinology Authors: Bell J, Parker KL, Swinford RD, Hoffman AR, Maneatis T, Lippe B Tags: J Clin Endocrinol Metab Source Type: journals

Hypoglycaemic seizure and neonatal acute adrenal insufficiency after maternal exposure to prednisone during pregnancy: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of AAI following maternal exposure to moderate doses of corticosteroids during pregnancy. The neonate, born at term, presented with hypoglycaemia complicated by seizures. The AAI was confirmed by endocrine tests and after exclusion of differential diagnoses. Early diagnosis and treatment led to full recovery. Content Type Journal ArticleCategory Short ReportDOI 10.1007/s00431-009-1095-9Authors Pierre-Jean Saulnier, CHU de Poitiers Department of Clinical Pharmacology and Regional Center of Pharmacovigilance Poitiers FranceXavier Piguel, CHU de Poitiers Department of Endocrinology and Diabetology Poi...
Source: European Journal of Pediatrics - November 9, 2009 Category: Pediatrics Tags: European Journal of Pediatrics Source Type: journals

Identification of a novel mutation in DAX1/NR0B1A gene in two siblings with severe clinical presentation of adrenal hypoplasia congenitaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: A novel frameshift mutation of DAX1 gene, which established the molecular etiology of the AHC in the siblings, was identified. Obtaining a precise genetic diagnosis of this adrenal disorder, which, sometimes, cannot be confirmed only by clinical aspects, may have important implications for the long-term management of the disease.OBJETIVO: Pesquisar mutações no gene DAX1/NR0B1A em dois irmãos com suspeita de hipoplasia adrenal congênita (HAC), rara doença potencialmente fatal, para estabelecer sua etiologia molecular. RELATO DOS CASOS: São apresentados os relatos de dois irmãos com síndrome perdedora de ...
Source: Arquivos Brasileiros de Endocrinologia e Metabologia - November 6, 2009 Category: Endocrinology Source Type: journals

Serum total cortisol and free cortisol index give different information regarding the hypothalamus-pituitary-adrenal axis reserve in patients with liver impairmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion When total cortisol alone is used to interpret SST in patients with liver impairment, 46% may have been classified as having adrenal insufficiency because of low CBG. FCI may be better for the evaluation of HPA axis insufficiency in patients with liver impairment. (Source: Annals of Clinical Biochemistry)
Source: Annals of Clinical Biochemistry - November 4, 2009 Category: Biochemistry Authors: Vincent, R. P, Etogo-Asse, F. E, Dew, T., Bernal, W., Alaghband-Zadeh, J., le Roux, C. W Tags: Short Reports Source Type: journals

An unusual case of profound hyponatraemia and bilateral adrenal calcificationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of a 65-year-old lady who presented with acute confusion and profound hyponatraemia (plasma sodium of 97 mmol/L). Five years earlier she had developed sepsis and was found to have hyponatraemia, thought to be due to syndrome of inappropriate antidiuretic hormone secretion. The patient was lost to follow-up. The patient was covered with steroids and investigations confirmed primary adrenal failure with flat response of cortisol to adrenocorticotropic hormone (ACTH) stimulation and very high level of ACTH. Adrenal auto-antibodies were negative and a computed tomography of the adrenals showed bilateral adrena...
Source: Annals of Clinical Biochemistry - November 4, 2009 Category: Biochemistry Authors: Cassar, C., Procter, R., Davidson, F., Collier, A., Malik, I. A, Ghosh, S., Elhadd, T. A Tags: Case Reports Source Type: journals

T Cell Responses to Steroid Cytochrome P450 21-Hydroxylase in Patients with Autoimmune Primary Adrenal Insufficiency.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Patients with autoimmune Addison's disease have circulating 21OH-specific T cells, with amino acids 342-361 of 21OH possibly constituting a disease-specific epitope presented by HLA-DRB1*0404. PMID: 19890026 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - November 4, 2009 Category: Endocrinology Authors: Bratland E, Skinningsrud B, Undlien DE, Mozes E, Husebye ES Tags: J Clin Endocrinol Metab Source Type: journals

Cytotoxic T lymphocyte antigen-4 Ala17 polymorphism is a genetic marker of autoimmune adrenal insufficiency: Italian association study and meta-analysis of European studies.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The CTLA4 +49 polymorphism is strongly associated with genetic risk for AAD, independentenly from the well known association with HLA class II genes. PMID: 19884265 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)
Source: European Journal of Endocrinology - November 2, 2009 Category: Endocrinology Authors: Brozzetti A, Marzotti S, Tortoioli C, Bini V, Giordano R, Dotta F, Betterle C, De Bellis A, Arnaldi G, Toscano V, Arvat E, Bellastella A, Mantero F, Falorni A Tags: Eur J Endocrinol Source Type: journals

GH replacement in adults: interactions with other pituitary hormone deficiencies and replacement therapies.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Severe GH deficiency (GHD) in adults has been described as a clinical entity. However, some of the features associated with GHD could be due to unphysiological and inadequate replacement of other pituitary hormone deficiencies. This may be true for glucocorticoid replacement that lacks a biomarker making dose titration and monitoring difficult. Moreover, oral estrogen replacement therapy decreases IGF1 levels compared with the transdermal route, which attenuates the responsiveness to GH replacement therapy in women. In addition, in untreated female hypogonadism, oral estrogen may augment the features associated with GH...
Source: European Journal of Endocrinology - November 1, 2009 Category: Endocrinology Authors: Filipsson H, Johannsson G Tags: Eur J Endocrinol Source Type: journals

Corticomedullary mixed tumor of the adrenal gland.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 34-year-old woman presented with weight gain, hirsutism, recent hypertension and secondary amenorrhea. Laboratory findings showed hypokalemia, elevated cortisol and androgen levels with normal urine metanephrines and normal aldosteronemia. Abdominal magnetic resonance imaging showed a right heterogeneous adrenal mass measuring 4x6cm with mixed component of fat and adrenal tissue suggesting corticosurrenaloma. After right adrenalectomy, blood pressure normalized and hypokalemia resolved. In the postoperative course, the patient presented adrenal insufficiency treated with hydrocortisone hemisuccinate. Histological exa...
Source: Annales d'Endocrinologie - October 28, 2009 Category: Endocrinology Authors: Trimeche Ajmi S, Chadli Chaieb M, Mokni M, Braham R, Ach K, Maaroufi A, Chaieb L Tags: Ann Endocrinol (Paris) Source Type: journals

Clinical, Immunological, and Genetic Features of Autoimmune Primary Adrenal Insufficiency: Observations from a Norwegian Registry.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: AD is almost exclusively autoimmune, with high autoimmune comorbidity. Both anti-21-hydroxylase antibodies and HLA class II can be clinically relevant predictors of AD. HRQoL is reduced, especially among diabetes patients, whereas thyroid disease did not have an impact on HRQoL. Treatment modalities that improve HRQoL are needed. PMID: 19858318 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - October 26, 2009 Category: Endocrinology Authors: Erichsen MM, Løvås K, Skinningsrud B, Wolff AB, Undlien DE, Svartberg J, Fougner KJ, Berg TJ, Bollerslev J, Mella B, Carlson JA, Erlich H, Husebye ES Tags: J Clin Endocrinol Metab Source Type: journals

[Correspondence] Etomidate versus ketamine for sedation in acutely ill patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In their study of sedative drugs for emergency intubation, Patricia Jabre and colleagues conclude that etomidate is associated with an increased incidence of adrenal insufficiency, defined as a random serum cortisol concentration of less than 276 nmol/L or an increase in serum cortisol concentration of less than 250 nmol/L after adrenocorticotropin stimulation. This conclusion might not be warranted, since current clinical testing for adrenocortical function in critically ill patients is unreliable. (Source: LANCET)
Source: LANCET - October 8, 2009 Category: Journals (General) Authors: David Kaufman Tags: Correspondence Source Type: journals

[Correspondence] Etomidate versus ketamine for sedation in acutely ill patients – Authors' replyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Nicolas Mongardon, Mervyn Singer, and David Kaufman all address questions related to the adrenal insufficiency seen in our trial. We agree with Mongardon and Singer that it is important to note patients who received corticosteroids during follow-up. 73 of 469 patients analysed received corticosteroids after admission to the intensive-care unit. 28-day mortality in the etomidate group did not differ significantly between steroid-treated patients and non-steroid-treated patients (13/42 [31%] vs 68/192 [35%]; p=0·58). These results are in accordance with those reported by Cuthbertson and colleagues in their CORTICUS substudy...
Source: LANCET - October 8, 2009 Category: Journals (General) Authors: P Jabre, D Annane, F Adnet Tags: Correspondence Source Type: journals

Homozygosity of the Polymorphism MICA5.1 Identifies Extreme Risk of Progression to Overt Adrenal Insufficiency among 21-Hydroxylase Antibody-Positive Patients with Type 1 Diabetes.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Identifying extreme risk should facilitate monitoring of progression from 21OH antibody positivity to overt AD. The HLA-DR3/0404 genotype defines high-risk subjects for adrenal autoimmunity. MICA5.1/5.1 may define those at highest risk for progression to overt AD, a feature unique to AD and distinct from T1D. PMID: 19820007 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - October 8, 2009 Category: Endocrinology Authors: Triolo TM, Baschal EE, Armstrong TK, Toews CS, Fain PR, Rewers MJ, Yu L, Miao D, Eisenbarth GS, Gottlieb PA, Barker JM Tags: J Clin Endocrinol Metab Source Type: journals

Flexion contractures in secondary adrenal insufficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report the case of a 55-year-old male with flexion contractures of the hips and the knees due to an isolated adrenocorticotropin (ACTH) deficiency, a rare cause of secondary adrenal insufficiency. The presenting symptoms and signs, the laboratory investigations and the treatment are described. The case description is followed by a brief overview of ACTH deficiency and its symptoms and causes. Our case is then compared with other case reports available in the literature. The aetiology of the flexion contractures in adrenal insufficiency is still unclear. The authors want to draw attention to adrenal insufficiency as ...
Source: Clinical Rheumatology - October 1, 2009 Category: Rheumatology Tags: Clinical Rheumatology Source Type: journals

Adrenal insufficiency in acute coronary syndrome.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Utilising the LDT, adrenal insufficiency is present in 21.6 percent of patients admitted with ACS. However, this is not associated with any significant morbidity and mortality. PMID: 19907885 [PubMed - in process] (Source: Singapore Medical Journal)
Source: Singapore Medical Journal - October 1, 2009 Category: Journals (General) Authors: Norasyikin AW, Norlela S, Rozita M, Masliza M, Shamsul AS, Nor Azmi K Tags: Singapore Med J Source Type: journals

Technical details influence the diagnostic accuracy of the 1 mcg ACTH stimulation test.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The high rate of abnormal results, especially in the afternoon, and loss of ACTH through tubing, suggest that morning testing and minimal tubing should be adopted to avoid an inappropriate diagnosis of adrenal insufficiency. Earlier time-points and standardized protocols would facilitate comparison of studies. PMID: 19797501 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)
Source: European Journal of Endocrinology - September 30, 2009 Category: Endocrinology Authors: Wade M, Baid S, Calis K, Raff H, Sinaii N, Nieman L Tags: Eur J Endocrinol Source Type: journals

Prevalence of occult adrenal insufficiency and the prognostic value of a short corticotropin stimulation test in patients with septic shockEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion:</b> A short corticotropin test using low-dose corticotropin (1 &#956;g) has a good prognostic value. High basal cortisol and a low increase in cortisol on corticotropin stimulation test are predictors of a poor outcome in patients with septic shock. (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - September 26, 2009 Category: Intensive Care Authors: Maqbool Muzaffar, Shah Zafar Amin, Wani Fayaz Ahmad, Wahid Abdul, Parveen Shaheena, Nazir Arjumand Source Type: journals

Hypopituitarism following traumatic brain injury: the prevalence is affected by the use of different dynamic tests and different normal values.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The reported variations in the prevalence rates of hypopituitarism after TBI are in part caused by differences in definitions, endocrine assessments of hypopituitarism and confounding factors. These methodological issues prohibit simple generalizations of results of original studies on TBI-associated hypopituitarism in the perspective of meta-analyses or reviews. PMID: 19783619 [PubMed - as supplied by publisher] (Source: European Journal of Endocrinology)
Source: European Journal of Endocrinology - September 24, 2009 Category: Endocrinology Authors: Kokshoorn N, Wassenaar M, Biermasz N, Roelfsema F, Smit J, Romijn J, Pereira A Tags: Eur J Endocrinol Source Type: journals

Pulmonary hypertension in a patient with Schmidt syndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe a 26-year-old patient with long-standing autoimmune hypothyroidism. She was doing well until she developed Addisonian crisis accompanied by severe metabolic acidosis, hypoglycemia, hypomagnesemia, and hypokalemia. Subsequently she developed a life-threatening cardiac arrhythmia due to QT prolongation secondary to electrolyte imbalance. The association of autoimmune hypothyroidism and adrenal insufficiency in our patient suggests the diagnosis of autoimmune polyglandular syndrome type II or Schmidt syndrome. An echocardiography that was performed detected pulmonary hypertension without apparent cardiac or lung p...
Source: The American Journal of Emergency Medicine - September 24, 2009 Category: Emergency Medicine Authors: Walid R. Saliba, Wasseem Rock, Mazen Elias Tags: Case Reports Source Type: journals

A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials of DHEA Treatment Effects on Quality of Life in Women with Adrenal Insufficiency.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: DHEA may improve, in a small and perhaps trivial manner, HRQOL and depression in women with adrenal insufficiency. There was no significant effect of DHEA on anxiety and sexual well-being. The evidence appears insufficient to support the routine use of DHEA in women with adrenal insufficiency. PMID: 19773400 [PubMed - as supplied by publisher] (Source: The Journal of Clinical Endocrinology and Metabolism)
Source: The Journal of Clinical Endocrinology and Metabolism - September 21, 2009 Category: Endocrinology Authors: Alkatib AA, Cosma M, Elamin MB, Erickson D, Swiglo BA, Erwin PJ, Montori VM Tags: J Clin Endocrinol Metab Source Type: journals

Factors Contributing to Hospitalization for Gastroparesis ExacerbationsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Poor glycemic control, infection, noncompliance with/intolerance of medications, and, perhaps, adrenal insufficiency were contributory factors leading to hospitalizations of gastroparetic patients. Hospitalized patients with gastroparesis exacerbations had elevated ESR and CRP levels. Although many patients with elevated inflammatory markers had evidence of infection, some did not. Assessment of inflammatory markers may help indicate those gastroparetic patients in whom a search for infection should be undertaken. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-009-...
Source: Digestive Diseases and Sciences - September 17, 2009 Category: Gastroenterology Tags: Digestive Diseases and Sciences Source Type: journals

The ACTH-induced cortisol response in acute pancreatitisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The evidence that severe acute pancreatitis can result in critical illness related corticosteroid insufficiency following impaired adrenal secretion is accumulating. The study by Peng and coworkers in Critical Care certainly contributes to that idea, even though the question whether relative adrenal insufficiency should prompt for treatment by substitution doses of corticosteroids remains unresolved. The study is discussed in terms of the risk factors, circumstances and significance of impaired corticosteroid secretion by adrenals in severe acute pancreatitis. (Source: Critical Care)
Source: Critical Care - September 15, 2009 Category: Intensive Care Authors: Johan Groeneveld Source Type: journals

Activities against hemostatic proteins and adrenal gland ultrastructural changes caused by the brown widow spider Latrodectus geometricus (Araneae: Theridiidae) venom.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Brown widow spider (BrWS) (Latrodectus geometricus) venom produces intense systemic reactions such as cramps, harsh muscle nociceptive, nauseas, vomiting and hypertension. The proposed pathogenic mechanisms resulting in these accidents have principally been damages occuring at the nervous system. However, it is suspected that there is also damage of the adrenal glands, as a result of the experimental animal's clinical manifestations, which developed symptoms compatible with acute adrenal insufficiency. We have currently found that the adrenal gland is damaged by this venom gland homogenates (VGH) producing severe alter...
Source: Comparative biochemistry and physiology. Toxicology and pharmacology : CBP - September 11, 2009 Category: Biochemistry Authors: Guerrero B, Finol HJ, Reyes-Lugo M, Salazar AM, Sánchez EE, Estrella A, Roschman-González A, Ibarra C, Salvi I, Rodríguez-Acosta A Tags: Comp Biochem Physiol C Toxicol Pharmacol Source Type: journals

Withdrawal of corticosteroids in inflammatory bowel disease patients after dependency periods ranging from 2 to 45 years: a proposed methodEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions Corticosteroid withdrawal using this protocol had a high success rate and durable effect and was effective in patients with long-standing (up to 45 years) dependency. As symptoms of CWS mimic symptoms of IBD disease flares, gastroenterologists may have difficulty distinguishing them, which may be a contributory factor to the frequency of corticosteroid dependency in IBD patients. (Source: Alimentary Pharmacology and Therapeutics)
Source: Alimentary Pharmacology and Therapeutics - September 3, 2009 Category: Drugs & Pharmacology Authors: S. J. MURPHY, L. WANG, L. A. ANDERSON, A. STEINLAUF, D. H. PRESENT, J. I. MECHANICK Tags: Original articles Source Type: journals

John F. Kennedy had the most complex medical history of any U.S. president, likely had polyendocrine syndrome type IIEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
From the Annals of Internal Medicine:In an Era of Less Media Scrutiny, John F. Kennedy Hid Serious Health Problems from the Public.At the age of 43, he was the youngest man ever elected president. During his campaign and presidency, the media portrayed him as the epitome of youth and vigor. However, a recent review of his medical records reveals that Kennedy had the most complex medical history of any U.S. president.Unbeknownst public, Kennedy was diagnosed with Addison's disease, a rare endocrine disorder in which the adrenal glands do not produce enough of the hormone cortisol.Later, when Kennedy was a senator, he was fo...
Source: Clinical Cases and Images - September 2, 2009 Category: Journals (General) Tags: People Endocrinology Source Type: info

Current controversies in critical illness-related corticosteroid insufficiency and glucocorticoid supplementation.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The stress response, which is triggered by a number of factors, including surgery, results in activation of the hypothalamic pituitary adrenal axis and subsequent release of cortisol from the adrenal glands. Critical illness-related corticosteroid insufficiency is an inadequate corticosteroid response relative to a patient's illness; patients with critical illness-related corticosteroid insufficiency have both insufficient circulating cortisol and impaired cellular use of glucocorticoids. Corticosteroids, such as hydrocortisone, have been cited to improve survival, oxygenation, duration of mechanical ventilation, and i...
Source: Orthopedics - August 31, 2009 Category: Orthopaedics Authors: Gross AK, Winstead PS Tags: Orthopedics Source Type: journals

Cytomegalovirus-Induced Adrenal Insufficiency in a Renal Transplant RecipientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Cytomegalovirus (CMV) is an important pathogen in organ-transplant recipients. There have been frequent reports of CMV-induced adrenal insufficiency in patients with human immunodeficiency virus infection. Herein, we report CMV-induced renal insufficiency in a renal transplant recipient. A 24-year-old woman had gradual onset of weakness, anorexia, nausea, hypotension, and skin hyperpigmentation at 5 months after renal transplantation. The immunosuppression regimen included cyclosporine, mycophenolate mofetil, and corticosteroid (prednisolone, 5 mg/d). Recent history included acute CMV infection, which was treated...
Source: Transplantation Proceedings - August 31, 2009 Category: Transplant Surgery Authors: M. Ardalan, M.M. Shoja Tags: Case Reports Source Type: journals

Severe sepsis in cirrhosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sepsis is physiologically viewed as a proinflammatory and procoagulant response to invading pathogens. There are three recognized stages in the inflammatory response with progressively increased risk of end-organ failure and death: sepsis, severe sepsis, and septic shock. Patients with cirrhosis are prone to develop sepsis, sepsis-induced organ failure, and death. There is evidence that in cirrhosis, sepsis is accompanied by a markedly imbalanced cytokine response ("cytokine storm"), which converts responses that are normally beneficial for fighting infections into excessive, damaging inflammation. Molecular mechanisms for...
Source: Hepatology - August 31, 2009 Category: Internal Medicine Authors: Thierry Gustot, François Durand, Didier Lebrec, Jean-Louis Vincent, Richard Moreau Source Type: journals

The diagnosis and investigation of adrenal insufficiency in adultsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is considerable variation in the methods used to diagnose and investigate adrenal insufficiency in clinical practice. These include a range of adrenocorticotropin (ACTH) stimulation and other dynamic testing protocols, serum cortisol cut-off values for diagnosis and tests used for differential diagnosis. With the introduction of modern cortisol and ACTH assays, the interpretation of tests used for diagnosis and differential diagnosis has become more complex and requires local validation. This review examines the basis of normal hypothalamic–pituitary–adrenal axis function and adrenal insufficiency states ...
Source: Annals of Clinical Biochemistry - August 30, 2009 Category: Biochemistry Authors: Wallace, I., Cunningham, S., Lindsay, J. Tags: Review Article Source Type: journals

[Ascending hyperkaliemic paralysis revealing adrenal insufficiency.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
PMID: 19720495 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)
Source: Annales Francaises d'Anesthesie et de Reanimation - August 28, 2009 Category: Anesthesiology Authors: Lehot JJ, Cahen R Tags: Ann Fr Anesth Reanim Source Type: journals

Acute adrenal crisis mimicking familial Mediterranean fever attack in a renal transplant FMF patient with amyloid goiterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe a 21-year-old-FMF amyloidosis case with a well-functioning allograft who presented to the emergency clinic with the complaints of abdominal pain, vomiting and diarrhea mimicking FMF attack. adrenocorticotrophic hormone stimulation test was performed due to resistant hyponatremia and disclosed Addison disease. In countries with a high prevalence of FMF, adrenal crisis should be borne in mind in long standing FMF patients. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00296-009-1115-0Authors Hamdi Emeksiz, Gazi University Ankara TurkeySevcan Bakkaloglu, Gazi University Ankara TurkeyOrhun C...
Source: Rheumatology International - August 27, 2009 Category: Rheumatology Tags: Rheumatology International Source Type: journals

Effects of glucose infusion on neuroendocrine and cognitive parameters in Addison diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Sucrose intake has been shown to suppress increased adrenocorticotropic hormone (ACTH) levels in adrenalectomized rats, suggesting that increased cerebral energy supply can compensate for the loss of glucocorticoid feedback inhibition of the hypothalamo-pituitary-adrenal axis. We hypothesized that glucose infusion might acutely down-regulate increased ACTH secretion in patients with Addison disease. We studied 8 patients with primary adrenal insufficiency (Addison group) with short-term discontinuation of hydrocortisone substitution and 8 matched healthy controls in 2 randomized conditions. Subjects received eith...
Source: Metabolism - Clinical and Experimental - August 26, 2009 Category: Biomedical Science Authors: Johanna Klement, Christian Hubold, Manfred Hallschmid, Cecilia Loeck, Kerstin M. Oltmanns, Hendrik Lehnert, Jan Born, Achim Peters Source Type: journals

Recent Advances in Adrenal AutoimmunityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Primary adrenal insufficiency (PAI), also known as Addison’s disease, is the result of the destruction or impaired function of adrenocortical cells. An autoimmune process is responsible. Expert Review of Endocrinology and Metabolism (Source: Medscape Diabetes Headlines)
Source: Medscape Diabetes Headlines - August 25, 2009 Category: Endocrinology Tags: Diabetes & Endocrinology Source Type: info

Predisposing Factors for Adrenal InsufficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
To the Editor: The review of predisposing factors for adrenal insufficiency by Bornstein (May 28 issue)1 includes a welcome discussion ... (Source: New England Journal of Medicine)
Source: New England Journal of Medicine - August 18, 2009 Category: Internal Medicine Authors: Kaufman, D. A., Seravalli, L., Anton, E., Bornstein, S. R. Tags: CORRESPONDENCE Source Type: journals

Addison’s disease due to tuberculosis that required differentiation from SIADHEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract A 77-year-old man was admitted to our hospital complaining of general fatigue. Serum sodium was 116 mEq/l and serum antidiuretic hormone (ADH) was elevated. Radiologic examination revealed nodules in the brain as well as in both adrenal glands. Based on the findings of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET), we had considered that the cause of the hyponatremia was syndrome of inappropriate secretion of antidiuretic hormone (SIADH) due to active extrapulmonary tuberculosis. Against our expectations, the patient’s condition got worse just after he began antituberculous...
Source: Journal of Infection and Chemotherapy - August 17, 2009 Category: Infectious Diseases Tags: Journal of Infection and Chemotherapy Source Type: journals

Levothyroxine sodium: Adrenal insufficiency: case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Reactions)
Source: Reactions - August 17, 2009 Category: Drugs & Pharmacology Tags: Short communication Source Type: journals

Growth hormone replacement in adults: interactions with other pituitary hormone deficiencies and replacement therapies.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Severe growth hormone deficiency (GHD) in adults has been described as a clinical entity. Some of the features associated with GHD could, however, be due to unphysiological and inadequate replacement of other pituitary hormone deficiencies. This may be true for glucocorticoid replacement that lacks a biomarker making dose titration and monitoring difficult. Moreover, oral oestrogen replacement therapy decreases insulin growth factor 1 (IGF-I) levels compared to transdermal route, which attenuates the responsiveness to GH replacement therapy in women. In addition, in untreated female hypogonadism, oral oestrogen may aug...
Source: European Journal of Endocrinology - August 13, 2009 Category: Endocrinology Authors: Filipsson H, Johannsson G Tags: Eur J Endocrinol Source Type: journals

[Adrenal function after induction of cardiac surgery patients with etomidate: A retrospective study.]Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
CONCLUSION: A high incidence of relative adrenal failure was observed in selected cardiac surgery patients with acute postoperative circulatory failure. PMID: 19683891 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)
Source: Annales Francaises d'Anesthesie et de Reanimation - August 13, 2009 Category: Anesthesiology Authors: Seravalli L, Pralong F, Revelly JP, Que YA, Chollet M, Chioléro R Tags: Ann Fr Anesth Reanim Source Type: journals

Researching nature's venoms and poisonsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Summary: Our environment hosts a vast diversity of venomous and poisonous animals and plants. Clinical toxinology is devoted to understanding, preventing and treating their effects in humans and domestic animals. In Sri Lanka, yellow oleander (Thevetia peruviana, Sinhala ‘kaneru’), a widespread and accessible ornamental shrub, is a popular means of self-harm. Its toxic glycosides resemble those of foxglove, against which therapeutic antibodies have been raised. A randomised placebo-controlled trial proved that this treatment effectively reversed kaneru cardiotoxicity. There are strong scientific grounds for the use of ...
Source: Transactions of the Royal Society of Tropical Medicine and Hygiene - August 13, 2009 Category: Tropical Medicine Authors: David A. Warrell Tags: Society Meeting Paper Source Type: journals

The Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy or Autoimmune Polyglandular Syndrome Type 1Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Liver Dis 2009; 29: 307-314DOI: 10.1055/s-0029-1233535ABSTRACTAutoimmune polyglandular syndromes are rare autoimmune endocrinopathies that are associated with nonendocrine autoimmunopathies. Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), also named autoimmune polyglandular syndrome type 1 (APS-1), is distinguished from autoimmune polyglandular syndrome 2 (APS-2). Major disease components of APECED are adrenal insufficiency, hypoparathyroidism, and candidiasis. The diagnosis is established by the presence of two out of the three components. Minor clinical features include autoimmune hepatitis...
Source: Seminars in Liver Disease - August 13, 2009 Category: Gastroenterology Source Type: journals

Surgery in the patient with endocrine dysfunction.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on 4 of the most common endocrinopathies: diabetes mellitus, hyperthyroidism, hypothyroidism, and adrenal insufficiency. Perioperative challenges in patients presenting with pheochromocytoma are also discussed. PMID: 19665618 [PubMed - in process] (Source: The Medical Clinics of North America)
Source: The Medical Clinics of North America - August 13, 2009 Category: Journals (General) Authors: Kohl BA, Schwartz S Tags: Med Clin North Am Source Type: journals

A novel mutation in DAX1 (NR0B1) causing X-linked adrenal hypoplasia congenita: clinical, hormonal and genetic analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe a family with three members affected, two adults and a neonate. The way of presentation of the adults was neonatal primary adrenal insufficiency and hypogonadotropic hypogonadism (one complete and another presenting as interrupted puberty). The genetic study revealed a new mutation in DAX1, p.Q76X gene (c.C226T), resulting in a truncated protein of 76 amino acids, the same in all three affected male patients and in the asymptomatic women of the family. These cases further expand the number of DAX1 mutations reported, as well as the description of infrequent forms of presentation of this disease as interrupte...
Source: Endocrine - August 11, 2009 Category: Endocrinology Tags: Endocrine Source Type: journals

Surgery in the Patient with Endocrine DysfunctionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on 4 of the most common endocrinopathies: diabetes mellitus, hyperthyroidism, hypothyroidism, and adrenal insufficiency. Perioperative challenges in patients presenting with pheochromocytoma are also discussed. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - August 8, 2009 Category: Primary Care Authors: Benjamin A. Kohl, Stanley Schwartz Source Type: journals

Antifungals/calcium channel antagonists/inhaled corticosteroids/protease inhibitors interaction: Cushing's syndrome and adrenal insufficiency: 15 case reportsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Reactions)
Source: Reactions - August 3, 2009 Category: Drugs & Pharmacology Tags: Short communication Source Type: journals

A prospective study on the incidence and predictive factors of relative adrenal insufficiency in Korean critically-ill patients.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study was undertaken to evaluate the incidence and risk factors associated with relative adrenal insufficiency (RAI) in Korean critically-ill patients. All patients who were admitted to the Medical Intensive Care Unit (MICU) of Samsung Medical Center between January 1, 2006 and April 30, 2007 were prospectively evaluated using a short corticotropin stimulation test on the day of admission. RAI was defined as an increase in the serum cortisol level of <9 microg/dL from the baseline after administration of 250 microg of corticotropin. In all, 123 patients were recruited and overall the incidence of RAI was 44% (54/12...
Source: J Korean Med Sci - July 31, 2009 Category: Journals (General) Authors: Kwon YS, Kang E, Suh GY, Koh WJ, Chung MP, Kim H, Kwon OJ, Chung JH Tags: J Korean Med Sci Source Type: journals

Addison's diseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Addison's disease or primary adrenocortical failure is a rare condition, most commonly caused in the UK by autoimmune destruction of the adrenal glands. The insidious onset of symptoms over many months means there is often a delay in diagnosis and patients can first present in adrenal crisis. The diagnosis is made by measurement of a low serum cortisol at 9 a.m. in the presence of an elevated adrenocorticotrophic hormone (ACTH) or by a poor cortisol response to exogenous ACTH on provocation testing. There are many possible causes of adrenal failure and once the diagnosis of adrenal insufficiency has been made the...
Source: Medicine - July 31, 2009 Category: Internal Medicine Authors: Antonia M. Brooke, John P. Monson Tags: Adrenal Source Type: journals

International Perspectives: Late-onset Circulatory Collapse in Very Low-birthweight Infants: A Japanese PerspectiveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The number of reports of sudden deterioration in blood pressure with concomitant decrease of urine output among extremely low-birthweight (ELBW) infants whose general condition is stable have increased recently in Japan. This disorder is clearly different from an unstable circulatory status during the acute phase soon after delivery. The disorder usually occurs more than 1 week after birth, when the infant's circulatory status already is stable. Blood pressure in such hypotensive infants cannot be restored with volume expanders or inotropic agents; it only improves with glucocorticoid administration. The efficacy of steroi...
Source: NeoReviews recent issues - July 30, 2009 Category: Pediatrics Authors: Miwa, M., Kusuda, S., Ikeda, K. Tags: Fetus and Newborn Infant, Critical Care, Cardiovascular Disorders Articles Source Type: info

Anti-CTLA-4 antibody therapy associated autoimmune hypophysitis: serious immune related adverse events across a spectrum of cancer subtypesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the first two cases of hypopituitarism in prostate cancer subjects undergoing experimental therapy with ipilimumab. The clinical evidence strongly suggests that the prostate cancer subjects developed autoimmune hypophysitis as a consequence of anti-CTLA-4 treatment. High dose glucocorticoid treatment resulted in markedly improved symptoms, and resolution of focal symptoms and diabetes insipidus. One subject recovered pituitary-thyroid axis function after 9 months; however, both continue to require GC replacement. These cases highlight the importance of early screening and treatment for hypopituitarism...
Source: Pituitary - July 28, 2009 Category: Endocrinology Tags: Pituitary Source Type: journals