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Adrenal Cortex Insufficiency

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Diana Alasmar – One of the best experts on this subject based on the ideXlab platform.

  • Reversible dilated cardiomyopathy as a complication of Adrenal Cortex Insufficiency: a case report
    Journal of Medical Case Reports, 2018
    Co-Authors: Mohammad Alkhateeb, Mohammad Alsakkal, Mohammad Nour Alfauri, Diana Alasmar
    Abstract:

    Background Cardiovascular manifestations associated with Addison’s disease are previously documented. We described a case of an 11-year-old girl who developed dilated cardiomyopathy as a complication to Addison’s disease. Glucocorticoid replacement therapy resulted in near-complete recovery of cardiac function. It is the first reported case of reversible cardiomyopathy as a complication of primary Adrenal Insufficiency in Syria. Case presentation An 11-year-old Caucasian girl with no significant past medical history presented with abdominal pain, vomiting after meals, and a low-grade fever. A physical examination and laboratory evaluation suggested primary Adrenal Insufficiency. An echocardiogram showed changes consistent with dilated cardiomyopathy. Causes of primary Adrenal Insufficiency other than autoimmune were excluded. Conclusions Dilated cardiomyopathy is a rare complication of primary Adrenal Insufficiency. Proper treatment of Adrenal Insufficiency with glucocorticoid replacement therapy resulted in restoration of normal cardiac function.

  • Reversible dilated cardiomyopathy as a complication of Adrenal Cortex Insufficiency: a case report.
    Journal of medical case reports, 2018
    Co-Authors: Mohammad Al-khateeb, Mohammad Nour Alfauri, Mohammad Alsakkal, Diana Alasmar
    Abstract:

    Cardiovascular manifestations associated with Addison’s disease are previously documented. We described a case of an 11-year-old girl who developed dilated cardiomyopathy as a complication to Addison’s disease. Glucocorticoid replacement therapy resulted in near-complete recovery of cardiac function. It is the first reported case of reversible cardiomyopathy as a complication of primary Adrenal Insufficiency in Syria. An 11-year-old Caucasian girl with no significant past medical history presented with abdominal pain, vomiting after meals, and a low-grade fever. A physical examination and laboratory evaluation suggested primary Adrenal Insufficiency. An echocardiogram showed changes consistent with dilated cardiomyopathy. Causes of primary Adrenal Insufficiency other than autoimmune were excluded. Dilated cardiomyopathy is a rare complication of primary Adrenal Insufficiency. Proper treatment of Adrenal Insufficiency with glucocorticoid replacement therapy resulted in restoration of normal cardiac function.

Gijs J. M. Limonard – One of the best experts on this subject based on the ideXlab platform.

  • Addison’s Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties.
    European journal of case reports in internal medicine, 2018
    Co-Authors: Sanne Van Haren Noman, Hannah Visser, Alex F Muller, Gijs J. M. Limonard
    Abstract:

    Objectives To demonstrate difficulties in diagnosing and treating Addison’s disease caused by tuberculosis. Materials and methods We present a clinical case and review of the literature. Results A 62-year-old man presented with gastrointestinal symptoms, weight loss and enlarged Adrenal glands. After 2 months of diagnostic tests, a working diagnosis of Addison’s disease due to extrapulmonary tuberculosis was made. Treatment was challenging due to interaction between rifampicin and steroids. Conclusion Our case illustrates that in non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease. Learning points In non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease.Treating tuberculosis and Adrenal Cortex Insufficiency can be challenging because of the interaction between rifampicin and adrenocorticoid drugs.Adrenal function does not recover in most cases of Addison’s disease caused by tuberculosis.

Martin Reincke – One of the best experts on this subject based on the ideXlab platform.

  • Funktionsdiagnostik in der Endokrinologie
    Der Internist, 2018
    Co-Authors: Christoph J. Auernhammer, Martin Reincke
    Abstract:

    Bei der Abklärung vieler endokrinologischer Krankheitsbilder reichen basale Laborparameter nicht aus, um zwischen einer physiologischen und pathologischen Hormonsekretion zu unterscheiden. In diesem Zusammenhang kommt der Funktionsdiagnostik eine entscheidende Rolle zu. Je nachdem ob Unter- oder Überfunktionszustände abgeklärt werden sollen, kommen Stimulations- bzw. Suppressionstests zur Anwendung. In diesem Übersichtsbeitrag sollen ausgewählte Funktionstests besprochen werden, die in aktuellen Leitlinien jeweils einen gesicherten Stellenwert einnehmen. Dabei wird auf Indikationen, Testprinzip und -durchführung, Aussagekraft und Limitationen eingegangen. Thematisiert werden unter anderem der ACTH-Stimulationstest zur Abklärung einer Nebennierenrindeninsuffizienz und der Dexamethasonhemmtest bei Verdacht auf ein Cushing-Syndrom, zudem Funktionstests zur Abklärung von primärem Hyperaldosteronismus, Phäochromozytom, Akromegalie, Wachstumshormonmangel, Schilddrüsenknoten und V.a. medulläres Schilddrüsenkarzinom, Insulinom und Zollinger-Ellison-Syndrom. Explizit nicht empfohlene Funktionstests werden ebenfalls angesprochen. When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. This review article discusses selected functional tests, each of which plays an important role in current guidelines. Indications and test principles, including their performance, reliability, and limitations, are discussed. Topics covered include the ACTH stimstimulationt for the diagnosis of Adrenal Cortex Insufficiency and the dexamethasone inhibition test for suspected Cushing’s syndrome, as well as functional tests for the diagnosis of primary hyperaldosteronism, pheochromocytoma, acromegaly, growth hormone deficiency, thyroid nodules and suspicion of medullary thyroid carcinoma, insulinoma, and Zollinger-Ellison syndrome. Functional tests that are explicitly not recommended are also addressed.

  • Funktionsdiagnostik in der Endokrinologie
    Der Internist, 2017
    Co-Authors: Christoph J. Auernhammer, Martin Reincke
    Abstract:

    When investigating many endocrinological diseases, basal laboratory parameters are not sufficient to distinguish between physiological and pathological hormone secretion. Functional diagnostics plays a decisive role in this context. Stimulation and suppression tests are used depending on whether under- or over-function needs to be diagnosed. This review article discusses selected functional tests, each of which plays an important role in current guidelines. Indications and test principles, including their performance, reliability, and limitations, are discussed. Topics covered include the ACTH stimstimulationt for the diagnosis of Adrenal Cortex Insufficiency and the dexamethasone inhibition test for suspected Cushing’s syndrome, as well as functional tests for the diagnosis of primary hyperaldosteronism, pheochromocytoma, acromegaly, growth hormone deficiency, thyroid nodules and suspicion of medullary thyroid carcinoma, insulinoma, and Zollinger-Ellison syndrome. Functional tests that are explicitly not recommended are also addressed.

Sanne Van Haren Noman – One of the best experts on this subject based on the ideXlab platform.

  • Addison’s Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties.
    European journal of case reports in internal medicine, 2018
    Co-Authors: Sanne Van Haren Noman, Hannah Visser, Alex F Muller, Gijs J. M. Limonard
    Abstract:

    Objectives To demonstrate difficulties in diagnosing and treating Addison’s disease caused by tuberculosis. Materials and methods We present a clinical case and review of the literature. Results A 62-year-old man presented with gastrointestinal symptoms, weight loss and enlarged Adrenal glands. After 2 months of diagnostic tests, a working diagnosis of Addison’s disease due to extrapulmonary tuberculosis was made. Treatment was challenging due to interaction between rifampicin and steroids. Conclusion Our case illustrates that in non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease. Learning points In non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease.Treating tuberculosis and Adrenal Cortex Insufficiency can be challenging because of the interaction between rifampicin and adrenocorticoid drugs.Adrenal function does not recover in most cases of Addison’s disease caused by tuberculosis.

Yntema J.l. – One of the best experts on this subject based on the ideXlab platform.

  • [Adrenal Cortex Insufficiency in children due to inhaled corticosteroids]
    , 2011
    Co-Authors: Eijkemans M.c.j., Otten B.j., Yntema J.l.
    Abstract:

    Item does not contain fulltextA 3-year-old boy was treated for asthmatic symptoms with fluticasone inhalations. Due to a flattening growth curve Cushing’s syndrome was suspected and the dosage of fluticasone was gradually decreased after which the boy became less active and his appetite decreased. Another patient, a 7-year-old boy with asthma was also treated with fluticasone inhalations. For 6 months he felt tired, nauseous and had abdominal pain. A third patient, an 8-year-old boy with asthma being treated with fluticasone inhalations was presented at the emergency department because he could not be roused; for the preceding few days he had been nauseous and pyrexic. Further laboratory tests showed that all three patients had Adrenal Cortex Insufficiency (addisonism) due to exogenic glucocorticoids in the form of inhaled corticosteroids. This condition is difficult to recognize as its symptoms are aspecific and may resemble those that accompany inadequately treated asthma; furthermore, inhaled corticosteroids may mask the symptoms. On long-term use of inhaled corticosteroids accompanied by aspecific symptoms, the possibility of Adrenal Cortex Insufficiency should be considered. In addition, it is important to prescribe the lowest possible dosage of inhaled corticosteroids