An 8-year-11-month-old girl with severe atopic dermatitis had previously received treatments including topical hydrocortisone butyrate, pimecrolimus, tacrolimus, hormone ointment encapsulation, and narrowband ultraviolet B (NB-UVB) phototherapy. She also took oral antihistamines such as cetirizine and loratadine, but these interventions provided limited relief, and her pruritus persisted. In August 2023, she began dupilumab therapy with a 400 mg subcutaneous loading dose, followed by 200 mg subcutaneous injections every two weeks. Vitiligo developed three months after dupilumab initiation in this child with severe atopic dermatitis and improved with combination therapy while dupilumab was continued. Together with previously published reports, this observation supports a possible temporal association between dupilumab exposure and vitiligo development; however, causality cannot be established from the currently available evidence.

Suffering the stress of others (termed empathic stress or stress contagion) may affect an individual's health and well-being. To understand the underlying hormonal processes of empathic stress, N = 108 opposite-sex dyads were tested, with one dyad partner passively observing the other undergoing a standardized psychosocial laboratory stressor. A positive link between oxytocin release and empathic stress response was hypothesized, while a negative relationship was expected for testosterone release. Associations of observer oxytocin and testosterone levels with two components of empathic stress were examined: stress resonance (i.e. synchronized observer-target responses) and vicarious stress (observer responses independent of target stress). During the passive observation of a stressed target, salivary oxytocin and testosterone levels increased by 16.64% and 23.00%, respectively, followed by a drop back to baseline levels. Supporting our hypotheses, increased observer oxytocin reactivity was linked to greater stress resonance in HF-HRV reactivity. This association was reversed in low oxytocin responders. Further, testosterone reactivity was negatively associated with stress resonance in heart rate activity. However, testosterone also showed a positive association with vicarious cortisol activity, which resembles the response pattern seen in first-hand stress exposure. We conclude that stress resonance may be the more empathy-dependent component of the empathic stress construct, aligning with previous work on the involvement of oxytocin and testosterone in empathy. To draw further conclusions about the role of oxytocin and testosterone in empathic stress response, future studies including a control group and hormone stimulation are needed.

Hypoadrenocorticism (HA) in dogs requires lifelong substitution therapy with glucocorticoids and, in most cases, also mineralocorticoids. For glucocorticoid replacement, prednisolone is administered at a maintenance dose of approximately 0.1 mg/kg/day. Alternative drugs such as hydrocortisone, dexamethasone, or methylprednisolone are used less frequently.

Thyroid storm is a rare, life-threatening endocrine emergency that can cause multiorgan dysfunction, although acute liver failure (ALF) remains an uncommon manifestation. A 52-year-old woman with Graves' disease who had discontinued methimazole presented with three days of nausea, vomiting, diarrhea, melena, generalized weakness, and chest pain. She was lethargic and tachycardic, with a diffusely enlarged thyroid gland, warm skin, bilateral hand tremors, and hypoglycemia. Laboratory testing demonstrated severe thyrotoxicosis, marked hepatocellular injury with an aspartate aminotransferase concentration of 1,059 units per liter (U/L) and an alanine aminotransferase concentration of 955 U/L, and an international normalized ratio of 7.8. Echocardiography showed a left ventricular ejection fraction of 25%-30%, while coronary angiography was normal, and evaluation for viral, autoimmune, and structural hepatobiliary disease was unrevealing. Treatment with hydrocortisone, propranolol, and methimazole resulted in clinical improvement and substantial biochemical recovery, with normalization of the hepatic and thyroid biochemical parameters at two-month follow-up. This case emphasizes the importance of considering thyroid storm in patients with ALF and promptly evaluating both thyroid-mediated and hemodynamic contributors to hepatic injury.

Pituitary apoplexy (PA) is an acute, potentially life-threatening neuroendocrine emergency caused by hemorrhage or infarction within the pituitary gland, most often arising in a previously unrecognized pituitary neuroendocrine tumor (PitNET). Reported precipitants include surgery, anticoagulation, dynamic pituitary testing, hypertension, and head trauma; alcohol is rarely implicated. We report a 61-year-old man with long-standing hypertension, type 2 diabetes mellitus and coronary artery disease (on aspirin after coronary stenting) who developed sudden thunderclap headache and complete right oculomotor nerve palsy the morning after consuming approximately 250 ml of distilled liquor (baijiu). Magnetic resonance imaging showed a 2.7 cm × 1.9 cm × 1.9 cm sellar mass with heterogeneous hemorrhagic signal, suprasellar extension and optic chiasm contact. Perioperative endocrine evaluation demonstrated secondary adrenal insufficiency, central hypothyroidism and low gonadotropins, consistent with multi-axis hypopituitarism. After aspirin withdrawal and immediate parenteral hydrocortisone, the patient underwent endoscopic endonasal transsphenoidal resection on day 8. Histopathology confirmed an SF-1 lineage gonadotroph PitNET with extensive infarction (Ki-67 2%; FSH+, SF-1+, PIT-1-, T-PIT-). At 3 months, the right oculomotor palsy had partially recovered, with improvement in ptosis and ocular motility but incomplete resolution. Follow-up contrast-enhanced magnetic resonance imaging showed no residual or recurrent tumor, a decompressed optic chiasm and a midline pituitary stalk, and the markedly elevated presenting 24h urinary free cortisol had returned to the laboratory reference range. Anterior pituitary function nonetheless remained deficient across the corticotroph, thyrotroph, and gonadotroph axes, and the patient continued stable hydrocortisone and levothyroxine replacement. This case adds to the limited literature on PA temporally associated with alcohol intake, illustrates the value of World Health Organization 2022 lineage-based PitNET classification, and supports individualized, semi-elective surgery in haemodynamically stable patients without acute visual-pathway compromise.

Mithun animals are primarily reared for meat production. However, there is scope for utilizing this majestic animal of North-East India as a draught animal due to its ability to thrive in hilly terrain. There are limited published data on physiological, blood biochemical and hormonal parameters of Mithun bullocks during ploughing and carting operations. The present study was conducted on three Mithun bullocks (castrated males) to evaluate the physiological, biochemical and hormonal responses to ploughing and carting operations. Recording of physiological parameters and blood collection were done before work, immediately after work, and after one hour of rest. Significant differences (P < 0.01) were observed for all physiological parameters between before-work and immediately after-work values during ploughing and carting operations. The respiration rate of Mithun was most greatly affected, followed by pulse rate and rectal temperature during work. The ploughing ability of Mithun was calculated as 28.15%. The fatigue score of Mithun (< 20) indicated that Mithun bullocks can be used efficiently for 2 continuous hours of ploughing. The concentrations of serum glucose, total protein and cortisol increased significantly (P < 0.01) during carting with a 300 kg load (excluding cart weight and cartman weight) for 2 h. However, lactic acid and cortisol values were non-significant between before-work and after-work during ploughing operations, indicating that the animals were physically challenged at the metabolic level but remained within a normal adaptive physiological range without mounting a significant hormonal stress response. The horsepower generated by Mithun bullocks under no-load carting was 0.39 hp.