- Postpartum spontaneous coronary dissection presenting with ventricular fibrillation. [Journal Article]
- JCJ Cardiol Cases 2011; 3(1):e17-e21
- CONCLUSIONS: We report the first case of survival after ventricular fibrillation arrest of a woman presenting with spontaneous coronary dissection in the post-partum period. Our case underscores the importance of recognizing ventricular fibrillation as a first presenting sign of spontaneous coronary artery dissection in the post-partum period.
- The plasma peptidome. [Journal Article]
- CPClin Proteomics 2018; 15:39
- CONCLUSIONS: The random and independent sampling of pre-fractionated blood peptides by LC-ESI-MS/MS with SQL Server-R analysis revealed the largest plasma proteome to date and was a practical method to quantify and compare the frequency or log10 intensity of individual proteins cleaved ex vivo across populations of plasma samples from multiple clinical locations to discover treatment-specific variation using classical statistics suitable for clinical science. It was possible to identify and quantify nearly all human proteins from EDTA plasma and compare the results of thousands of LC-ESI-MS/MS experiments from multiple clinical populations using standard database methods in SQL Server and classical statistical strategies in the R data analysis system.
- Age may influence the impact of TRAbs on thyroid function and relapse-risk in patients with Graves' disease. [Journal Article]
- JCJ Clin Endocrinol Metab 2018 Dec 03
- CONCLUSIONS: In GD, age can influence the impact of TRAbs on thyroid function and relapse risk. TRAbs at diagnosis have better predictive value in younger patients with GD.
- [Autoimmune diseases in dogs and their impact for breeding programs with special reference of the Nova Scotia Duck Tolling Retriever]. [Journal Article]
- SASchweiz Arch Tierheilkd 2018; 160(12):711-717
- Autoimmune diseases are of considerable importance in dog breeding. An increased risk of diseases with genetic predisposition is present especially in breeds with a limited genetic diversity. Strict ...
Autoimmune diseases are of considerable importance in dog breeding. An increased risk of diseases with genetic predisposition is present especially in breeds with a limited genetic diversity. Strict breeding regulations and a high degree of self responsibility of the breeders are essential to prevent these diseases. There are only a few DNA tests available for detecting carriers of genes predisposing for autoimmune diseases. In this review, we describe the special situation in the Nova Scotia Duck Tolling Retriever, who has a special predisposition for Systemic Lupus Erythematosus (SLE) and for Immune-mediated Rheumatoid Disease (IMRD), as well as for Steroid-Responsive Meningitis Arteritis (SRMA) and Juvenile Addison's Disease (JADD). In addition a short overview on the pathogenesis of autoimmune disease is presented.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Laugier-Hunziker syndrome, also known as Laugier-Gerbig-Hunziker syndrome or Laugier-Hunziker-Baran syndrome or idiopathic lenticular mucocutaneous pigmentation, is a hereditary pigmentary disorder c...
Laugier-Hunziker syndrome, also known as Laugier-Gerbig-Hunziker syndrome or Laugier-Hunziker-Baran syndrome or idiopathic lenticular mucocutaneous pigmentation, is a hereditary pigmentary disorder characterized by a unique expression of pigmentation over the mucosal, nail, and acral sites. The condition is known to be benign nevertheless a few associations with esophageal melanocytosis, actinic lichen planus, hypocellular bone marrow, and thrombocytopenia have been reported. Due to its close semblance to more serious conditions such as Addison disease, Peutz-Jeghers syndrome, Cronkhite-Canada syndrome, and lentiginosis profusa, this is usually classed as a diagnosis of exclusion.
- Addison's disease in antiphospholipid syndrome: a rare complication. [Journal Article]
- EDEndocrinol Diabetes Metab Case Rep 2018 Nov 22; 2018
- Addison's disease (AD) is the most common endocrine manifestation of antiphospholipid syndrome (APS), but it remains a very rare complication of the syndrome. It is caused by adrenal venous thrombosi...
Addison's disease (AD) is the most common endocrine manifestation of antiphospholipid syndrome (APS), but it remains a very rare complication of the syndrome. It is caused by adrenal venous thrombosis and consequent hemorrhagic infarction or by spontaneous (without thrombosis) adrenal hemorrhage, usually occurring after surgery or anticoagulant therapy. We present a clinical case of a 36-year-old female patient with a previous diagnosis of APS. She presented with multiple thrombotic events, including spontaneous abortions. During evaluation by the third episode of abortion, a CT imaging revealed an adrenal hematoma, but the patient was discharged without further investigation. A few weeks later, she presented in the emergency department with manifestations suggestive of adrenal insufficiency. Based on that assumption, she started therapy with glucocorticoids, with significant clinical improvement. After stabilization, additional investigation confirmed AD and excluded other etiologies; she also started mineralocorticoid replacement. This case illustrates a rare complication of APS that, if misdiagnosed, may be life threatening. A high index of suspicion is necessary for its diagnosis, and prompt treatment is crucial to reduce the morbidity and mortality potentially associated. Learning points: AD is a rare but life-threatening complication of APS. It is important to look for AD in patients with APS and a suggestive clinical scenario. APS must be excluded in patients with primary adrenal insufficiency and adrenal imaging revealing thrombosis/hemorrhage. Glucocorticoid therapy should be promptly initiated when AD is suspected. Mineralocorticoid replacement must be started when there is confirmed aldosterone deficiency. Hypertension is a common feature of APS; in patients with APS and AD, replacement therapy with glucocorticoids and mineralocorticoids may jeopardize hypertension management.
- Early Clinical Indicators of Addison's Disease in Adults with Type 1 Diabetes: a Nationwide, Observational, Cohort Study. [Journal Article]
- JCJ Clin Endocrinol Metab 2018 Nov 21
- CONCLUSIONS: These data suggest that medical treatment for thyroid disease, a severe infection, and glucagon prescription for severe hypoglycemia should raise the suspicion of AD development in adults with T1DM. Development of diabetic retinopathy might also be associated with glucocorticoid deficiency and the development of AD among patients with T1DM.
- Reversible dilated cardiomyopathy as a complication of adrenal cortex insufficiency: a case report. [Journal Article]
- JMJ Med Case Rep 2018 Nov 21; 12(1):345
- 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.
- Polyglandular endocrine emergency: lessons from a patient, which a book cannot teach. [Journal Article]
- BCBMJ Case Rep 2018 Nov 08; 2018
- A 30-year-old woman with polyglandular autoimmune type 2 syndrome was found collapsed at home with a cardiac arrest, which required direct current cardioversion. On admission, she was hypothermic, hy...
A 30-year-old woman with polyglandular autoimmune type 2 syndrome was found collapsed at home with a cardiac arrest, which required direct current cardioversion. On admission, she was hypothermic, hypotensive and bradycardic. Initial biochemical investigations were consistent with a pre-renal acute kidney injury, metabolic acidosis and a possible sepsis. She had significantly elevated thyroid-stimulating hormone levels on admission with the clinical profile consistent with dual Addisonian and myxoedema crisis. She received intravenous liothyronine and hydrocortisone along with supportive therapy. Echo showed severe left ventricular impairment with apical ballooning although coronary angiogram disclosed nothing abnormal. She made a gradual recovery and was discharged home after 2 weeks. She was diagnosed to have primary autoimmune hypothyroidism, Addison's diseaseand type 1 diabetes and coeliac disease in October 2006, July 2007, May 2010 and September 2016, respectively. Her inability to stick to gluten-free diet at her workplace was considered a significant contributory factor for out-of-hospital cardiac arrest.
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- Dairy milk proteins attenuate hyperglycemia-induced impairments in vascular endothelial function in adults with prediabetes by limiting increases in glycemia and oxidative stress that reduce nitric oxide bioavailability. [Journal Article]
- JNJ Nutr Biochem 2018 Sep 25; 63:165-176
- Postprandial hyperglycemia (PPH) transiently impairs vascular endothelial function (VEF) in an oxidative stress-dependent manner by decreasing nitric oxide (NO•) bioavailability. Dairy milk and its p...
Postprandial hyperglycemia (PPH) transiently impairs vascular endothelial function (VEF) in an oxidative stress-dependent manner by decreasing nitric oxide (NO•) bioavailability. Dairy milk and its proteins attenuate PPH, but whether this improves VEF is unknown. We hypothesized that dairy milk, mediated by its whey and/or casein proteins, improves VEF by attenuating PPH-induced oxidative stress that otherwise decreases NO• bioavailability. A randomized, cross-over trial was conducted in adults with prediabetes (n=23) who ingested glucose (75 g, GLU) alone or with 473 mL of non-fat dairy milk (MILK) or isonitrogenous (16.5 g) amounts of whey (WHEY) or casein (CASEIN) in 473 mL of water. Prior to and at 30 min intervals for 180 min postprandially, we assessed brachial artery flow-mediated dilation (FMD) and measured biomarkers of glycemic control, oxidative stress, and NO• homeostasis. FMDAUC decreased to the greatest extent during GLU, which was similarly improved in dairy trials. Compared with GLU, AUCs for glucose, malondialdehyde, F2-isoprostanes, methylglyoxal, and endothelin-1 were similarly lower in dairy trials. Plasma arginine and NO• metabolites were greater but methylated arginine metabolites were lower in dairy trials compared with GLU. Postprandial insulin, lipids, and tetrahydrobiopterin redox status did not differ among trials. Thus, dairy milk, mediated by its whey and casein proteins, attenuates PPH-mediated impairments in VEF by limiting oxidative stress. This improves NO• bioavailability to the vascular endothelium by increasing arginine availability and limiting competitive inhibition on NO• biosynthesis by asymmetric dimethylarginine. These findings support observational studies that dairy milk lowers cardiovascular disease risk.