- Audit of management of children and adolescents with congenital adrenal hyperplasia as per recent Endocrine Society guidelines. [Journal Article]Pediatr Endocrinol Diabetes Metab. 2023 Feb 03 [Online ahead of print]PE
- CONCLUSIONS: A shift to conservative surgical management of females, utility of neonatal screening for CAH, judicious use of growth promoting therapy is highlighted. Need for bone age testing, emergency hydrocortisone provision is warranted in our series.
- Publisher Full Text (DOI)
- #corticophobia: a review on online misinformation related to topical steroids. [Review]Clin Exp Dermatol. 2023 Feb 02; 48(2):112-115.CE
- Misinformation in healthcare is at crisis level worldwide, with the internet as primary source of prevarication. Topical corticosteroids (TCS) are a safe and effective treatment used in multiple dermatological conditions. Nonadherence to prescribed TCS can be due to phobia secondary to misinformation. TCS phobia is a complex multifaceted phenomenon that exploits patients with skin disease, create…
- Publisher Full Text (DOI)
- Akutt binyrebarksvikt hos et barn. [Case Reports]Tidsskr Nor Laegeforen. 2023 Jan 31; 143(2)TN
- CONCLUSIONS: Acute adrenal crisis is a rare primary presentation of adrenal insufficiency, especially in the paediatric population. It is an important differential diagnosis of shock and has high morbidity and mortality.
- Publisher Full Text (DOI)
- A rare case of multiple paragangliomas in the head and neck, retroperitoneum and duodenum: A case report and review of the literature. [Case Reports]
- Pheochromocytomas and paragangliomas (PGLs) are rare non-epithelial neuroendocrine neoplasms of the adrenal medulla and extra-adrenal paraganglia respectively. Duodenal PGL is quite rare and there are only two previous reports. Herein, we report a case of multiple catecholamines (CAs)-producing PGLs in the middle ear, retroperitoneum, and duodenum, and review the literature of duodenal PGLs. A 40…
- PMC Free PDF
- Dual-energy spectral detector computed tomography differential diagnosis of adrenal adenoma and pheochromocytoma: Changes in the energy level curve, a phenomenon caused by lipid components? [Journal Article]
- CONCLUSIONS: The effect of lipid components on SDCT parameters can be used to differentiate adrenal adenoma from pheochromocytoma.
- PMC Free PDF
- Intracardiac paraganglioma with a cough as the first symptom. [Case Reports]
- CONCLUSIONS: Pheochromocytomas and paragangliomas (PPGLs) are a kind of neuroendocrine tumors. PPGLs can cause secondary hypertension, and lead to a series of clinical syndromes, including myocardial injury, metabolic changes, and so on. The occurrence of PPGIs is related to gene mutation. Biochemical detection, imaging examination, and genetic testing can help diagnose. The tumor should be surgically removed as soon as possible after the diagnosis. As a functional tumor, PPGLs should be fully prepared before surgery to avoid anesthesia and huge fluctuations in blood pressure during and after surgery, or the occurrence of fatal hypertensive crisis and intractable hypotension after tumor resection. Adequate preoperative preparation directly affects the prognosis of patients after surgery. Therefore, multidisciplinary cooperation before, during, and after the operation is extremely important.
- PMC Free PDF
- A case of shock after STEMI: Think beyond the cardiogenic one. [Case Reports]
- Acute ST-segment elevation myocardial infarction (STEMI) can typically complicate with the development of cardiogenic shock; nevertheless, other less frequent types of shock may occur, including adrenal crisis (AC). We describe a case of STEMI complicated by AC and, for the first time, AC-induced focal takotsubo syndrome.
- PMC Free PDF
- Approach to the Patient: Preventing adrenal crisis through patient and clinician education. [Journal Article]J Clin Endocrinol Metab. 2023 Jan 11 [Online ahead of print]JC
- Adrenal crisis continues to be an important cause of death despite being a preventable condition. Significant deficits in patient education in the prevention of adrenal crisis have been identified as a contributor to adrenal crisis risk despite the importance of patient education being highlighted in international guidelines. Deficits in clinician education have also been identified as risk facto…
- Publisher Full Text (DOI)
- Etiology, clinical characteristics and mortality among Indian patients with Addison's disease. [Journal Article]Endocr Connect. 2023 Jan 01 [Online ahead of print]EC
- The etiology, presentation and mortality of patients with primary adrenal insufficiency (PAI) in developing countries may differ from economically developed nations. However, information in this regard is scanty. The aim of this study was to determine the etiology and compare the clinical characteristics and mortality in infectious and autoimmune causes of PAI in Indian patients. All eligible (n=…
- Publisher Full Text (DOI)
- Childhood pheochromocytoma crisis complicated with brain stem infarction: A case report. [Case Reports]
- CONCLUSIONS: Early clinical symptoms of pheochromocytoma in children are not typical. It may induce serious complications and develop into a pheochromocytoma crisis and cause death without proper treatment.
- PMC Free PDF
- Electrolyte abnormalities and stress dosing predict illness-related hospitalizations among infants and toddlers with congenital adrenal hyperplasia. [Journal Article]Clin Endocrinol (Oxf). 2023 Jan 02 [Online ahead of print]CE
- CONCLUSIONS: Infants and toddlers with classical CAH are at high risk for acute illness and hospitalizations and often do not receive adequate stress dosing before the ED.
- Publisher Full Text (DOI)
- Challenges in the treatment of late-identified untreated congenital adrenal hyperplasia due to CYP11B1 deficiency: Lessons from a developing country. [Journal Article]
- CONCLUSIONS: Medical treatment and sex assignment in late-identified 46,XX CAH patients in Indonesia may often depend on local and cultural factors. The management of DSD conditions may have to be individualized and integrated into the psychological and social context of the affected family.
- PMC Free PDF
- Bladder paraganglioma treated with open partial cystectomy: a case report. [Case Reports]
- CONCLUSIONS: The rarity of cases having been reported in the literature leads to uncertainties in the management of bladder paraganglioma. Adrenergic symptoms developing during transurethral resection should suggest paraganglioma in the differential diagnosis. A multidisciplinary approach and medical treatment are mandatory to prevent life-threatening complications such as hypertensive crisis, vascular collapse, and multiple-organ system failure. We aimed to report the clinical presentation that includes only macroscopic hematuria mimicking urothelial cancer and to emphasize the multidisciplinary approach in the treatment.
- PMC Free PDF
- Perioperative Evaluation and Management of Patients on Glucocorticoids. [Review]
- Myriad questions regarding perioperative management of patients on glucocorticoids (GCs) continue to be debated including which patients are at risk for adrenal insufficiency (AI), what is the correct dose and duration of supplemental GCs, or are they necessary for everyone? These questions remain partly unanswered due to the heterogeneity and low quality of data, studies with small sample sizes,…
- PMC Free PDF
- A case of unilateral post-COVID-19 adrenal haemorrhage and follow-up during pregnancies. [Journal Article]
- The spectrum of endocrine-related complications of COVID-19 infection is expanding; one of the most concerning of which is adrenal haemorrhage due to the risk of catastrophic adrenal crisis. In this study, we present a case that highlights the challenging management of a large, indeterminate unilateral adrenal mass during pregnancy and draws attention to a rare yet probably underestimated complic…
- PMC Free PDF
- Autoimmune Polyglandular Syndrome Type II: A Case Report. [Case Reports]
- Autoimmune polyglandular syndromes (APS) are polyendocrinopathies characterized by autoimmune dysfunction of multiple endocrine organs. We present the case of a 23-year-old male with a past medical history of autoimmune thyroiditis diagnosed seven months prior who presented with a chief complaint of six months of fatigue, shortness of breath, and weight loss. Physical exam was remarkable for glob…
- PMC Free PDF
- Loss of LGR4/GPR48 causes severe neonatal salt-wasting due to disrupted WNT signaling altering adrenal zonation. [Journal Article]J Clin Invest. 2022 Dec 20 [Online ahead of print]JCI
- Disorders of isolated mineralocorticoid deficiency causing potentially life-threatening salt-wasting crisis early in life have been associated with gene variants of aldosterone biosynthesis or resistance, but in some patients no such variants are found. WNT/β-catenin signaling is crucial for differentiation and maintenance of the aldosterone producing adrenal zona glomerulosa (zG). We describe a …
- Publisher Full Text (DOI)
- Rare cause of a resistant hypertension in a middle-aged man: A case report. [Case Reports]
- Congenital adrenal hyperplasia associated to 11-beta-hydroxylase deficiency is a rare cause of secondary hypertension, usually discovered during childhood; however, a late diagnosis in adults has also been reported. Despite low cortisol levels, accumulated adrenal steroid precursors can activate the glucocorticoid receptor and thus protect the patient against adrenal crisis.
- PMC Free PDF
- The search for a unifying diagnosis involving neurological, endocrine and immune dysfunction: a case report of a novel presentation of DAVID syndrome. [Case Reports]
- CONCLUSIONS: This case demonstrates pseudotumour cerebri as a novel neurological presentation of DAVID syndrome, highlights the rare association between adrenal insufficiency and intracranial hypertension, and shows the challenges in diagnosing isolated ACTH deficiency. We emphasise that cortisol should be checked in pre-pubertal children with pseudotumour cerebri and a diagnosis of DAVID syndrome considered in those presenting with low cortisol and neurological symptoms.
- PMC Free PDF
- APPROACH TO THE PATIENT WITH IMMUNE CHECKPOINT INHIBITOR-ASSOCIATED ENDOCRINE DYSFUNCTION. [Journal Article]J Clin Endocrinol Metab. 2022 Dec 09 [Online ahead of print]JC
- Immune checkpoint inhibitors (ICI) are cancer therapies that are approved in at least 19 different cancers. They function by stimulating immune cell responses against cancer, and their toxicities comprise a host of autoinflammatory syndromes that may impact any organ system. Endocrine toxicities occur in as high as 25-50% of ICI recipients, depending on the treatment regimen used. These toxicitie…
- Publisher Full Text (DOI)
- Pheochromocytoma-induced Subarachnoid and Intracerebral Hemorrhage. [Case Reports]
- Pheochromocytomas are rare adrenal tumors that are often diagnosed in workup for endocrine causes of refractory hypertension, as an incidental imaging finding, or in patients with classic symptoms of headache, palpitations, and/or diaphoresis. We describe a case of pheochromocytoma presenting in a 63-year-old woman with spontaneous and multifocal subarachnoid and intracerebral hemorrhage without …
- PMC Free PDF
- Effects of epidural anesthesia in pheochromocytoma and paraganglioma surgeries: A protocol for systematic review and meta-analysis. [Controlled Clinical Trial]
- CONCLUSIONS: Currently, no published RCTs have yet assessed clinically relevant outcomes with respect to the application of epidural anesthesia during PPGLs surgeries. Well-designed RCTs should nonetheless be encouraged to properly assess the efficacy and safety of epidural anesthesia for PPGLs surgeries.
- PMC Free PDF
- Case report: Hypoadrenocorticism crisis complicated by non-cardiogenic pulmonary edema in a dog. [Case Reports]
- A 6-year-old castrated male Labradoodle was referred in uncompensated hypovolemic shock, with a 72-h history of lethargy, vomiting and diarrhea that had acutely worsened with subsequent development of profuse hemorrhagic diarrhea in the last 24 h after a visit to the groomer. In most respects this case was classic for a patient with a primary hypoadrenocortical crisis. After initial attempts to a…
- PMC Free PDF
- Intracardiac thrombosis following intravenous zoledronate treatment in a child with steroid-induced osteoporosis. [Case Reports]J Pediatr Endocrinol Metab. 2022 Nov 28 [Online ahead of print]JP
- CONCLUSIONS: Potential causes for intracardiac thrombosis in this patient include ventricular dysfunction due to acute adrenal crisis or electrolyte disturbance, and hypercoagulability due to the APR. Echocardiography should be considered in children with acute cardiovascular compromise following zoledronate. Stress-dose steroids to cover the APR and a reduced starting dose of zoledronate might have reduced the risk of this complication.
- Publisher Full Text (DOI)
- Pheochromocytoma Multisystem Crisis Complicated by Severe Acute Pancreatitis. [Journal Article]Intern Med. 2022 Nov 23 [Online ahead of print]IM
- A 43-year-old man developed headache, dizziness, abdominal pain, and vomiting. His blood pressure was 203/121 mmHg, heart rate 122 beats/min, body temperature 39.1 °C, and respiratory rate 24/min. He had elevated levels of creatinine at 2.95 mg/dL and lipase at 1,364 U/L as well as an extremely low calcium level at 5.2 mg/dL. Hypertriglyceridemia and hyperglycemia were seen. Chest and abdominal c…
- Publisher Full Text (DOI)
- Retroperitoneal paraganglioma in a young patient presenting with hypertensive crisis and transient loss of sight; a rare case report and literature review. [Case Reports]
- CONCLUSIONS: Tumor localisation and adequate patient preparation with alpha blockers and adequate hydration is an important prerequisite to surgical resection.
- PMC Free PDF
- Approach to the Patient with Adrenal Hemorrhage. [Journal Article]J Clin Endocrinol Metab. 2022 Nov 21 [Online ahead of print]JC
- Adrenal hemorrhage is an uncommon underrecognized condition that can be encountered in several clinical contexts. Diagnosing adrenal hemorrhage is challenging due to the non-specific clinical features. Therefore, it remains a diagnosis that is made serendipitously on imaging of acutely unwell patients rather than with prospective clinical suspicion. Adrenal hemorrhage can follow abdominal trauma …
- Publisher Full Text (DOI)
- The management of congenital adrenal hyperplasia during preconception, pregnancy, and postpartum. [Review]
- Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders of steroidogenesis of the adrenal cortex, most commonly due to 21-hydroxylase deficiency caused by mutations in the CYP21A2 gene. Although women with CAH have decreased fecundity, they are able to conceive; thus, if pregnancy is not desired, contraception options should be offered. If fertility is desired, women with…
- PMC Free PDF
- Successful diagnosis and treatment of pheochromocytoma during severe coronavirus disease 2019 (COVID-19): a case report. [Journal Article]Endocr J. 2022 Nov 15 [Online ahead of print]EJ
- Pheochromocytoma is a rare but life-threatening condition due to catecholamine release induced by drug treatments such as β-blockers or glucocorticoids. We present a case of hypertensive crisis due to pheochromocytoma, induced after the initiation of dexamethasone and landiolol during intensive care for severe coronavirus disease 2019 (COVID-19). Based on a detailed medical history review, the pa…
- Publisher Full Text (DOI)
- An Unexpected Death Due to a Subclinical Pheochromocytoma After an Induced Abortion. [Case Reports]Am J Forensic Med Pathol. 2022 Dec 01; 43(4):376-379.AJ
- Deaths due to hypertensive crisis can be unexplained because of the impossibility to identify-before the decease-the specific cause of the crisis. In these cases, autopsy and microscopic examinations are needed. It can happen that the request to conduct these examinations can be submitted to forensic pathologists by prosecutors to ascertain medical malpractice claims. Indeed, we report the case o…
- Publisher Full Text (DOI)