... receiving long-term glucocorticoid treatment are at risk of developing adrenalinsufficiency during treatment. We investigated the prevalence of prednisolone-induced adrenalinsufficiency in the particular clinical situation where patients receive ongoing low ... generally low and anti-adrenal antibodies were negative indicating secondary adrenalinsufficiency as the most likely diagnosis.
Immune System Diseases (3) Adrenal Insufficiency (5), Rheumatoid Arthritis (3), more mentions
AbstractText: Low cortisol levels are associated with several functional pain syndromes. In patients with secondary adrenalinsufficiency (SAI), the lack in endogenous cortisol production is substituted by the administration of oral hydrocortisone (HC. Our previous study showed that a lower dose of HC led to an increase in reported subjective pain symptoms.
Pain Management (1) Adrenal Insufficiency (2), Neuralgia (1), more mentions
21-Hydroxylase deficiency presents with increased levels of cytochrome P450 21-hydroxylase substrates, progesterone and 17α-hydroxyprogesterone, which have been implicated in the production of androgens via the backdoor pathway. This study shows the biosynthesis of C11-oxy C21 steroids, 21-deoxycortisol and 21-deoxycortisone, and their metabolism by steroidogenic enzymes in the backdoor pathway yielding novel steroid metabolites: 5α-pregnan-11β,17α-diol-3,20-dione; 5α-pregnan-17α-ol-3,11,20-trione; 5α-pregnan-3α,11β,17α-triol-20-one and 5α-pregnan-3α,17α-diol-11,20-dione. The metabolism of 21-deoxycortisol was validated in LNCaP cells expressing the relevant steroidogenic enzymes showing for the first time that the steroid, produced at high levels in 21OHD, is metabolised via the C11-oxy derivatives of 5α-pregnan-17α-ol-3,20-dione and 5α-pregnan-3α,17α-diol-20-one to substrates for the lyase activity of CYP17A1, leading to the production of C11-oxy C19 steroids. 21-Deoxycortisol thus contributes to the pool of potent androgens in 21OHD, with novel steroid metabolites also presenting possible biomarkers in disease identification.
Abstract: Acute adrenalcrisis is a life-threatening medical emergency requiring immediate recognition and ... Among individuals with primary adrenalinsufficiency it has a frequency of 6-8 per 100 patient ... Unfortunately, delays in diagnosis and management of acute adrenalcrisis are commonplace - even in patients with documented steroid-dependency - constituting ... Keyword: adrenalcrisis.
PURPOSE: to assess bone damage and metabolic abnormalities in patients with Addison's disease given replacement doses of glucocorticoids and mineralocorticoids.
METHODS: A total of 87 patients and 81 age-matched and sex-matched healthy controls were studied. The following parameters were measured: urinary cortisol, serum calcium, phosphorus, creatinine, 24-h urinary calcium excretion, bone alkaline phosphatase, parathyroid hormone, serum CrossLaps, 25 hydroxyvitamin D, and 1,25 dihydroxyvitamin D. Clear vertebral images were obtained with dual-energy X-ray absorptiometry in 61 Addison's disease patients and 47 controls and assessed using Genant's classification.
RESULTS: Nineteen Addison's disease patients (31.1%) had at least one morphometric vertebral fracture, as opposed to six controls (12.8%, odds ratio 3.09, 95% confidence interval 1.12-8.52). There were no significant differences in bone mineral density parameters at any site between patients and controls. In Addison's disease patients, there was a positive correlation between urinary cortisol and urinary calcium excretion. Patients with fractures had a longer history of disease than those without fractures. Patients taking fludrocortisone had a higher bone mineral density than untreated patients at all sites except the lumbar spine.
CONCLUSIONS: Addison's disease patients have more fragile bones irrespective of any decrease in bone mineral density. Supra-physiological doses of glucocorticoids and longer-standing disease (with a consequently higher glucocorticoid intake) might be the main causes behind patients' increased bone fragility. Associated mineralocorticoid treatment seems to have a protective effect on bone mineral density.
Muscular and Skeletal Diseases (6) Addison Disease (6), Osteoporosis (1), more mentions
Abstract: Addison's disease is a rare autoimmune disorder leading to adrenalinsufficiency and life-long glucocorticoid dependency. Vitamin D receptor (VDR) polymorphisms and vitamin D deficiency predispose to Addison's disease. Aim of the current study was, to investigate potential anti-inflammatory vitamin D effects on monocytes in Addison's disease, focusing on inflammatory CCL-2 and IL6, as well on monocyte ...
Immune System Diseases (1) Addison Disease (6), Vitamin D Deficiency (1), Adrenal Insufficiency (1), more mentions
AbstractText: The appropriate cosyntropin dose during cosyntropin stimulation tests remains uncertain. We conducted a prospective, randomized pilot study to compare 1 μg IV low dose cosyntropin test, 25 μg IM medium dose cosyntropin test, and 250 μg IM standard dose cosyntropin test to evaluate secondary adrenalinsufficiency... Keyword: Secondary adrenalinsufficiency.
Hyponatremia can unmask hypopituitarism and secondary adrenalinsufficiency. This is important, since the need to screen for steroid deficiency, in patients with hyponatremia is often neglected.In a retrospective study, twenty-five patients (13f/12m, age 58.9 ± 18.6 years) with hyponatremia (119.7 ± 10.5 mmol/L) were identified among 260 in-patients treated for hypopituitarism in our specialized endocrine unit, over ...
Oncology (1) Hypopituitarism (15), Hyponatremia (14), Carcinoma (1), more mentions