Diagnosis of secondary hypoadrenalism

1996 ◽  
Vol 45 (1) ◽  
pp. 122-123
Author(s):  
Max Rieu ◽  
Philippe Chanson
Keyword(s):  
Secondary Hypoadrenalism

Corticotrophic Hormone in the Treatment of Involutional Melancholia with Hypopituitarism and Pituitary Cachexia

1942 ◽  
Vol 88 (373) ◽  
pp. 559-565 ◽  
Author(s):  
R. E. Hemphill ◽  
Max Reiss
Keyword(s):  
Young Women ◽  
Clinical Applications ◽  
The Past ◽  
Involutional Melancholia ◽  
Secondary Hypoadrenalism

During the past three years some clinical applications of corticotrophic hormone have been studied, and in this paper is described a form of involutional melancholia in which hypopituitarism and secondary hypoadrenalism are factors. Nine such cases were treated with corticotrophic hormone; in addition two cases of pituitary cachexia in young women were similarly treated.

Endocrine disorders with craniopharyngioma in adults before and after surgery

2016 ◽  
Vol 62 (5) ◽  
pp. 61-62 ◽  
Author(s):  
Irina S. Klochkova ◽  
Lyudmila I. Astafieva ◽  
Alexsander N. Konovalov ◽  
Pavel L. Kalinin ◽  
Maksim A. Kutin ◽  
...  
Keyword(s):  
Endocrine Function ◽  
Pituitary Stalk ◽  
Hormone Deficiency ◽  
Endocrine Disorders ◽  
Free T4 ◽  
Group 4 ◽  
Before And After ◽  
Group 2 ◽  
Secondary Hypoadrenalism ◽  
Secondary Hypogonadism

Background. Craniopharyngiomas (CF) - a benign tumor of the embryologic origin. The surgical method of treatment is basic.Aim: to estimate dynamics of endocrine disorders before and after surgical treatment of CF at different topographical variations.Methods.The research involved 42 patients older than 18 years (25 women and 17 men) with a mean age - 41 [21; 69] with a verified diagnosis of CF. All patients were operated in 28 cases – total resection, in 7 - the pituitary stalk was saved. Before and 6 months after the surgery all patients were examined by means of hormonal blood tests (TSH, free T4, cortisol, prolactin, LH , FSH, estradiol, testosterone, IGF-1). By tumor localizing patients were divided into 4 groups: 1 – intra-suprasellar (2) 2 – at location of the pituitary stalk (15), 3 – combined «the pituitary stalk» and ventricular (10), 4 –intra-ventricular (15).Results. In group 1: panhypopituitarism -2 (100%), diabetes insipidus (DI) – 0. Both patients had subtotal ablation. After the surgery the nature of disturbance has not changed. In group 2: secondary hypoadrenalism - 9 (60%), hypothyroidism - 11 (73%), hypogonadism - 12 (80%), DI - 7 (46%), hyperprolactinemia - 9 (60%). After the surgery panhypopituitarism - 15 (100%), DI - 14 (93%), hyperprolactinemia - 4 (26 %). In group 3: secondary hypoadrenalism - 3 (30%), hypothyroidism - 6 (60%), hypogonadism - 6 (60%), DI - 2 (20%), hyperprolactinemia - 3 (30%). After the surgery panhypopituitarism - 10 (100%), DI - 10 (100%), hyperprolactinemia - 3 (30 %). In group 4: secondary hypoadrenalism - 6 (40%), hypothyroidism - 9 (60%), hypogonadism - 12 (80%), DI - 5 (33%), hyperprolactinemia - 8 (53%). After the surgery panhypopituitarism - 10 (71%), secondary hypoadrenalism - 12 (85%), hypothyroidism - 13 (92%), hypogonadism - 11 (79%), DI - 11 (78%), hyperprolactinemia - 8 (53%).Conclusion. The high incidence of endocrine disorders is caused by the localization of the CF with predominance of secondary hypogonadism and hypothyroidism. After the surgery worsening hormone deficiency was mentioned, also while preserving the pituitary stalk. Non-radical ablation of ventricular CF can partially maintain endocrine function.

scholarly journals A Nonfunctioning Pituitary Macroadenoma Presenting as Cyclical Vomiting and Severe Hyponatremia in a Young Female

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Dinuka S. Warapitiya ◽  
Dimuthu Muthukuda ◽  
W. A. H. P. Sanjeewa ◽  
Kushalee Poornima Jayawickreme ◽  
Shyama Subasinghe
Keyword(s):  
Case Report ◽  
Hypogonadotropic Hypogonadism ◽  
Serum Osmolality ◽  
Normal System ◽  
Pituitary Hormone ◽  
Pituitary Macroadenoma ◽  
Severe Hyponatremia ◽  
Optic Chiasma ◽  
Secondary Hypoadrenalism ◽  
Pituitary Macroadenomas

Introduction. Recurrent vomiting is a commonly overlooked debilitating symptom which causes significant impact on the quality of life. There are several causes for vomiting, ranging from commonly known causes to rare causes. Nonfunctioning pituitary macroadenomas generally present with visual disturbances, headache, and symptoms due to anterior pituitary hormone deficiencies. This case report is about an atypical presentation of a nonfunctioning pituitary macroadenoma in which the patient presented with cyclical vomiting with severe hyponatremia. Case Report. A 23-year-old girl presented with four to five episodes of vomiting per day for two days duration. She had a history of similar episodes of vomiting since 2016, with each episode generally lasting for 4-5 days and occurring in every four to six months. All episodes exhibited similar symptomatology and she was free of symptoms in-between. Generalized body weakness, postural dizziness, reduced appetite, and secondary amenorrhea were other symptoms she has had since 2016. Examination findings showed a low body mass index (BMI) (16 kg/m2) with normal system examination. Investigations showed severe hyponatremia (110 mmol/L) with hypokalemia (3.2 mmol/L) and hypochloremia (74 mmol/L). Her urinary excretion of potassium, sodium, and serum osmolality was low. Urine osmolality was mildly elevated compared to serum osmolality. Blood urea was normal. Severe hyponatremia with minimal hyponatremic symptoms was suggestive of chronic hyponatremia, which was accentuated by ongoing vomiting and possible reduced intake of salt. Further investigations showed evidence of secondary hypoadrenalism, central hypothyroidism, hypogonadotropic hypogonadism, and mild hyperprolactinemia. Magnetic resonance imaging (MRI) revealed a pituitary macroadenoma with mass effect on the optic chiasma. Hydrocortisone and levothyroxine were started, and she underwent transsphenoidal resection of the pituitary tumor. She recovered from cyclical vomiting. Conclusion. There can be multiple overlapping aetiologies for every observed symptom, sign, and abnormal investigation finding. Therefore, aetiological diagnosis is challenging, especially in the presence of an atypical clinical presentation. Cyclical vomiting and severe hyponatremia are atypical presentations of nonfunctioning pituitary macroadenomas.

CHARGE association and secondary hypoadrenalism

2002 ◽  
Vol 117A (2) ◽  
pp. 177-180 ◽  
Author(s):  
Paul A. James ◽  
Salim Aftimos ◽  
Paul Hofman
Keyword(s):  
Charge Association ◽  
Secondary Hypoadrenalism

STUDIES OF METYRAPONE RESPONSES IN PATIENTS WITH PITUITARY DISEASE

1969 ◽  
Vol 43 (3) ◽  
pp. 377-380
Author(s):  
P. CUSHMAN ◽  
J. G. HILTON
Keyword(s):  
Normal Subjects ◽  
Pituitary Insufficiency ◽  
Secondary Adrenal Insufficiency ◽  
Pituitary Tumours ◽  
Quantitative Criterion ◽  
Acth Stimulation ◽  
The Third ◽  
Group I ◽  
Secondary Hypoadrenalism ◽  
Acth Release

SUMMARY Intravenous 8 hr. metyrapone tests were performed in 12 patients with probable pituitary tumours. Plasma 17-hydroxycorticosteroids and substance S concentrations were measured, and the concentrations of 11-deoxycortisol present after 8 hr. of continuous metyrapone administration were employed as the quantitative criterion of responsiveness. Plasma 11-deoxycortisol, undetectable at the start, rose at 8 hr. to 10·1 ± 1·5 s.e. (range 6–14) μg./100 ml. in the 15 normal control subjects. Three patterns of pituitary adrenal function were seen in the patients. Group I (three cases) had secondary adrenal insufficiency. A second group (five cases) was normal by all tests. The third group of patients (four cases) had normal baseline plasma and urinary corticosteroids but was distinguished from the normal subjects by subnormal 11-deoxycortisol levels after metyrapone. Two subjects had also subnormal responses to corticotrophin (ACTH), indicating partial secondary hypoadrenalism. In the two others whose response to ACTH stimulation was normal, impairment of ACTH release would not have been suspected without the metyrapone test. It is in the detection of this type of patient with occult pituitary insufficiency that tests with metyrapone may be of great value.

Comparison of the overnight metyrapone and glucagon stimulation tests in the assessment of secondary hypoadrenalism

2013 ◽  
Vol 78 (5) ◽  
pp. 738-742 ◽  
Author(s):  
Jaimini Cegla ◽  
Ben Jones ◽  
Lata Seyani ◽  
Deborah Papadoulou ◽  
Katie Wynne ◽  
...  
Keyword(s):  
Stimulation Tests ◽  
Secondary Hypoadrenalism

Secondary hypoadrenalism presenting with hypercalcaemia

1994 ◽  
Vol 41 (2) ◽  
pp. 261-264 ◽  
Author(s):  
S. D. Vasikaran ◽  
G. A. Tallis ◽  
W. J. Braund
Keyword(s):  
Secondary Hypoadrenalism

Failure of the short ACTH test to unequivocally diagnose long-standing symptomatic secondary hypoadrenalism

1996 ◽  
Vol 44 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Steven G. Soule ◽  
Michael Fahie-Wilson ◽  
Sophie Tomlinson
Keyword(s):  
Acth Test ◽  
Secondary Hypoadrenalism

scholarly journals Hypercalcemia in an Euthyroid Patient with Secondary Hypoadrenalism and Diabetes Insipidus due to Hypothalamic Tumor.

1998 ◽  
Vol 45 (6) ◽  
pp. 773-778 ◽  
Author(s):  
MARI HOTTA ◽  
KANJI SATO ◽  
TAMOTSU SHIBASAKI ◽  
HIROSHI DEMURA
Keyword(s):  
Diabetes Insipidus ◽  
Euthyroid Patient ◽  
Secondary Hypoadrenalism

scholarly journals Addisonian Crisis Precipitated By Thyroxine Therapy In A Patient With Type 2 Autoimmune Polyglandular Syndrome

2014 ◽  
Vol 3 (4) ◽  
pp. 54-56
Author(s):  
Sunil Pokharel ◽  
A Shrestha ◽  
D Maksey ◽  
B Shrestha ◽  
P Paudel ◽  
...  
Keyword(s):  
Skin Pigmentation ◽  
Rare Condition ◽  
Addison’S Disease ◽  
Addison's Disease ◽  
Medical College ◽  
Thyroxine Therapy ◽  
Autoimmune Polyglandular Syndrome ◽  
Adrenocortical Failure ◽  
Secondary Hypoadrenalism

Primary hypoadrenalism(Addison’s disease) refers to glucocorticoid deficiency occurring in the setting of adre­nal disease(mostly due to autoimmune adrenalitis), whereas secondary hypoadrenalism arises because of deficiency of ACTH(mostly due to pituitary disease) . A major distinction between these two is that mineralocorticoid deficiency invari­ably accompanies primary hypoadrenalism, but this does not occur in secondary hypoadrenalism because only ACTH is de­ficient; the renin-angiotensin-aldosterone axis is intact and in primary hypoadrenalism skin pigmentation is always present due to increased ACTH secretion(unless of short duration) but it is absent in secondary hypoadrenalism. Addison’s disease or primary adrenocortical failure was first described by English physician Thomas Addison, who found it in six patients with adrenal tuberculosis in 1855(1). Addisonian crisis is a potentially fatal condition associated mainly with an acute defi­ciency of the glucocorticoid cortisol and, to a lesser extent, the mineralocorticoid aldosterone. This is a rare condition with an estimated incidence in the developed world of 0.8 cases per 100,000 and prevalence of 4 to 11 cases/100,000 population. Despite optimised life-saving glucocorticoid replacement and mineralocorticoid-replacement therapy, it is life threatening if overlooked(2-3). Hypothyroidism may mask the addison’s disease so in patients with panhypopituitarism and autoim­mune polyglandular syndrome type 2 thyroxine replacement without adequate steroid replacement may precipitate acute addisonian crisis. Journal of Chitwan Medical College 2013; 3(4); 54-56 DOI: http://dx.doi.org/10.3126/jcmc.v3i4.9557

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