High Adrenocorticotropic Hormone before and after bilateral adrenal surgery

2018 ◽  
Author(s):  
Ana Valea ◽  
Roxana Turturea ◽  
Oana Botezan ◽  
Mara Carsote ◽  
Bogdan Mircea Botezan ◽  
...  
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Adrenal Surgery ◽  
Before And After

Postdexamethason intact and multisequentia ACTH in melancholia

1991 ◽  
Vol 3 (1) ◽  
pp. 8-13
Author(s):  
M. Maes ◽  
C. Vandervorst ◽  
E. Suy ◽  
M. Martin ◽  
B. Minner ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Plasma Levels ◽  
Clinical Relevance ◽  
Plasma Cortisol ◽  
Adrenocorticotropic Hormone ◽  
Severity Of Illness ◽  
Dexamethasone Suppression Test ◽  
Before And After ◽  
Suppression Test ◽  
Dexamethasone Suppression

SummaryThe dexamethasone suppression test has been carried out in 111 depressed inpatients. Fasting, 8 a.m. plasma levels of Cortisol and adrenocorticotropic hormone (ACTH) were determined before and after administration of 1 mg dexamethasone. In 64 subjects multisequential (1-17,1-24,1-39) ACTH, and in 47 subjects intact (1-39) ACTH has been determined. Patients with melancholia exhibited significantly higher postdexamethasone Cortisol and intact ACTH values as compared with minor and simple major depressives. Severity of illness was significantly and positively related to postdexamethasone intact ACTH - but not to multisequential ACTH. Cortisol nonsuppressors showed higher postdexamethasone (only intact) ACTH values than Cortisol suppressors. Both postdexamethasone ACTH values were significantly and positively related with the postdexamethasone Cortisol values. We have established that Cortisol nonsuppression during melancholia is determined by an augmented escape of ACTH from suppression by dexamethasone. Intact ACTH showed the most significant clinical relevance for depression and Cortisol nonsuppression. In the clinical practice we advize the use of postdexamethasone intact ACTH in stead of plasma Cortisol or multisequential ACTH.

ACTH and cortisol responses to hypotension in fetal sheep after a prior CRF injection

1992 ◽  
Vol 262 (3) ◽  
pp. E325-E329
Author(s):  
D. R. Kerr ◽  
M. I. Castro ◽  
N. K. Valego ◽  
N. M. Rawashdeh ◽  
J. C. Rose
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Plasma Acth ◽  
Fetal Sheep ◽  
Feedback Effects ◽  
Maximal Stimulation ◽  
Endogenous Cortisol ◽  
Before And After ◽  
Cortisol Responses ◽  
Releasing Factors ◽  
Stimulation Of

To determine whether an ovine corticotropin-releasing factor (oCRF) injection modifies adrenocorticotropic hormone (ACTH) and cortisol responses to hypotension and whether the effect of any interactions between these stimuli changes across gestation, we studied chronically cannulated fetal lambs of 103-113 ("immature") and 133-139 days gestation ("mature"). Experimental groups received 500 ng/kg oCRF injections and 6 h later had arterial pressure reduced 20% for 10 min with nitroprusside. Blood samples were obtained before and after each manipulation. Controls received vehicle instead of oCRF. The oCRF increased plasma cortisol levels from 2.1 +/- 0.4 to 14.2 +/- 4.7 (SE) ng/ml in immature and 44.9 +/- 2.2 to 102.8 +/- 15 ng/ml in mature animals. In mature fetuses the oCRF did not alter plasma ACTH and cortisol increases due to hypotension. In immature animals ACTH increases were normal but cortisol increases were eliminated. This suggests that the CRF caused maximal stimulation of the adrenal gland. In older fetuses, it appears that the action of ACTH-releasing factors, secreted in response to arterial hypotension, can overcome the negative feedback effects of elevations in endogenous cortisol.

scholarly journals Plasma profiles of adrenocorticotropic hormone, cortisol, α-melanocyte-stimulating hormone, and growth hormone in dogs with pituitary-dependent hyperadrenocorticism before and after hypophysectomy

2006 ◽  
Vol 190 (3) ◽  
pp. 601-609 ◽  
Author(s):  
J M Hanson ◽  
H S Kooistra ◽  
J A Mol ◽  
E Teske ◽  
B P Meij
Keyword(s):  
Plasma Cortisol ◽  
Adrenocorticotropic Hormone ◽  
Plasma Concentrations ◽  
Pulse Frequency ◽  
Cortisol Concentration ◽  
Melanocyte Stimulating Hormone ◽  
Plasma Cortisol Concentration ◽  
Before And After ◽  
Basal Plasma ◽  
Stimulating Hormone

The 6-h plasma profiles of adrenocorticotropic hormone (ACTH), cortisol, α-melanocyte-stimulating hormone (α-MSH), and GH were studied in 17 dogs with pituitary-dependent hyperadrenocorticism (PDH) before and after hypophysectomy. The aim of the study was to investigate the relation between the hormone profile characteristics and recurrence of PDH after surgery. The hormones were secreted in a pulsatile fashion. The basal plasma cortisol concentration and area under the curve (AUC) for cortisol were significantly higher in the PDH cases than in eight controls. The characteristics of the plasma profiles of ACTH and α-MSH were not significantly different between the PDH cases and the controls. In the PDH cases, less GH was secreted in pulses than in the controls, but the difference was not significant. The basal plasma cortisol concentration, the AUC for ACTH and cortisol, and the pulse frequency of ACTH and cortisol decreased significantly after hypophysectomy for the group of PDH cases. The basal plasma concentrations of ACTH and α-MSH, the AUC for α-MSH, and the characteristics of the plasma GH profiles of the PDH cases remained unchanged after hypophysectomy. No pulses of α-MSH were observed after hypophysectomy. The co-occurrence between the ACTH and cortisol pulses decreased significantly with hypophysectomy. The postoperative pulse frequency of ACTH was the only characteristic with predictive value for the recurrence of PDH after hypophysectomy. The results of this study demonstrate that ACTH, cortisol, α-MSH, and GH are secreted in a pulsatile fashion in dogs with PDH. Hypophysectomy effectively reduces the secretion of ACTH and cortisol. The presence of ACTH pulses after hypophysectomy is a risk factor for the recurrence of hyperadrenocorticism.

Single-Epileptic Spasms with or without Hypsarrhythmia: A Study of 16 Patients

2017 ◽  
Vol 06 (03) ◽  
pp. 149-155
Author(s):  
Raffaele Falsaperla ◽  
Robinson Gutierrez ◽  
Gabriela Valenzuela ◽  
Piero Pavone ◽  
Sebastian Fortini ◽  
...  
Keyword(s):  
Antiepileptic Drugs ◽  
Ketogenic Diet ◽  
Adrenocorticotropic Hormone ◽  
Main Type ◽  
Epileptic Encephalopathy ◽  
Unknown Etiology ◽  
Epileptic Spasms ◽  
Before And After ◽  
Eeg Recordings ◽  
Electroencephalogram Eeg

Objective We evaluated the electroclinical features, etiology, treatment, and outcome of 16 patients with single-epileptic spasms (ESs) with or without hypsarrhythmia (WoH). Methods Nine boys and seven girls had single-ESs. ESs were considered as single epileptic spasm variants when no other spasm occurred for 1 minute before and after each spasm. Age at the onset of ESs was between 2 and 84 months, with a mean age of 11 months. Results We recognized a group of 15 patients with single-ESs as the main type of seizure; 6 patients with WoH and 9 patients with hypsarrhythmia, respectively. Nine of these 15 patients had other types of seizures before the onset of single-ESs, and 12 patients had other types of seizures during the period in which the ESs occurred. Nine of 15 patients had a structural and seven had an unknown etiology. In 10 cases, the ESs were refractory to antiepileptic drugs, while 4 patients responded well to adrenocorticotropic hormone (ACTH), 1 to pyridoxine, and 2 to the ketogenic diet (KD). The remaining patient (patient.16) had single-ESs and electroclinical features of Lennox–Gastaut syndrome (LGS). Conclusion In this article, we present a series of infants who had daily single-ESs with or WoH. Those with single-ESs with hypsarrhythmia evolved to an epileptic encephalopathy. Video-electroencephalogram (EEG) and polygraphic-EEG recordings are crucial to identify the single-ESs.

Plasma dehydroepiandrosterone sulfate levels in patients with hyperfunctioning and non-hyperfunctioning adrenal tumors before and after adrenal surgery

1997 ◽  
Vol 136 (3) ◽  
pp. 290-295 ◽  
Author(s):  
Miklós Tóth ◽  
Károly Rácz ◽  
Ibolya Varga ◽  
Vilmos Adleff ◽  
Csilla Jakab ◽  
...  
Keyword(s):  
Normal Subjects ◽  
Dehydroepiandrosterone Sulfate ◽  
High Plasma ◽  
Adrenal Tumors ◽  
Adrenal Surgery ◽  
Adrenocortical Tumors ◽  
Adrenocortical Adenomas ◽  
Before And After ◽  
Adrenocortical Carcinomas ◽  
Glucocorticoid Production

Abstract To investigate the clinical significance of plasma dehydroepiandrosterone sulfate (DHEAS) measurements, 175 patients with histologically confirmed adrenal tumors, 10 cortisol-producing adenomas, 59 aldosterone-producing adenomas, 56 non-hyperfunctioning adenomas, 13 adrenocortical carcinomas, 13 adrenal cysts, and 24 adrenomedullary tumors were studied. Plasma DHEAS levels were expressed as percentage of the mean of sex- and age-matched groups of healthy, normal subjects (DHEAS %). We found that before adrenal surgery, DHEAS % values were significantly reduced in patients with cortisol-producing (mean, 15·2% of control; 95% confidence interval (CI), 9·4–24·7%), non-hyperfunctioning (28·4%; 22·4–36·0% as well as aldosterone-producing adrenocortical adenomas (55·4%; 47·1–65·1%) compared with controls, while values were normal in patients with adrenal cysts and in those with adrenomedullary tumors. Plasma DHEAS % values exhibited a great variability in adrenocortical carcinomas (mean, 84·0%; 95% CI, 33·2–212·5%). Death from adrenocortical carcinoma was more frequent in patients with high plasma DHEAS % values compared with those with low DHEAS %. During long-term postoperative monitoring, we found that plasma DHEAS levels of patients with aldosterone-producing and non-hyperfunctioning adenomas returned to normal in the second and fourth postoperative year respectively. In patients with cortisol-producing adenomas, plasma DHEAS remained suppressed for as long as 8 years after the operation. These findings show that except in adrenocortical carcinomas and cysts, plasma DHEAS levels are significantly decreased in all groups of adrenocortical tumors, including non-hyperfunctioning and aldosteroneproducing tumors. The extent of this decrease and the postoperative persistence of suppressed plasma DHEAS levels may be related to the glucocorticoid production of adrenocortical tumors. European Journal of Endocrinology 136 290–295

scholarly journals Effect of Adrenocorticotropic Hormone Stimulation During Simultaneous Bilateral Adrenal Vein Sampling in Primary Aldosteronism

2021 ◽  
Vol 53 (06) ◽  
pp. 364-370
Author(s):  
Wei Liu ◽  
Jingjing Zhang ◽  
Yaling Yang ◽  
Yinxin Jin ◽  
Zaizhao Li ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Adrenocorticotropic Hormone ◽  
Base Excess ◽  
Serum Potassium Level ◽  
Adrenal Vein ◽  
Acth Stimulation ◽  
Adrenal Vein Sampling ◽  
Before And After ◽  
Carbon Dioxide Combining Power ◽  
Lateralization Index

AbstractThe aim of the study was to investigate the significance and influence of adrenocorticotropic hormone (ACTH) stimulation in primary aldosteronism (PA) patients with simultaneous bilateral adrenal vein sampling (AVS). All patients diagnosed with PA underwent simultaneous bilateral AVS with ACTH. In 95 patients, the post-ACTH SI significantly increased (p<0.001), and it gradually decreased from t10–t30 after ACTH stimulation (p<0.001). The unsuccessful catheterization decreased after ACTH stimulation. Time points within 20 min after ACTH stimulation were better for sampling, and the selectivity did not increase over longer periods. According to lateralization before and after ACTH stimulation, the patients could be divided into 3 groups (U, unilateral; B, bilateral): U/U , U/B or B/U, and B/B. Compared with the U/U group, in the U/B or B/U and B/B groups, the lateralization index (LI) was lower both at baseline and after ACTH stimulation (p<0.0001), the contralateral index (CLI) was higher after ACTH stimulation (p<0.003), the serum potassium level was higher (p<0.001), and the carbon dioxide combining power (CO2CP) and base excess (BE) levels were lower. In conclusion, in simultaneous bilateral AVS, ACTH stimulation had significant effects on increasing the catheterization selectivity. Lateralization change was observed after stimulation. After ACTH stimulation, fewer patients could be diagnosed with lateralized PA. Patients with consistent lateralized PA showed a more serious phenotype.

scholarly journals Decreased abundance of Akkermansia after adrenocorticotropic hormone therapy in patients with West syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lu Xu ◽  
Dandan Chen ◽  
Congying Zhao ◽  
Lihua Jiang ◽  
Shanshan Mao ◽  
...  
Keyword(s):  
Relative Abundance ◽  
Adrenocorticotropic Hormone ◽  
Illumina Miseq ◽  
Epileptic Encephalopathy ◽  
Shannon Index ◽  
West Syndrome ◽  
Healthy Infants ◽  
Blood Cytokines ◽  
Before And After ◽  
Acth Therapy

Abstract Background Infants suffer from a severe epileptic encephalopathy known as West syndrome (WS). Treatment with adrenocorticotropic hormone (ACTH) indicates the involvement of the gut-brain axis in WS. Several pieces of evidence show the communication of the gut microbiota (GM) with the brain via the hypothalamic–pituitary–adrenal axis (HPA axis) and blood cytokines. This study aimed at (1) determining the GM diversity in infants having WS and (2) comparing the results of infants having WS with those of the healthy infants and also in the patients with WS before and after the ACTH therapy. Results In this study, 29 infants with WS and 29 healthy infants aged 3–13 months were recruited. Fecal samples were collected, and DNA was extracted and sequenced on the Illumina MiSeq platform. Kruskal-Wallis rank-sum test was used to analyze the between-group differences in the Chao1 index, Shannon index, and the abundances of GM at different taxonomy levels. R software was used to plot the graphs. The top five dominant GM genera between patients with WS and healthy infants showed no significant differences. However, the relative abundance of genus Akkermansia was observed to be significantly (P = 0.011) higher in the BT group than in the HC group and AT group. After 2 weeks of ACTH therapy, the relative abundance of Akkermansia significantly (P = 0.003) decreased. Conclusion The relative abundance of Akkermansia was observed to be significantly higher in patients with WS than that in healthy infants. However, the relationship between Akkermansia and WS pathogenesis needs to be clarified in further studies.

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