scholarly journals Progesterone Receptor Antagonists – A Novel Treatment for Severe Hyponatremia from the Endocrine Paraneoplastic Syndrome

2021 ◽  
Vol 3 (2) ◽  
pp. 40
Author(s):  
Jerome H. Check ◽  
Diane L. Check ◽  
Michael P. Dougherty
Keyword(s):  
Lung Cancer ◽  
Progesterone Receptor ◽  
Paraneoplastic Syndrome ◽  
Receptor Modulator ◽  
Novel Treatment ◽  
Ectopic Secretion ◽  
200Mg Tablet ◽  
Life Threatening ◽  
Length Of Life ◽  
The Ideal

Hyponatremia related to ectopic secretion of cancer cells of argininevasopressin (AVP) or atrial natriuretic peptide (ANP) is most commonlycaused by small cell lung cancer. The ideal treatment would be one thatnot only corrects the hyponatremia, especially if it is life threatening, butat the same time causes regression of the cancer, and thus improves bothquality and length of life. As one is waiting for chemotherapy, surgery,or radiotherapy to decrease the cancer burden, tolvaptan has been usedto correct the hyponatremia to improve symptoms or prevent death.Mifepristone, a progesterone receptor modulator/antagonist has been usedto treat various cancers. The oral 200mg tablet was given to an 80-year-oldwoman who developed sudden extensive lung cancer with a serum sodiumof 118 mmol/L. She refused chemotherapy but agreed to take mifepristone.The hyponatremia was completely corrected (145 mmol/L) within onemonth of treatment. She was in complete remission for 5 years and diednot from lung cancer, but an acute myocardial infarction. Mifepristonemay serve the purpose to not only quickly correct hyponatremia when itis related to an endocrine paraneoplastic syndrome, but also to provideimproved quality and length of life.

scholarly journals Case report: Schizophrenia and hypertrophic osteoarthropathy, a rare syndrome hiding a life-threatening condition

2021 ◽  
Author(s):  
emna Baklouti ◽  
Mehdi Karoui ◽  
rania kammoun ◽  
Faten Ellouze
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Paraneoplastic Syndrome ◽  
Hypertrophic Osteoarthropathy ◽  
Rare Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Somatic Disorders ◽  
Cardio Vascular

Schizophrenia is associated to somatic disorders especially cardio-vascular and auto-immune. Through this case report, we describe an association with hypertrophic osteoarthropathy (HPO). For this patient it was a paraneoplastic paraneoplastic syndrome secondary to lung cancer. This syndrome is rare but important to recognize since it could hide a life-threatening condition.

scholarly journals Brain reactivity during aggressive response in women with premenstrual dysphoric disorder treated with a selective progesterone receptor modulator

2021 ◽  
Author(s):  
Elisavet Kaltsouni ◽  
Patrick M. Fisher ◽  
Manon Dubol ◽  
Steinar Hustad ◽  
Rupert Lanzenberger ◽  
...  
Keyword(s):  
Progesterone Receptor ◽  
Negative Relationship ◽  
Premenstrual Dysphoric Disorder ◽  
Aggressive Response ◽  
Anterior Cingulate ◽  
Reproductive Age ◽  
Gonadal Hormone ◽  
Dorsal Anterior Cingulate Cortex ◽  
Response Condition ◽  
Receptor Modulator

AbstractPremenstrual dysphoric disorder (PMDD) is a psychiatric condition characterized by late luteal phase affective, cognitive, and physical impairment. The disorder causes significant suffering in about 5% of women in their reproductive age. Altered sensitivity of cognitive-affective brain circuits to progesterone and its downstream metabolite allopregnanolone is suggested to underlie PMDD symptomatology. Core mood symptoms include irritability and anger, with aggression being the behavioral outcome of these symptoms. The present study sought to investigate the neural correlates of reactive aggression during the premenstrual phase in women with PMDD, randomized to a selective progesterone receptor modulator (SPRM) or placebo. Self-reports on the Daily Record of Severity of Problems were used to assess PMDD symptoms and gonadal hormone levels were measured by liquid chromatography tandem mass spectrometry. Functional magnetic resonance imaging was performed in 30 women with PMDD, while performing the point subtraction aggression paradigm. Overall, a high SPRM treatment response rate was attained (93%), in comparison with placebo (53.3%). Women with PMDD randomized to SPRM treatment had enhanced brain reactivity in the dorsal anterior cingulate cortex and dorsomedial prefrontal cortex during the aggressive response condition. The fronto-cingulate reactivity during aggressive responses depended on treatment, with a negative relationship between brain reactivity and task-related aggressiveness found in the placebo but not the SPRM group. The findings contribute to define the role of progesterone in PMDD symptomatology, suggesting a beneficial effect of progesterone receptor antagonism, and consequent anovulation, on top-down emotion regulation, i.e., greater fronto-cingulate activity in response to provocation stimuli.

scholarly journals Effects of the Progesterone Receptor Modulator VA2914 in a Continuous Low Dose on the Hypothalamic-Pituitary-Ovarian Axis and Endometrium in Normal Women: A Prospective, Randomized, Placebo-Controlled Trial

2007 ◽  
Vol 92 (9) ◽  
pp. 3582-3589 ◽  
Author(s):  
Nathalie Chabbert-Buffet ◽  
Axelle Pintiaux-Kairis ◽  
Philippe Bouchard
Keyword(s):  
Progesterone Receptor ◽  
Endometrial Hyperplasia ◽  
Low Dose ◽  
Ethinyl Estradiol ◽  
Controlled Trial ◽  
Endometrial Biopsy ◽  
Receptor Modulator ◽  
Phase Range ◽  
Normal Women ◽  
Estradiol Levels

Abstract Context: Progestin-only pills, the main hormonal alternative to ethinyl estradiol-containing pills in women bearing vascular risk factors, are poorly tolerated due to irregular bleeding. In contrast, progesterone receptor modulators can inhibit ovulation, alter endometrial receptivity, and improve cycle control. Objective: We evaluated the effects of a new progesterone receptor modulator, VA2914, administered continuously for 3 months, on ovulation and endometrial maturation. Design, Settings, and Patients: Forty-six normal women were included in a prospective, placebo-controlled, randomized trial, conducted in four referral centers. Intervention: VA2914 (2.5, 5, or 10 mg/d) was administered continuously for 84 d. Pelvic ultrasound (treatment d 67 and 77), hormonal monitoring (FSH, LH, estradiol, and progesterone on treatment d 59, 63, 67, 70, 74, 77, 80, and 84), and endometrial biopsy (treatment d 77) were performed. Main Outcome Measure: Ovulation inhibition was assessed by the absence of progesterone values above 3 ng/ml at any time during treatment month 3. Results: Anovulation was observed in 81.8% women in the 5-mg group and 80% in the 10-mg group, and amenorrhea occurred in 81.2 and 90% of cases in the 5- and 10-mg groups. We did not detect any cases of endometrial hyperplasia despite estradiol levels that remained in the physiological follicular phase range throughout treatment cycle 3. Conclusions: Continuous low-dose VA2914 can induce amenorrhea and inhibit ovulation without down-regulating estradiol levels or inducing endometrial hyperplasia in normal women. Long-term studies with a larger population are required to confirm the contraceptive efficacy of this regimen.

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