Case Rep Med
Department of Endocrinology and Metabolism, Trabzon Numune Education and Research Hospital, 61000 Trabzon, Turkey.
Published: August 2012
A 51-year-old man developed anorexia, dizziness, nausea, vomiting, and weight loss. He had orthostatic hypotension, hyponatremia, hyperkalemia, and hypocortisolemia, and the diagnosis of adrenal insufficiency was made. Magnetic resonance imaging (MRI) showed asymmetrically enlarged adrenal glands. Biopsy of a hypoechoic, enlarged, inguinal lymph node showed caseating granulomas. Lumbar MRI showed vertebral body height loss and abnormal signal in L1 and L2; vertebral biopsy showed chronic, necrotic, caseating granulomatous inflammation consistent with tuberculous osteomyelitis. Clinical improvement occurred with isoniazid, rifampicin, pyrazinamide, and corticosteroids. The differential diagnosis of adrenal insufficiency should include tuberculosis, especially in geographic regions where tuberculosis is endemic.
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http://dx.doi.org/10.1155/2012/574845 | DOI Listing |
Cureus
December 2024
Internal Medicine, Max Smart Super Speciality Hospital, New Delhi, IND.
In this case, the message is conveyed that after ruling out sinister causes of hypotension, endocrine causes should also be considered, particularly in the light of a relatively long history, absence of any sepsis and organ dysfunction, preserved urine output, euvolemic status, and with no significant response to intravenous fluid. In our case, a patient with hypotension with relatively stable other clinical parameters has been evaluated to reveal pituitary macroadenoma as an underlying diagnosis.
View Article and Find Full Text PDFRev Med Liege
January 2025
Service d'Endocrinologie, CHU Liège, Belgique.
In 1849, Thomas Addison discovered alterations in the adrenal glands at autopsy of three patients who had died with idiopathic anemia. Struck by Addison's work, Charles-Edouard Brown-Séquard demonstrated in 1851 that bilateral adrenalectomy in dogs was fatal. It was not until 1950 that the discovery of the hormones of the adrenal cortex, their structure and their biological effects allowed Kendall, Reichstein and Hench to win the Nobel Prize in Physiology or Medicine.
View Article and Find Full Text PDFPatient Prefer Adherence
January 2025
Respiratory Research@Alfred, Monash University, Melbourne, VIC, Australia.
Purpose: Oral corticosteroids (OCS) are an effective treatment for severe uncontrolled asthma or asthma exacerbations, but frequent bursts or long-term use carry serious and sometimes irreversible adverse effects, or complications such as adrenal insufficiency upon discontinuation. Our aim was to survey people with asthma on their experiences of, and attitudes towards, using OCS.
Patients And Methods: This study was a national descriptive cross-sectional survey of people with asthma in Australia.
This article provides an overview of treatment approaches for chronic kidney disease (CKD) in patients with IgA nephropathy (IgAN). IgAN is the most common primary glomerulonephritis and results from an autoimmune reaction to aberrantly glycosylated immunoglobulin A (IgA) antibodies. Although historically considered largely benign, it is now recognized that a significant percentage of patients develop dialysis-dependent kidney disease over the years.
View Article and Find Full Text PDFBMJ Open
December 2024
Clinical Medicine, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK
Introduction: Cortisol is an essential stress hormone and failure of its production, known as adrenal insufficiency (AI), is associated with significant mortality due to adrenal crisis. The Short Synacthen Test (SST) is the current diagnostic test of choice for AI, but it is both invasive and resource intensive. Globally, there is an unmet need for a non-invasive, cost-effective test.
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