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Adult Height Following Prepubertal Treatment With Antiandrogen, Aromatase Inhibitor, and Reduced Hydrocortisone in CAH.
J Clin Endocrinol Metab
December 2024
Department of Pediatrics, National Institutes of Health Clinical Center, Bethesda, MD 20892, USA.
Context: Height outcome in patients with classic congenital adrenal hyperplasia (CAH) is suboptimal due to glucocorticoid and androgen excess.
Methods: In an open, randomized, controlled trial, children with classic CAH were randomized to receive a combination regimen of antiandrogen, aromatase inhibitor, reduced hydrocortisone, and fludrocortisone prior to puberty or standard therapy (hydrocortisone, fludrocortisone). Females continued on antiandrogen during puberty.
Adrenocortical insufficiency after bilateral adrenal hemorrhage due to anticoagulation and chronic immunothrombocytopenia.
Endocrinol Diabetes Metab Case Rep
October 2024
Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland.
Article Synopsis
- - Adrenocortical insufficiency is a serious condition caused by a lack of glucocorticoids and/or mineralocorticoids from the adrenal cortex, leading to life-threatening adrenal crises, requiring immediate hydrocortisone treatment.
- - Symptoms like low blood pressure, weight loss, and fatigue are often vague, causing delays in diagnosis; the case study involves a 43-year-old woman who experienced adrenal insufficiency due to bleeding in her adrenal glands while also having immune thrombocytopenia (ITP).
- - Proper diagnosis is crucial, especially in patients with bleeding risk factors, and treatment typically starts with high doses of hydrocortisone and possibly fludrocortisone, which can later be adjusted as
Fludrocortisone with hydrocortisone in sepsis: new evidence in an ongoing debate.
Intensive Care Med
December 2024
Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK.
Primary adrenal insufficiency: case study IN 5 tertiary hospitals.
An Pediatr (Engl Ed)
November 2024
Hospital Universitario Miguel Servet, Zaragoza, Spain.
Article Synopsis
- Primary adrenal insufficiency (PAI) is a rare condition in children marked by low production of important hormones, leading to nonspecific symptoms that can make early diagnosis challenging but crucial for effective management.
- A study was conducted with 29 patients diagnosed with PAI at an average age of 5.6 years, revealing various underlying causes, including genetic conditions and autoimmune issues, with many patients experiencing an adrenal crisis at onset.
- Common signs of PAI include asthenia, hyperpigmentation, and hyponatraemia, but even in their absence, the possibility of PAI should still be considered, particularly as ACTH levels remain high despite treatment.
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