Severe Hyperkalemia in a Child with Vomiting and Diarrhea.

Case Presentation: A 13-month-old child with past medical history of congenital adrenal insufficiency presented to the emergency department with vomiting and diarrhea. Initially the child was noticed to have bradycardia with normal blood pressure. An electrocardiogram (ECG) showed tall T waves, broad QRS complex, and widened PR interval suggestive of severe hyperkalemia.

Immune Checkpoint Inhibitor-Induced Primary Adrenal Insufficiency: A Case Report.

Introduction: One of the less common and more life-threatening etiologies of adrenal insufficiency is immune checkpoint inhibitor (ICI)-induced primary adrenal insufficiency (PAI). Patients typically present with fatigue, malaise, and nausea and are treated empirically with hydrocortisone.

Case Report: We present the case of a 59-year-old female who presented with hypotension, which initially was thought to be due to hypovolemia or medication-related, but was ultimately found to have PAI.

Altered lipid profile and reduced neuronal support in human induced pluripotent stem cell-derived astrocytes from adrenoleukodystrophy patients.

X-linked adrenoleukodystrophy (ALD) is a peroxisomal disorder resulting from pathogenic variants in the ABCD1 gene that primarily affects the nervous system and is characterized by progressive axonal degeneration in the spinal cord and peripheral nerves and leukodystrophy. Dysfunction of peroxisomal very long-chain fatty acid (VLCFA) degradation has been implicated in ALD pathology, but the impact on astrocytes, which critically support neuronal function, remains poorly understood. Fibroblasts from four ALD patients were reprogrammed to generate human-induced pluripotent stem cells (hiPSC).

Impact of psychological stress on ovarian function: Insights, mechanisms and intervention strategies (Review).

Mental stress may lead to ovarian dysfunction. Psychological stress disrupts ovarian function, leading to adverse fertilization outcomes, premature ovarian insufficiency and decreased ovarian reserve. Furthermore, psychological stress caused by decreased ovarian function and infertility can exacerbate the mental burden.

Challenging granulomatous differential diagnosis of CNS lesions in a 75-year-old patient with indolent lymphoma.

We report here on a patient with concomitant indolent lymphoma who showed a rapid progressive deterioration of his general condition and emerging neurological symptoms. The combination of severe B symptoms with hypermetabolic involvement of the adrenal glands and multiple central nervous system (CNS) lesions initially suggested a malignant disease. However, when the patient presented to us with biopsy results from one of the CNS lesions, the biopsy revealed granulomatous inflammation but no evidence of malignancy.

[LORENZO'S OIL AND ADRENOLEUKODYSTROPHY EXAMINING AN ARTIFICIAL INTELLIGENCE TOOL INTENDED FOR CONDUCTING LITERATURE SEARCHES AND ANALYSES].

Adrenoleukodystrophy is a genetic metabolic disorder characterized by a heterogeneous phenotype. Its severe form, known as cerebral adrenoleukodystrophy, involves unpredictable cerebral damage and progressive central nervous system deterioration. This rare condition became famous because of a Hollywood movie in which the Italian parents of a child with the condition supposedly discovered a medication for treating the condition.

The effects of adrenal insufficiency and its treatment on cognition in an athlete with post-concussion syndrome.

Post-concussion Syndrome (PCS) describes persistent nonspecific neurological, cognitive and emotional symptoms following concussion. A young male presented to a sports concussion clinic with persistent symptoms post-injury. Neurocognitive testing found unexpected severe memory impairment.

[Systemic lupus erythematosus involving the fornix column leading to hyponatremia: A case report].

We reported the diagnostic and therapeutic process of a young male patient with systemic lupus erythematosus (SLE) who presented with severe hyponatremia as the main manifestation upon admission, and analyzed and discussed the case. The patient was a 19-year-old young male with a subacute course of disease, fever ≥38.3 ℃ that could not be explained by other causes, acute and subacute cutaneous lupus erythematosus, oral ulcers, arthritis, leukopenia (< 4×10/L), low C3+low C4, and positive anti-double-stranded DNA (anti-dsDNA).

Endocrinologic Abnormalities Observed Among Total Joint Arthroplasty Patients Using "Artri King" and Related Over-the-Counter Supplements: A Cautionary Tale from a Safety Net Hospital.

: Artri King is an over-the-counter supplement previously marketed to treat joint pain and arthritis. In 2022, the Food and Drug Administration (FDA) issued a product warning after it discovered Artri King contained hidden ingredients including dexamethasone, diclofenac, and methocarbamol. Given the risk of adrenal insufficiency in the context of long-term dexamethasone use, we sought to report on adverse endocrinologic outcomes observed among patients endorsing the use of these supplements who presented to an orthopedic surgery clinic at a county safety net hospital.

Triglyceride-glucose index in patients with non-functioning adrenal incidentaloma, cortisol-secreting adrenal incidentaloma and healthy controls.

Objective: Cushing's syndrome increases the risk of cardiovascular disease. The triglyceride-glucose (TyG) index has been linked to an increased risk of cardiometabolic disorders. Whether patients with non-functioning adrenal incidentaloma (NFAI) or cortisol-secreting adrenal incidentaloma (CSAI) have altered TyG index is unknown.

Glucocorticoid replacement therapy after retroperitoneal laparoscopic unilateral adrenal adenoma resection in patients with non-cortisol secreting tumors: a retrospective cohort study.

Background: Adrenal Cushing's syndrome is caused by an adrenal tumor that produces hypercortisolism and requires glucocorticoid supplementation following resection of the tumour to prevent adrenal insufficiency. Few studies have examined whether glucocorticoid replacement (GR) therapy is required after retroperitoneal laparoscopic unilateral adrenal adenoma resection in patients with non-cortisol secreting tumors, or whether there is any correlation between preoperative biochemical indicators and postoperative cortisol function. This study sought to investigate which patients with non-cortisol secreting tumors required GR therapy after undergoing retroperitoneal laparoscopic resection of unilateral adrenal cortical adenoma.

Prognostic value of relative adrenal insufficiency in patients with severe alcohol-associated hepatitis-a prospective clinical study.

Background/aims: Relative adrenal insufficiency (RAI) is frequent in patients with liver cirrhosis and affects their prognosis. Scarce data on RAI in patients with alcohol-associated hepatitis (AAH) exists. This study aimed to document the prevalence and prognostic implication of RAI in patients with severe AAH.

Regulation of the blood-brain barrier function by peripheral cues in health and disease.

The blood-brain barrier (BBB) is formed by microvascular endothelial cells which are ensembled with pericytes, astrocytes, microglia and neurons in the neurovascular unit (NVU) that is crucial for neuronal function. Given that the NVU and the BBB are highly dynamic and regulated structures, their integrity is continuously challenged by intrinsic and extrinsic factors. Herein, factors from peripheral organs such as gonadal and adrenal hormones may influence vascular function also in CNS endothelial cells in a sex- and age-dependent manner.

Pulmonary thromboembolism-a rare presentation for Strongyloides hyperinfection in an immunocompetent patient.

is an intestinal nematode. It is widely distributed in the tropics and sub-tropics of the world. It can cause a wide array of illnesses ranging from asymptomatic autoinfection to a severe form of hyperinfection and disseminated strongyloidiasis.

The Use Of Prednisolone 2.5 mg Daily During Ramadan Fasting In Patients With Adrenal Insufficiency.

Background: A previous study had established the safety and preserved of quality of life in patients with adrenal insufficiency (AI) who received prednisolone 5 mg once daily at sahur (predawn) during Ramadan fasting. It has been postulated that a lower dose of prednisolone between 2 and 3 mg may be sufficient for glucocorticoid replacement in this group of patients. This study aimed to assess the safety and effect on quality of life in patients with AI given prednisolone 2.

Performance of dehydroepiandrosterone sulfate and baseline cortisol in assessing adrenal insufficiency.

Context: Diagnosing adrenal insufficiency (AI) often requires complex testing which can be time consuming and expensive. Dehydroepiandrosterone sulfate (DHEAS) is a promising marker of hypothalamic-pituitary-adrenal (HPA) axis function, however its diagnostic performance has not yet been evaluated in a large-scale study.

Objective: Evaluate the performance of DHEAS and baseline cortisol in assessing AI.

Extended-release hydrocortisone formulations - Is there a clinically meaningful benefit?

Despite best practice replacement therapy with corticosteroids, patients with adrenal insufficiency report diminished quality of life and face increased mortality and morbidity. Conventional formulations of hydrocortisone have short half-lives (about 90 minutes) requiring multiple dosing during the day. Extended-release hydrocortisone (ER-HC) formulations have since 2011 been available enabling once, sometimes twice daily dosing.

A Case of MIRAGE Syndrome with Mutation and Refractory Infantile Diarrhea: Endoscopic Biopsy Evaluation via Light and Electron Microscopy.

An infant with intrauterine growth restriction, suspected of having MIRAGE syndrome based on prenatal ultrasound, presented with genital ambiguity, adrenal insufficiency, intractable diarrhea from birth, and a pathogenic mutation (). Endoscopic biopsies of the duodenum revealed complex light and electron microscopic abnormalities. Hypoplastic villi without signs of enteritis suggests a disorder of mucosal growth with reduced absorptive surface area contributes to intractable diarrhea.

Addisonian Pigmentation - The Great Mimicker - A Review.

Skin colour usually depends upon melanin, haemoglobin, and carotenoids. Pigmentary disorders indicate an increased amount of melanin, leading to a darker colour of the skin, called hypermelanosis. Addison's disease is a rare endocrinal disorder with severe oral and systemic manifestations.

An emergency medicine review: Multiple myeloma and its complications.

Introduction: Multiple myeloma (MM) and its complications carry a high rate of morbidity and mortality.

Objective: This review evaluates MM and its complications, including presentation, diagnosis, and management in the emergency department (ED) based on current evidence.

Discussion: MM is the second most common hematologic cancer and associated with monoclonal plasma cell proliferation.