MyMedR

Fulltext Adrenal insufficiency in acute coronary syndrome

Norasyikin AW, Norlela S, Rozita M, Masliza M, Shamsul AS, Nor Azmi K

Singapore Med J, 2009 Oct;50(10):962-6.

PMID: 19907885

Acute coronary syndrome (ACS) is an acute stressful condition which stimulates the hypothalamus-pituitary-adrenal axis that regulates neurovascular and hormonal responses. Functional hypoadrenalism has been shown to be associated with significant morbidity and mortality in the critically-ill patient, but there is to date no known study done to determine its prevalence in patients with ACS.

Matched MeSH terms: Adrenal Insufficiency/blood; Adrenal Insufficiency/complications*

Fulltext Histoplasmosis with Addisonian crisis: call for bird control

Hu AS, Hu AS, Hu CH

Med J Malaysia, 2015 Apr;70(2):104-5.

PMID: 26162388 MyJurnal

We report a case of disseminated histoplasmosis, initially diagnosed from gut nodule colonoscopically, along with evidence of lung disease. Subsequently he developed Addisonian crisis due to adrenal involvement. Lessons were learnt from the importance of detailed history-personal and social/family, as well as psychosocial aspects of illness. Public health measures to reduce bird dropping (and thus possibility of histoplasmosis) are discussed.

Matched MeSH terms: Adrenal Insufficiency

Fulltext Relative adrenal insufficiency amongst hospitalized mild to moderate acute ischemic stroke patients

Wahab NA, Razak NZ, Sukor N, Zainudin S, Razali AM, Mustafa N, et al.

Arch Iran Med, 2015 Feb;18(2):89-93.

PMID: 25644796 DOI: 015182/AIM.006

Acute ischemic stroke is a stressful condition where there is marked increase in the production of cortisol. In the past, adrenal insufficiency in critically ill patients had been shown to be associated with significant morbidity and mortality. To date, there have been no studies performed to determine its prevalence among patients with acute ischemic stroke.

Matched MeSH terms: Adrenal Insufficiency/epidemiology*

Fulltext A Case Report of Steroid Withdrawal Syndrome

Wahab F, Rahman RA, Yaacob LH, Noor NM, Draman N

Korean J Fam Med, 2020 Sep;41(5):359-362.

PMID: 32961047 DOI: 10.4082/kjfm.18.0181

We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing's syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.

Matched MeSH terms: Adrenal Insufficiency

Adrenal insufficiency in a child with MELAS syndrome

Afroze B, Amjad N, Ibrahim SH, Humayun KN, Yakob Y

Brain Dev, 2014 Nov;36(10):924-7.

PMID: 24508408 DOI: 10.1016/j.braindev.2013.12.009

Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) are established subgroups of mitochondrial encephalomyopathy. m.3243A>G a common point mutation is detected in tRNA in majority of patients with MELAS phenotype whereas m.8344A>G point mutation in tRNA is observed, in MERRF phenotype. Adrenal insufficiency has not been reported in mitochondrial disease, except in Kearns-Sayre Syndrome (KSS), which is a mitochondrial deletion syndrome. We report an unusual presentation in a five year old boy who presented with clinical phenotype of MELAS and was found to have m.8344A>G mutation in tRNA. Addison disease was identified due to hyperpigmentation of lips and gums present from early childhood. This is the first report describing adrenal insufficiency in a child with MELAS phenotype.

Matched MeSH terms: Adrenal Insufficiency/complications*

Effects of dehydroepiandrosterone (DHEA) supplementation on the lipid profile: A systematic review and dose-response meta-analysis of randomized controlled trials

Qin Y, O Santos H, Khani V, Tan SC, Zhi Y

Nutr Metab Cardiovasc Dis, 2020 08 28;30(9):1465-1475.

PMID: 32675010 DOI: 10.1016/j.numecd.2020.05.015

BACKGROUND AND AIMS: Dehydroepiandrosterone (DHEA) supplementation has gained attention in individuals with adrenal insufficiency, and as a tool for increasing androgens and estrogens whereby is proposed to improve the accretion of muscle and bone mass. However, DHEA supplementation has demonstrated negative effects on the lipid profile and, thus, we aimed to analyze the body of evidence in this regard.

METHODS AND RESULTS: A systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was performed employing in Scopus, PubMed/Medline, Web of Science, Embase and Google Scholar, then including relevant articles that addressed the effects of DHEA supplementation on the lipid profile, up to February 2020. Combined findings were generated from 23 eligible articles. Hence, total cholesterol (TC) (weighted mean difference (WMD): -3.5 mg/dl, 95% confidence interval (CI): -8.5 to 1.6)), low-density lipoprotein-cholesterol (LDL-C) (WMD: 0.34 mg/dl, 95% CI: -3 to 3.7) and triglycerides (TG) levels (WMD: -2.85 mg/dl, 95% CI: -9.3 to 3.6) did not alter in DHEA group compared to the control, but HDL-C levels significantly reduced in DHEA group (WMD: -3.1 mg/dl, 95% CI: -4.9 to -1.3). In addition, a significant reduction in HDL-C values was observed in studies comprising women (WMD: -5.1 mg/dl, 95% CI: -7.2 to -3) but not in males (WMD: 0.13 mg/dl, 95% CI: -1.4 to 1.7).

CONCLUSIONS: Overall, supplementation with DHEA did not change circulating values of TC, LDL-C and TG, whereas it may decrease HDL-C levels. Further long-term RCTs are required to investigate the effects of DHEA particularly on major adverse cardiac events.

Matched MeSH terms: Adrenal Insufficiency

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