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Effects of non-phthalate plasticizer bis(2-ethylhexyl) sebacate (DEHS) on the endocrine system in Japanese medaka (Oryzias latipes)

Horie Y, Nomura M, Ramaswamy BR, Harino H, Yap CK, Okamura H

Comp Biochem Physiol C Toxicol Pharmacol, 2023 Feb;264:109531.
PMID: 36470400 DOI: 10.1016/j.cbpc.2022.109531

Water pollution due to plasticizers is one of the most severe environmental problems worldwide. Phthalate plasticizers can act as endocrine disruptors in vertebrates. In this study, we investigated whether the non-phthalate bis(2-ethylhexyl) sebacate (DEHS) plasticizer can act as an endocrine disruptor by evaluating changes in the expression levels of thyroid hormone-related, reproduction-related, and estrogen-responsive genes of Japanese medaka (Oryzias latipes) exposed to the plasticizer. Following the exposure, the gene expression levels of thyroid-stimulating hormone subunit beta (tshβ), deiodinase 1 (dio1), and thyroid hormone receptor alpha (trα) did not change. Meanwhile, DEHS suppressed dio2 expression, did not induce swim bladder inflation, and eventually reduced the swimming performance of Japanese medaka. These findings indicate that DEHS can potentially disrupt the thyroid hormone-related gene expression and metabolism of these fish. However, exposure to DEHS did not induce changes in the gene expression levels of kisspeptin 1 (kiss1), gonadotropin-releasing hormone (gnrh), follicle-stimulating hormone beta (fshβ), luteinizing hormone beta (lhβ), choriogenin H (chgH), and vitellogenin (vtg) in a dose-dependent manner. This is the first report providing evidence that DEHS can disrupt thyroid hormone-related metabolism in fish.

Matched MeSH terms: Endocrine System
Fulltext Endocrine complications in transfusion dependent thalassaemia in Penang Hospital

Ong CK, Lim SL, Tan WC, Ong EE, Goh AS

Med J Malaysia, 2008 Jun;63(2):109-12.
PMID: 18942294 MyJurnal

Frequent blood transfusions can lead to iron overload which may result in several endocrine complications especially in the absence of adequate chelation therapy. The objectives of this study are to determine the prevalence of endocrine complications in transfusion dependent thalassaemia patients and the correlation of endocrine complications with the degree of iron chelation. This retrospective study looked at cases of adult patients with transfusion dependent thalassaemia treated in the Haematology Unit, Penang Hospital. Of the 25 transfusion dependent thalassaemia patients, there were 10 male and 15 female patients respectively with almost equal number of Malay and Chinese patients (13 and 12 patients respectively). Short stature was seen in 36.0% of our patients. In our cohort, 12 patients had delayed puberty (male 70.0% and female 33.3%). Prevalence of osteoporosis was 36.0%. Hypogonadism was noted in 40.0% of males and 46.7% of females. 53.4% of the female population had menstrual abnormalities with prevalence of primary and secondary amenorrhoea at 26.7% each. The prevalence of other endocrinopathies was much lower: 8.0% had diabetes mellitus and only one patient had hypocortisolism. Iron chelation appeared insufficient in our study population. The high frequency of endocrine complications noted in our study supports the rationale for regular follow-up of transfusion dependent thalassaemic patients to ensure early detection and timely treatment of associated complications.

Matched MeSH terms: Endocrine System Diseases/etiology*
Fulltext Pigmented 'black' adenoma: a rare cause of Conn's syndrome

Saladina, J.J., Rohaizak, M., Jasmi, A.Y., Sellymiah, A., Aishah, M.A.S., Das, S., et al.

JUMMEC, 2011;14(1):23-25.
MyJurnal

Presence of a hypofunctioning pigmented adenoma are commonly asymptomatic and is usually only found during an autopsy. In contrast, hyperfunctioning pigmented adenoma is a rare clinical entity and in the majority of cases results in Cushing's syndrome. In this case study, we report a 66-year-old male who presented instead with the clinical and biochemical features of Conn's syndrome. On laparoscopic adrenalectomy, it was found that the tumour had a functioning black adenoma which does not usually present with Conn's syndrome but rather to that of a Cushing's. The intraoperative changes and histopathological findings are discussed.

Matched MeSH terms: Endocrine System Diseases
Fulltext Preliminary study: effects of social instability stress on depressive behaviours in ovariectomised rats

Al-Rahbi B, Zakaria R, Muthuraju S, Othman Z, Hassan A

Malays J Med Sci, 2013 Mar;20(2):35-40.
PMID: 23983575 MyJurnal

Depression is one of the common post-menopausal symptoms. In addition to estrogen deficiency, social instability stress may contribute as an additional underlying factor in the development of depressive behaviour in females. Therefore, this study was aimed at examining the influence of social instability stress on depressive behaviour in ovariectomized rats.

Matched MeSH terms: Endocrine System Diseases
Multi-class of endocrine disrupting compounds in aquaculture ecosystems and health impacts in exposed biota

Ismail NAH, Wee SY, Aris AZ

Chemosphere, 2017 Dec;188:375-388.
PMID: 28892772 DOI: 10.1016/j.chemosphere.2017.08.150

Fishes are a major protein food source for humans, with a high economic value in the aquaculture industry. Because endocrine disrupting compounds (EDCs) have been introduced into aquatic ecosystems, the exposure of humans and animals that depend on aquatic foods, especially fishes, should be seriously considered. EDCs are emerging pollutants causing global concern because they can disrupt the endocrine system in aquatic organisms, mammals, and humans. These pollutants have been released into the environment through many sources, e.g., wastewater treatment plants, terrestrial run-off (industrial activities, pharmaceuticals, and household waste), and precipitation. The use of pharmaceuticals, pesticides, and fertilizers for maintaining and increasing fish health and growth also contributes to EDC pollution in the water body. Human and animal exposure to EDCs occurs via ingestion of contaminated matrices, especially aquatic foodstuffs. This paper aims to review human EDC exposure via fish consumption. In respect to the trace concentration of EDCs in fish, types of instrument and clean-up method are of great concerns.

Matched MeSH terms: Endocrine System/drug effects*; Endocrine System/metabolism
Fulltext Prevalence of growth and endocrine disorders in Malaysian children with transfusion-dependent thalassaemia

Tan KA, Lum SH, Yahya A, Krishnan S, Jalaludin MY, Lee WS

Singapore Med J, 2019 Jun;60(6):303-308.
PMID: 30556093 DOI: 10.11622/smedj.2018155

INTRODUCTION: Endocrine dysfunction due to iron overload secondary to frequent blood transfusions is a common complication in children with transfusion-dependent thalassaemia (TDT). We ascertained the prevalence of endocrine dysfunction in children with TDT seen in a hospital setting in Malaysia.
METHODS: We reviewed all patients with TDT who had ≥ 8 blood transfusions per year. Patients who had a history of stem cell transplantation, concurrent autoimmune diseases or were newly diagnosed to have TDT were excluded. Standard diagnostic criteria were used in the diagnosis of various endocrine dysfunctions.
RESULTS: Of the 82 patients with TDT, 65% had at least one endocrine dysfunction. Short stature was the commonest (40.2%), followed by pubertal disorders (14.6%), hypoparathyroidism (12.3%), vitamin D deficiency (10.1%), hypocortisolism (7.3%), diabetes mellitus (5.2%) and overt hypothyroidism (4.9%). Subclinical hypothyroidism and pre-diabetes mellitus were seen in 13.4% and 8.6% of the patients, respectively. For children aged < 10 years, the prevalence of both thyroid dysfunction and hypoparathyroidism was 9.1%.
CONCLUSION: Two-thirds of children with TDT experienced at least one endocrine dysfunction. Thyroid dysfunction and hypoparathyroidism may be missed if endocrine screening is only performed in children with TDT > 10 years of age. Close monitoring for endocrine dysfunction and hormonal therapy is essential to prevent long-term adverse outcomes.

Matched MeSH terms: Endocrine System Diseases/etiology*; Endocrine System Diseases/epidemiology
The Functional Significance of Endocrine-immune Interactions in Health and Disease

Muthusami S, Vidya B, Shankar EM, Vadivelu J, Ramachandran I, Stanley JA, et al.

Curr Protein Pept Sci, 2020;21(1):52-65.
PMID: 31702489 DOI: 10.2174/1389203720666191106113435

Hormones are known to influence various body systems that include skeletal, cardiac, digestive, excretory, and immune systems. Emerging investigations suggest the key role played by secretions of endocrine glands in immune cell differentiation, proliferation, activation, and memory attributes of the immune system. The link between steroid hormones such as glucocorticoids and inflammation is widely known. However, the role of peptide hormones and amino acid derivatives such as growth and thyroid hormones, prolactin, dopamine, and thymopoietin in regulating the functioning of the immune system remains unclear. Here, we reviewed the findings pertinent to the functional role of hormone-immune interactions in health and disease and proposed perspective directions for translational research in the field.

Matched MeSH terms: Endocrine System Diseases/genetics; Endocrine System Diseases/immunology; Endocrine System Diseases/metabolism*; Endocrine System Diseases/pathology; Endocrine System/cytology; Endocrine System/immunology; Endocrine System/metabolism*
Occult primary spontaneous pneumothorax

Tai, Yong-Ting, Tong, Chin-Voon

International e-Journal of Science, Medicine & Education, 2017;11(2):30-33.
MyJurnal

We report a case of occult primary spontaneous
pneumothorax in a 30 years-old woman. She
developed symptoms and signs that were suggestive of
pneumothorax. However, chest radiograph failed to
reveal pneumothorax. Therefore, we proceeded with
computed tomography (CT) thorax which revealed
significantly moderate right pneumothorax. The
diagnostic approach and the management of this case
are discussed.

Matched MeSH terms: Endocrine System Diseases
Fulltext The occurrence and analysis of bisphenol A (BPA) in environmental samples – a review

Farhana Mohamed Ghazali, Wan Lutfi Wan Johari

Journal of Biochemistry, Microbiology and Biotechnology, 2015;3(2):30-38.
MyJurnal

This review paper briefly explains the meaning and characteristics of endocrine disrupting compounds (EDCs). EDCs comprise various types of natural and synthetic chemical compounds that can impede the reproductive action of the endocrine system in animals and humans. Further discussion is on bisphenol A (BPA), one of the examples of EDCs that is extensively used in industries nowadays. It acts as a monomer, which is desired in the production of polycarbonate plastics and epoxy resins. BPA later ends up in environmental compartments (air, water, sediment). In spite of this, BPA is not categorized as a persistent compound and it will be degraded either by photolysis or bacteria. It can only exist between three and five days in the environment. The concentration of BPA varies in different locations depending on the temperature, pH, source and time of sampling. BPA has been frequently debated due to its toxicity and carcinogenicity towards animals and humans. This paper also explains several extraction procedures and analytical methods concerning how to identify BPA in either aqueous or solid samples. However, an additional review is needed in respect of how to handle, reduce the level of BPA in the environment and understand the details concerning the existence of BPA.

Matched MeSH terms: Endocrine System
Bisphenol A exposure modulates reproductive and endocrine system, mitochondrial function and cellular senescence in female adult rats: A hallmarks of polycystic ovarian syndrome phenotype

Prabhu NB, Adiga D, Kabekkodu SP, Bhat SK, Satyamoorthy K, Rai PS

Environ Toxicol Pharmacol, 2022 Nov;96:104010.
PMID: 36334871 DOI: 10.1016/j.etap.2022.104010

Bisphenol A (BPA) mimics estrogen and consequently suspected to be detrimental to female reproductive system. Biomonitoring confirms the BPA burden in body leading to a complex condition called polycystic ovarian syndrome (PCOS) which is frequently attributed to female infertility. Due to unclear precise molecular pathomechanisms of BPA in PCOS, we intend to examine the molecular mechanisms of the reproductive, endocrine, mitochondrial features, and cellular senescence in BPA-treated rats. We analyzed vaginal smears and ovarian follicles using microscope, assessed sex hormones by ELISA, analyzed BPA target gene expression by semi-quantitative RT-PCR, assessed senescence induction by β-galactosidase staining and immunofluorescence in BPA-treated rats. Our data showed hormonal imbalance, impaired folliculogenesis, abnormal expression patterns of target genes, CDKN2A overexpression and enhanced ROS levels in BPA-treated rats. This study provides insights on the effects of BPA exposure on ovulatory, hormonal, mitochondrial dysfunction, and senescence that benefit in better understanding of PCOS induced by BPA.

Matched MeSH terms: Endocrine System
Effects of plasticizer diisobutyl adipate on the Japanese medaka (Oryzias latipes) endocrine system

Horie Y, Ramaswamy BR, Ríos JM, Yap CK, Okamura H

J Appl Toxicol, 2023 Jul;43(7):982-992.
PMID: 36647207 DOI: 10.1002/jat.4437

Plasticizer pollution of the water environment is one of the world's most serious environmental issues. Phthalate plasticizers can disrupt endocrine function in vertebrates. Therefore, this study analyzed thyroid-related, reproduction-related, and estrogen-responsive genes in Japanese medaka (Oryzias latipes) to determine whether non-phthalate diisobutyl adipate (DIBA) plasticizer could affect endocrine hormone activity or not. Developmental toxicity during fish embryogenesis was also evaluated. At a concentration of 11.57 mg/l, embryonic exposure to DIBA increased the mortality rate. Although abnormal development, including body curvature, edema, and lack of swim bladder inflation, was observed at 3.54 and 11.57 mg/l DIBA, growth inhibition and reduced swimming performance were also observed. In addition, DIBA exposure increased the levels of thyroid-stimulating hormone beta-subunit (tshβ) and deiodinase 1 (dio1) but decreased the levels of thyroid hormone receptor alpha (trα) and beta (trβ). These results suggest that DIBA has thyroid hormone-disrupting activities in fish. However, kisspeptin (kiss1 and kiss2), gonadotropin-releasing hormone (gnrh1), follicle-stimulating hormone beta (fshβ), luteinizing hormone beta (lhβ), choriogenin H (chgH), and vitellogenin (vtg1) expression did not change dose-dependently in response to DIBA exposure, whereas gnrh2 and vtg2 expression was elevated. These results indicate that DIBA has low estrogenic activity and does not disrupt the endocrine reproduction system in fish. Overall, this is the first report indicating that non-phthalate DIBA plasticizer is embryotoxic and disrupt thyroid hormone activity in fish.

Matched MeSH terms: Endocrine System
Analysis of endosulfan and its metabolites in rat plasma and selected tissue samples by gas chromatography-mass spectrometry

Chan MP, Mohd MA

Environ Toxicol, 2005 Feb;20(1):45-52.
PMID: 15712329

A method has been developed for the determination of trace levels of alpha-endosulfan, beta-endosulfan, endosulfan sulfate, and endosulfan diol in rat plasma and tissue samples. Endosulfan and its metabolites in the plasma samples were extracted with solid-phase extraction Chromabond-end-capped C18 cartridges and analyzed by a Shimadzu QP-5050A gas chromatograph-mass spectrometer (GCMS) with quadrupole detector in selected-ion-monitoring mode. The analysis of endosulfan and its metabolites in liver and kidney samples involved solvent extraction, Florisil solid-phase-extraction cleanup, and quantitation by GCMS. Recovery experiments for the plasma and tissue samples were conducted over concentration ranges of 10-100 ng mL(-1) and 100-1000 ng mL(-1), respectively. The method was applied to the analysis of trace levels of endosulfan and its metabolites in plasma and tissue samples collected from an animal study. Trace levels of alpha-endosulfan and beta-endosulfan in the ranges of undetectable to 3.11 microg g(-1) and undetectable to 1.19 microg g(-1), respectively, were detected in the kidney samples, whereas trace levels of endosulfan sulfate in the range of 0.02-0.22 microg g(-1) were detected in the liver samples of rats. Neither endosulfan nor its metabolites was detected in any of the plasma samples.

Matched MeSH terms: Endocrine System/drug effects
Bilateral adrenal cysts and ectopic pancreatic tissue in Beckwith-Wiedemann syndrome: is a conservative approach acceptable?

Rahmah R, Yong JF, Sharifa NA, Kuhnle U

J Pediatr Endocrinol Metab, 2004 Jun;17(6):909-12.
PMID: 15270410

Beckwith-Wiedemann syndrome is a common overgrowth syndrome associated with an increased risk of neoplasias which might be explained by the nature and localization of the genetic defect. While malignant tumors are often associated with hemihypertrophy, benign tumors are also found. We report a patient with the typical features of Beckwith-Wiedemann syndrome with two histologically different abdominal tumors, bilateral cystic adrenals and ectopic pancreatic tissue present at birth. In both tumors no malignancy could be detected. Ectopic pancreatic tissue is rarely seen and has been described in Beckwith-Wiedemann syndrome only once. After extirpation of the ectopic pancreatic tissue the cystic adrenals were left in situ since macroscopically no normal adrenal tissue could be identified and separated. Regular ultrasound examinations revealed complete resolution of the cystic adrenals within 24 months. Thus it seems that a conservative approach in selected tumors associated with the Beckwith-Wiedemann syndrome might be acceptable.

Matched MeSH terms: Endocrine System Diseases/complications*
Development and Validation of Decision Forest Model for Estrogen Receptor Binding Prediction of Chemicals Using Large Data Sets

Ng HW, Doughty SW, Luo H, Ye H, Ge W, Tong W, et al.

Chem Res Toxicol, 2015 Dec 21;28(12):2343-51.
PMID: 26524122 DOI: 10.1021/acs.chemrestox.5b00358

Some chemicals in the environment possess the potential to interact with the endocrine system in the human body. Multiple receptors are involved in the endocrine system; estrogen receptor α (ERα) plays very important roles in endocrine activity and is the most studied receptor. Understanding and predicting estrogenic activity of chemicals facilitates the evaluation of their endocrine activity. Hence, we have developed a decision forest classification model to predict chemical binding to ERα using a large training data set of 3308 chemicals obtained from the U.S. Food and Drug Administration's Estrogenic Activity Database. We tested the model using cross validations and external data sets of 1641 chemicals obtained from the U.S. Environmental Protection Agency's ToxCast project. The model showed good performance in both internal (92% accuracy) and external validations (∼ 70-89% relative balanced accuracies), where the latter involved the validations of the model across different ER pathway-related assays in ToxCast. The important features that contribute to the prediction ability of the model were identified through informative descriptor analysis and were related to current knowledge of ER binding. Prediction confidence analysis revealed that the model had both high prediction confidence and accuracy for most predicted chemicals. The results demonstrated that the model constructed based on the large training data set is more accurate and robust for predicting ER binding of chemicals than the published models that have been developed using much smaller data sets. The model could be useful for the evaluation of ERα-mediated endocrine activity potential of environmental chemicals.

Matched MeSH terms: Endocrine System
Fulltext Hormones in experimental autoimmune encephalomyelitis (EAE) animal models

Ghareghani M, Ghanbari A, Eid A, Shaito A, Mohamed W, Mondello S, et al.

Transl Neurosci, 2021 Jan 01;12(1):164-189.
PMID: 34046214 DOI: 10.1515/tnsci-2020-0169

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS) in which activated immune cells attack the CNS and cause inflammation and demyelination. While the etiology of MS is still largely unknown, the interaction between hormones and the immune system plays a role in disease progression, but the mechanisms by which this occurs are incompletely understood. Several in vitro and in vivo experimental, but also clinical studies, have addressed the possible role of the endocrine system in susceptibility and severity of autoimmune diseases. Although there are several demyelinating models, experimental autoimmune encephalomyelitis (EAE) is the oldest and most commonly used model for MS in laboratory animals which enables researchers to translate their findings from EAE into human. Evidences imply that there is great heterogeneity in the susceptibility to the induction, the method of induction, and the response to various immunological or pharmacological interventions, which led to conflicting results on the role of specific hormones in the EAE model. In this review, we address the role of endocrine system in EAE model to provide a comprehensive view and a better understanding of the interactions between the endocrine and the immune systems in various models of EAE, to open up a ground for further detailed studies in this field by considering and comparing the results and models used in previous studies.

Matched MeSH terms: Endocrine System
Fulltext Endocrinopathies in HIV infected patients

Rosdina Zamrud Ahmad Akbar, Sharifah Faradila Wan Muhammad Hatta, Rosnida Mohd Noh, Fatimah Zaherah Mohd Shah, Thuhairah Abdul Rahman, Rohana Abdul Ghani, et al.

Journal of Clinical and Health Sciences, 2020;5(2):39-45.
MyJurnal

Introduction: Hormonal abnormality is one of many clinical manifestations of HIV infections
that is not well understood. However, the consequences could affect quality of life and are
potentially treatable. Thus, this study aimed to determine the prevalence and associated
factors of thyroid, adrenal and gonadal dysfunctions among HIV-infected patients. Methods:
This is a single centre cross-sectional study involving 150 HIV-infected patients attending the
HIV clinic. Each subject was required to answer specific symptoms questionnaire and their
medical records were reviewed for relevant clinical and biochemical data. Blood for was
collected and thyroid hormones, cortisol, ACTH, FSH, LH, testosterone and estradiol were
analysed using electrochemiluminescent immunoassay. Thyroid, adrenal and gonadal axes
abnormalities were identified. Results: Hypogonadism had the highest prevalence amongst
the endocrine abnormalities, which was detected in 23 patients (15.3%), followed by thyroid
dysfunction in 18 patients (12%) and hypocortisolism in 2 patients (1.3%). There was
significant correlation between CD4 count, BMI and age with the hormone levels. Conclusion:
Prevalence of endocrine abnormalities was low in these well-treated HIV-positive patients,
with hypogonadism being the most common. However, significant correlations between CD4
count, age and BMI with the hormonal levels were detected. Clinical symptoms in relation to
endocrinopathy are not specific as a screening tool thus underscoring the need for
biochemical tests to identify these treatable conditions.

Matched MeSH terms: Endocrine System Diseases
Hydroxychloroquine and Chloroquine in Prophylaxis and Treatment of COVID-19: What Is Known?

Shankar PR, Palaian S, Gulam SM

J Pharm Bioallied Sci, 2020 10 06;13(1):4-10.
PMID: 34084043 DOI: 10.4103/jpbs.JPBS_404_20

The corona virus disease-19 (COVID-19) pandemic has affected the entire world causing huge economic losses and considerable morbidity and mortality. Considering the explosive growth of the pandemic repurposing existing medicines may be cost-effective and may be approved for use in COVID-19 faster. Researchers and medical practitioners worldwide have explored the use of chloroquine and hydroxychloroquine, in few occasions combined with the macrolide antibiotic azithromycin, for COVID-19 treatment. These two drugs are economic and easily available, and hence gained attention as a potential option for COVID-19 management. As per the available evidence, the outcomes of treatments with these medications are conflicting from both the efficacy and safety (predominantly cardiac related) perspectives. Currently, multiple studies are underway to test the safety and efficacy of these medications and more results are expected in the near future. The retina, the endocrine system (with risk of hypoglycemia), the musculoskeletal system, the hematological system, and the neurological system may also be affected. The use of these drugs is contraindicated in patients with arrhythmias, known hypersensitivity, and in patients on amiodarone. In addition to the published literature, personal communication with doctors treating COVID-19 patients seems to suggest the drugs may be effective in reducing symptoms and hastening clinical recovery. The literature evidence is still equivocal and further results are awaited. There has been recent controversy including retraction of articles published in prestigious journals about these medicines. Their low cost, long history of use, and easy availability are positive factors with regard to use of these drugs in COVID-19.

Matched MeSH terms: Endocrine System
Fulltext Co-Occurrence of Exogenous and Endogenous Cushing's Syndromes-Dilemma in Diagnosis

Tong CV, Rajoo S

Case Rep Endocrinol, 2019;2019:2986312.
PMID: 31737375 DOI: 10.1155/2019/2986312

Approach to patients who manifest with features of Cushing's syndrome often begin with exclusion of exposure to excessive exogenous source of glucocorticoids (GC). Most guidelines advocate no further assessment if excessive exogenous GC use is present. We present a case of a 66-year-old lady who was noted to have typical features of Cushing's syndrome. As she gave a very clear history of ingesting exogenous GC for a year, no further work up was undertaken. Despite cessation of GC for a year, she continued to have thin skin and easy bruising. Upon admission for hypertensive emergency, her clinician took note of her changes and investigated her for endogenous Cushing's syndrome. Her cortisol post overnight dexamethasone suppression test was 707 nmol/l. Post low dose dexamethasone suppression test yielded a cortisol of 1133.2 nmol/l. 24 hours urine cortisol was 432.2 nmol/l. Plasma ACTH was 1.1 pmol/l, indicating an ACTH independent Cushing's syndrome. We proceeded with Computed tomography scan (CT scan) of adrenals which revealed a right adrenal adenoma measuring 4.4 × 3.4 × 4.0 cm. Right retroperiteneoscopic adrenalectomy was done. Histopathology examination was consistent with adrenal cortical adenoma with foci of myelolipoma. Post adrenalectomy she developed hypocortisolism secondary to contralateral adrenal suppression which lasted up to the present date. Her cutaneous and musculoskeletal manifestations improved substantially. Co-occurrence of endogenous and exogenous Cushing's syndromes is uncommon but should be considered in patients whose Cushingnoid features do not resolve after cessation of exogenous GC.

Matched MeSH terms: Endocrine System Diseases
Fulltext The Microbiome and Irritable Bowel Syndrome - A Review on the Pathophysiology, Current Research and Future Therapy

Chong PP, Chin VK, Looi CY, Wong WF, Madhavan P, Yong VC

Front Microbiol, 2019;10:1136.
PMID: 31244784 DOI: 10.3389/fmicb.2019.01136

Irritable bowel syndrome (IBS) is a functional disorder which affects a large proportion of the population globally. The precise etiology of IBS is still unknown, although consensus understanding proposes IBS to be of multifactorial origin with yet undefined subtypes. Genetic and epigenetic factors, stress-related nervous and endocrine systems, immune dysregulation and the brain-gut axis seem to be contributing factors that predispose individuals to IBS. In addition to food hypersensitivity, toxins and adverse life events, chronic infections and dysbiotic gut microbiota have been suggested to trigger IBS symptoms in tandem with the predisposing factors. This review will summarize the pathophysiology of IBS and the role of gut microbiota in relation to IBS. Current methodologies for microbiome studies in IBS such as genome sequencing, metagenomics, culturomics and animal models will be discussed. The myriad of therapy options such as immunoglobulins (immune-based therapy), probiotics and prebiotics, dietary modifications including FODMAP restriction diet and gluten-free diet, as well as fecal transplantation will be reviewed. Finally this review will highlight future directions in IBS therapy research, including identification of new molecular targets, application of 3-D gut model, gut-on-a-chip and personalized therapy.

Matched MeSH terms: Endocrine System
Prevalence of endocrine complications in transfusion dependent thalassemia in Hospital Pulau Pinang: A pilot study

Lee KT, Lim SL, Goh AS

Med J Malaysia, 2020 01;75(1):33-37.
PMID: 32008017

INTRODUCTION: Frequent blood transfusions results in iron overload and lead to multiple endocrine complications. In spite of improvements in iron chelation therapy, a significant number of transfusion dependent thalassaemia (TDT) patients still develop endocrine complications. The aim of this study is to evaluate the prevalence of various endocrine complications in our adult TDT patients and to study the correlation with serum ferritin and liver iron concentration (LIC).
METHODS: A retrospective review of all TDT patients treated in Haematology Unit, Hospital Pulau Pinang (HPP) was conducted.
RESULTS: Of the 45 adult TDT patients, 22 were males and 23 were females with mean age of 28.8±6.9 years old. Majority of TDT in HPP were beta thalassemia major (71.1%), followed by E-Beta thalassemia (24.4%) and HbH-Constant Spring (4.4%). Frequency of transfusion was 3-4 weekly. 40.0% of adult TDT suffered from at least one endocrine complication. Among the adult TDT patients with endocrine complication, 50% have one endocrinopathy, 38.9% with two types of endocrinopathies and 11.1% of them have three or more types of endocrinopathies. Hypogonadism (22.2%) was the commonest endocrine complication, followed by osteoporosis (20%), hypothyroidism (13.3%), diabetes mellitus (6.7%) and hypocortisolism (4.4%). Patients with endocrine complications were significantly older. Mean serum ferritin level and LIC was higher among patients with endocrine complications but both were not statistically significant.
CONCLUSION: Endocrinopathy is still prevalent in 40% of adult TDT patients. This leads to higher health-care resource utilization, cost and significant morbidities among patients with TDT. Therefore, regular monitoring and early detection with intensification of chelation therapy is essential.

Matched MeSH terms: Endocrine System

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