1/10. survival of a 75% burn in a patient with longstanding Addison's disease.This is the first reported case of survival of a significant burn in a patient with established Addison's disease. The systemic stress response to thermal injury is well recognised, there is a marked hypermetabolic response with prolonged periods of catabolism. In particular, the elevation of plasma cortisol levels is crucial for this response to severe systemic stress. Cortisol elevation is maintained for the duration of burn wound healing, is proportional to the burned body surface area and the normal circadian rhythm of endogenous cortisol is lost. Acute adrenal insufficiency has been described in patients suffering major burn injuries with generally poor outcomes. We discuss the management and complications of adrenal replacement therapy in a severe burn setting, as illustrated by this case report.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
2/10. Addisonian crisis presenting with a normal short tetracosactrin stimulation test.We report the case of a 70 year old man who presented with physical and biochemical features suggestive of Addison's disease, but had a normal short tetracosactrin (Synacthen) test. Six months later he re-presented with similar clinical features but with an abnormal response to tetracosactrin confirming the diagnosis of Addison's disease. We recommend that if adrenal insufficiency is strongly suggested further investigation should be performed to exclude this diagnosis.- - - - - - - - - - ranking = 0.96839533244577keywords = physical (Clic here for more details about this article) |
3/10. pregnancy in a woman suffering from type 1 diabetes associated with Addison's disease and Hashimoto's thyroiditis (fully developed Autoimmune Polyglandular syndrome Type 2).In this article the pregnancy of a woman suffering from the complete triad typical of Autoimmune Polyglandular syndrome Type 2 (Addison's disease type 1 diabetes Hashimoto's thyroiditis) is reported. By using insulin pump therapy with insulin lispro, it was possible to balance diabetes control with changes of steroid replacement therapy. pregnancy was uneventful until week 27, when signs of preeclampsia occurred. The boy was born without difficulty at gestational age 37 weeks by planned cesarean section but signs of diabetic fetopathy (macrosomia, hypoglycaemia and hypocalcaemia) were expressed. He required a short course of hydrocortisone therapy. He made a good and rapid recovery. The mother made a good post-operative recovery too, but 4 months after the delivery microalbuminuria as well as mild hyperuricemia are still present. Interdisciplinary approach and very careful observation of the mother as well as of the child enabled successful outcome of this highly risky pregnancy.- - - - - - - - - - ranking = 5keywords = suffering (Clic here for more details about this article) |
4/10. Atypical presentation of shock from acute adrenal insufficiency in an adolescent male.OBJECTIVE: To report an atypical presentation of shock and acute adrenal insufficiency in an adolescent male. CASE SUMMARY: A 14-year-old boy with a history of nocturnal enuresis presented with a clinical picture suggestive of septic shock refractory to aggressive fluid and vasopressor management. history and physical examination were suggestive of shock secondary to an infectious etiology, associated with skin findings of hyperpigmentation. The laboratory studies were remarkable for normal sodium, potassium, glucose, as well as normal renin levels. hydrocortisone therapy led to improvement of his blood pressure and allowed weaning of vasopressor medications. Further laboratory studies, including adrenocorticotropic hormone stimulation test and adrenal antibodies, confirmed the diagnosis of primary adrenal insufficiency. CONCLUSION: Acute adrenal insufficiency is an uncommon cause of shock in the adolescent population. We report a clinical presentation suggestive of shock secondary to acute adrenal insufficiency remarkable for an atypical clinical and laboratory presentation. We further provide information on the management of acute adrenal crisis.- - - - - - - - - - ranking = 0.96839533244577keywords = physical (Clic here for more details about this article) |
5/10. Addison's disease presenting as anorexia nervosa in a young man.A young man with a long history of obsessional traits and food fads presented with anorexia, vomiting and marked weight loss. He showed little concern for his physical state and his vomiting was frequently witnessed as self-induced. A diagnosis of anorexia nervosa was made and he took his own discharge from hospital. He was readmitted one month later, severely cachectic and with biochemical abnormalities consistent with advanced Addison's disease which was subsequently confirmed. He responded dramatically, both mentally and physically, to corticosteroid therapy. It is likely that anorexia nervosa, relatively rare in males, was a manifestation of the psychological abnormalities commonly seen in severe Addison's disease.- - - - - - - - - - ranking = 1.9367906648915keywords = physical (Clic here for more details about this article) |
6/10. Addison's disease secondary to lymphomatous infiltration of the adrenal glands. Recovery of adrenocortical function after chemotherapy.This case represents the first known instance of reversal of Addison's disease after antineoplastic therapy. Malignant infiltration of the adrenal glands was demonstrated by cytologic findings of needle biopsy in a 57-year-old man suffering from disseminated large cell lymphoma and Addison's disease. He was treated with combination chemotherapy and adrenal hormone replacement. Improvement shown in his computed tomography (CT) scan and clinical status led to the successful discontinuance of cortisone and 9-alpha fluorohydrocortisone. Basal adrenal function and response to ACTH stimulation recovered.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
7/10. patients presenting with Addison's disease need not be pigmented.Three consecutive cases of Addison's disease without increased pigmentation are described. We suggest that the absence of this important physical sign contributed to serious delays in diagnosis and markedly increased morbidity. We emphasize that, despite the usual textbook description, excess pigmentation is not necessarily a feature of Addison's disease.- - - - - - - - - - ranking = 0.96839533244577keywords = physical (Clic here for more details about this article) |
8/10. Keratopathy associated with hypoparathyroidism and Addison's disease.Two siblings suffering from keratopathy, one with hypoparathyroidism associated with Addison's disease and the other with Addison's disease alone, are described. The hypothesis that there was an autoimmune etiology with variant manifestations in each subject is suggested and discussed.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
9/10. Sudden death due to auto-immune Addison's disease in a 12-year-old girl.A 12-year-old female suffering from adrenocortical insufficiency showed symptoms similar to a gastro-enteritis, and severe electrolytic and acid/base disturbances which progressed into cerebral oedema and death. autopsy findings included depletion of the adrenal cortex, with enlargement and eosinophilia of surviving cells. In ante-mortem blood, anti-adrenal auto-antibodies were found and elevated levels of ACTH and cortisol with a low level of aldosterone.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
10/10. Collagenous colitis in a patient with Addison's disease: a case report.diarrhea is a non-specific symptom which may be associated with Addison's disease and several causes had been demonstrated in the aetiology. We describe a patient with Addison's disease who was suffering from chronic diarrhea for three months. She was diagnosed as having collagenous colitis and successfully treated with Sulphasalazine, 2 g/day. Collagenous colitis is an uncommon cause of chronic diarrhea and the association of collagenous colitis with Addison's disease has not previously been described. We think that collagenous colitis may play a role in the aetiology of diarrhea in patients with Addison's disease and therefore we suggest a full colonoscopic examination in other patients with Addison's disease and diarrhea to determine the incidence of collagenous colitis in the aetiology of diarrhea.- - - - - - - - - - ranking = 1keywords = suffering (Clic here for more details about this article) |
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