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J A Alvarez Barreiro

Publications and source records attributed to J A Alvarez Barreiro.

5 recordsLinked to original sources
PubMed2000

[Primary adrenal insufficiency and primary antiphospholipid syndrome].

Primary adrenal insufficiency (PAI) is a rare complication of antiphospholipid syndrome (APS). The hypercoagulable state in the APS may lead to adrenal vein thrombosis and subsequently to hemorrhagic necrosis of the adrenal glands. This complication of APS is important to recognize because it may be fatal if untreated. We describe one case of PAI and primary APS, with magnetic resonance studies consistent with hemorrhagic necrosis of the adrenal glands.

Adrenal Glands↗
PubMed1999

[Ketoconazole in the control of arterial hypertension in Cushing's syndrome].

OBJECTIVE: To determine the usefulness of ketoconazole for the control of arterial hypertension (AH) in Cushing syndrome (CS) as temporary treatment. PATIENTS AND METHODS: Fifteen cases of CS were collected (eleven cases of Cushing disease, two cases of ectopic secretion of ACTH, one case of adrenal adenoma, and one case of adrenal carcinoma). The clinical characteristics as well as laboratory data of patients with AH and the response to therapy were studied. RESULTS: Six patients (40%) had AH. A significant difference was observed of an older age, a higher frequency of association with diabetes mellitus and a higher 24 hour free urine cortisol (FUC) for patients with AH compared with non hypertensive patients. Ketoconazole was efficient for controlling AH in five cases, and in all of them the return to normal levels of 24 hour FUC was achieved. A failure of AH control under treatment with ketoconazole occurred in the only case of adrenal carcinoma. There was no significant secondary adverse reaction to ketoconazole. CONCLUSIONS: Ketoconazole is an efficient drug for the control of AH in CS and is well tolerated. In our series, the return to normal levels of FUC was associated with control of AH.

Adult↗
PubMed1999

[Thyrotropin-producing hypophyseal adenomas].

Thyrotropin (TSH)-producing adenoma or TSH-oma is an uncommon entity. Most cases correspond to macroadenomas, and microadenomas are exceptional. The differential diagnosis should include mainly hypophyseal resistance to thyroid hormones, which can be difficult because of normal findings of imaging studies of the pituitary gland in some cases of TSH-oma and also because of the clinical and biochemical heterogeneity of both entities. Hypophyseal surgery is the treatment of choice for TSH-omas, although clinical and biochemical recovery of hyperthyroidism is not achieved in a considerable proportion of cases. When surgery fails or is contraindicated, radiotherapy and somatostatine analogues are therapeutic alternatives. We report here two cases of TSH-producing microadenoma which were confirmed after hypophyseal surgery.

Adenoma↗
PubMed1998

[Cushing's syndrome: clinical study of fifteen cases].

OBJECTIVE: To study the epidemiological and clinical features and diagnostic tests of Cushing's syndrome (CS) of non-iatrogenic etiology, because of there are few similar studies in the last ten years. METHODS: Fifteen cases of CS were diagnosed from 1992 to 1997 at our hospital. We describe the epidemiological, clinical, biochemical, radiologic, therapeutic and evolutive characteristics. RESULTS: Both diabetes mellitus and hypertension were observed in 40% of patients. The frequency of etiologies was: Cushing's disease, 66.6%; ectopic ACTH syndrome, 13.3%; adrenal adenoma, 6.6%; adrenal carcinoma, 6.6%; and undiagnosed, 6.6%. The 24-hour urine free cortisol (UFC) and the overnight 1 mg oral dexamethasone suppression test yielded 93.3 and 100% diagnostic sensitivity for CS, respectively. The overnight 8 mg oral dexamethasone suppression test, the metyrapone test and the 7 mg intravenous dexmethasone test had 75, 50 and 60% diagnostic sensitivity for Cushing's disease, respectively. Ketoconazole treatment had success in to normalize the 24-hour UFC in all patients, except for the case of adrenal carcinoma. CONCLUSIONS: The Cushing's disease was the most common form of CS. The 24-hour UFC and overnight 1 mg oral dexamethasone suppression test were good screening studies. Ketoconazole was successful in normalizing the adrenal cortex function.

Adult↗