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PubMed1976

[131-I cholesterol (19-C) in the functional and localization diagnosis of adrenal cortex disorders].

Results are reported of quantitative adrenal scintigraphy with 131I-cholesterol in 8 patients with normal adrenal function before and after ACTH-stimulation and cortisol-suppression respectively, in one case with an adrenal metastasis from a pulmonary cancer, in two cases with Cushing's disease and in 7 cases with Conn's disease. In normal cases and in patients with M. Cushing a diagnosis of adrenal cortical function is possible with this method but can usually be replaced by more specific biochemical studies of serum and urine. The scintigraphic method is in addition of value in localization studies and can in unequivocal cases replace the selective adrenal phlebography. In patients with M. Conn increased uptake values (bilateral adrenal cortex hyperplasia) as well as reduced or non-detectable uptakes were observed, one of these cases suffering from a cortex carcinoma with M. Conn.

Adrenal Cortex Function Tests↗
PubMedDate not supplied

Adrenocortical insufficiency in smear positive pulmonary tuberculosis.

We studied 40 patients with pulmonary tuberculosis. All were positive for acid-fast bacilli (AFB) in the sputum. Their mean age was 30 yrs (range 10-50 yrs) and the duration of illness was 26.3 +/- 2.3 months. Radiologically minimal, moderately advanced and far advanced lesions were present in 7 (17.5%), 9 (22.5%) and 23 (57.5%) patients respectively. One patient with endobronchial lesion had no radiological evidence of pulmonary tuberculosis. Clinically, 14 patients (35%) had one or the other features of adrenocortical insufficiency. Postural hypotension was the commonest feature and was present in 11 patients (27.5%), followed by nausea and vomiting (20%), loss of axillary hair and libido (10%), skin and mucosal pigmentation in 7.5% of the cases. ACTH stimulation revealed incomplete adrenocortical insufficiency (partially responsive adrenal) in 5 patients (12.5%) and complete adrenocortical insufficiency (non-responsive adrenal) in 2 patients (5%). Patients with features of adrenal insufficiency had significantly longer duration of illness (p < 0.001) but there was no correlation with extent or type of lesion.

Adolescent↗
PubMed1992

[Adrenal gland disorders].

Adrenal diseases are generally rare but of variable manifestation and high diagnostic expenditure for definitive conformation of the disease in the individual case; therefore, the definitive diagnosis is often made by the specialist. On the other hand the supposed diagnosis, based on the knowledge of clinical symptoms, is frequently made by the nonspecialist who also initiates the first diagnostic steps in order to confirm or exclude the diagnosis. It is the aim of this survey to discuss not only the clinical symptoms of the most important adrenal diseases, but also the essential diagnostic steps in order to at least narrow down the diagnosis with as little expenditure as possible and to avoid a diagnostic maze.

Adrenal Cortex Function Tests↗
PubMed1976

[Investigation of adrenal function with corticotrophin-(1-23)-tricosipeptide-amide (author's transl)].

The new peptide corticotrophin-(1-23)-tricosipeptide-amide (Acethropan S) was shown to be useful in the assessment of adrenal function. Both in normal subjects and patients with adrenal insufficiency, the cortisol releasing capacity could be better evaluated with a dosage of 0.5 mg than with 0.25 mg. There were no obvious side effects induced by corticotrophin-(1-23)-tricosipeptide-amide.

Adrenal Cortex Function Tests↗
PubMed1991

Clinical significance of the solitary functioning adrenal gland.

To assess the compensatory functional and anatomic changes in the remaining adrenal cortex after unilateral adrenalectomy or in the unaffected adrenal in patients with unilateral adrenal destruction by neoplasm, 17 patients with a single, functioning adrenal gland and normal indices of adrenocortical function, nine after adrenalectomy and eight with a unilateral, destructive adrenal lesion were studied with 131I-6 beta-iodomethyl-19-norcholesterol (NP-59) scintigraphy and computed tomography. Adrenal masses with a mean (+/- s.d.) diameter of 2.8 +/- 1.0 cm; (range 1-4 cm; 95% confidence interval (Cl), 2.5-3.1 cm) were identified by computed tomography in seven of nine patients in the remaining adrenal cortex at variable times (6.1 +/- 5.9 y; range 0.5-19 y) after unilateral adrenalectomy. Mean (+/- s.e.m.) NP-59 uptake was elevated (p less than 0.01) in both adrenalectomy and adrenal destruction groups, mean uptake (+/- s.e.m.) was 0.32% +/- 0.04% administered dose (95% Cl, 0.24%-0.4% administered dose) as compared to normal (0.16% +/- 0.05% administered dose, 95% Cl, 0.06%-0.26% administered dose). The remaining adrenal cortex may be anatomically abnormal after unilateral adrenalectomy and demonstrate compensatory, increased NP-59 uptake in the presence of overall, normal adrenocortical function.

Adosterol↗
PubMedDate not supplied

[Addison's disease: principal clinical associations and description of natural history of the disease].

From 1967 to 1988 we studied 75 cases of Addison's disease (AD). An autoimmune etiology was found in 68%, while previous tubercular infection was demonstrated in 21% of the cases; minor causes were involved in 3%, and in 8% of the cases the disease remained of unknown origin. Autoimmune adrenalitis has become the most frequent cause of AD as a consequence of decreased tubercular infection. Autoimmune AD prevailed in children or in young people, and tubercular AD in adults. The finding of calcifications in adrenals and/or other organs was the specific diagnostic sign for the identification of tubercular forms. On the other hand, the finding of circulating adrenal autoantibodies (AA) and/or other organ specific autoantibodies was the fundamental diagnostic marker of autoimmune forms. In 72% of the cases autoimmune AD is associated with other organ-specific autoimmune diseases. Subjects with AA but without clinical signs of hypoadrenalism were considered to have "potential AD", because they showed a high risk of developing clinical hypoadrenalism. This condition develops over a long period characterized by different stages of subclinical adrenal hypofunction. Steroid cell autoantibodies (StCA) are frequently detectable in patients with autoimmune AD, in whom they are markers of autoimmune premature ovarian failure. The study of StCA-positive cases without hypogonadism will be important to clarify whether or not these autoantibodies could be markers of potential autoimmune hypogonadism.

Addison Disease↗
PubMed1987

[Adrenal function in patients with chronic obstructive lung diseases].

The hydrocortisone and ACTH blood levels, 17-hydroxycorticosteroids urine excretion and suprarenal function stimulation with Synacthen were studied in 22 patients with chronic obstructive pulmonary disease and 12 healthy persons as controls. The results show the presence of reliably higher hydrocortisone and 17-hydroxycorticosteroids levels in patients with low partial oxygen pressure as well as a higher ACTH plasma level and a strong Synacthen stimulation. After a comprehensive treatment including oxygen therapy the blood concentrations of hydrocortisone, ACTH, 17-hydroxycorticosteroids fell to levels found in healthy persons. The study shows that hypoxemia stimulates the suprarenal-cortex secretion.

17-Hydroxycorticosteroids↗
PubMed1986

Urinary excretion rates of 15 free steroids: potential utility in differential diagnosis of Cushing's syndrome.

To evaluate their potential usefulness in the differential diagnosis of Cushing's syndrome, we estimated the urinary excretion rates of the following non-metabolized, unbound steroid hormones: pregnenolone, progesterone, 17-OH-pregnenolone, 17-OH-progesterone, dehydroepiandrosterone (DHEA), androstenedione, testosterone, dihydrotestosterone, 11-deoxycorticosterone, 11-deoxycortisol, corticosterone, cortisol, 18-OH-11-deoxycorticosterone, 18-OH-corticosterone, and aldosterone. These were measured in normal subjects and in patients with Cushing's disease, adrenal adenoma, or ectopic corticotropin syndrome. We used "high-performance" liquid chromatography and subsequent radioimmunoassay. Our results indicate that simultaneous estimation of urinary free cortisol and DHEA may be useful in differential diagnosis of hypercorticoid states due to adrenal adenoma and Cushing's disease.

ACTH Syndrome, Ectopic↗