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At least 289 records · Page 16Linked to original sources
PubMed2006

Hypothalamic-pituitary-adrenal axis function in Sjögren's syndrome: mechanisms of neuroendocrine and immune system homeostasis.

To date, evidence suggests that rheumatic diseases are associated with hypofunctioning of the hypothalamic-pituitary-adrenal (HPA) axis. Sjögren's syndrome (SS), the second most common autoimmune disorder, is characterized by diminished lacrimal and salivary gland secretion. To examine HPA axis activity in SS patients, the adrenocorticotropin (ACTH) response to ovine corticotropin-releasing factor (oCRH) was used as a direct measure of corticotrophic function, and the plasma cortisol response to the ACTH released during oCRH stimulation as an indirect measure of adrenal function. Significantly lower basal ACTH and cortisol levels were found in patients with SS and were associated with a blunted pituitary and adrenal response to oCRH compared to normal controls. Fibromyalgia (FM) patients demonstrated elevated evening basal ACTH and cortisol levels and a somewhat exaggerated peak, delta, and net integrated ACTH response to oCRH. A subgroup of SS patients also met the diagnostic criteria for FM and demonstrated a pituitary-adrenal response that was intermediate to SS and FM. These findings suggest not only adrenal axis hypoactivity in SS and FM patients, but also that varying patterns of adrenal and thyroid axes dysfunction may exist in patients with different rheumatic diseases.

Animals↗
PubMed1994

Endocrine abnormalities in patients with amyloidosis.

This study was conducted to examine systematically the endocrine function in 10 patients diagnosed to have renal amyloidosis. Basal and dynamic endocrine tests (GnRh, TRH, and ACTH stimulation tests as well as modified glucose tolerance test) were performed in all patients. Eight patients had advanced renal disease (creatinine clearance < 10 mL/min). Hypofunction of the thyroid gland was present in 5 out of those 8 patients, and thyroid biopsy confirmed amyloid deposition. Of those 5 patients, pituitary and adrenal defects were present in 2. In conclusion, endocrine abnormalities were evident at a later stage of renal amyloidosis. Hypothyroidism was present in all patients who manifested endocrine defects and should be considered as an early sign of endocrine involvement with the disease.

Adrenal Glands↗
PubMed1983

The relationship between the pineal gland and the pituitary--adrenal axis in health, endocrine and psychiatric conditions.

Evidence is reviewed in favour of a close relationship between the pineal hormone, melatonin and ACTH--cortisol in man. Subgroups of patients with Cushing's disease as well as with major depressive disorder have low levels of nocturnal serum melatonin. Depressed patients with an abnormal dexamethasone suppression test (DST) have lower melatonin levels than do patients with a normal DST. Low melatonin levels may be a genetic trait marker for vulnerability to depression. The mechanism may be related to increased corticotropin-releasing factor (CRF), secondary to hypofunction of a pineal factor which physiologically inhibits CRF.

Adenoma↗
PubMed1987

[Reactions of the adrenal cortex and thyroid gland of hypophysectomized rats to hypothermia].

Male Wistar rats were hypophysectomized 7 days (group 1) and 4-7 weeks (group II) before exposure to hypothermia (4 degrees C for 1 1/2 h). The hypophysectomized rats from group I were devoid of both the posterior lobe and the adenohypophysis, while the rats from group II had the posterior hypophysis but not the adenohypophysis regenerated. A decreased arginine-vasopressin (AVP) blood level in group I (32%) and a very high level of AVP in group II (311%, P less than 0.05) was determined by RIA. The exposure to hypothermia did not influence the AVP plasma level. The thyroid hypofunction was revealed morphometrically in both hypophysectomized groups. Nevertheless, cooling stimulated the thyroid glands in rats of both experimental groups, like it was in the control. Thus, there is no evidence that thyroid gland reaction to hypothermia is affected by AVP. Cooling caused an increase of corticosteroid blood and adrenal cortex content in nonoperated control rats as well as in group II, but not in group I of experimental animals. Hence, it may be assumed that when the adenohypophysis is ablated, a high AVP blood level is necessary to realize the adrenal cortex response to hypothermia.

11-Hydroxycorticosteroids↗
PubMed1991

[Mycoses and adrenocortical function. New pathogenetic aspects of adrenal hypofunction].

Three aspects of the possible relationships between adrenocortical function and mycoses are considered: a) abnormal steroid hormone concentrations that may favour onset and/or clinical course of mycotic diseases; b) presence of granulomas in the adrenal glands during systemic mycoses; c) effects of antifungal drugs on steroidogenesis. Glucocorticoids are potent inhibitors of T-lymphocyte proliferation, in that they affect both the production of IL-1 from monocytes/macrophages and IL-2 from activated T-lymphocytes. Consequently opportunistic fungal infections are frequently observed in patients with chronic hypercortisolism (Cushing's syndrome) and in particular in those under chronic treatment with corticoids. On the other hand, mucocutaneous candidiasis is a prominent feature of the autoimmune polyglandular syndrome type I, characterized by adrenal insufficiency, hypoparathyroidism and mucocutaneous candidiasis. Its onset is usually at childhood, first with symptoms and signs of the fungal infection and then with those of endocrine failure. It is a complex disorder, familiar or sporadic, not linked to particular HLA haplotype, potentially associated with other autoimmune diseases (endocrine and not), thus forming the so called candidiasis endocrinopathy syndrome (CES). Adrenal involvement is very frequent in systemic mycoses, such as histoplasmosis (Histoplasma capsulatum), cryptococcosis (Cryptococcus neoformans), and paracoccidioidomycosis. From the pathogenetic view point, corticostatins-defensins may play a role. They are a family of recently discovered cationic peptides, that are able to inhibit adrenal steroidogenesis by interfering with ACTH at the specific receptor level. The pharmacological effects of ketoconazole on adrenal (and gonadal) steroidogenesis are a focus of great interest. This compound has been demonstrated to be a potent inhibitor of cytochrome P450-dependent enzymes.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1998

Serum dehydroepiandrosterone sulfate and androstenedione concentrations in children with adrenal disorders.

This study evaluated the clinical usefulness of serum dehydroepiandrosterone sulfate (DHAS) and androstenedione concentrations in diagnosing adrenal disorders in children. Serum concentrations of DHAS and androstenedione were determined in 20 children with adrenal disorders, including virilizing adrenal tumor (3), classic congenital adrenal hyperplasia (16), and Addison's disease (1). For comparison, the sera of 276 age-matched normal children were studied. All three children with virilizing adrenal tumors had elevated serum concentrations of DHAS and androstenedione. All of the 16 children with classic congenital adrenal hyperplasia had elevated serum androstenedione concentrations and 11 had elevated serum DHAS concentrations. The serum concentrations of DHAS and androstenedione of the patient with Addison's disease were within the normal range for his age. Our findings demonstrate the value and limitations of the determination of serum DHAS and androstenedione concentration for the diagnosis of adrenal hyperandrogenic disorders in children. We suggest that the determination of serum DHAS and androstenedione concentrations may be of limited clinical value in the diagnosis of adrenal hypofunction due to Addison's disease in children.

Adrenal Gland Diseases↗
PubMed1952

Operations on the adrenal glands.

Various conditions of the adrenal gland are amenable to surgical treatment. Removal of a pheochromocytoma is almost always indicated when the tumor is diagnosed. The results of extirpation have been excellent in cases in which patients were operated upon before the onset of chronic hypertension. Removal of the "nerve cell" tumors of the adrenal is indicated if metastasis cannot be demonstrated. Hypofunction of the adrenal cortex may be partially alleviated by the repeated implantation of pellets of desoxycorticosterone acetate. Hyperfunction of the adrenal cortex causes a variety of clinical manifestations depending upon which of the numerous hormones are affected. Removal of a cortical tumor alleviates these symptoms. These tumors are malignant in more than 50 per cent of cases, and recurrence is frequent. Bilateral hyperplasia of the glands rather than a tumor may be present. In such circumstances, resection of 95 per cent of the adrenal tissue is effective in controlling the symptoms of the disease. Total bilateral excision of the adrenals is, at present, under investigation as a means of treatment for a variety of conditions.

Adrenal Cortex Neoplasms↗
PubMedDate not supplied

Adrenal bilateral incidentaloma by reactivated histoplasmosis.

We report a case of bilateral adrenal incidentaloma caused by the capsulatum variety of Histoplasma capsulatum diagnosed in a 74 years old man born in and a life time resident of Treviso, Italy, with the exception of two years spent in Pakistan (1964-1966) as a well-driller. The patient was hospitalized in 1995 for alcoholic chronic hepatitis, chronic Helicobacter pylori gastritis and post-infarction ischemic cardiomyopathy. Abdominal ultrasound incidentally showed bilateral adrenal masses (the right one 6.3 cm in diameter) confirmed by computed tomography, with adrenal function within normal limits. After three months, the patient was again hospitalized due to evening fever, asthenia, anorexia, weight loss and occasional hyperhidrosis. Abdominal ultrasound showed an increase of the right adrenal lesion with normal adrenal function. Ultrasound-guided fine needle aspiration did not prove useful for diagnosis. Accordingly, a laparotomy with bilateral biopsy was performed; histology showed the presence of numerous tissue form cells of H. capsulatum variety capsulatum. Serum anti-H. capsulatum antibodies were negative. Since March, 1996, the patient was given itraconazole and his symptoms quickly regressed but the computed tomography findings, however, have not changed and the patient has adrenal hypofunction that is being treated with cortisone acetate.

Adrenal Gland Diseases↗
PubMed1993

Polyendocrine autoimmunity in thyroid diseases.

Anti-adrenal and anti-pituitary autoantibodies have been determined in 45 patients with autoimmune diseases of the thyroid, including 25 patients with Graves' disease and 20 patients with hypothyroidism of autoimmune origin. The determinations were carried out with the use of solid-phase RIA methods previously developed by us, involving polyethylene tubes coated with the solubilized microsomal fractions obtained from human adrenal and pituitary glands. In the majority of patients with autoimmune diseases of the thyroid the presence of both anti-adrenal and anti-pituitary autoantibodies was detected. In 13 among 20 patients with hypothyroidism of autoimmune origin, the presence of anti-adrenal autoantibodies, and in 12 the presence of anti-pituitary autoantibodies was found. Among 25 patients with Graves' disease, 19 had both anti-adrenal and anti-pituitary autoantibodies. In the majority of patients with autoimmune diseases of the thyroid the titers of autoantibodies of both types were high but in no case were the clinical symptoms of adrenal or pituitary hypofunction observed. Our studies indicate that the thyroid diseases of autoimmune origin can be regarded as manifestation of some more generalized autoimmunization process.

Adrenal Glands↗
PubMed1975

[Influencing of acetylation and corticosterone biosynthesis through long-term pantothenic acid deficiency in rats].

The effect of different dietary intake of pantothenic acid (150;100;25 and 0% of the requirement) on the metabolism of rats was studied during 15 months. The ability of the adrenals for synthesis of corticosterone and the rate of acetylation of a sulfonamid (Sulfisomidin) were taken as parameters. The above mentioned parameters were influenced significantly already after two weeks and a pantothenic acid free diet containing the antagonist omega-methyl-pantothenic acid. With a 25% supply of pantothenic acid and without omega-methyl-pantothenic acid it lasted half a year until significant alterations of acetylation could be demonstrated. The synthetic ability of the adrenals for corticosteroids was significantly increased after a year in the 25% group. After the end of the study, this hyperfunctional state was followed by hypofunction, resulting in a significantly reduced ability of synthesis of the glands. Studies of this type were conducted to obrain basic informations for later experiments in human beings.

Acetylation↗
PubMed1979

[Pathogenetic mechanisms of cyst formation in the breasts and mammae].

Mammary glands and endocrine organs of human females ranging in ages from 6 months to 25 years (228 cases) as well as in intact, castrated, hypophysectomized, thyroidectomized, adrenalectomized young virgin female rats treated with steroid hormones and thyroxin were studied by various morphological methods. The process of cyst formation in female mammary glands was found to be enhanced by intensified endocrine influences on them in the interval of 6 months to 2 1/2 years (the effect of maternal hormones received by the baby with milk) and from 11 to 15 years (physiological activation of endocrine glands) and to decline in the period of relative quiescence at the age of 2 1/2 to 11 years. Both hyperestrogenism and hypercorticism and hypofunction of the thyroid gland as well as dysfunction of adenohypophysis and neuro-trophic apparatus of mammary glands are important in the pathogenesis of cysts.

Adolescent↗
PubMed2000

Hormonal alterations in rheumatoid arthritis, including the effects of pregnancy.

A number of hormonal abnormalities are present in RA patients. A major theme of these abnormalities seems to be that deficiencies in the production or action of gonadal (estrogens and androgens) and adrenal (corticosteroids and DHEA) hormones may be involved in regulating the onset, severity, and progression of RA. Differences in RA incidence and activity in the pregnant and postpartum periods provide the strongest support for this view. Hormonal changes during these periods clearly have the potential to exert profound effects on RA incidence and activity. The effect of pregnancy on RA activity is actually greater than the effect of some of the newer therapeutic agents. The striking increase in corticosteroids, estrogen, and progesterone during pregnancy may suppress RA onset or activity through the regulation of production or action of cytokines such as TNF alpha, IL-1, IL-6, IL-12, and IL-10. The relative adrenal- and gonadal-deficient environment of the postpartum period further supports the view that hormonal deficiencies predispose to the development or increased activity of RA. These observations justify the search for hormonal abnormalities in RA patients outside the pregnancy and postpartum periods. In particular, further studies on the period before the onset of disease are needed. Additional evidence does exist that a functional abnormality in the adrenal glands in RA patients results in dysregulation of corticosteroid and DHEA production. These abnormalities seem to be linked to aging and disease activity. It is still not established whether these abnormalities are primary or secondary, although data indicating adrenal hypofunction before the development of RA or within the first year of disease activity suggest a primary abnormality. Several hormonal abnormalities seem to be restricted by gender and age, particularly around perimenopause and menopause. These age- and gender-influenced effects may be the cause of some of the contradictory data reviewed here. Studies in the future should make greater efforts to segregate study populations by age, gender, and reproductive status. The identification of the specific hormonal abnormalities and patient populations that are at risk is important, because these factors may allow new therapeutic approaches that are less toxic than current regimens.

Arthritis, Rheumatoid↗
PubMed1974

Glucocorticoid induced stress susceptibility in swine: adrenocortical pathology.

The studies reported here were undertaken to better characterize the role of the adrenal cortex in the increased susceptibility to stress observed in porcine stress syndrome. Since adrenal hypofunction was suggested during early studies as a factor in events leading to porcine stress syndrome it was decided to produce such a state by the exogenous administration of the glucocorticoids prednisolone and fluoroprednisolone.A total of 34 pigs (weighing 90 to 100 kg) received a series of graded doses (given intramuscularly) of one or the other of the foregoing compounds and were necropsied 48, 72, and 120 hours after the last treatment. The major adrenocortical changes produced by these treatments were atrophy, an accentuation of degenerative changes which could be observed in milder form in many of the 30 control pigs examined, a marked increase in stainable lipid 120 hours after the last fluoroprednisolone treatment and, ultrastructurally, an increase in lysosome-like bodies and cellular debris ("myelin bodies").Adrenocortical atrophy is not a feature of porcine stress syndrome nor were the localized depositions of stainable lipid within the zona reticularis, described in porcine stress syndrome, found in the glucocorticoid treated pigs. Consequently, the findings reported here bear a somewhat limited resemblance to those observed in pigs affected by porcine stress syndrome and cast some doubt on whether adrenal hypofunction plays a role in the pathogenesis of the latter condition.

Adrenal Glands↗
PubMed1989

Hypothalamic pituitary adrenal function in patients with thalassemia major.

We examined the adrenocortical function in 14 italian thalassemic patients (8 f., 6 m.) aged 12 to 28. The following hormones were determined in each subject: plasma cortisol and aldosterone levels in both basal conditions and after maximal and submaximal stimulus (250 and 5 micrograms respectively) with synthetic corticotrophin beta 1-24 (Synacthen Ciba); corticotrophin and cortisol response to insulin-induced hypoglycaemia (0.15 U/kg iv.). Tests were repeated in all patients four years later. Normal controls were a group of 10 normal subjects matched for age, sex and body mass. Normal basal values of cortisol, aldosterone and ACTH were observed. Impaired cortisol response after stimulation with 5 micrograms of ACTH (6 patients) and after hypoglycaemia (4 patients) was identified. At the second test, four years later, one patient showed impaired cortisol response to both ACTH (5, micrograms) and hypoglycaemia, unlike the normal response to the first test. In all the others the cortisol response to stimulation did not differ from previous ones. In conclusion reduced ACTH and cortisol reserves detected in some thalassemic patients may be related to iron infiltration in the pituitary and adrenal glands. However, the present study did not indicate any significant correlation between either total blood load or serum ferritin and adrenal function parameters. Alteration in circulating hormones catabolism and impaired synthesis of transport proteins caused by chronic liver disease made adrenocortical hypofunction an even more complex picture to understand.

Adolescent↗
PubMedDate not supplied

[Influence of destruction of the subcommissural organ on the glomerular zone of the adrenal cortex].

Experiments were conducted on 30 rats; a study was made of the morphometric and quantitative enzymatico-chemical changes in the glomerular zone of the adrenal cortex in stereotaxic disturbance of the subcomissural organ; there was established a marked atrophy of the glomerular zone, a significant reduction of the diameter of the nuclei of the adrenocorticocytes and depression in these structures of the enzymatic activity of the energy metabolism. Histophysiological characteristics of the glomerular zone can be assessed as its hypofunctional condition and indicates an association between the functional activity of the subcommissural organ and the production of aldosterone.

Adrenal Cortex↗