Approach to the Patient: A Case With an Unusual Cause of Hypopituitarism

The Journal of Clinical Endocrinology & Metabolism, Год журнала: 2022, Номер 108(6), С. 1488 - 1504

Опубликована: Дек. 27, 2022

Abstract Hypopituitarism, which refers to insufficiency of one or more hormones the pituitary, can be due myriad causes. The clinical and radiological spectrum condition is heterogeneous, based on patient’s age, gender, setting, and/or other past medical history. Hypopituitarism includes central hypocortisolism, hypothyroidism, hypogonadism, growth hormone deficiency. Both hypo- hyperprolactinemia associated with hypopituitarism, low prolactin signifying extensive pituitary damage. Posterior (arginine vasopressin deficiency) occurs either in isolation anterior Clinical symptomatology hypopituitarism usually nonspecific insidious onset progression. Overall, most common cause a adenoma its management (surgery, radiotherapy, pharmacotherapy, combination these). However, it this subset patients likely identified managed timely manner, possibly alleviating premature mortality hypopituitarism. What challenging recognition less settings, may direct involvement (infection, traumatic brain injury, infiltrative causes) indirectly as consequence primary process (thalassemia, vasculotoxic snakebite, subarachnoid hemorrhage). These entities are often under-recognized, increased awareness help greater burden. Further, these settings dynamic progress, rarely, show recovery function. This renders complexity problem, but makes even imperative suspect, screen, appropriately manage causes

Язык: Английский

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Obesity-Associated Hepatic Steatosis, Somatotropic Axis Impairment, and Ferritin Levels Are Strong Predictors of COVID-19 Severity

Viruses, Год журнала: 2023, Номер 15(2), С. 488 - 488

Опубликована: Фев. 9, 2023

The full spectrum of SARS-CoV-2-infected patients has not yet been defined. This study aimed to evaluate which parameters derived from CT, inflammatory, and hormonal markers could explain the clinical variability COVID-19. We performed a retrospective including SARS-CoV-2–infected hospitalized March 2020 May 2021 at Umberto I Polyclinic Rome. Patients were divided into four groups according degree respiratory failure. Routine laboratory examinations, BMI, liver steatosis indices, CT attenuation, ferritin, IGF-1 serum levels assessed correlated with severity. Analysis variance between showed that worse prognoses had higher BMI ferritin levels, but lower density, albumin, GH, IGF-1. ROC analysis confirmed prognostic accuracy in discriminating who experienced death/severe failure those did (AUC 0.688, CI: 0.587 0.789, p < 0.001). A multivariate considering degrees severity disease as dependent variable standard deviation score regressors all three significant predictors. Ferritin, IGF-1, account for increased risk poor prognosis COVID-19 obesity.

Язык: Английский

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New onset of isolated adrenocorticotropin deficiency associated with encephalopathy following coronavirus disease 2019 in a healthy elderly man

Endocrine Journal, Год журнала: 2024, Номер 71(3), С. 305 - 312

Опубликована: Янв. 1, 2024

Coronavirus disease 2019 (COVID-19) due to a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can include various systemic organ disorders including endocrinopathies and neurological manifestations. We report the case of 65-year-old Japanese man who developed isolated adrenocorticotropic hormone (ACTH) deficiency encephalopathy following SARS-CoV-2 infection. Two weeks after his COVID-19 diagnosis, he was emergently admitted our hospital because subacute-onset delirium. On admission, presented hyponatremia (128 mEq/L) secondary adrenal insufficiency (ACTH <1.5 pg/mL, cortisol 0.53 μg/dL). Brain imaging laboratory examinations polymerase chain reaction testing in cerebrospinal fluid revealed no abnormalities. His consciousness level worsened despite amelioration by intravenous hydrocortisone (100 mg/day), but presentations completely resolved three consecutive days high-dose (400 mg/day) hydrocortisone. did not deteriorate during tapering. He continued 15 mg/day discharge. might have via disturbance autoimmune system, or metabolic effect associated with insufficiency, although time lag between hyponatremia's improvement patient's response steroid incompatible common cases delirium concurrent insufficiency. At 13 months hospitalization, symptoms recurred has endocrinological dysfunctions other than remaining ACTH deficiency. A thorough consideration immunological characteristics is advisable when clinicians treat patients even their period.

Язык: Английский

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Pituitary surgery and COVID

Pituitary, Год журнала: 2024, Номер unknown

Опубликована: Июль 5, 2024

Язык: Английский

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Covid-19 and Thyroid: A Scopus-based Bibliometric Assessment of Research Output

Journal of Young Pharmacists, Год журнала: 2021, Номер 13(3s), С. s84 - s88

Опубликована: Дек. 8, 2021

Introduction: A bibliometric assessment of coronavirus disease 2019 (Covid-19)-related thyroid research is unavailable. Materials and Methods: We searched Elsevier’s Scopus database for publications on Covid-19 up to August 18, 2021, using a predefined search strategy. The data were analyzed by publication characteristics, the most active countries, institutions, authors, journals, citations, trends. Results: global totaled 599; 446 (74.4%) original articles. Only 18.0% (108) funded, but these received higher citations per paper (CPP) than non-funded (average CPP 14.8 versus 9.8). Of 97 countries that participated in research, USA, Italy, India, China productive, whereas China, Germany, UK, USA impactful. studied patient population groups “Adults” (50.5%), “Middle-Aged” (33.7%), “Aged” (29.3%), “Children” (7.8%), “Adolescents” (6.5%). organizations authors numbered 272 404, respectively. productive Universita Degli Studi Napoli, Harvard Medical School, Milano, Italy. G. Troncone, L. Glovanella, Anedda. top journals Endocrine, Journal Endocrine Investigation, Frontiers Endocrinology. 22 (3.6%) highly-cited 141.8). Conclusion: concerning disorders has been largely conducted Europe with contributions from India. There need foster collaboration between high- low-income formulating better strategies tackle thyroidrelated morbidities Covid-19. Additionally, such should involve younger age groups. justify;">Key words: Coronavirus 2019, Thyroid diseases, Co-morbidities, Children, Adults.

Язык: Английский

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