RUSSIAN ASSOCIATION OF ENDOCRINOLOGISTS NATIONAL PRACTICE GUIDELINES (CLINICAL SIGNS, DIAGNOSIS, DIFFERENTIAL DIAGNOSIS, TREATMENT). Primary adrenal insufficiency in children and adolescents

2013 ◽  
Vol 59 (6) ◽  
pp. 44-49
Author(s):  
E M Orlova
Keyword(s):  
Differential Diagnosis ◽  
Children And Adolescents ◽  
Adrenal Insufficiency ◽  
Practice Guidelines ◽  
Clinical Signs ◽  
Primary Adrenal Insufficiency ◽  
National Practice ◽  
Russian Association

RUSSIAN ASSOCIATION OF ENDOCRINOLOGISTS NATIONAL PRACTICE GUIDELINES (CLINICAL SIGNS, DIAGNOSIS, DIFFERENTIAL DIAGNOSIS, TREATMENT). Hyperprolactinemia

2013 ◽  
Vol 59 (6) ◽  
pp. 19-26 ◽  
Author(s):  
G A Mel'nichenko ◽  
L K Dzeranova ◽  
E A Pigarova ◽  
S Iu Vorotnikova ◽  
L Ia Rozhinskaia ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Practice Guidelines ◽  
Clinical Signs ◽  
National Practice ◽  
Russian Association

IMPORTANCE OF ANTIBODIES TO 21-HYDROXYLASE FOR THE DIAGNOSIS, DIFFERENTIAL DIAGNOSIS AND PROGNOSIS OF AUTOIMMUNE CHRONIC PRIMARY ADRENAL INSUFFICIENCY

2021 ◽  
Vol 100 (2) ◽  
pp. 78-86
Author(s):  
L.S. Sozaeva ◽  
◽  
N.V. Makazan ◽  
L.V. Nikankina ◽  
N.M. Malysheva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Adrenal Insufficiency ◽  
Predictive Value ◽  
Primary Adrenal Insufficiency ◽  
Polyglandular Autoimmune Syndrome ◽  
Diagnosis And Prognosis ◽  
Specificity And Sensitivity ◽  
Enzymelinked Immunosorbent Assay

21-hydroxylase (21-OH) is the main antigen of the adrenal cortex, so the determination of antibodies (Ab) to 21-OH can help in the diagnosis and prognosis of chronic primary adrenal insufficiency (CPAI). Purpose of the study: evaluation of the relevance of Ab to 21-OH for the diagnosis and prediction of autoimmune CPAI. Materials and methods of research: the study consisted of three blocks: 1) assessment of the specificity and sensitivity, as well as the prognostic potential of Ab to 21-OH in patients with polyglandular autoimmune syndrome (APS) – individuals with APS type 1 with and without CPAI (n=106); 2) assessment of the dynamics of the level of Ab to 21-OH – patients with autoimmune CPAI were included (n=41); 3) assessment of the significance of Ab data for the differential diagnosis of various forms of CPAI, including patients with CPAI and APS type 1 exclusion (n=30). The study of Ab to 21-hydroxylase was performed using enzymelinked immunosorbent assay (BioVendor kits, Czech Republic). Results: statistically significant differences were obtained in the frequency of detection of Ab to 21-OH in patients with or without PCNI (p<0,001). The sensitivity of the method was 96%, specificity was 75%, a positive predictive value was 90%, and the negative predictive value was 89%. In 83% of patients, the level of Ab decreased with time (median size decreases – 20,4%/year). An inverse relationship was also found between the level of Ab and the duration of the course of CPAI (R=–0,460, p<0,001). In a group of 30 patients with CPAI and with exclusion of APS type 1, 21 were found to have Ab to 21-OH, only one of them had a monogenic non-autoimmune cause of CPAI (a mutation in the MC2R gene). Monogenic forms of CPAI were found in another 7 patients (mutations were found in the DAX1 and ABCD1 genes), among them an increase in Ab to 21-OH was not detected. Conclusion: determination of Ab to 21-OH is a specific and sensitive method for the diagnosis of autoimmune CPAI. An increase in Ab to 21-OH is a risk marker of autoimmune CPAI development.

scholarly journals Obojestranska krvavitev v nadledvičnico: vzrok visoki zgodnji zlatenici in akutni primarni insuficienci nadledvičnic pri novorojenčku

2018 ◽  
Vol 87 (3-4) ◽  
Author(s):  
Petja Fister ◽  
Marta Žnidaršič Eržen ◽  
Primož Kotnik ◽  
Mojca Tomažič
Keyword(s):  
Gestational Diabetes ◽  
Adrenal Insufficiency ◽  
Clinical Case ◽  
Adrenal Glands ◽  
Clinical Signs ◽  
Term Neonate ◽  
Primary Adrenal Insufficiency ◽  
Acute Adrenal Insufficiency ◽  
Life Threatening ◽  
Threatening Situation

Adrenal bleeding in a newborn is rare. The cause of bleeding is unknown, most likely due to several factors. Bleeding may be minimal with no clinical signs or fulminant with acute adrenal insufficiency, which is a life-threatening situation that requires immediate detection and treatment.In this paper we represent a clinical case of a term neonate born to the mother with gestational diabetes, who was hospitalised due to high early hyperbilirubinemia. Significant bleeding in both adrenal glands was identified by ultrasound and primary adrenal insufficiency diagnosed. We discuss possible causes, the diagnostic clues, the treatment of disease and its prognosis.

scholarly journals Severe Psychotic Disorder as the Main Manifestation of Adrenal Insufficiency

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Julia de Lima Farah ◽  
Carolina Villar Lauand ◽  
Lucas Chequi ◽  
Enrico Fortunato ◽  
Felipe Pasqualino ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Psychotic Disorder ◽  
Clinical Presentation ◽  
Neuropsychiatric Symptoms ◽  
Clinical Signs ◽  
Brain Magnetic Resonance Imaging ◽  
Serum Cortisol ◽  
Psychotic Symptoms ◽  
Primary Adrenal Insufficiency ◽  
Very High

We describe a case of severe psychotic disorder as the only manifestation of primary adrenal insufficiency. A 63-year-old man presented with psychotic symptoms without any prior psychiatric history. During the clinical and laboratorial investigation, exams revealed a normovolemic hyponatremia. The patient showed no other clinical signs or symptoms compatible with adrenal insufficiency but displayed very high ACTH and low serum cortisol concentrations. Brain magnetic resonance imaging showed no significant changes, including the pituitary gland. The patient was initially treated with intravenous corticosteroids, resulting in rapid remission of the psychotic symptoms. The association between adrenal insufficiency and neuropsychiatric symptoms is rare but these symptoms can often be the first clinical presentation of the disease.

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