Format
Sort by
Items per page

Send to

Choose Destination

Search results

Items: 1 to 20 of 67904

1.
Medicine (Baltimore). 2018 Sep;97(39):e12336. doi: 10.1097/MD.0000000000012336.

Non-α-fetoprotein-producing adrenal hepatoid adenocarcinoma: A case report and literature review.

Author information

1
Oncology Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.

Abstract

RATIONALE:

Adrenal hepatoid adenocarcinoma typically secretes alpha-fetoprotein (AFP). Here, we report a case of non-AFP-producing adrenal hepatoid adenocarcinoma. Next-generation sequencing (NGS) was conducted to identify gene mutations.

PATIENT CONCERNS:

A 64-year-old man presented with mild back pain and unexplained weight loss for 3 months.

DIAGNOSES:

Contrast-enhanced magnetic resonance imaging (MRI) showed a mass (9.9 × 9.7 × 9.1 mm) above the upper pole of the left kidney. The left renal artery and vein were compressed. The tumor was positive for CK8/18, CK19, CK7, hepatocyte marker (Hepatocyte), and Hep Par 1, but negative for AFP. Plasma AFP was 2.75 ng/mL (normal range: 0-7 ng/mL). NGS revealed mutations of the following genes: ATM, CDKN2A, EGFR, STK11, TP53, BIM, and MLH1. A diagnosis of adrenal hepatoid adenocarcinoma was established.

INTERVENTIONS:

The treatment included 4 cycles of the mFOLFOX6 regimen (oxaliplatin, leucovorin, and fluorouracil), transcatheter arterial chemoembolization, and apatinib.

OUTCOMES:

The patient died 9 months after the diagnosis.

LESSONS:

This case highlights the importance of thorough clinical, radiological, and immunohistochemical investigation for suspected adrenal hepatoid adenocarcinoma. Metastasis from other primary tumors should be ruled out. Furthermore, AFP is not necessarily elevated in adrenal hepatoid adenocarcinoma. NGS could be helpful in establishing the diagnosis and selecting treatments.

PMID:
30278510
DOI:
10.1097/MD.0000000000012336
[Indexed for MEDLINE]
Free full text
Icon for Wolters Kluwer
2.
Anticancer Res. 2018 Aug;38(8):4767-4773. doi: 10.21873/anticanres.12785.

Relationship Among Tumor Attenuation Value of Pre-contrast Computed Tomography (CT), Washout Rate and Constituent Cells in Adrenal Adenoma: Proposition of a New Approach for Diagnosing Adrenal Adenoma on Dynamic CT.

Author information

1
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan anishie@radiol.med.kyushu-u.ac.jp.
2
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
3
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
4
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Abstract

AIM:

To elucidate the relationship among tumor attenuation of pre-contrast-enhanced (TApre) computed tomography (CT), washout rate and clear cell ratio (CCR) in adrenal adenoma (AA) and propose a new approach for diagnosing AA on dynamic CT.

MATERIALS AND METHODS:

The training set consisted of 43 AAs and 15 non-AAs, while the validation set comprised 44 AAs and 11 non-AAs. Using the training set, the pairwise correlation between CCR, TApre and washout rate in AA was evaluated by linear regression analysis. A predictive formula for diagnosing AA was established by multiple logistic regression analysis using washout rate and TApre. Using the validation set, the diagnostic performance of this formula was investigated by comparing with the conventional diagnostic criteria: TApre ≤10 HU or washout rate ≥an optimal threshold calculated in the training set.

RESULTS:

Washout rate increased as CCR decreased, and as TApre increased. The formula predicting the probability of AA was: p(AA)=1/{1+exp(-1.5257+0.4923× TApre-0.3264×washout rate)}. Diagnostic performance of this formula was sensitivity of 93.2% and accuracy of 89.1%, while for the conventional diagnostic criteria, sensitivity was 81.8-86.4% and accuracy 81.8-83.6%.

CONCLUSION:

The diagnostic potential of dynamic CT for diagnosing AA may be improved by changing the threshold of washout rate based on substituting TApre for CCR.

KEYWORDS:

CT; adrenal adenoma; clear cell; compact cell; washout

PMID:
30061247
DOI:
10.21873/anticanres.12785
[Indexed for MEDLINE]
Icon for HighWire
3.
N Engl J Med. 2018 Jun 28;378(26):e36. doi: 10.1056/NEJMicm1711735.

Adrenal Calcifications in an Infant.

Author information

1
Schneider Children's Medical Center of Israel, Petah Tikva, Israel iritk3@clalit.org.il.
2
Ben Gurion University of the Negev, Beer-Sheva, Israel.
PMID:
29949482
DOI:
10.1056/NEJMicm1711735
[Indexed for MEDLINE]
Free full text
Icon for Atypon
4.
Radiol Clin North Am. 2018 Jul;56(4):549-563. doi: 10.1016/j.rcl.2018.03.004.

Practical Applications of Dual-Energy Computed Tomography in the Acute Abdomen.

Author information

1
Medical Imaging Department, Abdominal Imaging Section, Ministry of the National Guard, Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Prince Mutib Ibn Abdullah Ibn Abdulaziz Road, Ar Rimayah, Riyadh 14611, Saudi Arabia. Electronic address: mohammed.f.mohammed@gmail.com.
2
Department of Medical Imaging, Emergency and Trauma Radiology Division, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
3
Medical Imaging Department, Abdominal Imaging Section, Ministry of the National Guard, Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Prince Mutib Ibn Abdullah Ibn Abdulaziz Road, Ar Rimayah, Riyadh 14611, Saudi Arabia.
4
Department of Radiology, Vancouver General Hospital, 899 West 12th Avenue, Vancouver, British Columbia V5Z1M9, Canada.

Abstract

With new developments in workflow automation, as well as technological advances enabling faster imaging with improved image quality and dose profile, dual-energy computed tomography is being used more often in the imaging of the acutely ill and injured patient. Its ability to identify iodine, differentiate it from hematoma or calcification, and improve contrast resolution has proven invaluable in the assessment of organ perfusion, organ injury, and inflammation.

KEYWORDS:

Abdomen; Dual-energy CT; Gallstone; Gangrene; Inflammation; Ischemia; Pelvis; Trauma

PMID:
29936947
DOI:
10.1016/j.rcl.2018.03.004
[Indexed for MEDLINE]
Icon for Elsevier Science
5.
Clin Biochem. 2018 Sep;59:86-89. doi: 10.1016/j.clinbiochem.2018.06.013. Epub 2018 Jun 21.

Two cases of Cushing's syndrome due to primary bilateral macronodular adrenal hyperplasia secondary to aberrant adrenal expression of hormone receptors.

Author information

1
Servicio de Análisis Clínicos, Hospital Virgen de Los Lirios, Spain. Electronic address: julia_marsan@gva.es.
2
Servicio de Endocrinología, Hospital Virgen de los Lirios, Spain.
3
Servicio de Análisis Clínicos, Hospital Virgen de Los Lirios, Spain.
4
Servicio de Análisis Clínicos, Hospital General Universitario de Alicante, Spain.

Abstract

OBJECTIVES:

Primary bilateral macronodular adrenal hyperplasia is an uncommon cause of endogenous Cushing's syndrome characterized by the presence of aberrant adrenal expression of ectopic receptors that regulate steroidogenesis by mimicking the events triggered by ACTH receptor activation. Receptors of this type have been described for several hormones. The aim of the study is to detect these receptors in two patients with ACTH-independent hypercortisolism by means of the application of a screening protocol.

DESIGN AND METHODS:

A protocolized study of aberrant receptors was performed including measurements of ACTH, cortisol and other steroids and hormones. Upright posture test, mixed food and administration of Gonadotropin-Releasing Hormone (GnRH) were used as stimuli. In both patients, a stimulation test with intravenous ACTH was conducted to determinate the cortical response capacity. The study was carried out in three separate days.

RESULTS:

The first patient, who had a hypergonadotropic hypogonadism, presented anomalous cortisol response to the GnRH stimulation, with potential medical treatment by the use of exogenous testosterone. In the second case, the patient with clinical Cushing's syndrome presented anomalous cortisol response to standing, whose potential medical treatment would be the use of beta-blockers.

CONCLUSIONS:

This etiological variant of ACTH-independent Cushing's syndrome leads to the use of specific pharmacologic therapies in some cases as alternatives to adrenalectomy. The studied cases show the importance of having a high degree of suspicion when diagnosing less frequent types of Cushing's syndrome.

KEYWORDS:

Aberrant receptors; Bilateral macronodular adrenal hyperplasia; Cushing's syndrome

[Indexed for MEDLINE]
Icon for Elsevier Science
7.
J Chromatogr B Analyt Technol Biomed Life Sci. 2018 Aug 15;1092:106-113. doi: 10.1016/j.jchromb.2018.06.001. Epub 2018 Jun 2.

A method for determination of aldosterone in adrenal tributary venous serum by derivatization using Girard P reagent isotopologues followed by LC/ESI-MS/MS.

Author information

1
Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda-shi, Chiba 278-8510, Japan. Electronic address: higashi@rs.tus.ac.jp.
2
Faculty of Pharmaceutical Sciences, Tokyo University of Science, 2641 Yamazaki, Noda-shi, Chiba 278-8510, Japan.
3
Department of Biochemistry, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo 160-8582, Japan.
4
Endocrinology & Diabetes Center, Yokohama Rosai Hospital, 3211 Kozukue-cho, Kohoku-ku, Yokohama 222-0036, Japan.
5
Department of Uro-Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama 350-1298, Japan.

Abstract

The quantification of aldosterone (ALD) in adrenal tributary venous blood serum/plasma combined with the super-selective adrenal venous sampling (ssAVS) technique is recognized as a definitive procedure for differentiation of the forms of primary aldosteronism (PA), identification of the affected segment(s) and operating decision-making. In this study, an enhanced throughput and sensitive method was developed and validated for the quantification of ALD in ssAVS serum samples by liquid chromatography/electrospray ionization-tandem mass spectrometry (LC/ESI-MS/MS) combined with derivatization using the Girard P reagent (GP) isotopologues (2H0- and 2H5-GP). The right and left adrenal serum samples were separately pretreated and derivatized with either isotopologue. The two samples were then combined and injected together for LC/ESI-MS/MS analysis. Based on the mass differences between the isotopologues, the derivatized ALD in the two samples were quantified within a single run. This method enabled the reproducible (intra- and inter-assay relative standard deviations, 6.6% or lower) and accurate (98.2-107.0%) quantification of the serum ALD using a 25-μL sample, and the lower limit of quantification was 1.0 ng/mL. The developed method was used for the analysis of 11 pairs of ssAVS serum samples (total of 22 samples) of patients with ALD-producing adenoma and proven to have a satisfactory applicability; this method enabled the identification of the affected adrenal and the determination of the laterality of PA, and reduced the analysis time to about 2/3 compared to the previous method for 22 samples.

KEYWORDS:

Aldosterone; Analysis throughput; Isotopologue; LC/ESI-MS/MS; Super-selective adrenal venous sampling

PMID:
29886288
DOI:
10.1016/j.jchromb.2018.06.001
[Indexed for MEDLINE]
Icon for Elsevier Science
8.
Biomed Res Int. 2018 Mar 29;2018:9046891. doi: 10.1155/2018/9046891. eCollection 2018.

Different Membrane Pathways Mediate Ca2+ Influx in Adrenal Chromaffin Cells Exposed to 150-400 ns Electric Pulses.

Author information

1
Department of Pharmacology, University of Nevada, Reno School of Medicine, Reno, NV 89557, USA.

Abstract

Exposing adrenal chromaffin cells to 5 ns electric pulses (nsPEF) causes a rapid rise in intracellular Ca2+ ([Ca2+]i) that is solely the result of Ca2+ influx through voltage-gated Ca2+ channels (VGCCs). This study explored the effect of longer duration nsPEF on [Ca2+]i. Single 150, 200, or 400 ns pulses at 3.1 kV/cm evoked rapid increases in [Ca2+]i, the magnitude of which increased linearly with pulse width and electric field amplitude. Recovery of [Ca2+]i to prestimulus levels was faster for 150 ns exposures. Regardless of pulse width, no rise in [Ca2+]i occurred in the absence of extracellular Ca2+, indicating that the source of Ca2+ was from outside the cell. Ca2+ responses evoked by a 150 ns pulse were inhibited to varying degrees by ω-agatoxin IVA, ω-conotoxin GVIA, nitrendipine or nimodipine, antagonists of P/Q-, N-, and L-type VGCCs, respectively, and by 67% when all four types of VGCCs were blocked simultaneously. The remaining Ca2+ influx insensitive to VGCC inhibitors was attributed to plasma membrane nanoporation, which comprised the E-field sensitive component of the response. Both pathways of Ca2+ entry were inhibited by 200 μM Cd2+. These results demonstrate that, in excitable chromaffin cells, single 150-400 ns pulses increased the permeability of the plasma membrane to Ca2+ in addition to causing Ca2+ influx via VGCCs.

PMID:
29789806
PMCID:
PMC5896273
DOI:
10.1155/2018/9046891
[Indexed for MEDLINE]
Free PMC Article
Icon for Hindawi Publishing Corporation Icon for PubMed Central
9.
Eur J Endocrinol. 2018 Aug;179(2):R95-R110. doi: 10.1530/EJE-17-0976. Epub 2018 May 17.

MECHANISMS OF ENDOCRINOLOGY: Cell cycle regulation in adrenocortical carcinoma.

Author information

1
Instituto de Investigação e Inovação em Saúde (I3S)Universidade do Porto, Porto, Portugal.
2
Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP)Porto, Portugal.
3
Clinical and Experimental EndocrinologyDepartment of Anatomy, Multidisciplinary Unit for Biomedical Research (UMIB), Instituto de Ciências Biomédicas Abel Salazar, University of Porto (ICBAS/UP), Porto, Portugal.
4
Endocrinology DivisionDepartment of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada.
5
Instituto de Investigação e Inovação em Saúde (I3S)Universidade do Porto, Porto, Portugal dpignatelli@yahoo.com.
6
Department of EndocrinologyHospital S. João, Porto, Portugal.

Abstract

Adrenocortical carcinomas (ACCs) are rather rare endocrine tumors that often have a poor prognosis. The reduced survival rate associated with these tumors is due to their aggressive biological behavior, combined with the scarcity of effective treatment options that are currently available. The recent identification of the genomic alterations present in ACC have provided further molecular mechanisms to develop consistent strategies for the diagnosis, prevention of progression and treatment of advanced ACCs. Taken together, molecular and genomic advances could be leading the way to develop personalized medicine in ACCs similarly to similar developments in lung or breast cancers. In this review, we focused our attention to systematically compile and summarize the alterations in the cell cycle regulation that were described so far in ACC as they are known to play a crucial role in cell differentiation and growth. We have divided the analysis according to the major transition phases of the cell cycle, G1 to S and G2 to M. We have analyzed the most extensively studied checkpoints: the p53/Rb1 pathway, CDC2/cyclin B and topoisomerases (TOPs). We reached the conclusion that the most important alterations having a potential application in clinical practice are the ones related to p53/Rb1 and TOP 2. We also present a brief description of on-going clinical trials based on molecular alterations in ACC. The drugs have targeted the insulin-like growth factor receptor 1, TOP 2, polo-like kinase1, cyclin-dependent kinase inhibitors, p53 reactivation and CDC25.

PMID:
29773584
DOI:
10.1530/EJE-17-0976
[Indexed for MEDLINE]
Icon for Sheridan PubFactory
10.
Medicine (Baltimore). 2018 May;97(20):e10730. doi: 10.1097/MD.0000000000010730.

Synchronous adrenocortical carcinoma and ovarian malignant mixed germ cell tumor: A case report and literature review.

He Y1,2, Xu L1,2, Li Q2,3, Feng M1,2, Wang W1,2.

Author information

1
Department of Pathology, West China Second Hospital of Sichuan University.
2
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education.
3
Department of Gynecology, West China Second Hospital of Sichuan University, Sichuan, China.

Abstract

RATIONALE:

Adrenocortical carcinoma (ACC) is an endocrine malignancy with poor prognosis, which commonly arises in a sporadic manner, but may also become a part of a familial syndrome. ACC rarely arises simultaneously with other malignant tumors.

PATIENT CONCERNS:

We report a case of a 29-year-old woman with ACC synchronously followed by an ovarian malignant mixed germ cell tumor. We describe the clinical, histopathological, and immunohistochemical findings and review the English literatures. So far, as we know, the patient presented here is the first case with synchronous malignant tumors of the adrenal gland and ovary.

DIAGNOSES:

She was diagnosed with ovarian malignant mixed germ cell tumor with admixture of dysgerminoma and yolk sac tumor after ACC.

INTERVENTIONS:

The left adrenal tumor was resected laparoscopically on April 28, 2017. A total laparoscopic hysterectomy with unilateral (right) adnexectomy was performed on November 11, 2017.

OUTCOMES:

Up to now, illness condition has not progressed. Patient is free of disease at 3 months of follow-up.

LESSONS:

This is the first report in English literature about coexistence of ACC with ovarian malignant mixed germ cell tumor and the sixteenth case that presents a synchronous tumor associated with a sporadic ACC. This case reminds us that a comprehensive examination of patients with ACC is necessary to identify a possible synchronous tumor.

PMID:
29768344
PMCID:
PMC5976290
DOI:
10.1097/MD.0000000000010730
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central
11.
Eur J Endocrinol. 2018 Aug;179(2):R57-R67. doi: 10.1530/EJE-18-0296. Epub 2018 May 10.

MANAGEMENT OF ENDOCRINE DISEASE: Differential diagnosis, investigation and therapy of bilateral adrenal incidentalomas.

Author information

1
Division of EndocrinologyDepartment of Medicine, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, Montréal, Canada isabelle.bourdeau@umontreal.ca.
2
Division of EndocrinologyDepartment of Medicine, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, Montréal, Canada.

Abstract

The investigation and management of unilateral adrenal incidentalomas have been extensively considered in the last decades. While bilateral adrenal incidentalomas represent about 15% of adrenal incidentalomas (AIs), they have been less frequently discussed. The differential diagnosis of bilateral incidentalomas includes metastasis, primary bilateral macronodular adrenal hyperplasia and bilateral cortical adenomas. Less frequent etiologies are bilateral pheochromocytomas, congenital adrenal hyperplasia (CAH), Cushing's disease or ectopic ACTH secretion with secondary bilateral adrenal hyperplasia, primary malignancies, myelolipomas, infections or hemorrhage. The investigation of bilateral incidentalomas includes the same hormonal evaluation to exclude excess hormone secretion as recommended in unilateral AI, but diagnosis of CAH and adrenal insufficiency should also be excluded. This review is focused on the differential diagnosis, investigation and treatment of bilateral AIs.

PMID:
29748231
DOI:
10.1530/EJE-18-0296
[Indexed for MEDLINE]
Icon for Sheridan PubFactory
12.
Int J Mol Sci. 2018 May 8;19(5). pii: E1406. doi: 10.3390/ijms19051406.

Endogenous Purification of NR4A2 (Nurr1) Identified Poly(ADP-Ribose) Polymerase 1 as a Prime Coregulator in Human Adrenocortical H295R Cells.

Author information

1
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. erika.noro.r7@dc.tohoku.ac.jp.
2
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. ayokoyama@med.tohoku.ac.jp.
3
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. mk59040@gmail.com.
4
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. h.shimada.is1@med.tohoku.ac.jp.
5
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. s.suzuki0616@med.tohoku.ac.jp.
6
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. m.hosokawa@med.tohoku.ac.jp.
7
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. ten10104shen@yahoo.co.jp.
8
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. rehanadu@yahoo.com.
9
Department of Biochemistry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. shima4@med.tohoku.ac.jp.
10
Department of Biochemistry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. igarashi@med.tohoku.ac.jp.
11
Department of Molecular Endocrinology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. akiras2i@med.tohoku.ac.jp.

Abstract

Aldosterone is synthesized in zona glomerulosa of adrenal cortex in response to angiotensin II. This stimulation transcriptionally induces expression of a series of steroidogenic genes such as HSD3B and CYP11B2 via NR4A (nuclear receptor subfamily 4 group A) nuclear receptors and ATF (activating transcription factor) family transcription factors. Nurr1 belongs to the NR4A family and is regarded as an orphan nuclear receptor. The physiological significance of Nurr1 in aldosterone production in adrenal cortex has been well studied. However, coregulators supporting the Nurr1 function still remain elusive. In this study, we performed RIME (rapid immunoprecipitation mass spectrometry of endogenous proteins), a recently developed endogenous coregulator purification method, in human adrenocortical H295R cells and identified PARP1 as one of the top Nurr1-interacting proteins. Nurr1-PARP1 interaction was verified by co-immunoprecipitation. In addition, both siRNA knockdown of PARP1 and treatment of AG14361, a specific PARP1 inhibitor suppressed the angiotensin II-mediated target gene induction in H295R cells. Furthermore, PARP1 inhibitor also suppressed the aldosterone secretion in response to the angiotensin II. Together, these results suggest PARP1 is a prime coregulator for Nurr1.

KEYWORDS:

AG14361; CYP11B2; H295R; HSD3B1; NR4A2; Nurr1; PARP1; aldosterone; hypertension; treatment-resistant hypertension

PMID:
29738496
PMCID:
PMC5983848
DOI:
10.3390/ijms19051406
[Indexed for MEDLINE]
Free PMC Article
Icon for Multidisciplinary Digital Publishing Institute (MDPI) Icon for PubMed Central
13.
Eur J Radiol. 2018 Jun;103:147-162. doi: 10.1016/j.ejrad.2018.03.026. Epub 2018 Mar 31.

Imaging paracoccidioidomycosis: A pictorial review from head to toe.

Author information

1
Department of Neuroradiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: marcos.rosa@ufes.br.
2
Department of Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: isabella.baldon@ufes.br.
3
Department of Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: andre.amorim@ufes.br.
4
Department of Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: ana.fonseca@ufes.br.
5
Department of Abdominal Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: richard.volpato@ebserh.gov.br.
6
Department of Musculoskeletal Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: rafael.lourenço@ebserh.gov.br.
7
Department of Thoracic Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: rodrigo.baptista@ufes.br.
8
Department of Musculoskeletal Radiology, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: ricardo.mello@ufes.br.
9
Department of Infectious Diseases, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: paulo.pecanha@ufes.br.
10
Department of Infectious Diseases, Hospital Universitário Cassiano Antônio de Moraes da Universidade Federal do Espírito Santo - HUCAM/UFES/EBSERH, Vitória ES, Brazil. Electronic address: aloisio.falqueto@ufes.br.

Abstract

Paracoccidioidomycosis is an infectious disease characterized primarily by pulmonary involvement and potential dissemination to other organs, mainly mucosa and skin; however, it can affect any organ in the body. Although difficult to diagnose purely based on imaging, imaging is important for diagnosis, follow-up, and assessment of disease-related complications. We provide a comprehensive review of the most notable imaging findings of paracoccidioidomycosis.

KEYWORDS:

Computed tomography; Magnetic resonance imaging; Paracoccidioidomycosis; Systemic mycosis

PMID:
29685479
DOI:
10.1016/j.ejrad.2018.03.026
[Indexed for MEDLINE]
Icon for Elsevier Science
14.
BMC Neurol. 2018 Apr 23;18(1):48. doi: 10.1186/s12883-018-1049-9.

Acquired modification of sphingosine-1-phosphate lyase activity is not related to adrenal insufficiency.

Author information

1
Department of Neurology, Marmara University, Istanbul, Turkey.
2
Department of Paediatric Endocrinology and Diabetes, Marmara University, Fevzi Cakmak Mh. Mimar Sinan Cd.No 41., Ustkaynarca/Pendik, 34899, Istanbul, Turkey.
3
Department of Biochemistry, Marmara University, Istanbul, Turkey.
4
Department of Paediatric Endocrinology and Diabetes, Marmara University, Fevzi Cakmak Mh. Mimar Sinan Cd.No 41., Ustkaynarca/Pendik, 34899, Istanbul, Turkey. tulayguran@yahoo.com.

Abstract

BACKGROUND:

Congenital sphingosine-1-phosphate (S1P) lyase deficiency due to biallelic mutations in SGPL1 gene has recently been described in association with primary adrenal insufficiency and steroid-resistant nephrotic syndrome. S1P lyase, on the other hand, is therapeutically inhibited by fingolimod which is an oral drug for relapsing multiple sclerosis (MS). Effects of this treatment on adrenal function has not yet been evaluated. We aimed to test adrenal function of MS patients receiving long-term fingolimod treatment.

METHODS:

Nineteen patients (14 women) with MS receiving oral fingolimod (Gilenya®, Novartis) therapy were included. Median age was 34.2 years (range; 21.3-44.6 years). Median duration of fingolimod treatment was 32 months (range; 6-52 months) at a dose of 0.5 mg/day. Basal and ACTH-stimulated adrenal steroid measurements were evaluated simultaneously employing LC-MS/MS based steroid panel. Basal steroid concentrations were also compared to that of sex- and age-matched healthy subjects. Cortisol and 11-deoxycortisol, 11-deoxycorticosterone and dehydroepiandrosterone were used to assess glucocorticoid, mineralocorticoid and sex steroid producing pathways, respectively.

RESULTS:

Basal ACTH concentrations of the patients were 20.8 pg/mL (6.8-37.8 pg/mL) (normal range; 5-65 pg/mL). There was no significant difference in the basal concentrations of cortisol, 11-deoxycortisol, 11-deoxycorticosterone and dehydroepiandrosterone between patients and controls (p = 0.11, 0.058, 0.74, 0.15; respectively). All patients showed adequate cortisol response to 250 mcg IV ACTH stimulation (243 ng/mL, range; 197-362 ng/mL). There was no significant correlation between duration of fingolimod treatment and basal or ACTH-stimulated cortisol or change in cortisol concentrations during ACTH stimulation test (p = 0.57, 0.66 and 0.21, respectively).

CONCLUSION:

Modification and inhibition of S1P lyase activity by the long-term therapeutic use of fingolimod is not associated with adrenal insufficiency in adult patients with MS. This suggests that S1P lyase has potentially a critical role on adrenal development rather than the function of a fully mature adrenal gland.

KEYWORDS:

Adrenal; Fingolimod; Multiple sclerosis; Sphingosine-1-phosphate lyase

PMID:
29685115
PMCID:
PMC5911956
DOI:
10.1186/s12883-018-1049-9
[Indexed for MEDLINE]
Free PMC Article
Icon for BioMed Central Icon for PubMed Central
15.
Clin Biochem. 2018 Jun;56:26-32. doi: 10.1016/j.clinbiochem.2018.04.006. Epub 2018 Apr 16.

Assessment of hair cortisol as a potential biomarker for possible adrenal suppression due to inhaled corticosteroid use in children with asthma: A retrospective observational study.

Author information

1
Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada; Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
2
Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
3
Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; University Institute of Clinical Chemistry, Inselspital Bern University Hospital, University of Bern, Switzerland.
4
Winnipeg Regional Health Authority, Pharmacy Department, Winnipeg, Manitoba, Canada.
5
Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, Toronto, ON, Canada.
6
Child & Family Research Institute, Vancouver, BC, Canada; Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, BC, Canada. Electronic address: bcarleton@popi.ubc.ca.
7
Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Maccabi-Kahn Research Institute, Tel Aviv, Israel.

Abstract

BACKGROUND:

Inhaled corticosteroids (ICS) are the recommended long-term control therapy for asthma in children. However, concern exists regarding potential adrenal suppression with chronic ICS use. Our pilot study reported that hair cortisol in children was 50% lower during ICS therapy than prior to therapy, suggestive of adrenal suppression.

OBJECTIVE:

To evaluate hair cortisol concentration (HCC) as a potential biomarker for possible adrenal suppression from ICS use in children with asthma.

METHODS:

A retrospective observational study was performed at asthma clinics in Vancouver, Winnipeg, and Toronto, Canada. Children (n = 586) were recruited from July 2012 to December 2014 inclusive of those without asthma, with asthma not using ICS, and with asthma using ICS. The most recent three-month HCC was measured by enzyme immunoassay and compared among the groups. Quantile regression analysis was performed to identify factors potentially affecting HCC.

RESULTS:

The median HCC was not significantly different among the children: No ICS (n = 47, 6.7 ng/g, interquartile range (IQR) 3.7-9.8 ng/g), ICS Treated (n = 360, 6.5 ng/g, IQR 3.8-14.3 ng/g), and Controls (n = 53, 5.8 ng/g, IQR 4.6-16.7 ng/g). 5.6% of the children using ICS had hair cortisol <2.0 ng/g compared to none in the control groups (P < .05, comparing ICS Treated (20/360) to all Controls combined (0/100)) and only half had been exposed to systemic corticosteroids. Age, sex, BMI, and intranasal corticosteroid use were significantly associated with HCC.

CONCLUSIONS:

Results suggest HCC may be a potential biomarker for adrenal suppression as a population of children using ICS with HCC < 2.0 ng/g was identified compared to none in the control groups. Further research is needed to determine if those children have or are at risk of adrenal suppression or insufficiency.

KEYWORDS:

Asthma; Biomarker; Children; Hair cortisol; Inhaled corticosteroids

[Indexed for MEDLINE]
Icon for Elsevier Science
16.
Ann Endocrinol (Paris). 2018 Jun;79(3):95-97. doi: 10.1016/j.ando.2018.03.014. Epub 2018 Apr 16.

Adrenocortical development: Lessons from mouse models.

Author information

1
GReD, CNRS, Inserm, université Clermont-Auvergne, 63001 Clermont-Ferrand, France.
2
Molecular endocrinology and rare diseases, university hospital, Claude-Bernard Lyon 1 University, 69500 Bron, France.
3
Unit of hormone and nutrition, department of biochemistry, university hospital, 38000 Grenoble, France.
4
Department of molecular biology, graduate school of medical sciences, Kyushu University, Fukuoka, Japan.
5
Division of endocrinology, Boston Children's Hospital, department of pediatrics, Harvard Medical School, Boston, MA, United States; Harvard Stem Cell Institute, Cambridge, MA, United States.
6
GReD, CNRS, Inserm, université Clermont-Auvergne, 63001 Clermont-Ferrand, France. Electronic address: antoine.martinez@uca.fr.

Abstract

The adrenocortical gland undergoes structural and functional remodelling in the fetal and postnatal periods. After birth, the fetal zone of the gland undergoes rapid involution in favor of the definitive cortex, which reaches maturity with the emergence of the zona reticularis(zR) at the adrenarche. The mechanisms underlying the adrenarche, the process leading to pre-puberty elevation of plasma androgens in higher primates, remain unknown, largely due to lack of any experimental model. By following up fetal and definitive cortex cell lines in mice, we showed that activation of protein kinase A (PKA) signaling mainly impacts the adult cortex by stimulating centripetal regeneration, with differentiation and then conversion of the zona fasciculata into a functional zR. Animals developed Cushing syndrome associated with primary hyperaldosteronism, suggesting possible coexistence of these hypersecretions in certain patients. Remarkably, all of these traits were sex-dependent: testicular androgens promoted WNT signaling antagonism on PKA, slowing cortical renewal and delaying onset of Cushing syndrome and the establishment of the zR in male mice, this being corrected by orchidectomy. In conclusion, zR derives from centripetal conversion of the zona fasciculata under cellular renewal induced by PKA signaling, determining the size of the adult cortex. Finally, we demonstrated that this PKA-dependent mobilization of cortical progenitors is sexually dimorphic and could, if confirmed in humans, account for female preponderance in adrenocortical pathologies.

KEYWORDS:

Adrenal cortex; Animal model; Cortex surrénalien; Cushing syndrome; Modèle animal; PKA; Syndrome de Cushing; Zona reticularis; Zone réticulée

PMID:
29673697
DOI:
10.1016/j.ando.2018.03.014
[Indexed for MEDLINE]
Icon for Masson (France)
17.
Ann Endocrinol (Paris). 2018 Jun;79(3):174-181. doi: 10.1016/j.ando.2018.03.016. Epub 2018 Apr 13.

News about the genetics of congenital primary adrenal insufficiency.

Author information

1
Laboratoire de biochimie et biologie moléculaire Grand Est, UM pathologies endocriniennes rénales musculaires et mucoviscidose, groupement hospitalier Est, hospices civils de Lyon, 69677 Bron, France; Université de Lyon, université Claude-Bernard Lyon 1, 69008 Lyon, France. Electronic address: florence.roucher@chu-lyon.fr.
2
Laboratoire de biochimie et biologie moléculaire Grand Est, UM pathologies endocriniennes rénales musculaires et mucoviscidose, groupement hospitalier Est, hospices civils de Lyon, 69677 Bron, France.
3
Laboratoire de biochimie et biologie moléculaire Grand Est, UM pathologies endocriniennes rénales musculaires et mucoviscidose, groupement hospitalier Est, hospices civils de Lyon, 69677 Bron, France; Université de Lyon, université Claude-Bernard Lyon 1, 69008 Lyon, France.

Abstract

Primary adrenal insufficiency (PAI) is characterized by impaired production of steroid hormones due to an adrenal cortex defect. This condition incurs a risk of acute insufficiency which may be life-threatening. Today, 80% of pediatric forms of PAI have a genetic origin but 5% have no clear genetic support. Recently discovered mutations in genes relating to oxidative stress have opened the way to research on genes unrelated to the adrenal gland. Identification of causal mutations in a gene responsible for PAI allows genetic counseling, guidance of follow-up and prevention of complications. This is particularly true for stress oxidative anomalies, as extra-adrenal manifestations may occur due to the sensitivity to oxidative stress of other organs such as the heart, thyroid, liver, kidney and pancreas.

KEYWORDS:

Adrenal development; Développement de la surrénale; Genetics; Génétique; Insuffisance surrénale primaire; Massively parallel sequencing; Primary adrenal insufficiency; Steroid biosynthesis; Stéroïdogenèse; Séquençage parallèle massif

PMID:
29661472
DOI:
10.1016/j.ando.2018.03.016
[Indexed for MEDLINE]
Icon for Masson (France)
18.
Clin Nucl Med. 2018 Jun;43(6):452-453. doi: 10.1097/RLU.0000000000002081.

Bilateral Adrenal Hyperplasia Due to Adrenocorticotropic Hormone-Secreting Esthesioneuroblastoma on FDG PET and 111In-Pentetreotide Scintigraphy.

Abstract

A 53-year-old woman with metastatic esthesioneuroblastoma was referred for FDG PET/CT imaging. FDG PET/CT showed symmetrical uptake in bilaterally enlarged adrenal glands, in addition to abnormal uptake in bone and lymph node metastases. In-pentetreotide scintigraphy was further performed and revealed the lack of adrenal uptake. The patient's serum adrenocorticotropic hormone (ACTH) level was extremely high, suggesting that hyperplastic condition in the adrenal glands due to ACTH stimulation from the metastatic esthesioneuroblastoma was responsible for increased FDG uptake. The combination of FDG PET and In-pentetreotide scintigraphy was useful for the pathophysiological evaluation of ACTH-secreting esthesioneuroblastoma.

PMID:
29659387
DOI:
10.1097/RLU.0000000000002081
[Indexed for MEDLINE]
Icon for Wolters Kluwer
19.
Int J Mol Sci. 2018 Apr 7;19(4). pii: E1111. doi: 10.3390/ijms19041111.

Transcriptome Profile in Unilateral Adrenalectomy-Induced Compensatory Adrenal Growth in the Rat.

Author information

1
Department of Histology and Embryology, Poznan University of Medical Sciences, Swiecickiego 6 Street, 60-781 Poznan, Poland. kjopek@ump.edu.pl.
2
Department of Histology and Embryology, Poznan University of Medical Sciences, Swiecickiego 6 Street, 60-781 Poznan, Poland. maritycz@ump.edu.pl.
3
Department of Anatomy and Histology, University of Zielona Gora, Zyty 28 Street, 65-046 Zielona Gora, Poland. maritycz@ump.edu.pl.
4
Department of Histology and Embryology, Poznan University of Medical Sciences, Swiecickiego 6 Street, 60-781 Poznan, Poland. pcelichowski@ump.edu.pl.
5
Department of Histology and Embryology, Poznan University of Medical Sciences, Swiecickiego 6 Street, 60-781 Poznan, Poland. lkm@ump.edu.pl.
6
Department of Histology and Embryology, Poznan University of Medical Sciences, Swiecickiego 6 Street, 60-781 Poznan, Poland. marcinruc@ump.edu.pl.

Abstract

Compensatory adrenal growth evoked by unilateral adrenalectomy (hemiadrenalectomy) constitutes one of the most frequently studied in vivo models of adrenocortical enlargement. This type of growth has been quite well characterized for its morphological, biochemical, and morphometric parameters. However, the molecular basis of compensatory adrenal growth is poorly understood. Therefore, the aim of this study was to investigate the rat adrenal transcriptome profile during the time of two previously described adrenocortical proliferation waves at 24 and 72 h after unilateral adrenalectomy. Surgical removal of the left adrenal or a sham operation was accomplished via the classic dorsal approach. As expected, the weight of the remaining right adrenal glands collected at 24 and 72 h after hemiadrenalectomy increased significantly. The transcriptome profile was identified by means of Affymetrix® Rat Gene 2.1 ST Array. The general profiles of differentially expressed genes were visualized as volcano plots and heatmaps. Detailed analyzes consisted of identifying significantly enriched gene ontological groups relevant to adrenal physiology, by means of DAVID and GOplot bioinformatics tools. The results of our studies showed that compensatory adrenal growth induced by unilateral adrenalectomy exerts a limited influence on the global transcriptome profile of the rat adrenal gland; nevertheless, it leads to significant changes in the expression of key genes regulating the circadian rhythm. Our results confirm also that regulation of compensatory adrenal growth is under complex and multifactorial control with a pivotal role of neural regulatory mechanisms and a supportive role of other components.

KEYWORDS:

adrenal gland; compensatory adrenal growth; gene expression profile; gene ontology; rat; unilateral adrenalectomy

PMID:
29642441
PMCID:
PMC5979382
DOI:
10.3390/ijms19041111
[Indexed for MEDLINE]
Free PMC Article
Icon for Multidisciplinary Digital Publishing Institute (MDPI) Icon for PubMed Central
20.
Medicine (Baltimore). 2018 Apr;97(15):e0367. doi: 10.1097/MD.0000000000010367.

Rebound thymic hyperplasia after adrenalectomy in a patient with Cushing syndrome caused by adrenocortical adenoma: A case report.

Author information

1
Department of Pediatrics, Chonbuk National University Medical School.
2
Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.

Abstract

RATIONALE:

The development of rebound thymic hyperplasia (RTH) has been reported in patients who have recovered from stressful conditions such as surgery and steroid therapy. We report a case of RTH following the resolution of hypercortisolism after adrenalectomy for the treatment of adrenocortical adenoma in a patient with Cushing syndrome.

PATIENT CONCERNS:

A 5-month-old female infant with a history of overeating, hirsutism, and excessive weight gain for the previous 2 months was referred to the hospital. The laboratory results revealed elevated 24-hour urinary free cortisol levels. An overnight dexamethasone suppression test showed no response. Abdominal imaging revealed a right-sided suprarenal mass measuring 4_3cm. Histology showed an adrenocortical adenoma. Thus, she underwent a right adrenalectomy.

DIAGNOSES:

The patient showed clinical improvement with weight loss and normal cortisol levels over the next 4 months. Six months after the operation, a chest computed tomography showed enlargement of the left thymic lobe, which was previously nonexistent.

INTERVENTIONS:

A fine needle aspiration biopsy was performed, and histological examination revealed diffuse thymic hyperplasia.

OUTCOMES:

At the 1-year follow-up, the chest imaging studies showed resolution of the RTH.

LESSIONS:

An understanding of RTH after adrenalectomy as a treatment for cortisol-producing adrenocortical tumors is important for the prevention of unnecessary surgical intervention and therapy.

PMID:
29642186
PMCID:
PMC5908590
DOI:
10.1097/MD.0000000000010367
[Indexed for MEDLINE]
Free PMC Article
Icon for Wolters Kluwer Icon for PubMed Central

Supplemental Content

Loading ...
Support Center