Article
Medicine, General & Internal
Kaori Takeshita, Ichiro Abe, Mai Nagata, Kentaro Ochi, Yuki Senda, Midori Koga, Kenji Ohe, Makiko Abe, Tadachika Kudo, Kunihisa Kobayashi
Summary: Hypothalamic adrenal insufficiency (AI) is a rare type of AI caused by the side-effects of exogenous steroid intake or the effect of a tumor in the hypothalamus. This study presents 9 cases of hypothalamic AI without any imaging abnormalities or history of steroid administration. Patients commonly experience symptoms such as general fatigue, hypoglycemia, and hypotension. Hydrocortisone replacement therapy significantly improves the morning plasma ACTH and serum cortisol levels.
Review
Endocrinology & Metabolism
Celina M. Caetano, Carl D. Malchoff
Summary: The Endocrine Society Guidelines and recent reviews provide recommendations for the treatment of adrenal insufficiency, but the suggested glucocorticoid replacement doses may be higher than necessary. This article reviews a method for individualized dosing and investigates the impact of lower doses.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Chris Worth, Avni Vyas, Indraneel Banerjee, Wei Lin, Julie Jones, Helen Stokes, Nicci Komlosy, Steven Ball, Peter Clayton
Summary: The study found that parents of children experiencing AC usually follow 'sick day' guidance for adjusting oral hydrocortisone dosage, but rarely use intramuscular hydrocortisone for emergency treatment. Additionally, despite 79% of parents reporting confidence in using intramuscular hydrocortisone, they rarely utilize it in practice, indicating that current training programs are not sufficient to prevent the most serious crises. New strategies need to be developed to encourage the usage of parenteral hydrocortisone.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Carla Bizzarri, Donatella Capalbo, Malgorzata Gabriela Wasniewska, Federico Baronio, Anna Grandone, Marco Cappa
Summary: This study summarized the clinical practice standards for adrenal crisis and investigated the prevalence of suspected/incipient adrenal crisis in children with adrenal insufficiency. The results showed that the number of adrenal crisis episodes varied among children using different treatment modalities and different age groups. Therefore, parental education and switching to parenteral hydrocortisone when necessary are essential for preventing adrenal crisis in children.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Uta Neumann, Katarina Braune, Martin J. Whitaker, Susanna Wiegand, Heiko Krude, John Porter, Dena Digweed, Bernard Voet, Richard J. M. Ross, Oliver Blankenstein
Summary: This prospective study on the efficacy and safety of hydrocortisone granules in children with CAH and AI demonstrates that accurate dosing and monitoring resulted in lower end of recommended dose range for hydrocortisone, without trends for accelerated or reduced growth, and no occurrence of adrenal crises despite treatment-emergent adverse events.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Endocrinology & Metabolism
Christopher A. M. Bannon, Daniel Border, Petra Hanson, John Hattersley, Martin O. Weickert, Ashley Grossman, Harpal S. Randeva, Thomas M. Barber
Summary: This study compared the metabolic effects of modified release hydrocortisone (MR-HC) and standard hydrocortisone (HC) therapies in adults with Adrenal Insufficiency. The results showed that switching to MR-HC for 3 months led to significant reductions in fat mass, increases in Sleeping Metabolic Rate (SMR), and significant decreases in body fat percentage. Other measures of body composition, energy expenditure, and biochemical analytes were found to be equivalent between HC and MR-HC assessments.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Review
Endocrinology & Metabolism
Kim M. J. A. Claessen, Cornelie D. Andela, Nienke R. Biermasz, Alberto M. Pereira
Summary: Adrenal crisis, the most severe manifestation of adrenal insufficiency, remains a major cause of mortality in AI patients. Integration of perspectives from both doctors and patients is crucial for successful improvement of HR-QoL in AI patients.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Review
Endocrinology & Metabolism
Birgit Harbeck, Peter Kropp, Ilonka Kreitschmann-Andermahr
Summary: Patients with adrenal insufficiency (AI) receive glucocorticoid (GC) replacement therapy (GRT). However, temporary phases of hypo- and hypercortisolism are common, and prolonged phases of these can impair cognitive functioning. Little is known about the effects of dosage and duration of GC replacement therapy on cognitive functioning in AI patients. This Mini-Review provides an overview of current studies on GRT for AI and discusses their implications for clinical practice.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Sofia Frigerio, Giulia Carosi, Emanuele Ferrante, Elisa Sala, Elisa Polledri, Silvia Fustinoni, Bruno Ambrosi, Iacopo Chiodini, Giovanna Mantovani, Valentina Morelli, Maura Arosio
Summary: This study aimed to assess clinical and biochemical modifications in patients shifted from cortisone acetate (CA) to modified-release hydrocortisone (MRH). The results showed that patients shifted to MRH treatment had improved blood pressure control and symptoms of over- or undertreatment, but no significant changes in glucose metabolism or total cortisol exposure were observed. Therefore, a dose reduction may be needed when shifting from CA to MRH.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Deborah P. Merke, Ashwini Mallappa, Wiebke Arlt, Aude Brac de la Perriere, Angelica Linden Hirschberg, Anders Juul, John Newell-Price, Colin G. Perry, Alessandro Prete, D. Aled Rees, Nicole Reisch, Nike Stikkelbroeck, Philippe Touraine, Kerry Maltby, F. Peter Treasure, John Porter, Richard J. Ross
Summary: The study showed that MR-HC improved biochemical disease control in adults with CAH, reducing steroid dose over time and providing patient-reported benefits, including menstrual restoration and pregnancies.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Surgery
Shenzhong Jiang, Chengxian Yang, Ming Feng, Yong Yao, Kan Deng, Bing Xing, Lin Lu, Huijuan Zhu, Renzhi Wang, Xinjie Bao
Summary: This study retrospectively analyzed the occurrence of thyrotoxicosis in patients who underwent surgery for Cushing's disease at Peking Union Medical College Hospital. The results revealed that thyrotoxicosis is a rare complication following surgery for Cushing's disease, with a relatively short duration, but special caution is needed following remission of Cushing's disease.
Article
Endocrinology & Metabolism
Francesca Delle Cese, Andrea Corsello, Marco Cintoni, Pietro Locantore, Alfredo Pontecorvi, Salvatore Maria Corsello, Rosa Maria Paragliola
Summary: Switching from IR-HC to lower-dose DR-HC in PAI patients showed significant improvements in clinical, biochemical and metabolic parameters, leading to decreased ACTH levels, HbA1C, total cholesterol, triglycerides, LDL cholesterol, BMI, and increased quality of life. Both once-daily and fractionated daily doses of DR-HC were effective in improving metabolic control and QoL in PAI.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Fabio Bioletto, Marco Barale, Mirko Parasiliti-Caprino, Jacopo Giannelli, Lorenzo Campioni, Vincenzo Cappiello, Maria Chiara Di Carlo, Ezio Ghigo, Massimo Procopio, Roberta Giordano
Summary: A study found that using the novel dual-release hydrocortisone (DR-HC) may have fewer detrimental effects on skeletal health compared to conventional glucocorticoids (C-GC) in patients with adrenal insufficiency (AI). Patients treated with DR-HC had better bone density and lower vertebral fracture risk compared to those treated with C-GC.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Medicine, General & Internal
Georgina Russell, Konstantinos Kalafatakis, Claire Durant, Nicola Marchant, Jamini Thakrar, Russell Thirard, Jade King, Jane Bowles, Thomas Upton, Ngoc Jade Thai, Jonathan C. W. Brooks, Aileen Wilson, Kirsty Phillips, Stuart Ferguson, Meryem Grabski, Chris A. Rogers, Theodoros Lampros, Sue Wilson, Catherine Harmer, Marcus Munafo, Stafford L. Lightman
Summary: This study aimed to evaluate the impact of pump therapy on quality of life, mood, functional neuroimaging, behavioral and cognitive responses, sleep, and metabolism in patients with primary adrenal insufficiency. The results showed subjective improvements in fatigue and mood with pump therapy, and functional magnetic resonance imaging revealed differential neural processing to emotional cues and visual stimulation.
JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Pharmacology & Pharmacy
Ioannis G. Violaris, Konstantinos Kalafatakis, Eder Zavala, Ioannis G. Tsoulos, Theodoros Lampros, Stafford L. Lightman, Markos G. Tsipouras, Nikolaos Giannakeas, Alexandros Tzallas, Georgina M. Russell
Summary: A pharmacokinetic model was developed to predict plasma cortisol levels at any point of the day from a limited number of measurements with high accuracy. The model accurately predicted levels with only four measurements and successfully supported clinical trials involving subcutaneous HC delivery in patients with reduced endogenous capacity to synthesize GCs.