43 research outputs found
Cushing\u27s Disease: Dilemmas of Diagnosis and Management
Determining the cause of Cushing\u27s disease and correcting the abnormality presents a continuing challenge to the clinician despite remarkable advances in diagnostic and therapeutic techniques. We present seven cases to illustrate 1) the classic disorder cured by pituitary adenomectomy: 2) persistence of the disease after adenomectomy: 3) Cushing\u27s disease manifesting in the puerperium and remitting with dopamine agonist therapy: 4) a patient whose disease relapsed at least five times during 20 years of treatment by adrenalectomy, pituitary radiation, mitotane, and pituitary adenomectomy; 5) the Nelson syndrome; 6) the ectopic adrenocorticotropic hormone (ACTH) syndrome in a patient with dexamethasone suppressible urinary cortisol who had a pituitary adenoma which stained positively for ACTH hut who was not cured by total hypophysectomy; and 7) a patient whose ACTH-secreting tumor proved fatal despite repeated surgical, radiologic, and pharmacologic measures
Non-melanoma skin cancer in Portuguese kidney transplant recipients - incidence and risk factors
Aldosterone-Producing Adenomas Responsive to Angiotensin Pose Problems in Diagnosis
1. A subgroup of patients with aldosteroneâproducing adenoma (APA) have been identified who lack many of the biochemical features regarded as characteristic of APA and used to distinguish APA from bilateral adrenal hyperplasia. 2. In these patients, aldosterone is responsive to infused angiotensin II (angiotensinâresponsive APA), which explains their uncharacteristic responses to upright posture, saline infusion and fludrocortisone acetate administration. 3. The angiotensinâresponsiveness of these patients may derive from the contraâlateral adrenal gland, since renin levels are less completely suppressed in angiotensinâresponsive APA than in angiotensinâunresponsive APA. 4. However, while the excretion of 18âoxoâcortisol was consistently increased in angiotensinâunresponsive APA, it was normal in angiotensinâresponsive APA, consistent with biochemical and biosynthetic distinctiveness residing in the tumours. 5. Angiotensinâresponsive APA should always be considered as an alternative diagnosis to bilateral hyperplasia causing primary aldosteronism. Copyrigh
Die Mineralocorticoidsekretion nach Furosemid ist bei Patienten mit low-renin Hypertonie gesteigert: 18-Hydroxycorticosteron reagiert dabei empfindlicher als Aldosteron
The epidemiology of transplant-associated keratinocyte cancers in different geographical regions
Angiotensin-Responsive Aldosterone-Producing Adenomas - Postoperative Disappearance of Aldosterone Response to Angiotensin
1. Nineteen out of 47 patients (40%) with confirmed unilateral aldosterone-producing adenoma (APA) were responsive to low-dose angiotensin II infusion (AII-R), as defined by an increase in plasma aldosterone concentration of > 50% over basal at 2 ng/ kg per min for 60 min