Adrenal Insufficiency: Conditions in which the production of adrenal CORTICOSTEROIDS falls below the requirement of the body. Adrenal insufficiency can be caused by defects in the ADRENAL GLANDS, the PITUITARY GLAND, or the HYPOTHALAMUS.Addison Disease: An adrenal disease characterized by the progressive destruction of the ADRENAL CORTEX, resulting in insufficient production of ALDOSTERONE and HYDROCORTISONE. Clinical symptoms include ANOREXIA; NAUSEA; WEIGHT LOSS; MUSCLE WEAKNESS; and HYPERPIGMENTATION of the SKIN due to increase in circulating levels of ACTH precursor hormone which stimulates MELANOCYTES.Adrenal Glands: A pair of glands located at the cranial pole of each of the two KIDNEYS. Each adrenal gland is composed of two distinct endocrine tissues with separate embryonic origins, the ADRENAL CORTEX producing STEROIDS and the ADRENAL MEDULLA producing NEUROTRANSMITTERS.Cosyntropin: A synthetic peptide that is identical to the 24-amino acid segment at the N-terminal of ADRENOCORTICOTROPIC HORMONE. ACTH (1-24), a segment similar in all species, contains the biological activity that stimulates production of CORTICOSTEROIDS in the ADRENAL CORTEX.Adrenal Cortex Function Tests: Examinations that evaluate and monitor hormone production in the adrenal cortex.Adrenal Gland Diseases: Pathological processes of the ADRENAL GLANDS.Hydrocortisone: The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.Adrenocorticotropic Hormone: An anterior pituitary hormone that stimulates the ADRENAL CORTEX and its production of CORTICOSTEROIDS. ACTH is a 39-amino acid polypeptide of which the N-terminal 24-amino acid segment is identical in all species and contains the adrenocorticotrophic activity. Upon further tissue-specific processing, ACTH can yield ALPHA-MSH and corticotrophin-like intermediate lobe peptide (CLIP).Adrenal Gland Neoplasms: Tumors or cancer of the ADRENAL GLANDS.Adrenal Cortex: The outer layer of the adrenal gland. It is derived from MESODERM and comprised of three zones (outer ZONA GLOMERULOSA, middle ZONA FASCICULATA, and inner ZONA RETICULARIS) with each producing various steroids preferentially, such as ALDOSTERONE; HYDROCORTISONE; DEHYDROEPIANDROSTERONE; and ANDROSTENEDIONE. Adrenal cortex function is regulated by pituitary ADRENOCORTICOTROPIN.Cortodoxone: 17,21-Dihydroxypregn-4-ene-3,20-dione. A 17-hydroxycorticosteroid with glucocorticoid and anti-inflammatory activities.Fludrocortisone: A synthetic mineralocorticoid with anti-inflammatory activity.Adrenal Medulla: The inner portion of the adrenal gland. Derived from ECTODERM, adrenal medulla consists mainly of CHROMAFFIN CELLS that produces and stores a number of NEUROTRANSMITTERS, mainly adrenaline (EPINEPHRINE) and NOREPINEPHRINE. The activity of the adrenal medulla is regulated by the SYMPATHETIC NERVOUS SYSTEM.DAX-1 Orphan Nuclear Receptor: An orphan nuclear receptor that is implicated in regulation of steroidogenic pathways. It is unlike most orphan nuclear receptors in that it appears to lack an essential DNA-binding domain and instead acts as a transcriptional co-repressor. Mutations in the gene Dax-1 cause congenital adrenal hypoplasia.Adrenal Hyperplasia, Congenital: A group of inherited disorders of the ADRENAL GLANDS, caused by enzyme defects in the synthesis of cortisol (HYDROCORTISONE) and/or ALDOSTERONE leading to accumulation of precursors for ANDROGENS. Depending on the hormone imbalance, congenital adrenal hyperplasia can be classified as salt-wasting, hypertensive, virilizing, or feminizing. Defects in STEROID 21-HYDROXYLASE; STEROID 11-BETA-HYDROXYLASE; STEROID 17-ALPHA-HYDROXYLASE; 3-beta-hydroxysteroid dehydrogenase (3-HYDROXYSTEROID DEHYDROGENASES); TESTOSTERONE 5-ALPHA-REDUCTASE; or steroidogenic acute regulatory protein; among others, underlie these disorders.Hypothalamic Diseases: Neoplastic, inflammatory, infectious, and other diseases of the hypothalamus. Clinical manifestations include appetite disorders; AUTONOMIC NERVOUS SYSTEM DISEASES; SLEEP DISORDERS; behavioral symptoms related to dysfunction of the LIMBIC SYSTEM; and neuroendocrine disorders.Cushing Syndrome: A condition caused by prolonged exposure to excess levels of cortisol (HYDROCORTISONE) or other GLUCOCORTICOIDS from endogenous or exogenous sources. It is characterized by upper body OBESITY; OSTEOPOROSIS; HYPERTENSION; DIABETES MELLITUS; HIRSUTISM; AMENORRHEA; and excess body fluid. Endogenous Cushing syndrome or spontaneous hypercortisolism is divided into two groups, those due to an excess of ADRENOCORTICOTROPIN and those that are ACTH-independent.Adrenalectomy: Excision of one or both adrenal glands. (From Dorland, 28th ed)Hyponatremia: Deficiency of sodium in the blood; salt depletion. (Dorland, 27th ed)Polyendocrinopathies, Autoimmune: Autoimmune diseases affecting multiple endocrine organs. Type I is characterized by childhood onset and chronic mucocutaneous candidiasis (CANDIDIASIS, CHRONIC MUCOCUTANEOUS), while type II exhibits any combination of adrenal insufficiency (ADDISON'S DISEASE), lymphocytic thyroiditis (THYROIDITIS, AUTOIMMUNE;), HYPOPARATHYROIDISM; and gonadal failure. In both types organ-specific ANTIBODIES against a variety of ENDOCRINE GLANDS have been detected. The type II syndrome differs from type I in that it is associated with HLA-A1 and B8 haplotypes, onset is usually in adulthood, and candidiasis is not present.Renal Insufficiency: Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.Diagnostic Techniques, Endocrine: Methods and procedures for the diagnosis of diseases or dysfunction of the endocrine glands or demonstration of their physiological processes.Venous Insufficiency: Impaired venous blood flow or venous return (venous stasis), usually caused by inadequate venous valves. Venous insufficiency often occurs in the legs, and is associated with EDEMA and sometimes with VENOUS STASIS ULCERS at the ankle.Glucocorticoids: A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system.Adrenal Cortex HormonesDehydroepiandrosterone: A major C19 steroid produced by the ADRENAL CORTEX. It is also produced in small quantities in the TESTIS and the OVARY. Dehydroepiandrosterone (DHEA) can be converted to TESTOSTERONE; ANDROSTENEDIONE; ESTRADIOL; and ESTRONE. Most of DHEA is sulfated (DEHYDROEPIANDROSTERONE SULFATE) before secretion.Pituitary-Adrenal System: The interactions between the anterior pituitary and adrenal glands, in which corticotropin (ACTH) stimulates the adrenal cortex and adrenal cortical hormones suppress the production of corticotropin by the anterior pituitary.Adrenoleukodystrophy: An X-linked recessive disorder characterized by the accumulation of saturated very long chain fatty acids in the LYSOSOMES of ADRENAL CORTEX and the white matter of CENTRAL NERVOUS SYSTEM. This disease occurs almost exclusively in the males. Clinical features include the childhood onset of ATAXIA; NEUROBEHAVIORAL MANIFESTATIONS; HYPERPIGMENTATION; ADRENAL INSUFFICIENCY; SEIZURES; MUSCLE SPASTICITY; and DEMENTIA. The slowly progressive adult form is called adrenomyeloneuropathy. The defective gene ABCD1 is located at Xq28, and encodes the adrenoleukodystrophy protein (ATP-BINDING CASSETTE TRANSPORTERS).Exocrine Pancreatic Insufficiency: A malabsorption condition resulting from greater than 10% reduction in the secretion of pancreatic digestive enzymes (LIPASE; PROTEASES; and AMYLASE) by the EXOCRINE PANCREAS into the DUODENUM. This condition is often associated with CYSTIC FIBROSIS and with chronic PANCREATITIS.46, XY Disorders of Sex Development: Congenital conditions in individuals with a male karyotype, in which the development of the gonadal or anatomical sex is atypical.Hypothalamo-Hypophyseal System: A collection of NEURONS, tracts of NERVE FIBERS, endocrine tissue, and blood vessels in the HYPOTHALAMUS and the PITUITARY GLAND. This hypothalamo-hypophyseal portal circulation provides the mechanism for hypothalamic neuroendocrine (HYPOTHALAMIC HORMONES) regulation of pituitary function and the release of various PITUITARY HORMONES into the systemic circulation to maintain HOMEOSTASIS.Hypopituitarism: Diminution or cessation of secretion of one or more hormones from the anterior pituitary gland (including LH; FOLLICLE STIMULATING HORMONE; SOMATOTROPIN; and CORTICOTROPIN). This may result from surgical or radiation ablation, non-secretory PITUITARY NEOPLASMS, metastatic tumors, infarction, PITUITARY APOPLEXY, infiltrative or granulomatous processes, and other conditions.Etomidate: Imidazole derivative anesthetic and hypnotic with little effect on blood gases, ventilation, or the cardiovascular system. It has been proposed as an induction anesthetic.Placental Insufficiency: Failure of the PLACENTA to deliver an adequate supply of nutrients and OXYGEN to the FETUS.Gonadal Dysgenesis, 46,XY: Defects in the SEX DETERMINATION PROCESS in 46, XY individuals that result in abnormal gonadal development and deficiencies in TESTOSTERONE and subsequently ANTIMULLERIAN HORMONE or other factors required for normal male sex development. This leads to the development of female phenotypes (male to female sex reversal), normal to tall stature, and bilateral streak or dysgenic gonads which are susceptible to GONADAL TISSUE NEOPLASMS. An XY gonadal dysgenesis is associated with structural abnormalities on the Y CHROMOSOME, a mutation in the GENE, SRY, or a mutation in other autosomal genes that are involved in sex determination.Primary Ovarian Insufficiency: Cessation of ovarian function after MENARCHE but before the age of 40, without or with OVARIAN FOLLICLE depletion. It is characterized by the presence of OLIGOMENORRHEA or AMENORRHEA, elevated GONADOTROPINS, and low ESTRADIOL levels. It is a state of female HYPERGONADOTROPIC HYPOGONADISM. Etiologies include genetic defects, autoimmune processes, chemotherapy, radiation, and infections.Mineralocorticoids: A group of CORTICOSTEROIDS primarily associated with water and electrolyte balance. This is accomplished through the effect on ION TRANSPORT in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by PLASMA VOLUME, serum potassium, and ANGIOTENSIN II.Steroid 21-Hydroxylase: An adrenal microsomal cytochrome P450 enzyme that catalyzes the 21-hydroxylation of steroids in the presence of molecular oxygen and NADPH-FERRIHEMOPROTEIN REDUCTASE. This enzyme, encoded by CYP21 gene, converts progesterones to precursors of adrenal steroid hormones (CORTICOSTERONE; HYDROCORTISONE). Defects in CYP21 cause congenital adrenal hyperplasia (ADRENAL HYPERPLASIA, CONGENITAL).Shock, Septic: Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include, but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.Lacrimal Apparatus Diseases: Diseases of the lacrimal apparatus.Adrenal Cortex Neoplasms: Tumors or cancers of the ADRENAL CORTEX.Steroidogenic Factor 1: A transcription factor and member of the nuclear receptor family NR5 that is expressed throughout the adrenal and reproductive axes during development. It plays an important role in sexual differentiation, formation of primary steroidogenic tissues, and their functions in post-natal and adult life. It regulates the expression of key steroidogenic enzymes.Pituitary Diseases: Disorders involving either the ADENOHYPOPHYSIS or the NEUROHYPOPHYSIS. These diseases usually manifest as hypersecretion or hyposecretion of PITUITARY HORMONES. Neoplastic pituitary masses can also cause compression of the OPTIC CHIASM and other adjacent structures.Gonadal Disorders: Pathological processes of the OVARIES or the TESTES.Metyrapone: An inhibitor of the enzyme STEROID 11-BETA-MONOOXYGENASE. It is used as a test of the feedback hypothalamic-pituitary mechanism in the diagnosis of CUSHING SYNDROME.Inappropriate ADH Syndrome: A condition of HYPONATREMIA and renal salt loss attributed to overexpansion of BODY FLUIDS resulting from sustained release of ANTIDIURETIC HORMONES which stimulates renal resorption of water. It is characterized by normal KIDNEY function, high urine OSMOLALITY, low serum osmolality, and neurological dysfunction. Etiologies include ADH-producing neoplasms, injuries or diseases involving the HYPOTHALAMUS, the PITUITARY GLAND, and the LUNG. This syndrome can also be drug-induced.Empty Sella Syndrome: A condition when the SELLA TURCICA is not filled with pituitary tissue. The pituitary gland is either compressed, atrophied, or removed. There are two types: (1) primary empty sella is due a defect in the sella diaphragm leading to arachnoid herniation into the sellar space; (2) secondary empty sella is associated with the removal or treatment of PITUITARY NEOPLASMS.Clobetasol: A derivative of PREDNISOLONE with high glucocorticoid activity and low mineralocorticoid activity. Absorbed through the skin faster than FLUOCINONIDE, it is used topically in treatment of PSORIASIS but may cause marked adrenocortical suppression.Receptor, Melanocortin, Type 2: A melanocortin receptor subtype found primarily in the ADRENAL CORTEX. It shows specificity for ADRENOCORTICOTROPIC HORMONE.Hormone Replacement Therapy: Therapeutic use of hormones to alleviate the effects of hormone deficiency.Central Nervous System Cysts: Congenital or acquired cysts of the brain, spinal cord, or meninges which may remain stable in size or undergo progressive enlargement.Anti-Inflammatory Agents: Substances that reduce or suppress INFLAMMATION.Pituitary ACTH Hypersecretion: A disease of the PITUITARY GLAND characterized by the excess amount of ADRENOCORTICOTROPIC HORMONE secreted. This leads to hypersecretion of cortisol (HYDROCORTISONE) by the ADRENAL GLANDS resulting in CUSHING SYNDROME.Aldosterone: A hormone secreted by the ADRENAL CORTEX that regulates electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium.Thyrotoxicosis: A hypermetabolic syndrome caused by excess THYROID HORMONES which may come from endogenous or exogenous sources. The endogenous source of hormone may be thyroid HYPERPLASIA; THYROID NEOPLASMS; or hormone-producing extrathyroidal tissue. Thyrotoxicosis is characterized by NERVOUSNESS; TACHYCARDIA; FATIGUE; WEIGHT LOSS; heat intolerance; and excessive SWEATING.Dehydroepiandrosterone Sulfate: The circulating form of a major C19 steroid produced primarily by the ADRENAL CORTEX. DHEA sulfate serves as a precursor for TESTOSTERONE; ANDROSTENEDIONE; ESTRADIOL; and ESTRONE.Esophageal Achalasia: A motility disorder of the ESOPHAGUS in which the LOWER ESOPHAGEAL SPHINCTER (near the CARDIA) fails to relax resulting in functional obstruction of the esophagus, and DYSPHAGIA. Achalasia is characterized by a grossly contorted and dilated esophagus (megaesophagus).Genetic Diseases, X-Linked: Genetic diseases that are linked to gene mutations on the X CHROMOSOME in humans (X CHROMOSOME, HUMAN) or the X CHROMOSOME in other species. Included here are animal models of human X-linked diseases.Pituitary Function Tests: Examinations that evaluate functions of the pituitary gland.Hypogonadism: Condition resulting from deficient gonadal functions, such as GAMETOGENESIS and the production of GONADAL STEROID HORMONES. It is characterized by delay in GROWTH, germ cell maturation, and development of secondary sex characteristics. Hypogonadism can be due to a deficiency of GONADOTROPINS (hypogonadotropic hypogonadism) or due to primary gonadal failure (hypergonadotropic hypogonadism).Pituitary Gland: A small, unpaired gland situated in the SELLA TURCICA. It is connected to the HYPOTHALAMUS by a short stalk which is called the INFUNDIBULUM.Corticotropin-Releasing Hormone: A peptide of about 41 amino acids that stimulates the release of ADRENOCORTICOTROPIC HORMONE. CRH is synthesized by neurons in the PARAVENTRICULAR NUCLEUS of the HYPOTHALAMUS. After being released into the pituitary portal circulation, CRH stimulates the release of ACTH from the PITUITARY GLAND. CRH can also be synthesized in other tissues, such as PLACENTA; ADRENAL MEDULLA; and TESTIS.
Primary hypoadrenocorticism in a dog receiving glucocorticoid supplementation. (1/362)
A 5-year-old, spayed, female husky-Labrador retriever cross was diagnosed with primary hypoadrenocorticism, an uncommon endocrine disorder caused by a deficiency of glucocorticoid and mineralocorticoid hormones. Subtle clinical signs and previous treatment with exogenous glucocorticoid drugs required an adrenocorticotropic hormone stimulation test to confirm the diagnosis. (+info)Tests of adrenal insufficiency. (2/362)
AIM: In suspected adrenal insufficiency, the ideal test for assessing the hypothalamo-pituitary-adrenal axis is controversial. Therefore, three tests were compared in patients presenting with symptoms suggestive of adrenal insufficiency. METHOD: Responses to the standard short Synacthen test (SSST), the low dose Synacthen test (LDST), and the 08:00 hour serum cortisol concentration were measured in 32 patients. A normal response to the synacthen test was defined as a peak serum cortisol of >/= 500 nmol/l and/or incremental concentration of >/= 200 nmol/l. The sensitivity and specificity of the 08:00 hour serum cortisol concentration compared with other tests was calculated. RESULTS: Three patients had neither an adequate peak nor increment after the SSST and LDST. All had a serum 08:00 hour cortisol concentration of < 200 nmol/l. Eight patients had abnormal responses by both criteria to the LDST but had normal responses to the SSST. Three reported amelioration of their symptoms on hydrocortisone replacement. Twenty one patients had a normal response to both tests (of these, 14 achieved adequate peak and increment after both tests and seven did not have an adequate peak after the LDST but had a normal increment). The lowest 08:00 hour serum cortisol concentration above which patients achieved normal responses to both the LDST and SSST was 500 nmol/l. At this cut off value (compared with the LDST), the serum 08:00 hour cortisol concentration had a sensitivity of 100% but specificity was only 33%. CONCLUSION: The LDST revealed mild degrees of adrenal insufficiency not detected by the SSST. The value of a single 08:00 hour serum cortisol concentration is limited. (+info)Adrenal insufficiency in septic shock. (3/362)
BACKGROUND: Functional adrenal insufficiency has been documented in critically ill adults. OBJECTIVE: To document the incidence of adrenal insufficiency in children with septic shock, and to evaluate its effect on catecholamine requirements, duration of intensive care, and mortality. SETTING: Sixteen-bed paediatric intensive care unit in a university hospital. METHODS: Thirty three children with septic shock were enrolled. Adrenal function was assessed by the maximum cortisol response after synthetic adrenocorticotropin stimulation (short Synacthen test). Insufficiency was defined as a post-Synacthen cortisol increment < 200 nmol/l. RESULTS: Overall mortality was 33%. The incidence of adrenal insufficiency was 52% and children with adrenal insufficiency were significantly older and tended to have higher paediatric risk of mortality scores. They also required higher dose vasopressors for haemodynamic stability. In the survivor group, those with adrenal insufficiency needed a longer period of inotropic support than those with normal function (median, 3 v 2 days), but there was no significant difference in duration of ventilation (median, 4 days for each group) or length of stay (median, 5 v 4 days). Mortality was not significantly greater in children with adrenal insufficiency than in those with adequate adrenal function (6 of 17 v 5 of 16, respectively). CONCLUSION: Adrenal insufficiency is common in children with septic shock. It is associated with an increased vasopressor requirement and duration of shock. (+info)Hypercalcemia in an euthyroid patient with secondary hypoadrenalism and diabetes insipidus due to hypothalamic tumor. (4/362)
A 20-year-old Japanese man with a hypothalamic tumor (most likely germ-cell tumor) which caused secondary hypoadrenalism, hypogonadism and diabetes insipidus developed hypercalcemia and acute renal failure. The serum levels of intact PTH (iPTH), PTH-related protein (PTH-rP), 1,25-dihydroxy vitamin D (1,25- (OH)2 D), ACTH, cortisol, gonadotropins and testosterone were decreased, but his serum levels of triiodothyronine (T3) and thyroxine (T4) were within the normal range at admission, with depressed TSH and slightly increased thyroglobulin. The hypercalcemia was refractory to extensive hydration and calcitonin, but was ameliorated by pamidronate. After irradiation of the hypothalamic tumor, panhypopituitarism gradually developed. The patient has been normocalcemic for the last 2 years and is doing well under replacement therapy with glucocorticoid, L-thyroxine, methyltestosterone and 1-desamino D arginine vasopressin (dDAVP). As to the mechanism of euthyroidism at admission, transient destructive thyroiditis associated with hypopituitarism or delayed development of hypothyroidism following the hypoadrenalism was suggested. This is the first reported case of hypercalcemia in secondary hypoadrenalism due to hypothalamic tumor. Hypercalcemia was most likely induced by increased bone resorption, which was probably elicited by the combined effects of deficient glucocorticoid and sufficient thyroid hormones in addition to hypovolemia and reduced renal calcium excretion. Furthermore, severe dehydration due to diabetes insipidus and disturbance of thirst sensation caused by the hypothalamic tumor aggravated the hypercalcemia, leading to acute renal failure. (+info)Severe hyponatremia caused by hypothalamic adrenal insufficiency. (5/362)
A 60-year-old woman was admitted with severe hyponatremia. Basal values of adrenocorticotropic hormone (ACTH), thyroid hormone and cortisol were normal on admission. Impairment of water diuresis was observed by water loading test. Initially, we diagnosed her condition as the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). By provocation test, we finally confirmed that the hyponatremia was caused by hypothalamic adrenal insufficiency. The basal values of ACTH and cortisol might not be sufficient to exclude the possibility of adrenal insufficiency. Therefore, it is necessary to evaluate adrenal function by provocation test or to re-evaluate it after recovery from hyponatremia. (+info)A case of primary bilateral adrenal lymphoma with partial adrenal insufficiency. (6/362)
Unilateral or bilateral non-Hodgkin's lymphomas arising primarily in the adrenal glands are extremely rare. These lymphomas are usually present with large, bilateral adrenal masses with or without lymphadenopathy, and may be accompanied by adrenal insufficiency in some cases. A review of the literature indicates that patients with primary lymphoma of the adrenal glands usually do not have disease elsewhere, and if present, it is frequently extranodal. We report here an unusual case of primary bilateral adrenal lymphoma with partial adrenal insufficiency. (+info)The 4A syndrome association with osteoporosis. (7/362)
4A syndrome is characterised by adrenocortical insufficiency, achalasia, alacrima, autonomic and other neurological abnormalities. We report an 18-year-old boy with 4 A syndrome and having all classical features of the disease including sensorimotor neuropathy. In addition, the patient had low aldosterone levels and signs of osteoporosis, which apparently developed without glucocorticoid replacement therapy. Although it is speculated that the lack of local growth factors, nutritional deficiency secondary to achalasia or receptor abnormalities regarding bone metabolism contribute to osteoporosis, its etiopathogenesis still needs to be clarified. (+info)Dehydroepiandrosterone replacement in women with adrenal insufficiency. (8/362)
BACKGROUND: The physiologic role of dehydroepiandrosterone in humans is still unclear. Adrenal insufficiency leads to a deficiency of dehydroepiandrosterone; we therefore, investigated the effects of dehydroepiandrosterone replacement, in patients with adrenal insufficiency. METHODS: In a double-blind study, 24 women with adrenal insufficiency received in random order 50 mg of dehydroepiandrosterone orally each morning for four months and placebo daily for four months, with a one-month washout period. We measured serum steroid hormones, insulin-like growth factor I, lipids, and sex hormone-binding globulin, and we evaluated well-being and sexuality with the use of validated psychological questionnaires and visual-analogue scales, respectively. The women were assessed before treatment, after one and four months of treatment with dehydroepiandrosterone, after one and four months of placebo, and one month after the end of the second treatment period. RESULTS: Treatment with dehydroepiandrosterone raised the initially low serum concentrations of dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and testosterone into the normal range; serum concentrations of sex hormone-binding globulin, total cholesterol, and high-density lipoprotein cholesterol decreased significantly. Dehydroepiandrosterone significantly improved overall well-being as well as scores for depression and anxiety. For the global severity index, the mean (+/-SD) change from base line was -0.18+/-0.29 after four months of dehydroepiandrosterone therapy, as compared with 0.03+/-0.29 after four months of placebo (P=0.02). As compared with placebo, dehydroepiandrosterone significantly increased the frequency of sexual thoughts (P=0.006), sexual interest (P=0.002), and satisfaction with both mental and physical aspects of sexuality (P=0.009 and P=0.02, respectively). CONCLUSIONS: Dehydroepiandrosterone improves well-being and sexuality in women with adrenal insufficiency. (+info)... and contraindicated in women with renal insufficiency, adrenal insufficiency, or liver disease according to FDA-approved labels ... Adrenal insufficiency. • Liver disease. Lidegaard, Øjvind; Milsom, Ian; Skovlund, Charlotte Wessel; Skjeldestad, Finn Egil; ... Contraindications: • Severe renal insufficiency or acute renal failure. • Presence or history of severe hepatic disease as long ... In women with mild or moderate renal insufficiency, or in combination with chronic daily use of other potassium-sparing ...
... deficiency leads to adrenal insufficiency, a lack of production of glucocorticoids such as cortisol by the adrenal gland. If ... Dorin RI, Qualls CR, Crapo LM (2003). "Diagnosis of adrenal insufficiency". Ann. Intern. Med. 139 (3): 194-204. doi:10.7326/ ... ISBN 0-7216-2921-0. Arlt W, Allolio B (May 2003). "Adrenal insufficiency". Lancet. 361 (9372): 1881-93. doi:10.1016/S0140-6736( ... for adrenal insufficiency, levothyroxine for hypothyroidism, testosterone for male hypogonadism, and estradiol for female ...
Winqvist, O., Rorsman, F., & Kampe, O. (2000). Autoimmune adrenal insufficiency. BioDrugs, 13(2), 107-114. Cole, J.T., Mitala, ... In either case, treatment may rely on removal of the tumor or of the adrenal glands. Without the adrenal glands, the human body ... In humans and other animals, the adrenocortical hormones are hormones produced by the adrenal cortex, the outer region of the ... The glucocorticoid family of hormones is synthesized in the middle layer of the adrenal cortex known as the zona fasciculata. ...
It may also cause glucocorticoid-related adverse effects such as adrenal insufficiency in some individuals and/or cases ( ... Bulchandani D, Nachnani J, Amin A, May J (August 2008). "Megestrol acetate-associated adrenal insufficiency". The American ... and adrenal insufficiency, have been reported with the use of MGA in the medical literature, albeit sporadically. MGA is ... Chidakel AR, Zweig SB, Schlosser JR, Homel P, Schappert JW, Fleckman AM (February 2006). "High prevalence of adrenal ...
Grinspoon, S.K.; B.M.K Biller (1994). "Laboratory assessment of adrenal insufficiency". Journal of Clinical Endocrinology and ... to the adrenal glands. Lastly, cortisol (non-tropic) is secreted from the adrenal glands and goes into the bloodstream where it ... The Hypothalamic-pituitary-adrenal axis is a perfect example of this chain reaction. The reaction begins in the hypothalamus ... CRH an ACTH are tropic hormones because they act on the anterior pituitary gland and adrenal glands, respectively, both of ...
2009). Predisposing factors for adrenal insufficiency. In: N Engl. J. Med. doi: 10.1056/NEJMra0804635 J. Dupuis u. a. (2010). ... Human adrenal cells express TNFα-mRNA: Evidence for a paracrine control of adrenal function 1995: „Einfach genial Preis" of the ... Restoration of adrenal steroidogenesis by adenovirus-mediated transfer of human cytochromeP450 21-hydroxylase into the adrenal ... 2000). Adrenal cortical activation in murine colitis.. In: Gastroenterology. doi: 10.1053/gast.2000.20235 D. P. Merke, G. P. ...
Hemodynamic changes in acute adrenal insufficiency. Intensive Care Medicine (1994) 20:138-141 Sattar, Hussain A. Pathoma: ... Kidney disease Hypervolemia Adrenal Crisis-especially after fluid replacement Anemia Anxiety Aortic Regurgitation AV fistulae ...
Primary adrenal insufficiency are: Addison's disease and congenital adrenal hyperplasia (CAH) (including enzyme deficiencies ... "Hyponatremia and hyperkalemia in adrenal insufficiency". UpToDate. Retrieved 6 October 2017. F Young, William; H Sterns, ...
Addison's disease Adrenal insufficiency (hypocortisolism) Celik, O; Niyazoglu, M; Soylu, H; Kadioglu, P (29 August 2012). " ... In adrenal Cushing's, excess cortisol is produced by adrenal gland tumors, hyperplastic adrenal glands, or adrenal glands with ... Tumors outside the normal pituitary-adrenal system can produce ACTH (occasionally with CRH) that affects the adrenal glands. ... CT scanning of the adrenal gland and MRI of the pituitary gland are performed to detect the presence of any adrenal or ...
Long-term use may cause adrenal insufficiency. Stopping the medication suddenly following long-term use may be dangerous. The ... Euphoria Depression Adrenal suppression Hypertension Groupings of fine blood vessels becoming prominent under the skin, ... by causing a decrease in the production of natural hormones by the adrenal glands. Betamethasone is also used prior to delivery ... and along with fludrocortisone for adrenocortical insufficiency, among others. It can be taken by mouth, injected into a muscle ...
Viruses may also be implicated in adrenal problems: Cytomegalovirus can cause adrenal insufficiency, especially in the ... Hydrocortisone can sometimes reverse the adrenal insufficiency. Plastic surgery and tissue grafting are sometimes needed to ... Waterhouse-Friderichsen syndrome (WFS) is defined as adrenal gland failure due to bleeding into the adrenal glands, commonly ... "Fatal Cytomegalovirus-Associated Adrenal Insufficiency in an AIDS Patient Receiving Corticosteroid Therapy". Internal Medicine ...
Abrupt discontinuation can result in adrenal insufficiency; and/or steroid withdrawal syndrome (a rebound effect in which ... This permits the adrenal glands to resume the body's natural production of cortisol. ...
Excessive thirst Excessive urination Adrenal insufficiency. This occurs because of a reduction in ACTH production, a reduction ... This is very uncommon and occurs with severe pituitary insufficiency. Large pituitary tumors can paradoxically elevate blood ... Pituitary insufficiency often occurs to some degree because craniopharyngiomas develop in the area of the pituitary stalk, ... insufficiency, caused by the reduction in growth hormone (GH) production. Symptoms include: Stunted growth and delayed puberty ...
... hyperthyroidism mild adrenal insufficiency, Basedow's disease); Spa with CO2, mofettes, galvanic baths, massage; Paraffin, ...
Hormone replacement is standard for ALD patients demonstrating adrenal insufficiency. Adrenal insufficiency does not resolve ... Onset of adrenal insufficiency is often the first symptom, appearing as early as two years of age. ALD is caused by mutations ... Treatment of the adrenal insufficiency that can accompany any of the common male phenotypes of ALD does not resolve any of the ... Adrenal insufficiency in ALD patients can be successfully treated. ALD is the most common peroxisomal inborn error of ...
2005). "Adrenal insufficiency in meningococcal sepsis: bioavailable cortisol levels and impact of interleukin-6 levels and ... link) Mullins, M. E.; Theodoro, D. L. (2008). "Lack of evidence for adrenal insufficiency after single-dose etomidate". Arch ... Daniell, Harry (2008). "Opioid and benzodiazepine contributions to etomidate-associated adrenal insufficiency". Intensive Care ... "Increased risk of adrenal insufficiency following etomidate exposure in critically injured patients". Arch Surg. 143 (1): 62-7 ...
Adrenal insufficiency has been documented in 60% of ALF cases, and is likely to contribute in haemodynamic compromise. There is ... Harry R, Auzinger G, Wendon J (2002). "The clinical importance of adrenal insufficiency in acute hepatic dysfunction". ...
... s may be used in low doses in adrenal insufficiency. In much higher doses, oral or inhaled glucocorticoids are ... During this recovery time, the patient is vulnerable to adrenal insufficiency during times of stress, such as illness. While ... Impaired memory and attention deficits Adrenal insufficiency (if used for long time and stopped suddenly without a taper) ... or reduced to physiologic replacement if patients are adrenal-deficient). Full adrenal recovery can be assumed to occur by a ...
... can be used in the diagnosis of adrenal insufficiency. Metyrapone 30 mg/kg, maximum dose 3000 mg, is administered at ... Metyrapone (trade name Metopirone) is a drug used in the diagnosis of adrenal insufficiency and occasionally in the treatment ... then it is highly suggestive of adrenal insufficiency. If neither 11-deoxycortisol nor ACTH rise, it is highly suggestive of an ... In patients with intact Hypothalamo-pituitary-adrenal axis, CRH and ACTH levels rise as a response to the falling cortisol ...
Elfström P, Montgomery SM, Kämpe O, Ekbom A, Ludvigsson JF (2007). "Risk of primary adrenal insufficiency in patients with ... primary adrenal insufficiency) relative to the normal population. GSE can result in high risk pregnancies and infertility. Some ...
... and adrenal insufficiency. In adrenal insufficiency it is generally taken together with hydrocortisone. It is taken by mouth. ... It is used primarily to replace the missing hormone aldosterone in various forms of adrenal insufficiency such as Addison's ... "Glucocorticoid Therapy and Adrenal Suppression". PMID 25905379. Thomas L. Lemke; David A. Williams (2008). Foye's Principles of ... Fludrocortisone is also a confirmation test for diagnosing Conn's syndrome (aldosterone producing-adrenal adenoma), the ...
... adrenal insufficiency, and red hair due to POMC deficiency; 609734; POMC Obesity, autosomal dominant; 601665; MC4R Obesity, ... CYP11B1 Adrenal hyperplasia, congenital, due to combined P450C17 and P450C21 deficiency; 201750; POR Adrenal hypoplasia, ... ADIPOQ Adrenal cortical carcinoma; 202300; TP53 Adrenal hyperplasia, congenital, due to 11-beta-hydroxylase deficiency; 202010 ... LMNB2 Lipoid adrenal hyperplasia; 201710; STAR Lipoid congenital adrenal hyperplasia; 201710; CYP11A Lipoid proteinosis; 247100 ...
Long-term use of the pill form may cause adrenal insufficiency. The pills may also cause mood or personality changes. The ...
"Utility of salivary cortisol measurements in Cushing's syndrome and adrenal insufficiency". J. Clin. Endocrinol. Metab. 94: ... The following conditions are among those that can be detected through saliva testing (list not comprehensive): adrenal ...
Long-term use of the pill form may cause adrenal insufficiency. Stopping the pills suddenly following long-term use may ... Todd GR, Acerini CL, Buck JJ, Murphy NP, Ross-Russell R, Warner JT, McCance DR (2002). "Acute Adrenal Crisis in Asthmatics ... Todd GR, Acerini CL, Ross-Russell R, Zahra S, Warner JT, McCance D (2002). "Survey of Adrenal Crisis Associated With Inhaled ...
Adrenal insufficiency. (Addison's, WF). *aldosterone: Hypoaldosteronism *21α CAH. *11β CAH ...
... which occurs when the adrenal gland itself is dysfunctional, or secondary, also called central adrenal insufficiency, which ... Adrenal insufficiency (Addison disease) can be classified as primary, ... because aldosterone secretion is reduced in primary adrenal insufficiency but not in secondary (central) adrenal insufficiency ... Neurological and adrenal dysfunction in the adrenal insufficiency/alacrima/achalasia (3A) syndrome. Arch Dis Child. 1993 Jun. ...
The clinical suspicion of acute adrenal insufficiency was supported by invasive haemodynamic data and the diagnosis was ... The ectopic production of ACTH from a carcinoid tumour of the thymus is recognised but a report of acute adrenal insufficiency ...
About 10% of patients with APS-2 and Addisons disease had a relative with adrenal insufficiency, and about 10% of patients ... www.niddk.nih.gov/health-information/health-topics/endocrine/adrenal-insufficiency-addisons-disease/Pages/fact-sheet.aspx. ... Adrenal Insufficiency United Toll-free: 1-855-AIUnite (248-6483) E-mail: [email protected] Website: http://aiunited.org/ ... National Adrenal Diseases Foundation (NADF) P.O. Box 566 Lake Zurich, IL 60047 Telephone: +1-(847) 726-9010 E-mail: [email protected] ...
Other side effects of Korlym include adrenal insufficiency, low potassium levels, vaginal bleeding and a potential for heart ... It is caused by the overproduction of cortisol (a steroid hormone that increases blood sugar levels) by the adrenal glands. ...
... associated autoimmune adrenal insufficiency or hypothyroidism; and 3) reduced bone mineral density and increased risk of ... keywords = "Menopause, premature, Primary ovarian insufficiency, Primary ovarian insufficiency",. author = "Martin, {Lisa Arndt ... associated autoimmune adrenal insufficiency or hypothyroidism; and 3) reduced bone mineral density and increased risk of ... associated autoimmune adrenal insufficiency or hypothyroidism; and 3) reduced bone mineral density and increased risk of ...
autoimmune adrenal insufficiency. However, patients often develop other diseases as well, such as: hypogonadism, alopecia, ... Even a low dose of ketoconasol can deteriorate the adrenal function of patients with a limited pituitary-adrenal reserve. ...
In some cases, the adrenal glands also dont produce enough of two other hormones. Heres what you can do at home to care for ... Addison disease occurs when your adrenal glands dont make enough of the hormone cortisol. ... This disease is also called adrenal insufficiency or hypocortisolism. A flare-up is called an Addisonian crisis or an adrenal ... Your adrenal glands dont make enough of the hormone cortisol. In some cases, the adrenal glands also dont make enough of the ...
Adrenal insufficiency may cause vomiting, anorexia, hypoglycaemia, malaise, fatigue, muscular weakness, hyperkalaemia, ...
Adrenal insufficiency and Addisons disease. National Institute of Diabetes and Digestive and Kidney Diseases website. ... Wear a medical alert bracelet that states adrenal insufficiency or Addison disease. This will let others know of your condition ... An update on the diagnosis of adrenal insufficiency and the use of corticotherapy in critical illness. Ann Pharmather. 2007;419 ... Wallace I, Cunningham S, Lindsay J. The diagnosis and investigation of adrenal insufficiency in adults. Ann Clin Biochem. 2009; ...
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... adrenal insufficiency occurs. Causes of Vaginal Acne. Compared to pungent smelling raw Neem oil, Neem Cure Oil has a pleasant ...
"Dorlands Medical Dictionary:adrenal insufficiency". "Secondary Adrenal Insufficiency: Adrenal Disorders: Merck Manual ... There are three major types of adrenal insufficiency. Primary adrenal insufficiency is due to impairment of the adrenal glands ... This would be an example of secondary adrenal insufficiency syndrome. Causes of adrenal insufficiency can be categorized by the ... Adrenoleukodystrophy can also cause adrenal insufficiency. Adrenal insufficiency can also result when a patient has a ...
Defects at each level of the hypothalamic-pituitary-adrenal axis can yield impaired adrenal function that... ... Adrenal insufficiency is an important source of potentially life-threatening human disease. ... Adrenal Steroids Adrenal insufficiency Addison Disease Congenital adrenal hyperplasia Adrenocorticotropic hormone (ACTH) ... and tertiary adrenal insufficiency. The components of establishing a diagnosis of adrenal insufficiency along with its ...
Adrenal insufficiency or Addison disease happens if the adrenal glands dont make enough hormones. Read more. ... Adrenal Insufficiency (Hormone Health Network) Also in Spanish * Adrenal Insufficiency and Addisons Disease (National ... Your adrenal glands are just above your kidneys. The outside layer of these glands makes hormones that help your body respond ... The immune system mistakenly attacks your own tissues, damaging your adrenal glands. Other causes include infections and cancer ...
secondary adrenal insufficiency starts with damage to your pituitary gland or to the part of your brain that controls it, ... What causes secondary adrenal insufficiency?. ANSWER Secondary adrenal insufficiency starts with damage to your pituitary gland ... If youve had surgery for a condition called Cushings syndrome, youre even more likely to get secondary adrenal insufficiency ... You can also get secondary adrenal insufficiency because of drugs called glucocorticoids, such as cortisone, hydrocortisone, ...
Autoimmune destruction of the aforementioned glands is the most common cause of primary adrenal insufficiency in the developed ... occurs when the adrenal glands situated on top of the kidneys produce inadequate amounts of glucocorticoid and ... Primary adrenal insufficiency - also known under the eponym Addisons disease - ... Primary adrenal insufficiency - also known under the eponym Addisons disease - occurs when the adrenal glands situated on top ...
... i wa originally diagnosed with secondary adrenal insufficiency--then another endo said i didnt have it because i had had ... i wa originally diagnosed with secondary adrenal insufficiency--then another endo said i didnt have it because i had had ... so, i know my adrenals were struggling, but i need to get a new stim test done. i staarted with cortisol of 2.4 and ACTH of 5. ... so, i know my adrenals were struggling, but i need to get a new stim test done. i staarted with cortisol of 2.4 and ACTH of 5. ...
... the reason for the adrenal insufficiency. Watch this space. He is on a stress dose again and we will see what happens! I am at ... I know another without adrenals that drops K too. Since that is not the norm - it is hard to get them to test let along listen ... He saw Rob in January and did some bloods, the main one being for Adrenal Antibodies but the results are not in his notes! Our ... Are they going to put him on florinef? I forget his age - but are they thinking about DHEA as well for the androgens? Adrenals ...
Primary adrenal insufficiency arises due to the damage of the glands or because of using drugs that halt synthesis of cortisol ... On the other hand, secondary adrenal insufficiency stems from processes that inhibit the secretion of the adrenocorticotropic ... The former is sometimes also referred to as tertiary adrenal insufficiency. ... Adrenal insufficiency is a condition that develops when most of the adrenal gland is not functioning normally. ...
Neurological and adrenal dysfunction in the adrenal insufficiency/alacrima/achalasia (3A) syndrome. Arch Dis Child. 1993 Jun. ... Absolute and relative adrenal insufficiency in children with septic shock. Crit Care Med. 2005 Apr. 33(4):855-9. [Medline]. ... Presentation of primary adrenal insufficiency in childhood. J Clin Endocrinol Metab. 2011 Jun. 96(6):E925-8. [Medline]. ... Adrenal insufficiency in patients on long-term opioid analgesia. Clin Endocrinol (Oxf). 2016 Jun 4. [Medline]. ...
Primary adrenocortical insufficiency occurs when the adrenal glands fail to release adequate amounts of these hormones to meet ... including 254 with primary adrenal insufficiency and 190 with secondary adrenal insufficiency. At least one adrenal crisis was ... Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term ... Drugs & Diseases , Endocrinology , Adrenal Crisis Q&A What is the pathophysiology of adrenocortical insufficiency in adrenal ...
Adrenal is tired, exhausted, I feel tingling moving sensations on both adrenal sides. My latest result show that my DHEA levels ... Other adrenal hormones seem in normal number. Just DHEA is questionable. Interestingly I have high Testosterone, I surely have ... And on top of all that, at the center is the Adrenal, the one responsible for handling stress. ...
... and primary adrenal insufficiency. Chronic lactic acidosis responded to treatment with dichloroacetate. Sequential muscle ... Oxidative phosphorylation defect associated with primary adrenal insufficiency J Pediatr. 1996 May;128(5 Pt 1):688-92. doi: ... and primary adrenal insufficiency. Chronic lactic acidosis responded to treatment with dichloroacetate. Sequential muscle ... phosphorylation and the need to consider mitochondrial disorders in the differential diagnosis of primary adrenal insufficiency ...
... Jakob Holm,1 Leif Breum,1 Katrine Stenfeldt,2 and ... Primary adrenal lymphoma is rare but most often present with bilateral tumors and symptoms of adrenal insufficiency. A high ... stomach and lymphoma is the most common course of adrenal metastasis giving rise to adrenal insufficiency. PAL on its own is an ... Adrenal insufficiency may be the primary symptom of presentation, especially with bilateral involvement as in bPAL [4]. ...
You have two adrenal glands. They are located just above the kidneys. They work with the hypothalamus and pituitary glands in ... Adrenal insufficiency occurs when the adrenal glands dont make enough of the hormone cortisol. ... What is adrenal insufficiency?. Adrenal insufficiency occurs when the adrenal glands dont make enough of the hormone cortisol ... Key points about adrenal insufficiency (Addisons disease). * Adrenal insufficiency occurs when the adrenal glands dont make ...
- In acute adrenal crisis (eg, hypotension, hypoglycemia) use pharmacologic doses of glucocorticoids, which can be in the form of hydrocortisone, methylprednisolone, or dexamethasone. (medscape.com)
- Glucocorticoid agents give patients with adrenal insufficiency (Addison disease) the equivalent of the body's missing cortisol produced by the adrenal cortex under normal conditions and under stress. (medscape.com)
- Hydrocortisone is the glucocorticoid drug of choice (DOC) because of its mineralocorticoid activity and glucocorticoid effects and its equivalency to the adrenal product (ie, cortisol). (medscape.com)
- It is caused by the overproduction of cortisol (a steroid hormone that increases blood sugar levels) by the adrenal glands. (healthcanal.com)
- Mineralocorticoid replacement is required only in primary adrenal insufficiency, because aldosterone secretion is reduced in primary adrenal insufficiency but not in secondary (central) adrenal insufficiency. (medscape.com)
- Fludrocortisone is the drug of choice (DOC) for mineralocorticoid replacement therapy if the zona glomerulosa of the adrenal cortex does not produce aldosterone. (medscape.com)
- About 10% of patients with APS-2 and Addison's disease had a relative with adrenal insufficiency, and about 10% of patients with APS-2 and type 1 diabetes had a sibling with the same disease, and, or with autoimmune thyroid disease. (nih.gov)
- A severe complication of Addison's disease is the Addisonian or adrenal crisis . (tristarsouthernhills.com)
- Primary Addison disease is caused by damage to the outer layer of the adrenal gland. (tristarsouthernhills.com)
- In this case, it attacks tissue of the adrenal gland. (tristarsouthernhills.com)
- The pituitary gland sends hormones that control the adrenal gland. (tristarsouthernhills.com)
- If the pituitary gland is damaged it will affect the adrenal glands. (tristarsouthernhills.com)
- They can also help prevent an adrenal crisis. (tristarsouthernhills.com)
- An adrenal crisis will need immediate medical attention to try to balance the hormones again. (tristarsouthernhills.com)
- Neary N, Nieman L. Adrenal insufficiency: etiology, diagnosis and treatment. (medscape.com)
- Mineralocorticoids are used as replacement therapy in aldosterone deficiency and as prophylaxis against hyponatremia and hyperkalemia in patients with primary adrenal insufficiency (Addison disease). (medscape.com)
- With Addison disease, the adrenal glands do not make enough of certain hormones. (tristarsouthernhills.com)
- Glucocorticoid replacement is required in all forms of adrenal insufficiency (Addison disease). (medscape.com)
- As a rare disease, the diagnosis of primary ovarian insufficiency presents special challenges. (elsevier.com)
- Addison disease is a disorder of the adrenal glands. (tristarsouthernhills.com)
- Wear a medical alert bracelet that states adrenal insufficiency or Addison disease. (tristarsouthernhills.com)
- Most clinicians are not prepared to provide integrated personal care to address all the clinical needs of women with primary ovarian insufficiency. (elsevier.com)
- Women who develop primary ovarian insufficiency related to a premutation in FMR1 are at risk of having a child with fragile X syndrome, the most common cause of inherited intellectual disability. (elsevier.com)
- Lashansky G, Saenger P, Fishman K, Gautier T, Mayes D, Berg G. Normative data for adrenal steroidogenesis in a healthy pediatric population: age- and sex-related changes after adrenocorticotropin stimulation. (medscape.com)