Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:1.1.1.1 (alcohol dehydrogenase)
 9,284 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of isolated ACTH deficiency who developed autoimmune-mediated hypothyroidism and still showed impaired water diuresis during glucocorticoid replacement therapy is reported. A 45-year-old woman was initially admitted for nausea, vomiting, and general malaise. Her serum sodium and plasma osmolality, ACTH and cortisol values were low, but her urine osmolality was high. Other pituitary hormone levels, thyroid hormone levels, and a computed tomogram of the pituitary gland were normal. The patient was treated with hydrocortisone and followed in the outpatient clinic; however, she was lost to follow up 18 months after admission. Three years later she presented with hypoglycemia and hyponatremia. Her serum or plasma ACTH, FT3, FT4, cortisol levels were low and her serum TSH level was high. Pituitary stimulation tests revealed a blunted response of ACTH to CRH and an exaggerated response of TSH to TRH. Plasma ADH was inappropriately high, and a water-loading test revealed impaired water diuresis and poor suppression of ADH. Although ADH was suppressed, impaired water diuresis was observed in the water loading test after hydrocortisone supplementation. Thyroxine supplementation completely normalized the water diuresis. Her outpatient clinic medical records revealed a gradual increase in TSH levels during follow up, indicating that she had developed hypothyroidism during glucocorticoid replacement therapy. The hyponatremia on the first admission was due to glucocorticoid deficiency, whereas the hyponatremia on the second admission was due to combined deficiencies of glucocorticoid and thyroid hormones.
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PMID:A case of isolated ACTH deficiency who developed autoimmune-mediated hypothyroidism and impaired water diuresis during glucocorticoid replacement therapy. 1122 40

The role of axial body orientation was weighed during acute adaptation to suit immersion (SI) in 3 hr vertical (SIv, n=4) exposure series, and 3 d experiments in which six volunteers participated in both SIv and SIh. Various types of SI recruited different hormonal mechanisms to induce similar reactions of the water-electrolyte metabolism (WEM). Changes in the body position relative to the gravity vector modified equally strength and dynamics of the WEM regulation. The experimental data suggest that osmo- and volume-regulation reactions to SIv shown the response to the actual volumetric stimulus against the "distributed" weight-bearing reaction. They are less vigorous as compared to SIh and do not reach maximum within 3 hrs. Physiological reactions to SIh were marked by greater effects of ADH on the kidney when compared with dry immersion, and an additional stimulation of aldosterone secretion by the sympathetic nervous system and/or ACTH. SIh caused rapid and more heavy symptoms of motion sickness that correlated with body mass reduction, negative water balance, degradation of tolerance of classic physical tests executed after SI. Three-days SIv, as opposed to SIh, resulted in more profound hypervolemia in the upper body of the test-subjects.
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PMID:Vertical and horizontal posture during suited immersion: similarity and differences according to some body functions. 1269 11

Cranial irradiation with or without chemotherapy can cause hypothalamic-pituitary dysfunction. Chemotherapy without cranial irradiation has not been thought to cause such deficiency. In order to determine whether chemotherapy without cranial irradiation can lead to hormonal deficiency, we reviewed the medical records of 362 childhood cancer patients who underwent full hypothalamic-pituitary evaluation because of altered growth and development after oncological therapy (1987-2002). Of these, 31 received chemotherapy but no cranial or total body irradiation and had no CNS tumor: 18 had hematological malignancy and 13 had a solid tumor of the torso or extremity. Duration of follow-up was 13.0 +/- 4.1 years (mean +/- SD). Growth hormone deficiency (GHD) was identified in 15 (48%), central hypothyroidism (TSH-D) in 16 (52%), and pubertal abnormalities in 10 (32%). Pubertal abnormalities included precocious puberty in two (6%), gonadal failure in five of 27 who were old enough to assess puberty (19%), and gonadotropin deficiency in three of 27 (11%). GHD and TSH-D were co-existent in eight patients (26%). Overall, 81% (n = 25) had GHD, TSH-D, precocious puberty, and/or gonadotropin deficiency. None had ACTH or ADH deficiency or primary hypothyroidism. Of note, this was not a study of prevalence, but rather an evaluation of clinically referred patients. In conclusion, hypothalamic dysfunction may occur in survivors of non-CNS tumors who receive chemotherapy but do not receive cranial irradiation. We recommend at least annual observation of growth rate and pubertal development of all children treated for pediatric malignancies, with evaluation for GHD, TSH-D, pubertal abnormalities, and other hypothalamic dysfunction in all poorly-growing cancer survivors, even those not treated with cranial irradiation.
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PMID:Hypothalamic dysfunction after chemotherapy. 1496 22

We report a case of a 41-year-old woman who was diagnosed as having the syndrome of inappropriate secretion of ADH (SIADH). There was no evidence of any disorders of the central nervous system, lung diseases, or drugs causing SIADH. Positron emission tomography (PET) using (18)F-fluorodeoxyglucose (FDG) was performed and indicated a tumor of the uterine cervix. After resection of the tumor, both serum sodium level and serum osmolarity were normalized concomitantly with a decrease in serum ADH level. This is the first case report suggesting the usefulness of a FDG-PET scan to detect an occult cancer responsible for SIADH. It seems plausible that FDG-PET may be helpful in the diagnosis of other ectopic hormone-producing tumors such as ectopic ACTH-producing tumors that cause Cushing's syndrome.
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PMID:Usefulness of FDG-PET in detecting an ADH-secreting tumor: a case report. 1524 22

The aim of the present study was to evaluate the characteristics of GH deficiency (GHD) in adult patients after neurosurgery for pituitary adenomas and craniopharingiomas. One hundred and one GHD patients, (42 F/59 M), aged 47.58+/-14.4 yr (mean+/-SD; range 21-78), body mass index (BMI) 28.6+/-0.6, with a history of adult-onset hypothalamic-pituitary disease, were recruited for the study. The whole group included: 45 non-functioning pituitary adenomas, 23 craniopharyngiomas, 16 PRLomas, 8 GHomas, 7 ACTHomas and 2 FSHomas; in particular 51 were macroadenomas and 27 microadenomas. At study entry, GHD diagnosis was carried out by assessing GH secretion after GHRH+arginine. All patients were submitted to the study at least 12 months after neurosurgery and, where needed, subjects were replaced with an appropriate treatment. GHD was mild in 3/101 (3%) and severe in 98/101 patients (97%). Other hormone deficiencies associated with GHD were considered: TSH, ACTH, FSH/LH, ADH. The distribution of peak GH among all patients, according to the type of disease before neurosurgery, showed that patients with Cushing disease were characterized by the presence of higher peak GH. According to the number of additional hormone deficits, the distribution of peak GH among all patients was as follows: GHD was isolated in 4/101 subjects (4%; group A), while it was associated with 1 (14/101, 14%; group B), 2 (22/101, 22%; group C), 3 (44/101, 43%; group D) and 4 hormone deficits (17/101, 16%; group E). GHD was severe in all patients in the panhypopituitaric group. Total IGF-I plasma levels in the whole group of GHD patients were 95.2+/-4.2 microg/l. In all groups of patients IGF-I was lower in subjects with severe GHD than in those with mild GHD (93.6+/-4.1 vs 148.6+/-33.6 microg/l, p<0.03). In particular, according to the type of disease presented before neurosurgery, patients with Cushing disease were characterized by the presence of higher IGF-I plasma levels compared to the other. According to the number of additional deficits, the distribution of IGF-I plasma levels was characterized by higher values when GHD was isolated than when it was associated with multiple hormone deficiencies. IGF-I plasma levels were positively associated to peak GH during GHRH+arginine (r=0.4, p<0.0005). We conclude that patients after neurosurgery approach for sellar and parasellar neoplasia, within an appropriate clinical context, and both the presence of additional pituitary hormone deficiency and low levels of IGF-I can be considered a clear GHD condition, and therefore do not require provocative tests evaluating GH secretion.
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PMID:Characteristics of adult patients with growth hormone deficiency who underwent neurosurgery for functioning and non-functioning pituitary adenomas and craniopharyngiomas. 1588 62

It has been shown that stress changes stimulated pro-inflammatory cytokine production and the sensitivity of stimulated cytokine production to glucocorticoid suppression. While glucocorticoid secretion habituates in response repeated stimulation, it is not known whether stimulation and suppression of cytokine production are also subject to adaptation. Eight healthy young subjects were exposed to repeated nauseogenic body rotation on four consecutive days. On each day subjects were rotated around the vertical axis up to five times for a period of 1 min or until subjects chose to stop due to nausea. Blood and saliva samples were obtained before and after rotation for assessment of cortisol, ACTH, plasma vasopressin (ADH), in vitro TNF-alpha and IL-6 production and glucocorticoid sensitivity of TNF-alpha and IL-6 production. Rotation induced increases of ACTH, cortisol, and ADH in the first session. All endocrine responses habituated over time, except for the free cortisol response in men. Pro-inflammatory cytokine production showed a sex-specific response pattern with increases in men and decreases in women in the first session vs. increases in men and women in the last session. Response patterns of GC sensitivity also changed over time: in the first session, sensitivity increased only in men, but in the last session, GC sensitivity decreased in all subjects. In conclusion, in response to repeated nausea induction, habituation occurs only in the endocrine system and predominantly in women. In the immune system, response patterns change in the favor of inflammatory conditions, with increases in stimulated IL-6 and TNF-alpha and decreases in the effectiveness of glucocorticoid suppression of these cytokines. These presumably unfavorable changes in the inflammatory system are more pronounced men.
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PMID:Sex-specific adaptation of endocrine and inflammatory responses to repeated nauseogenic body rotation. 1614 52

The objective of this article is to review clinical outcomes in patients presenting with pituitary apoplexy and compare the results of conservative and surgical management. It took the form of a retrospective review of 30 patients (23M, 7F; age range: 17-86 years) with pituitary apoplexy diagnosed between 1988 and 2004. Presenting features included headache in 27 patients, 'collapse' in three and vomiting in 14. Complete blindness occurred in four patients, monocular blindness in two, decreased visual acuity in 12, visual field loss in 10 and ophthalmoplegia in 15. Only five had no initial visual deficit. CT was the initial mode of imaging in 22 patients: three such scans were initially reported as 'normal' and a further 10 as pituitary tumour only, with no haemorrhage. Ten patients proceeded to early pituitary surgery and 20 were managed conservatively. There was one death 24 days after admission in a patient with multiple co-morbidities. Of the six patients with blindness, three (two conservatively treated) regained partial vision. Of the remaining 19 patients with visual deficits, 10 (two surgically treated) recovered fully and eight (four surgically treated) partly so. At latest follow-up the following pituitary hormone deficiencies were identified: ACTH 19; TSH 20; testosterone 18; ADH (diabetes insipidus) eight. Later recurrence of a pituitary adenoma was observed in seven cases (including six of the 10 surgically treated patients). There was no evidence that those patients managed surgically had a better outcome. Early neurosurgical intervention may not be required in most patients presenting with pituitary apoplexy.
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PMID:Pituitary apoplexy: retrospective review of 30 patients--is surgical intervention always necessary? 1743 89

The case of a 61-year-old man presenting with dizziness, nausea, vomiting, reduced serum osmolality, and hyponatremia is reported. Endocrinologically, low levels for ADH, cortisol and testosterone as well as low-normal values for ACTH, LH and FSH were detected. Cranial computed tomography and MRI scans revealed an intra- and suprasellar tumor of adenoma-like appearance with elevation of the optic chiasm. No infiltration of the cavernous sinus was seen. After transsphenoidal resection of the tumor, no additional anterior lobe insufficiencies or diabetes insipidus occurred. Histological examination revealed a tumor consisting of spindle-shaped cells of uniformly high cellularity with no evidence of hypocellular areas. A cellular schwannoma was diagnosed. An intrasellar cellular schwannoma clinically and radiologically mimicking a non-secreting pituitary adenoma is uncommon. However, rare entities like schwannomas, melanocytomas or pituicytomas have to be considered in addition to the more common tumors like pituitary adenomas and meningiomas.
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PMID:A 61-year-old man with hyponatremia. 1836 39

Paraneoplastic syndromes induced by inappropriate-ectopic production of hormones, cytokines and growth factors, therefore not mediated directly by local infiltration or metastatic spread, occur in approximately 10 per cent of patients with malignant disease in initial phase. Subjects with paraneoplastic syndromes often are affected by small occult tumors which may be diagnosed only at autopsy. Inappropriate secretion of peptide hormones is the commonest cause of paraneoplastic syndromes. On the basis of an up-to-date review of the literature, this article discusses pathogenetic mechanisms, diagnostic features and essential therapeutic measures concerning the syndromes of inappropriate ACTH/CRH, PTHrp, TRH/TSH, ADH and MSH secretion. Moreover, some of paraneoplastic syndromes, that are associated with production of cytokines and growth factors by either tumor- or non malignant host microenvironment -cells, are briefly outlined.
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PMID:[Paraneoplastic syndromes associated with urogenital tumours: an up-to-date review]. 1894 70

In the kidney there is a co-transport relationship in the nephron between the reabsorption of positive Na(+) ions and the reabsorption of negative ions such as uric acid anions. Uric acid acts as an anti-oxidant and it has been shown to have a sealing effect on the blood-brain barrier. The theory developed here is that chronic neurological vasoconstriction in cool environmental conditions injects an offset into the rennin-angiotensin-aldosterone system (RAAS) blood pressure control loop and reduces demand for angiotensin and aldosterone. (Aldosterone is produced in the adrenal gland and has a direct effect on renal reabsorption of Na(+) ions.) Via co-transport these conditions will reduce the body's ability to reabsorb uric acid and this in turn will weaken the integrity of the blood-brain barrier. Also, in cool environments, where levels of vasopressin (ADH) and aldosterone are lower, the gain of the hypothalamus-pituitary-adrenal gland (HPA) axis is reduced so that the production average levels of ACTH, cortisone and aldosterone will be biased at a lower level and the kidney-local levels of aldosterone in particular will remain lower. This paper develops these ideas and suggests that they can help explain the traditionally-recognized latitudinal gradient in MS epidemiology. Also, acclimatization to heat encourages sweating, which should create a greater demand for the renal reabsorption of Na(+) ions which enables greater reabsorption of uric acid. Therefore people living at low latitudes should have a lower chance of hypouricemia and a lower chance of developing MS. In fact people who spend their first fifteen years in the tropics almost never go onto develop MS. And MS patients in relapse are consistently hypouricemic. This hypothesis can explain both of these facts. The paper goes onto show how the MS condition will tend to progress because of a number of self-sustaining effects: over time the immune system becomes more targeted to myelin, MS patients are unlikely to become acclimatized to heat because they tend to avoid heat since demyelinated nerve function is worsened by elevated temperature, and the normal circadian excitation of the HPA axis gets weaker under the benign environmental conditions typically adopted by MS patients as the disease develops.
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PMID:Endocrine system dynamics and MS epidemiology. 2389 28


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