Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 39-year-old female with a history of three psychotic episodes in 6 months developed Cushingoid features and catatonia. Despite the surgical removal of a pituitary basophil adenoma and treatment with neurleptics, her catatonia worsened. Electroconvulsive therapy provided rapid, life-saving relief for this patient. Patient characteristics are discussed and treatment recommendations provided.
 ...
PMID:Electroconvulsive therapy following pituitary surgery. 4 85

This is a case presentation of a 52 year old woman with a past history of schizophrenia who develops an acute psychosis. The point is emphasized that a deterioration in mental state in a patient with schizophrenia should not too readily be attributed to the 'functional' psychosis. Psychiatric patients may present with organic mental disorders requiring medical or surgical intervention. Thus the psychiatrist must always be alert to the possibility of new pathology and examine carefully for signs of organic disturbances. This case turned out to be one of acute hyperparathyroidism cured by surgical removal of an adenoma of the parathyroid gland.
 ...
PMID:Primary hyperparathyroidism in a schizophrenic women. 343 88

A case is described of recurrent mania without depressive episodes in a patient subsequently diagnosed as having an ACTH-producing basophil adenoma. The difficulties involved in the clinical and laboratory diagnosis of Cushing's syndrome, and the ramifications of neuroendocrinopathies' ability to mimic symptoms of functional psychosis, are discussed.
 ...
PMID:Mania in Cushing's syndrome: case report. 631 60

Hyperparathyroidism with or without adenoma has occasionally been reported in association with lithium treatment, and in symptomatic patients depression, psychosis and an exacerbation of existing psychopathology may occur. Three lithium-treated patients with hyperparathyroidism are reported, in whom discontinuation of lithium in one and removal of parathyroid adenomata in two led to both a reduction in plasma calcium levels and an improvement in their psychopathology.
 ...
PMID:Lithium and symptomatic hyperparathyroidism. 642 22

A 37-year-old woman presented with acute psychosis and cognitive impairment. Skull x-ray showed an enlarged sella turcica with erosion of the floor. Endocrinologic workup suggested the diagnosis of Cushing's disease and hyperprolactinemia. She had no cushingoid feature, and the only physical sign was mild generalized obesity. She showed a paradoxic response to dexamethasone suppression, and underwent trans-sphenoidal resection of a pituitary macroadenoma. Electron microscopy showed the tumor to be a Crooke's cell adenoma. Results of immunohistochemical staining were positive only for ACTH and beta-endorphin. The neuropsychiatric manifestations resolved after surgery.
 ...
PMID:Occult Cushing's disease presenting with acute psychosis. 671 82

Acute onset of primary hyperparathyroidism is uncommon; neuropsychiatric signs are prominent clinical features in acute hypercalcemia and they can subside after normalization of serum calcium. Radiation therapy is a well-known risk factor for non medullary thyroid cancer, but it induces also parathyroid tumors. Data from the literature show that patients previously treated with neck radiation have an increased risk of primary hyperparathyroidism. Furthermore concomitant thyroid cancer is more frequent in radiation-induced hyperparathyroidism than in sporadic primary hyperparathyroidism. The case of a 63-year-old female patient who at the age of 14 had been irradiated to the neck for goiter and at the age of 50 had been repeatedly hospitalized for psychosis is presented. She was admitted to the hospital for suspected recurrence of psychosis, but clinical findings and urgent biochemical data showed on the contrary that she had a severe hypercalcemic crisis. Serum parathormone concentrations, neck echography and 99mTc-Sestamibi scintigraphy suggested hyperfunction of the right lower parathyroid gland; therefore the patient was operated on. Pathological examination disclosed a parathyroid adenoma but also two foci of follicular cancer in the right thyroid lobe with a metastasis to a lymph node were observed. Neuropsychiatric signs disappeared after normalization of calcemia and 6 months after operation the patient is free from psychiatric symptoms, despite she had stopped neurolectic drugs. It is underlined that patients who had received neck irradiation must be carefully observed because they are at increased risk of primary hyperparathyroidism and concurrent thyroid cancer.
 ...
PMID:[Acute hyperparathyroidism associated with follicular carcinoma in the thyroid: possible role of juvenile cervical irradiation. Description of a case]. 922 12

Cushing's disease is most commonly caused by a corticotrope adenoma of the pituitary. Between 50 and 70% of patients with spontaneous hypercortisolism have ACTH-producing pituitary adenomas. The tumors are usually microadenomas with approximately 20% of patients with the disease showing no evidence of tumor on CT-scans or MR imaging of their pituitary glands. In contrast to patients with ectopic ACTH production, plasma ACTH concentrations in patients with spontaneous disease are generally within the normal range. We describe here a patient with a pituitary macroadenoma that showed evidence of necrosis on MRI. The patient had an atypical clinical presentation with plasma ACTH levels considerably higher than that seen in patients with non-ectopic ACTH-secretory syndrome, markedly elevated urine free cortisol, lack of phenotypical signs of hypercortisolism such as wide purplish striae, and whose most prominent and distressing symptom was severe myopathy that resulted in the patient becoming bed-ridden. Psychosis was another striking feature in this patient who during his hospital course developed multiple opportunistic infections that contributed to his demise.
 ...
PMID:Severe myopathy and psychosis in a patient with Cushing's disease macroadenoma. 1464 7

Dopamine agonists are the drugs of choice in the treatment of prolactinomas, the most common type of pituitary adenomas. However, up to 25% of prolactinomas do not respond to these drugs and alternative treatments have to be considered. We describe a 37-year old female with a microprolactinoma who, although having received all available formulations of dopamine agonists over a period of 11 years, did not respond either clinically--diminution of galactorrhea and restoration of her menstrual cycle--or hormonally through normalisation of the elevated prolactin levels. Throughout the same period, the size of the adenoma remained unchanged. While on high doses of dopamine agonists, the patient presented with side effects such as nausea, vomiting, orthostatic hypotension and tachycardia without any symptoms of psychosis. Therefore, either the dose of the dopamine agonists was not toxic enough for the mesolimbic dopaminergic pathway to be activated or the patient was dopamine-resistant in this pathway as well.
 ...
PMID:A case of a prolactinoma resistant to dopamine agonists. 1661 27

Cushing's syndrome is associated with serious morbidity and increased mortality. Irrespective of its cause, i.e. a pituitary adenoma, ectopic ACTH production or an adrenal neoplasia, Cushing's syndrome is primarily treated surgically. However, when surgery is unsuccessful or contraindicated, medical therapy is needed to treat hypercortisolism. The spectrum of available drugs includes adrenal-blocking agents, neuromodulatory drugs and glucocorticoid receptor antagonists. Adrenal blocking drugs suppress adrenal cortisol production via inhibition of steroidogenic enzymes. Ketoconazole and metyrapone are most frequently used for this purpose, but chronic treatment with these drugs can be limited by side effects like hepatotoxicity (ketoconazole) and increased androgen and mineralocorticoid production (metyrapone). Etomidate can be used to rapidly reverse cortisol excess in patients with acute complications of (severe) hypercortisolism like psychosis. In Cushing's disease, combination therapy with drugs that target the corticotropic adenoma, i.e. the universal somatostatin analogue pasireotide and/or the dopamine agonist cabergoline, and low-dose ketoconazole seems a rational approach to achieve biochemical control.
 ...
PMID:Medical treatment of Cushing's syndrome: adrenal-blocking drugs and ketaconazole. 2082 30

Primary hyperparathyroidism (PHPT) is a disorder of calcium homeostasis. We report the case of a 17-year-old adolescent male, who presented with an acute psychosis coinciding with severe hypercalcemia and markedly elevated intact parathyroid hormone (iPTH) level and low vitamin D level. A Sestamibi scan showed a positive signal inferior to the left lobe of the thyroid gland. He had only a partial response to the initial medical and psychiatric management. The enlarged parathyroid gland was resected surgically and postoperatively serum calcium and iPTH levels normalized. The histopathology was compatible with a benign adenoma. Patient's acute psychotic symptoms resolved gradually after surgery; however he remained under psychiatric care for the behavioral issues for about 6 months after surgery. While psychosis is a rare clinical manifestation of hypercalcemia secondary to PHPT in pediatric population, it should be considered as a clinical clue in an otherwise asymptomatic pediatric patient.
...
PMID:A case of acute psychosis in an adolescent male. 2479 26


1 2 Next >>