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Query: UMLS:C0011849 (
diabetes
)
277,896
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The contribution of the adrenal gland to the development of the spontaneous syndrome of obesity and
diabetes
in Yellow-KK (Y-KK) mice was studied. Six-month old Y-KK mice exhibited
hyperadrenocorticism
and adrenal cortex enlargement. Light microscopic morphometric studies of Y-KK adrenals revealed an expanded volume of the adrenal cortex resulting from hyperplasia of zona fasciculata and reticularis cells. Ultrastructural studies revealed fewer lipid droplets, increased numbers of mitochondria and a more extensively developed Golgi system with zona fasciculata and reticularis cells. This cytological evidence of enhanced steroid biosynthetic and secretory activity was consistent with increased levels of plasma immunoreactive corticosterone. Structural and functional abnormalities of Y-KK adrenals were preceded by the development of obesity, hyperglycaemia and hyperinsulinaemia. It is unlikely, therefore, that the adrenal plays a casual role in the syndrome's pathogenesis, although,
hyperadrenocorticism
may be in part responsible for an exacerbation of the observed phenomena.
...
PMID:Adrenal gland involvement in mice with hereditary obesity and diabetes mellitus. Morphological studies. 46 49
A cyclic excess of cortisol secretion was detected in a patient with diabetes insipidus and
diabetes mellitus
. The cycles of
hypercortisolism
were of 7 days' duration, but during the nadir of these cycles urinary excretion of corticosteroids and 17-ketosteroids was within the normal range. The radiological appearance of the sella turcica was normal; however, computerized axial tomography of the head revealed a small tumor immediately superior to the sella turcica. At operation a small chromophobe adenoma superior to the diaphragma sellae and involving the hypophysial stalk was partially resected. Postoperatively, the patient continued to have 7-day cycles of increased corticosteroid excretion, but the amounts excreted were less than they had been preoperatively. Other patients have been described in whom Cushing's disease has been due to cyclic
hypercortisolism
. These cycles have been remarkably regular in individual patients, but of variable duration in different patients. Furthermore, cyclic hormonogenesis probably occurs in a variety of endocrinopathies. (Neurosurgery, 5: 598--603, 1979).
...
PMID:Cushing's disease with cyclic hormonogenesis and diabetes insipidus. 53 67
A 57-year-old obese woman with hypertension,
diabetes mellitus
, osteoporosis, and a 40-year history of secondary amenorrhea was diagnosed with corticotropin-dependent Cushing's syndrome. Dynamic endocrine testing and radiological evaluation did not reveal definitively the source of the excess corticotropin. Bilateral adrenalectomy was performed with resolution of the signs and symptoms of
hypercortisolism
. Four years later, the patient was noted to have rising serum corticotropin levels and an enlarging pituitary mass; hyperprolactinemia also was documented. A diagnosis of Nelson-Salassa syndrome was made, and she underwent a transsphenoidal adenomectomy. A histological examination of the specimen revealed two distinct, albeit contiguous, adenomas: a corticotroph adenoma and a lactotroph adenoma. Postoperatively, the serum prolactin and corticotropin levels decreased significantly. Although the stalk section effect resulting from compression by a pituitary adenoma can raise serum prolactin levels, a concurrent lactotroph adenoma should be considered in patients with nonfunctional or functional pituitary adenomas of other types associated with significantly elevated prolactin levels. The mechanisms underlying simultaneous adrenocorticotropic hormone and prolactin excess are discussed.
...
PMID:Coexisting corticotroph and lactotroph adenomas: case report with reference to the relationship of corticotropin and prolactin excess. 131 62
This paper describes four cats with
hyperadrenocorticism
. Cat 1 showed polydipsia and polyphagia.
Diabetes mellitus
was initially diagnosed. As the animal appeared to be insulin resistant, pituitary and adrenocortical function tests were performed and the diagnosis of
hyperadrenocorticism
was made. Resistance to the high-dose dexamethasone suppression test was noticed in this cat. Pathological examination revealed a pituitary chromophobe adenoma. Cat 2 presented with
diabetes mellitus
, which was treated with insulin. The animal had a pendulous abdomen and its coat was in a poor condition. The low-dose dexamethasone suppression test demonstrated
hyperadrenocorticism
. Necropsy findings of pituitary tumour and hyperplasia of the adrenal cortex confirmed the diagnosis. Cat 3 showed clinical abnormalities indicative of
hyperadrenocorticism
, for instance, muscle weakness, alopecia, multiple abscesses. The diagnosis of
hyperadrenocorticism
was confirmed by the results of the lowe-dose dexamethasone suppression test. Pathological examination revealed an adrenocortical carcinoma. Cat 4 presented with polydipsia. The cause of this symptom was not found initially. One and a half years later additional symptoms, such as nephritis and polyphagia developed.
Hyperadrenocorticism
was diagnosed because of a palpable mass cranial to the left kidney. The diagnosis was confirmed by the results of the lowe-dose dexamethasone suppression test and the necropsy findings.
...
PMID:Hyperadrenocorticism in four cats. 141 43
The present study communicates the interim experience with the diagnostic value of the canine corticosteroid-induced alkaline phosphatase isoenzyme (CIAP), qualitatively assessed by agarose gel electrophoresis, for the diagnosis of
Hypercorticism
(prolonged exposure to increased concentrations of exogenous or endogenous corticosteroids) and
Diabetes mellitus
. A total of 106 canine serum samples with a total alkaline phosphatase activity greater than 2.90 mu kat/l were included. CIAP was identified in 28 out of 29 cases of
Hypercorticism
, in 7 out of 9 cases of
Diabetes mellitus
, and in 33 out of 68 cases of various other diseases. Sensitivity and specificity with respect to
Hypercorticism
were 0.97 and 0.48, respectively, while for
Diabetes mellitus
sensitivity and specificity were 0.78 and 0.37. From this, the positive and the negative predictive values were calculated using standard formulas. The main conclusion may be summarized as follows: In the dog, only the negative finding of CIAP seems to be of diagnostic value in ruling out
Hypercorticism
as a cause for an increased total alkaline phosphatase activity.
...
PMID:Preliminary experience with the diagnostic value of the canine corticosteroid-induced alkaline phosphatase isoenzyme in hypercorticism and diabetes mellitus. 149 63
Adrenal tumors are usually diagnosed by clinical symptoms of hormone excess. The increasing use of ultrasound and computed tomography results in the detection of a substantial number of incidentally discovered adrenal tumors. Most of these tumors are nonfunctional adrenocortical adenomas, but a few cases of subclinical cortisol production in "incidentalomas" have been reported. We investigated prospectively the prevalence of autonomous cortisol production in 68 patients (44 females and 24 males, aged 25-90 yr) with adrenal incidentalomas at our institution. As a screening procedure all patients with incidentalomas underwent an overnight dexamethasone suppression test (1 mg). Patients who failed to suppress serum cortisol below 140 nmol/L (5 micrograms/dL) underwent more comprehensive studies (prolonged dexamethasone suppression test, determination of the diurnal rhythm of cortisol secretion in saliva, and CRH stimulation test). Eight patients (12% of all patients with incidentalomas; 5 females and 3 males, aged 25-71 yr) were finally identified as having cortisol-producing tumors, and the findings in these patients were compared with those of overt Cushing's syndrome in 8 patients (8 females, aged 26-50 yr) suffering from cortisol-producing adrenal adenomas. The tumor size of patients with cortisol-producing incidentalomas ranged from 2-5 cm. No specific signs and symptoms of
hypercortisolism
were present, but arterial hypertension (seven of eight subjects), diffuse obesity (four of eight subjects), and noninsulin-dependent
diabetes mellitus
(NIDDM; two of eight subjects) were frequently observed. Baseline cortisol levels were in the normal to upper normal range, whereas baseline ACTH levels were suppressed in five of the eight patients. In none of the patients was serum cortisol suppressible by low dose or high dose dexamethasone. The ACTH and cortisol responses to CRH were normal in two, blunted in one, and suppressed in four patients. Unilateral adrenalectomy was performed in seven patients and resulted in temporary adrenal insufficiency in four of them. After surgery, improvement of arterial hypertension, a permanent weight loss in obese subjects, and a better metabolic control of NIDDM were noted in the majority of patients. The following conclusions were reached. Incidentally diagnosed adrenal tumors with pathological cortisol secretion in otherwise clinically asymptomatic patients are more frequently observed than previously assumed. Adrenocortical insufficiency is a major risk in these patients after adrenalectomy. After surgery, hypertension, obesity, and NIDDM may improve. Patients with asymptomatic adrenal incidentalomas, therefore, should be screened for cortisol production by means of an overnight dexamethasone suppression test.
...
PMID:Preclinical Cushing's syndrome in adrenal "incidentalomas": comparison with adrenal Cushing's syndrome. 151 73
Blood serum trypsin was radioimmunoassayed in 46 patients with adrenocortical hyperfunction and in 24 ones with its hypofunction. The findings evidence that excess of endogenous adrenal steroids leads to elevation of radioimmune trypsin (RIT) concentration. The presence of chronic pancreatitis in hypercorticism did not essentially influence the value of the examined parameter, nor did the development of
diabetes mellitus
. Corticosteroid deficit in the body was not associated with changes in the blood serum RIT concentration. Systematic glucocorticoid therapy resulted in elevation of RIT level. The serum enzyme concentration was also increased in hypoadrenocorticism patients not administered glucocorticoids, suffering from concomitant chronic pancreatitis. Therefore the test was not informative for the diagnosis of chronic pancreatitis in the patients with the endogenous
hyperadrenocorticism
syndrome but may be helpful in the recognition of the condition in the patients with chronic adrenal insufficiency; interpretation of this test results in hypoadrenocorticism patients treated with glucocorticoids should be performed by efficient specialists.
...
PMID:[Immunoreactive trypsin in the blood of patients with functional disorders of the adrenal cortex]. 169 72
The manifestations of endocrine derangements in the musculoskeletal system in infancy and childhood are disturbances in growth and maturation and in adulthood are disturbances in maintenance and metabolism.
Hypercortisolism
during skeletal immaturity suppresses growth. In the adult,
hypercortisolism
leads to osteoporosis, osteonecrosis, and muscle wasting. Deficiency of growth hormone during skeletal development results in short stature. An excess of growth hormone in a skeletally immature individual results in gigantism, an excess in a skeletally mature individual results in acromegaly. Patients with gigantism have extreme height with normal body proportions. Musculoskeletal manifestations of acromegaly include soft-tissue thickening, vertebral body enlargement, characteristic hand and foot changes, and enthesal bony proliferation. Hyperthyroidism causes catabolism of protein and loss of connective tissue, which manifest as muscle wasting. Deficient levels of thyroid hormone cause defects in growth and development. Severe growth retardation from congenital hypothyroidism is rare because neonatal screening recognizes the disorder and leads to early treatment. The skeletal manifestation of hypergonadism in children is precocious growth and early skeletal maturation. Although the initial precocious growth spurt results in a tall child, early closure of the growth plates results in a short adult. Hypogonadism in the prepubertal child results in delayed adolescence and delayed skeletal maturation.
Diabetes mellitus
in childhood results in decreased growth, a phenomenon presumed to be secondary to nutritional abnormalities. Generalized osteoporosis and short stature are common. In the adult, generalized osteoporosis may accompany insulin-dependent
diabetes mellitus
if obesity is absent. Calcification of interdigital arteries of the foot is common in diabetics and uncommon in other conditions. Additional skeletal manifestations relate to complications of
diabetes
such as peripheral neuropathy and diabetic foot disease.
...
PMID:Radiologic manifestations in the musculoskeletal system of miscellaneous endocrine disorders. 198 24
Pregnancy and Cushing's syndrome are seldom found together (40 cases in the literature), since
hyperadrenocorticism
is often responsible for anovulation by gonadotropin suppression. We report the case of a 25-year old para II woman whose pregnancy was complicated by
diabetes
and arterial hypertension at 31 weeks and who received the conventional treatments (special diet, insulin therapy, pindolol). Caesarean section, motivated by premature rupture of the membranes, was performed at 37 weeks, delivering a healthy infant. The diagnosis of
hypercortisolism
with low ACTH level was made post partum. An adrenal tumour (the most frequent cause of Cushing's syndrome occurring during pregnancy) was removed after pre-operative treatment with ketoconazole, and endocrine functions returned to normal.
...
PMID:[Adrenal adenoma disclosing after delivery]. 209 25
The long-acting somatostatin analog (octreotide) was administered to a 37-yr-old woman with the ectopic ACTH syndrome. The patient had diffuse metastatic spread of a nonpituitary tumor, presumably of pancreatic origin, and severe and rapidly progressive
hypercortisolism
with extreme myopathy, hypokalemia, and
diabetes mellitus
. Plasma ACTH and lipotropin levels and 24-h urinary cortisol excretion were greatly elevated [218 pg/mL (48 pmol/L), 1340 pg/mL (220 pmol/L), and up to 830 micrograms/24 h (2290 nmol/day), respectively]. Urinary cortisol excretion decreased to normal within 3 days after the initiation of octreotide therapy (150, 300, and 600 micrograms/day), and plasma ACTH and lipotropin levels also decreased. Urinary cortisol excretion remained normal for 2 months during chronic octreotide therapy, and her general condition improved dramatically. The only side-effect was a slight increase in the number of bowel movements. Tumor progression, however, was not controlled, and she eventually died of hepatic insufficiency. These data indicate that octreotide can be a highly effective treatment for patients with the ectopic ACTH syndrome.
...
PMID:Suppression of ectopic adrenocorticotropin secretion by the long-acting somatostatin analog octreotide. 256 15
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