An unusual cause of syncope

Yeo, L.; Pyburn, Rachel; Venkatanarayana, Thirumalesha Desa

doi:10.1016/j.ejim.2006.01.004

Cited by 1 publication

(2 citation statements)

References 4 publications

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“…1). Four case reports did not meet inclusion criteria leaving 13 cases reports [14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26], one case series of four patients [27] and six original research articles [13, 28, 29, 30, 31, 32]. Of these original research articles, four articles met criteria for the initial prevalence calculation requiring bilateral disease and ACTH stimulation test to diagnose AI.…”

Section: Resultsmentioning

confidence: 99%

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Adrenal insufficiency due to bilateral adrenal metastases – A systematic review and meta-analysis

Tallis

Rushworth

Torpy

et al. 2019

Heliyon

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Objective Bilateral adrenal metastases may cause adrenal insufficiency (AI) but it is unclear if screening for AI in patients with bilateral adrenal metastases is justified, despite the potential for adrenal crises. Method A search using PubMed/Medline, ScienceDirect and Cochrane Reviews was performed to collect all original research articles and all case reports from the past 50 years that describe AI in bilateral adrenal metastases. Results Twenty studies were included with 6 original research articles, 13 case reports and one case series. The quality was generally poor. The prevalence of AI was 3–8%. Of all cases of AI (n = 25) the mean pooled baseline cortisol was 318 ± 237 nmol/L and stimulated 423 ± 238 nmol/L. Hypotension was present in 69%, hyponatremia in 9% and hyperkalemia in 100%. Lung cancer was the cause in 35%, colorectal 20%, breast cancer 15% and lymphoma 10%. The size of the adrenal metastases was 5.5 ± 2.8 cm (left) and 5.5 ± 3.1 cm (right), respectively. There was no correlation between basal cortisol, stimulated cortisol concentration or ACTH with the size of adrenal metastases. The median time to death was 5.0 months (IQR 0.6–6.5). However, two cases were alive after 12–24 months. Conclusion The prevalence of AI in patients with bilateral adrenal metastases was low. Prognosis was very poor. Due to the low prevalence of AI, screening is likely only indicated in patients with symptoms and signs suggestive of hypocortisolism.

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Section: Resultsmentioning

confidence: 99%

“…SX improved. Died 3 weeks later.Yeo et al [26]78FBreastY---265 nmol/L (9.6ug/dL)-235 nmol/L (8.5ug/dL)ACTH-stimulation test-TX with GC. SX improved.…”

Section: Methodsmentioning

confidence: 99%