Diagnostic dilemma of adrenal enlargement after acute pancreatitis

Motallebzadeh, Reza; Godfrey, Edmund; Nv, Jamieson

doi:10.1308/147870808x303029

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…A retrospective study evaluating abdominal CT scans in patients with depression demonstrated that 12 out of 38 subjects had significantly increased adrenal volumes compared to normal controls ( 6 ). Non-functional reversible adrenal enlargement cases have been previously reported ( 7 , 8 ), suggesting hematomas, cystic lesions, and infections of adrenal glands as possible etiologies. Functional differentials include Cushing's disease with cyclical ACTH production, stress-induced ACTH-dependent adrenal hyperplasia, and ectopic ACTH production.…”

Section: Discussionmentioning

confidence: 99%

Stress-induced severe transient hypercortisolism with reversible bilateral adrenal enlargement after cardiogenic shock

Noreña

Joshi

Rawla

et al. 2023

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary Acute illness-related stress can result in severe hypercortisolism and bilateral adrenal enlargement in certain patients. We report a case of stress-induced hypercortisolism and bilateral adrenal enlargement in a patient admitted for acute respiratory distress and cardiogenic shock. Bilateral adrenal enlargement and hypercortisolism found during hospitalization for acute illness resolved 3 weeks later following the resolution of acute illness. Acute illness can be a precipitating factor for stress-induced hypercortisolism and bilateral adrenal enlargement. We hypothesize that increased adrenocorticotrophic hormone mediated by corticotrophin-releasing hormone from physical stress resulted in significant adrenal hyperplasia and hypercortisolism. This mechanism is downregulated once acute illness resolves. Learning points Adrenal enlargement with abnormal adrenal function after stress is uncommon in humans; however, if present, it can have self-resolution after the acute illness is resolved. Stress induces enlargement of the adrenals, and the degree of cortisol elevation could be very massive. This process is acute, and the absence of cushingoid features is expected. Treatment efforts should be focused on treating the underlying condition.

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Section: Discussionmentioning

confidence: 99%

Stress-induced severe transient hypercortisolism with reversible bilateral adrenal enlargement after cardiogenic shock

Noreña

Joshi

Rawla

et al. 2023

Endocrinology, Diabetes &Amp; Metabolism Case Reports

View full text Add to dashboard Cite

show abstract

“…58 While relatively rare, it is a life-threatening event that is associated with a 15% mortality rate. 59 Most commonly, it is unilateral (80%) and rightsided. 58 Bilateral adrenal hemorrhage is extremely emergent and may lead to rapid cardiovascular decline and ultimately death if not promptly diagnosed and treated.…”

Section: Adrenal Massesmentioning

confidence: 99%

Extraspinal Critical Findings on Lumbar Spine Imaging: What the Neuroradiologist Cannot Afford to Miss

Goldin¹,

Mansoor²,

Krishnan³

et al. 2013

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The adrenocorticotropic hormone-induced cortisol response in acute pancreatitis

Groeneveld

2009

Critical Care

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The evidence that severe acute pancreatitis can result in critical illness-related corticosteroid insufficiency following impaired adrenal secretion is accumulating. The study by Peng and coworkers in Critical Care certainly contributes to that idea, even though the question whether relative adrenal insufficiency should prompt for treatment by substitution doses of corticosteroids remains unresolved. The study is discussed in terms of the risk factors, circumstances and significance of impaired corticosteroid secretion by adrenals in severe acute pancreatitis.

show abstract

Diagnostic dilemma of adrenal enlargement after acute pancreatitis

Cited by 3 publications

References 5 publications

Stress-induced severe transient hypercortisolism with reversible bilateral adrenal enlargement after cardiogenic shock

Stress-induced severe transient hypercortisolism with reversible bilateral adrenal enlargement after cardiogenic shock

Extraspinal Critical Findings on Lumbar Spine Imaging: What the Neuroradiologist Cannot Afford to Miss

The adrenocorticotropic hormone-induced cortisol response in acute pancreatitis

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