Eight-six Cases of Adison's Disease

Dunlop, Derrick

doi:10.1136/bmj.2.5362.887

Cited by 196 publications

(68 citation statements)

References 6 publications

(4 reference statements)

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“…This suggests a connection between the size of a melaninbased ornament and the underlying tissue's responsiveness to CORT, supporting prior relationships between melanization and activity of the hypothalamus-pituitary -adrenal (HPA) axis [14,28,29]. An earlier study [21], however, found that larger bibbed male house sparrows secreted more CORT in response to a stressor compared with smaller bibbed males, suggesting that circulating CORT and skin CORT receptors are independently regulated in this species.…”

Section: Rsblroyalsocietypublishingorg Biol Lett 9: 20130440mentioning

confidence: 72%

“…Alternative splicing of the POMC gene produces several products, including adrenocorticotropin hormone, which stimulates CORT release, and a-, b-and g-melanin-stimulating hormones, which are involved in melanin production, among other functions [30]. POMC is under negative feedback regulation from CORT [30]; indeed, locally applied CORT can result in skin blanching [28], and the lack of CORT negative feedback can cause hyper-pigmentation [29]. There is evidence that CORT's negative feedback role on POMC may be a direct effect of a GR-CORT complex, rather than owing to the induction of a repressor-like molecule [30].…”

Section: Rsblroyalsocietypublishingorg Biol Lett 9: 20130440mentioning

confidence: 99%

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The size of a melanin-based plumage ornament correlates with glucocorticoid receptor concentrations in the skin of that ornament

Lattin

Romero

2013

Biol. Lett.

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PhysiologyThe size of a melanin-based plumage ornament correlates with glucocorticoid receptor concentrations in the skin of that ornament Christine R. Lattin and L. Michael Romero Department of Biology, Tufts University, Medford, MA 02155, USA Glucocorticoid hormones such as corticosterone (CORT) play crucial roles in many physiological processes. CORT's actions are primarily mediated via binding to two receptors (glucocorticoid receptors (GRs) and mineralocorticoid receptors (MRs)) in different target tissues. CORT receptors can be independently regulated from circulating hormone titres, from tissue to tissue and even within different regions of the same tissue type. Increasing evidence has shown relationships between circulating CORT and melaninbased pigmentation in skin and feathers, yet to our knowledge, there have been no studies of CORT receptors in the skin of melanized ornaments. Male house sparrows (Passer domesticus) have a black, melanized bib, and evidence suggests that bib size is an important intraspecific signal. We examined the relationship between bib area and tissue sensitivity to CORT by quantifying GR and MR in bib skin and in adjacent paler-feathered belly skin (as a control tissue) at different life-history stages using radioligand binding assays. Males with larger bibs relative to their life-history stage had less GR in bib skin, but not belly skin, than males with smaller bibs. These results suggest a connection between the size of a melanin-based ornament and the underlying tissue's responsiveness to CORT.

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Section: Rsblroyalsocietypublishingorg Biol Lett 9: 20130440mentioning

confidence: 72%

Section: Rsblroyalsocietypublishingorg Biol Lett 9: 20130440mentioning

confidence: 99%

The size of a melanin-based plumage ornament correlates with glucocorticoid receptor concentrations in the skin of that ornament

Lattin

Romero

2013

Biol. Lett.

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“…The discovery of cortisone by Hench, Kendall, and Reichstein in the late 1940s improved the outlook on patients with adrenal insufficiency dramatically, and initial data suggested that life expectancy was normalized. 5,6 However, during an acute stress event, these patients are unable to mount a normal physiological response with increased endogenous cortisol production. Failure to increase their dose of exogenous glucocorticoids adequately can lead to acute adrenal insufficiency, or adrenal crisis.…”

Section: Definition and Epidemiologymentioning

confidence: 99%

Adrenal Crisis: Still a Deadly Event in the 21st Century

Puar

Stikkelbroeck

Smans

et al. 2016

The American Journal of Medicine

144

140

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Adrenal crisis is a life-threatening medical emergency, associated with a high mortality unless it is appropriately recognized and early treatment is rendered. Despite it being a treatable condition for almost 70 years, failure of adequate preventive measures or delayed treatment has often led to unnecessary deaths. Gastrointestinal illness is the most common precipitant for an adrenal crisis. Although most patients are educated about "sick day rules," patients, and physicians too, are often reluctant to increase their glucocorticoid doses or switch to parenteral injections, and thereby fail to avert the rapid deterioration of the patients' condition. Therefore, more can be done to prevent an adrenal crisis, as well as to ensure that adequate acute medical care is instituted after a crisis has occurred. There is generally a paucity of studies on adrenal crisis. Hence, we will review the current literature, while also focusing on the incidence, presentation, treatment, prevention strategies, and latest recommendations in terms of steroid dosing in stress situations.

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“…With regard to the causes of AD, the adrenalitis due to tuberculosis fell from 79 to 17% during the years (2,3,10,11).…”

Section: Introductionmentioning

confidence: 99%

Addison's disease: a survey on 633 patients in Padova

Betterle

Scarpa

Garelli

et al. 2013

European Journal of Endocrinology

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Objective: Addison's disease (AD) is a rare endocrine condition. Design: We aimed to evaluate clinical, immunologic, adrenal imaging, and genetic features in 633 Italian patients with AD followed up since 1967. Methods: Adrenal cortex autoantibodies, presence of other autoimmune and nonautoimmune diseases, nonadrenal autoantibodies, adrenal imaging, and genetic profile for HLA-DRB1 and AIRE were analyzed. Results: A total of 492 (77.7%) patients were found to be affected by autoimmune AD (A-AD), 57 (9%) tuberculous AD, 29 (4.6%) genetic-associated AD, 10 (1.6%) adrenal cancer, six (0.94%) post-surgical AD, four (0.6%) vascular disorder-related AD, three (0.5%) post-infectious AD, and 32 (5.1%) were defined as idiopathic. Adrenal cortex antibodies were detected in the vast majority (88-100%) of patients with recent onset A-AD, but in none of those with nonautoimmune AD. Adrenal imaging revealed normal/atrophic glands in all A-AD patients: 88% of patients with A-AD had other clinical or subclinical autoimmune diseases or were positive for nonadrenal autoantibodies. Based on the coexistence of other autoimmune disorders, 65.6% of patients with A-AD were found to have type 2 autoimmune polyendocrine syndrome (APS2), 14.4% have APS1, and 8.5% have APS4. Class II HLA alleles DRB1*03 and DRB1*04 were increased, and DRB1*01, DRB1*07, DRB1*013 were reduced in APS2 patients when compared with controls. Of the patients with APS1, 96% were revealed to have AIRE gene mutations. Conclusions: A-AD is the most prevalent form of adrenal insufficiency in Italy, and w90% of the patients are adrenal autoantibody-positive at the onset. Assessment of patients with A-AD for the presence of other autoimmune diseases should be helpful in monitoring and diagnosing APS types 1, 2, or 4 and improving patients' care.

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Eight-six Cases of Adison's Disease

Cited by 196 publications

References 6 publications

The size of a melanin-based plumage ornament correlates with glucocorticoid receptor concentrations in the skin of that ornament

The size of a melanin-based plumage ornament correlates with glucocorticoid receptor concentrations in the skin of that ornament

Adrenal Crisis: Still a Deadly Event in the 21st Century

Addison's disease: a survey on 633 patients in Padova

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