Adrenocorticotrophin (ACTH) deficiency undetected by standard dynamic tests of the hypothalamic-pituitary-adrenal axis
| dc.contributor.author | Tsatsoulis, A. | en |
| dc.contributor.author | Shalet, S. M. | en |
| dc.contributor.author | Harrison, J. | en |
| dc.contributor.author | Ratcliffe, W. A. | en |
| dc.contributor.author | Beardwell, C. G. | en |
| dc.contributor.author | Robinson, E. L. | en |
| dc.date.accessioned | 2015-11-24T19:37:25Z | |
| dc.date.available | 2015-11-24T19:37:25Z | |
| dc.identifier.issn | 0300-0664 | - |
| dc.identifier.uri | https://olympias.lib.uoi.gr/jspui/handle/123456789/24028 | |
| dc.rights | Default Licence | - |
| dc.subject | Adolescent | en |
| dc.subject | Adrenocorticotropic Hormone/*deficiency | en |
| dc.subject | Adult | en |
| dc.subject | Aged | en |
| dc.subject | Female | en |
| dc.subject | Glucagon/diagnostic use | en |
| dc.subject | Humans | en |
| dc.subject | Hypothalamo-Hypophyseal System/*physiopathology/radiation effects | en |
| dc.subject | Insulin/diagnostic use | en |
| dc.subject | Male | en |
| dc.subject | Middle Aged | en |
| dc.subject | Pituitary Neoplasms/blood/radiotherapy | en |
| dc.subject | Pituitary-Adrenal System/*physiopathology/radiation effects | en |
| dc.subject | Radiation Injuries/blood/physiopathology | en |
| dc.title | Adrenocorticotrophin (ACTH) deficiency undetected by standard dynamic tests of the hypothalamic-pituitary-adrenal axis | en |
| heal.abstract | Six patients (four females, two males; aged 18-65 years), previously treated by external pituitary irradiation (2000-4000 cGY in 8-15 fractions over 10-20 days) for pituitary tumours, presented with the symptoms of excessive and inappropriate tiredness suggestive of ACTH deficiency, despite a normal peak cortisol response to an insulin tolerance test (four cases) or to a glucagon stimulation test (two cases). These six patients were found to have significantly lower mean 24 h urinary free cortisol levels (100 +/- 40 nmol; mean +/- SD) compared with the mean value of 31 normal controls (210 +/- 70.8 nmol; P less than 0.01). In addition serum cortisol profiles based on a series of four timed samples between 0900-2300 h were subnormal (mean 130 nmol/l) in comparison with profiles obtained from 12 normal controls (mean 270 nmol/l) (P less than 0.001). Glucocorticoid replacement therapy promptly abolished their symptoms. These results suggest that a discordance between ACTH secretion under basal circumstances and ACTH response to pharmacological tests may exist in patients with ACTH deficiency. We speculate that defective endogenous corticotrophin-releasing hormone (CRF) secretion, due to radiation-induced damage at hypothalamic level, is one cause of this phenomenon. | en |
| heal.access | campus | - |
| heal.fullTextAvailability | TRUE | - |
| heal.identifier.secondary | http://www.ncbi.nlm.nih.gov/pubmed/2844448 | - |
| heal.identifier.secondary | http://onlinelibrary.wiley.com/store/10.1111/j.1365-2265.1988.tb03659.x/asset/j.1365-2265.1988.tb03659.x.pdf?v=1&t=h0outa5a&s=4cfa75ce917e2b7712b446ec80ce4fd122acb0bf | - |
| heal.journalName | Clin Endocrinol (Oxf) | en |
| heal.journalType | peer-reviewed | - |
| heal.language | en | - |
| heal.publicationDate | 1988 | - |
| heal.recordProvider | Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής | el |
| heal.type | journalArticle | - |
| heal.type.el | Άρθρο Περιοδικού | el |
| heal.type.en | Journal article | en |
Αρχεία
Φάκελος/Πακέτο αδειών
1 - 1 of 1
Φόρτωση...
- Ονομα:
- license.txt
- Μέγεθος:
- 1.74 KB
- Μορφότυπο:
- Item-specific license agreed upon to submission
- Περιγραφή: