- |||||||||| dexamethasone / Generic mfg., hydrocortisone / Generic mfg.
Adrenal adenoma with biochemical findings suggestive of Cushing's disease (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1939;
Absolute washout of 85 % and a relative washout of 63%, having 12 Hounsfield units (HU) on the non-contrast phase, findings suggestive of a benign adenoma.Further work up including 1 mg Dexamethasone suppression test (DST) showed unsuppressed plasma ACTH 17 pg/ml and total cortisol 9.4 mcg/dL...The follow-up cortisol level was 11.3 mcg/dL when the patient was off hydrocortisone...(1-2) Therefore, it is important to analyze clinical findings and biochemical testing and if lab tests are discordant, recheck using a different analytical platform in a different lab or an alternate ACTH assay to confirm ACTH levels. (1-2
- |||||||||| hydrocortisone / Generic mfg.
Psychiatric Illness Masking Autoimmune Polyglandular Syndrome in a Middle-Aged Woman. (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1934;
Poly endocrinopathies often present with vague symptoms that need to be worked up to prevent the life-threatening effects of APS2 including adrenal crisis. We present an uncommon case of middle-aged woman with Tri-glandular syndrome with delayed diagnosis due to underlying psychiatric disease.(1)Meyer et al.Horm Metab 2013; 45:92-95
- |||||||||| hydrocortisone / Generic mfg.
A Rare Case of Cushing Syndrome in Pregnancy: Diagnosis and Therapeutic Challenges (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1929;
Was started on hydrocortisone (HC) following surgery...Clinical Lesson:This case depicts the challenges in managing CS in pregnancy and its repercussions regarding maternal, fetal, and delivery outcomes. Additionally, it highlights the importance of implementing a multidisciplinary approach, including obstetricians, endocrinologists, endocrine surgeons, and pediatricians, to ensure the optimization of therapeutic strategies.
- |||||||||| A Curious Case of Psychosis (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1927;
Two of her medications, gabapentin and mirtazapine were thought to be the contributors and were stopped upon admission, however with little improvement...She was ultimately started on hydrocortisone replacement therapy, with subsequent improvement and stabilization of her mental status, mood, and behavior; and was discharged with outpatient Endocrinology follow-up.This case highlights the importance of the broad differentials to consider for mental and behavioral changes...The exact mechanism of neuropsychiatric symptoms (which may precede metabolic abnormalities) is unknown but is hypothesized to involve elevated levels of endorphins and electrophysiological disturbances as glucocorticoid receptors are widely distributed in the brain, specifically in the hippocampus. Megestrol is an established cause of secondary adrenal insufficiency, and monitoring is essential with long-term use.
- |||||||||| Lysodren (mitotane) / HRA Pharma
Severe Hypertriglyceridemia and Acute Pancreatitis in a Patient with Adrenocortical Carcinoma (ACC) taking Mitotane (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1924;
We describe an ACC patient with a history of fatty liver disease and mixed hyperlipidemia who developed severe hypertriglyceridemia and acute pancreatitis leading to multiorgan failure about one month after starting mitotane. This case highlights hypertriglyceridemia as a serious complication of mitotane in a patient with preexisting dyslipidemia.*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation.
- |||||||||| hydrocortisone / Generic mfg.
Tuberculosis and Adrenal Glands: The Great Forgotten (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1921;
He also refers progressive hyperpigmentation for the past 3 years. Denies recent travel abroad.On physical examination hypotension (80/53 mmHg) and generalized hyperpigmentation predominantly in the oral mucosa stand out.Blood test: Glu: 41 mg/dL, Na+: 122 mmol/L, K+: 4.8 mmol/L, ACTH: 922 pg/mL, Cortisol: 4.63 ug/dL, Anti-Hydroxylase Ab and Anti-Adrenal glands Ab: negativeA computed tomography scan of the abdomen with intravenous contrast revealed bilaterally enlarged adrenal glands with small bilateral calcifications (12-18mm).TB QuantiFERON test: positiveShe was initially treated with saline serum and intravenous hydrocortisone causing her symptoms to improve significantly in a few days and was subsequently discharged on hydrocortisone and fludrocortisone and proper treatment for TB Adrenalitis and follow-up in outpatient clinicsConclusionsAlthough not frequent, infectious causes should always be kept in mind, such as the etiology of adrenal insufficiency in a patient with long-term compatible symptoms, even though it is a developed country, given world globalization, which makes infectious diseases highly transmissible between countries and continents.
- |||||||||| hydrocortisone / Generic mfg.
Clinical Conundrum: Salt Wasting Congenital Adrenal Hyperplasia With Paradoxical High Cortisol (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1741;
An ACTH stimulation test is often used to diagnose adrenal insufficiency and initiate life-saving hydrocortisone therapy.Clinical Case: I present a case of a male infant who was found to have salt-wasting CAH crisis despite a paradoxically high serum cortisol... By reporting this case, I draw attention to the possibility that high levels of cortisol do not definitely rule out salt-wasting CAH.Reference Ranges:NA 132 - 145 mmol/L K 3.0 - 6.0 mmol/L Cortisol:1.7 - 14.0 ug/dL17 OHP:INTERPRETIVE INFORMATION for 17-Hydroxyprogesterone in premature and normal male infants: Premature (26 to 28 weeks) 124 to 841 ng/dL Premature (29 to 35 weeks) 26 to 568 ng/dL Full term Day 3 7 to 77 ng/dL 4 days to 2 months Less than 200 ng/dL
- |||||||||| methimazole / Generic mfg., metoprolol tartrate / Generic mfg., hydrocortisone / Generic mfg.
A Case of Contrast Induced Thyrotoxicosis in a Patient Newly Diagnosed with Hyperthyroidism (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1651;
This usually happens in older patients with known underlying coronary artery disease in response to the rise in cardiac contractility and strain caused by thyrotoxicosis. Our case did not have any history or risk factors of coronary artery disease other than hyperthyroidism.
- |||||||||| hydrocortisone / Generic mfg.
Circulating and Urinary Metabolites Associated with Total Exposure of Cortisol and Cortisol Time Profile (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1590;
The aim of this study was to better understand these outcomes by identifying metabolites associated with total exposure of cortisol and cortisol time profile separately.This was a hypothesis-generating study using a randomized, two-armed, 12-week cross-over study comparing once-daily (OD) dual-release hydrocortisone tablet treatment with the same daily dose of thrice-daily (TID) conventional immediate-release hydrocortisone tablet treatment...The study results therefore support that the total exposure and the time profile of cortisol may have different metabolic effects. The outcome of the study may be a step towards identifying novel biomarkers of the action of cortisol.
- |||||||||| hydrocortisone / Generic mfg.
Adrenal Insufficiency Presenting with Isolated Severe Hyponatremia: A Case Series (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1586;
A) Despite various hyponatremia guidelines suggesting ruling out AI and hypothyroidism before empirical diagnosis of SIADH, there can still be delay in checking cortisol status. B) AI presentation can lack hemodynamic instability or other electrolyte abnormalities so a high clinical index of suspicion should be exercised in diagnosing this potentially fatal condition when encountering isolated severe hyponatremia.
- |||||||||| dexamethasone / Generic mfg.
Once Daily Dexamethasone for Treatment of Severe Salt-Wasting 3?-hydroxysteroid Dehydrogenase Deficiency (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1582;
Children with HSD3B2 CAH and their unaffected age-matched siblings had similar scores within the normal range on Beck Youth Inventories. In conclusion, we show that once nightly dexamethasone is a reasonable alternative to thrice daily hydrocortisone for treatment of severe salt-wasting HSD3B2 deficiency, allowing for improved medication adherence, normal growth, and acceptable endocrine control, but does not reduce risk for hypertension more closely related to fludrocortisone overtreatment or prevent the emergence of TARTs.
- |||||||||| hydrocortisone / Generic mfg.
Remote monitoring of biometric, proteomic, and patient-reported outcomes in adrenal insufficiency (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1578;
In conclusion, we show that once nightly dexamethasone is a reasonable alternative to thrice daily hydrocortisone for treatment of severe salt-wasting HSD3B2 deficiency, allowing for improved medication adherence, normal growth, and acceptable endocrine control, but does not reduce risk for hypertension more closely related to fludrocortisone overtreatment or prevent the emergence of TARTs. Remote monitoring of biometrics and blood proteome in AI is feasible and informative and may identify biomarkers to optimize hydrocortisone replacement therapy.
- |||||||||| epinephrine / Generic mfg.
Is Stress Vulnerability in CAH Related to Epinephrine Deficiency and CYP21A2 genotype? (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1571;
However, it may put these patients at increased risk of fatigue or burn out syndrome. The psychological effects of the virilization due to CAH per se may partly overshadow the effects of the epinephrine deficiency in women with CAH.Larger studies are needed to be able to study what role the capacity to produce epinephrine, has for the psychological stress vulnerability in CAH.
- |||||||||| dexamethasone / Generic mfg., prednisone / Generic mfg., hydrocortisone / Generic mfg.
Adrenal Insufficiency In Olmsted County, MN, USA: A Population-Based Study (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1566;
Surprisingly, even after controlling for morbidity and prior hospitalizations, patients with AI were more likely to be hospitalized. In comparison to referent subjects, mortality was higher in patients with AI, even after adjustment for morbidity index.
- |||||||||| A Case of Acute Liver Failure Within 48 Hours of Initiation of High Dose Thionamides for Thyroid Storm (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1305;
Viral and autoimmune hepatitis panel, acetaminophen and alcohol levels were negative...Risk factors appear to include very high dose methimazole and PTU exposure as well as potentially the patient's intermittent use of methimazole in the past. Further study is needed to clarify potential risk factors of thionamide-induced hepatotoxicity as data is limited.
- |||||||||| Central Hypothyroidism following Neonatal Graves Presentation (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_1287;
This case highlights the severity of neonatal Graves' disease and the possibility of the subsequent development and persistence of central hypothyroidism following neonatal Graves' diagnosis despite the resolution of hyperthyroidism and normalization of TSI antibody. Due to the risk of the development of hypothyroidism, it may be worthwhile to continue to trend TSH and FT4 to ensure that the infant has not developed hypothyroidism.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
Diffuse Large B-Cell Lymphoma Pituitary Metastasis (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_964;
She was initiated on methotrexate and leucovorin chemotherapy. This is an unprecedented case of metastatic DLBCL to the leptomeninges, hypothalamus, and pituitary infundibulum confirmed by CSF cytologic analysis that presented in the context of associated panhypopituitarism that manifested initially as SIADH followed by sudden DI.Abbreviations: R-CHOP: Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone
- |||||||||| A case of Papillary Craniopharyngioma WHO Grade 1 turned into Abscess (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_955;
PA associated with residual craniopharyngioma tissue is extremely rare and the exact pathophysiology is not well understood. If no evidence of sepsis or meningitis, treatment with transsphenoidal decompression and intravenous antibiotics has good clinical outcomes.
- |||||||||| thyroxine / Generic mfg., hydrocortisone / Generic mfg.
Gonadotropin Secreting Pituitary Tumor Presenting as Primary Hypogonadism (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_951;
The extremely low testosterone levels postoperatively suggest that his testicular function was mostly stimulated by the adenoma secreted FSH and was therefore drastically lost after surgery. This case increases awareness to consider a gonadotropin-secreting tumor in the differential diagnosis of a pituitary adenoma with high FSH or LH, even when testosterone level is unexpectedly low.
- |||||||||| ketoconazole / Generic mfg., hydrocortisone / Generic mfg.
Hiding in Plain Sight: Florid Cushing's Disease Presenting as a Severe Extremity Cellulitis (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_893;
Following surgery, she developed transient adrenal insufficiency requiring hydrocortisone and she no longer required antihypertensives, insulin, or potassium therapy...Severe hypercortisolism was responsible for this patient's refractory infection, and if not controlled, she likely would have endured a lower extremity amputation. Rapid detection with elevated random serum and/or urine cortisol and treatment with a cortisol-lowering agent is critical and lifesaving.
- |||||||||| dexamethasone / Generic mfg., hydrocortisone / Generic mfg.
Unilateral Adrenal Hyperplasia Causing ACTH-Independent Hypercortisolism (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_892;
This case report would be one of few describing the rare diagnosis of unilateral adrenal hyperplasia associated with ACTH-independent hypercortisolism and would add to the sparse literature currently available on this condition. Additionally, this case report highlights the clinical significance of mild autonomous cortisol secretion (MACS); despite only having an unsuppressed cortisol level following LDDS, this patient was found to have a suppressed HPA axis after unilateral adrenalectomy requiring corticosteroids.
- |||||||||| cefazolin / Generic mfg., prednisone / Generic mfg., hydrocortisone / Generic mfg.
DRESS/DHIS-associated thyroiditis and hypophysitis (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_856;
Review of medication charts identified the most likely causative agent as cefazolin...Biochemical abnormalities gradually normalized and his hydrocortisone ceased with symptomatic resolution.Endocrine involvement, particularly pancreas and thyroid has previously been reported in cases of DHIS/DRESS (3) (4). In this case, DHIS/DRESS-associated hypophysitis with thyroiditis may explain the clinical findings of pituitary dysfunction affecting multiple pituitary axes and the gradual recovery to normal pituitary function.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS, Yervoy (ipilimumab) / Ono Pharma, BMS
Immunotherapy Induced Pituitary Apoplexy (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_853;
We present a case of a 42 year old male with past history of metastatic melanoma s/p 3 cycles of ipilimumab and nivolumab immunotherapy that originally was referred to endocrinology due to elevated prolactin of 40 and MRI finding of questionable 6 mm pituitary adenoma...Repeat hormonal testing showed persistent hormonal deficiencies with undetectable cortisol and ACTH despite holding hydrocortisone therapies...We hope this case helps bring awareness to the evolving list of conditions to survey for with immunotherapy and suggests a role of identifying prolactinomas biochemically and or radiographically to affect management. It may even suggest a role in treatment for medically refractory pituitary adenomas.
- |||||||||| dexamethasone / Generic mfg., leuprolide acetate for depot suspension / Generic mfg., hydrocortisone / Generic mfg.
A Successful Ovulation Induction and Embryo Generation in a Woman With P450-Oxidoreductase Deficiency From Mutation G539R, Which Preferentially Impairs 17,20-Lyase Activity (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_826;
Very few examples of pregnancy in women with POR deficiency have been reported, and we describe the first example of successful ovulation induction and embryo generation in a woman with POR deficiency caused by the G539R mutation, which preferentially impairs 17,20-lyase activity. The complex array of steroid excess and deficiencies, from both adrenal and ovarian origin, must be systematically managed during assisted reproduction treatment for these women.
- |||||||||| dexamethasone / Generic mfg., hydrocortisone / Generic mfg.
Severe Exogenous Cushing Syndrome Caused by a Potent Steroid Concealed in Arthritis Supplement (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_818;
A study by Tucker.et.al. reported that 20% of dietary supplements have unapproved ingredients.1 This is especially concerning, considering that over half of the US population admits to taking dietary supplements.2 On April 2022, the FDA published a public notice for "Artri-King", declaring the presence of unlisted dexamethasone.3 Should such agents prove to be the culprit of CS, they must be tapered off gradually or in the presence of physiologic hydrocortisone to avoid the risk of adrenal crisis.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS, Yervoy (ipilimumab) / Ono Pharma, BMS
A Curious Case of Immune Checkpoint Inhibitor Induced Hypophysitis with Transient ACTH-Dependent Hypercortisolism (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_817;
We report a relatively novel irAE case of transient central hypercortisolism that progressed to hypopituitarism.A 72-year-old woman with metastatic melanoma on combined ICI therapy of nivolumab-ipilimumab developed subclinical hyperthyroidism (TSH <0.02 mU/L [reference range (RR) 0.40-4.50 mU/L]; FT4 20.2 pmol/L [RR 9.0-26.0 pmol/L]) eight weeks following initiation of her immunotherapy...The low dose dexamethasone suppression test was not suppressed (morning cortisol at 983 nmol/L)...The hydrocortisone and levothyroxine replacement were continued, and the patient remained asymptomatic throughout her follow-ups.This case highlights that a transient episode of ACTH dependent hypercortisolism may be an early marker prior to the development of central adrenal insufficiency from ICI-related destructive immune hypophysitis. Furthermore, our report highlights that physicians and other healthcare professionals should remain vigilant in monitoring laboratory progression in these patients, as early recognition facilitated timely management in our patient and prevented complications.
- |||||||||| Massive Adrenomyelolipomas Due to Longstanding CAH (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_816;
Massive adrenomyelolipomas are thought to be ACTH driven, especially seen in undertreated and longstanding CAH. Without the 21 hydroxylase enzyme to convert 17 OH Progesterone to 11 deoxycortisol, levels of ACTH rise.
- |||||||||| dexamethasone / Generic mfg., hydrocortisone / Generic mfg., midodrine hydrochloride / Generic mfg.
Recurrent Pericardial Effusion as Initial Presentation of Primary Adrenal Insufficiency (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_815;
Having a high clinical suspicion is crucial to a prompt diagnosis. Pericardial effusion should prompt clinical suspicion for PAI as multiple cases have now been reported in the literature.
- |||||||||| megestrol / Generic mfg.
Megestrol-Induced Adrenal Insufficiency (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_809;
SAI is often associated with prolonged glucocorticoid use but can also be seen in patients with pituitary tumors, pituitary surgery, or granulomatous disease. SAI can cause hyponatremia, hypoglycemia, and fatigue but is not typically associated with hypotension or hyperkalemia as the mineralocorticoid function of the adrenals remains intact.
- |||||||||| Autoimmune Polyglandular Syndrome II in a Young Female with Severe Weight Loss, DKA, and Psychiatric Features (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_808;
Frequent visits, vital checks, CMP, and antibody screening tests including GAD antibodies, anti-adrenal antibodies, and TPO antibodies help in diagnosing this syndrome earlier.Clinicians also should be mindful of psychiatric features in a patient. They should try to rule out medical causes before diagnosing a patient with psychiatric disease as profound hyponatremia can cause acute psychosis.
- |||||||||| hydrocortisone / Generic mfg.
Adrenal Insufficiency diagnosed during pregnancy (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_807;
Diagnosis of AI during pregnancy is rare as it is considered a hypercortisolemic state. Changes in cortisol levels during pregnancy make the diagnosis of AI even more challenging.
- |||||||||| ketoconazole / Generic mfg., trimethoprim/sulfamethoxazole / Generic mfg., hydrocortisone / Generic mfg.
Severe Cushing's Syndrome Due to Ectopic ACTH in Newly Diagnosed Small Cell Lung Cancer: The Pivotal Role of Etomidate in Acute Treatment (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_806;
Hypercortisolism comorbidities were treated appropriately: trimethoprim-sulfamethoxazole for pneumocystis pneumonia prophylaxis, anticoagulation for DVT prophylaxis, antibiotics for acute diverticulitis, and insulin for hyperglycemia...While effective, this strategy poses risks of etomidate toxicity and makes serum cortisol interpretation unreliable. Etomidate analogs are on the horizon that retain the potent adrenostatic action of etomidate without its sedative-hypnotic activity, offering an alternative treatment option for treating patients with severe CS in non-ICU hospital settings.
- |||||||||| Lysodren (mitotane) / HRA Pharma
Therapeutic Dosing of Steroids in Patients on Mitotane (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_803;
Her other home medications included mitotane 500mg QID and hydrocortisone 180mg (40mg-40mg-30mg -20mg QID)...Best Practice & Research Clinical Endocrinology & Metabolism, 34(3), 101415. https://doi.org/10.1016/j.beem.2020.101415
- |||||||||| prednisone / Generic mfg., hydrocortisone / Generic mfg.
Doege-Potter Syndrome in a Patient with Solitary Fibrous Tumor of the Lung (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_714;
A ratio of IGF-2/IGF-1 more than 10 confirms NICTH; however, normal ratio cannot exclude the diagnosis and factors such as low IGFBP 3 or steroid therapy for other conditions need to be considered. Surgery is the mainstay of treatment.
- |||||||||| hydrocortisone / Generic mfg., acarbose / Generic mfg.
Sugar Crash: A Case of Recurrent Hypoglycemia (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_709;
RYGB increases stimulation of islet ?-cells by enteral signals and enhances GLP-1 sensitivity and insulin secretion, predisposing some individuals to hypoglycemic episodes. Patients may have remission of diabetes and no longer need medications post-operatively.
- |||||||||| Tecentriq (atezolizumab) / Roche
Metastatic Insulinoma Diagnosed Postpartum (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_659;
Liver biopsy revealed well-differentiated neuroendocrine tumor, WHO grade 3 likely from a pancreatic primary and chemotherapy was initiated with carboplatin and paclitaxel with some response...She was also given octreotide, hydrocortisone, and eventually diazoxide...Tumor board meeting was held and her chemotherapy regimen was changed to Carboplatin/Etoposide/Atezolizumab...Given the degree of extensive metastases at time of presentation, we expect our patient's insulinoma was present prior to delivery. Hypoglycemia may have only manifested in the postpartum period when there was decreased levels of placenta-derived counterregulatory hormones.
- |||||||||| A rare case of acute Sheehan's Syndrome in an antepartum patient (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_583;
In our case, septic shock caused an abrupt onset of persistent hypotension leading to hormone levels suggestive of panhypopituitarism while the patient was pregnant at 31 weeks of gestation, which has not been reported in prior literature. While known as a chronic diagnosis in the postpartum population, further research should explore possible stunning effect of acute hypotension manifesting as acute SS in peripartum patients.
- |||||||||| hydrocortisone / Generic mfg.
Fitting together the pieces of the puzzle between isolated ACTH deficiency and immunodeficiency: DAVID syndrome (ENDOExpo) - May 11, 2023 - Abstract #ENDO2023ENDO_123;
This patient is unique in having asymptomatic, acquired, isolated ACTH deficiency diagnosed in later childhood, despite having frequent sinopulmonary infections since infancy as part of DAVID syndrome. Further research needs to be done to elucidate how NFKB2 variants contribute to acquired, isolated, central ACTH deficiency or autoimmune pituitary disease.
- |||||||||| hydrocortisone / Generic mfg.
Review, Journal, IO biomarker: Advancements in the pharmacological management of sepsis in the elderly. (Pubmed Central) - May 11, 2023
Antibioticshave been the cornerstone for the treatment of sepsis while immune modulatorytherapies, except hydrocortisone, have gained a lot of attention lately...Adjunctive precision immunotherapy treatment is a new era of research which recentlyattracts much attention. Combination of antibiotics with precisionimmunotherapy inan individualized pattern may be the key for decreasing mortality and improveoutcomes.
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