| Adrenal insufficiency. | |
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MedLine Citation:
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PMID: 16287959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 44-year-old woman reported several weeks of fatigue, somnolence, pain in the large joints, nausea, and decreased appetite. She had also noted an unintentional 11-kg weight loss over a period of 6 months. She had a remote history of amenorrhea, but she was presently menstruating regularly. She was taking no medications, with the exception of acetaminophen as needed for knee pain. The diagnosis of adrenal insufficiency (AI) was considered. Serum cortisol level after adrenocorticotropin hormone (ACTH) stimulation was abnormal. Because her plasma ACTH level was not increased, a diagnosis of secondary AI (due to deficiency in ACTH) was made. Magnetic resonance imaging of the brain performed to exclude the presence of a sellar or suprasellar mass showed reduction in size of the pituitary gland and an increased cerebrospinal fluid content within the sella, consistent with a partially empty sella. The patient's symptoms improved rapidly with hydrocortisone therapy but during follow-up, the dose of hydrocortisone was found to be excessive. Important differences exist between primary and secondary AI, and the diagnosis of secondary AI may be challenging. The therapy of AI should be carefully tailored to the requirements of the individual patient. |
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Authors:
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Roberto Salvatori |
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Publication Detail:
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Type: Case Reports; Clinical Conference; Journal Article |
Journal Detail:
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Title: JAMA : the journal of the American Medical Association Volume: 294 ISSN: 1538-3598 ISO Abbreviation: JAMA Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-11-18 Completed Date: 2005-11-22 Revised Date: 2006-11-07 |
Medline Journal Info:
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Nlm Unique ID: 7501160 Medline TA: JAMA Country: United States |
Other Details:
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Languages: eng Pagination: 2481-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Md 21287, USA. salvator@jhmi.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenal Insufficiency
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diagnosis*,
drug therapy*,
etiology Adult Female Glucocorticoids / therapeutic use Humans |
| Chemical | |
Reg. No./Substance:
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0/Glucocorticoids |
| Comments/Corrections | |
Comment In:
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JAMA. 2006 Mar 8;295(10):1124; author reply 1124
[PMID:
16522831
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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