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cortisol at 08:00 h (29 µg/dL; n.v. 5–25), and high urinary free cortisol (UFC) (280 µg/24 h; n.v. 36–137), while ACTH levels at 08:00 h were in the normal range (26 pg/mL; n.v. 10–50). The patient’s diabetes was poorly controlled (HbA1c 8%). The
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Introduction Cushing’s disease (CD) is a state of cortisol excess, caused by an ACTH-secreting pituitary adenoma. Although a rare disease with an annual incidence of 1.5 patients/million ( 1 ), it is associated with significant morbidity and
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The University of Liverpool, Brownlow Hill, Liverpool, UK
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screening. CTCAE grade 1–2. Other important considerations; hypophysitis and maintenance glucocorticoid therapy. Management of a life-threateningly unwell patient (CTCAE grade 3–4) Cortisol Features of acute cortisol
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Department of Neuroscience, Georgetown University, Washington, District of Columbia, USA
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glucocorticoid levels and high anxiety. Despite this, individuals with PTSD also have higher levels of CRH in the cerebral spinal fluid ( 27 ) and appear to have similar cortisol reactivity to individuals without the disorder ( 28 ). Based on these findings, it
Department of Neuroscience DNS, University of Padova, Padova, Italy
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Nuclear Medicine Unit, Department of Medicine – DIMED, University-Hospital of Padova, Padova, Italy
Padova Neuroscience Center PNC, University of Padova, Padova, Italy
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Department of Mathematics ‘Tullio Levi-Civita’ DM, University of Padova, Padova, Italy
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Introduction Cushing’s syndrome (CS), characterized by excessive endogenous cortisol secretion, is in most cases ACTH-dependent. Corticotropin (ACTH) secretion arises from a pituitary adenoma (Cushing’s disease) or, less frequently, from a non
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
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Introduction Acute adrenal insufficiency , also termed adrenal crisis , is a life-threatening endocrine emergency brought about by a lack of production of the adrenal hormone cortisol, the major glucocorticoid. Identifying patients at risk
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, the rate-limiting step in adrenal steroidogenesis, is also upregulated by ACTH-induced MC2R activation ( 43 ). Likewise, the final enzyme for cortisol synthesis, 11-β-hydroxylase, which converts 11-deoxycortisol into cortisol is upregulated upon ACTH
Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Department of Neurosurgery, Rui-Jin Lu-Wan Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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College of Information Technology and Engineering, Chengdu University, Chengdu, China
College of Computer Science, Sichuan Normal University, Chengdu, Sichuan, China
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-h urinary free cortisol (UFC) level, bilateral petrosal sinus sampling, absence of a blunted circadian rhythm of cortisol secretion, and other clinical features ( 18 ). CD remission was confirmed in all remitted CD patients by normal UFC after
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intake. However, our cases were tolerating feeds during their illness (barring case 1 during early phase of illness). We postulate that this phenomenon may involve cortisol-driven effects on 1,25(OH) 2 -vitamin D. It is recognised that the stress of
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Department of Clinical Biochemistry, Imperial College Healthcare NHS Trust, London, UK
Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Department of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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which treatment with supraphysiological doses of exogenous steroid is required. The aim of glucocorticoid replacement therapy in adrenal failure is to reverse the deficiency using only physiological doses of steroids. Reproducing the diurnal cortisol