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neural POMC is multifactorial (e.g. (65, 67) , and this is primarily linked to its role in energy balance and nutrition, see text. There is, however, much evidence to show the feedback of glucocorticoids on CRH expression in several brain regions. Mostly
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countries ( 1 ) and the lowest in Japan. Despite the advent of glucocorticoid replacement therapy in the early 1950s, life expectancy remains lower than in the general population ( 2 ), with increased morbidity and impaired quality of life ( 3 , 4
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combination with other anteropituitary hormone deficiency (CPHD) ( 2 ). This rare condition needs chronic glucocorticoid and, sometimes, mineralocorticoid administration. Despite replacement therapy, AI is characterized by high mortality rate compared to
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suggests that this condition is confined to the anterior pituitary and primarily involves glucocorticoid deficiency ( 8 , 9 , 10 , 11 , 12 , 13 , 14 ). Published evidence of pituitary disease is restricted to case reports with a small number of case
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cessation of CPI therapy and immunosuppression with glucocorticoids as first-line agents ( 5 ). Figure 1 Graphic illustrating checkpoint inhibitor action to shift immune response. Without treatment self and tumour reacting T-cells are driven to
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Royal Marsden Hospital, London, UK
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of immunotherapy and/or immunomodulation with glucocorticoid therapy is usually unnecessary, with immunosuppressive doses of glucocorticoids only rarely required where the initial inflammation causes severe symptoms. Lastly, optimal exogenous
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Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
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of glucocorticoids and mineralocorticoids, which are life-saving. Despite the availability of appropriate replacement therapy in developed countries, there is a residual increased mortality, morbidity, and reduced quality of life ( 12 ) associated
University of Alcalá, Madrid, Spain
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associated glucocorticoid hypersecretion (PA-only). Nevertheless, the studies investigating this aspect are scarce and most of them included a limited number of patients or had been performed in a single center. In addition, the definition of ACS is widely
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Introduction Cushing’s syndrome (CS) comprises diverse manifestations resulting from chronic exposure to excess glucocorticoids. The incidence is 0.2–5.0 per million people per year. Approximately 80% of endogenous CS is adrenocorticotrophin
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chromatography-tandem mass spectrometry (LC–MS/MS). Antibody-based immunoassays can be affected by cross-reactivity (especially cortisone, which has a structure similar to that of cortisol) and synthetic glucocorticoids ( 9 ). In fact, cortisol is converted into