Symptoma

Bilateral Adrenalectomy

Total Adrenalectomy

The first patient, a ten-year-old with XX genotype, reared as a male, presented with resistant hypokalaemia and hypertension. The second patient, a 23-year-old with XY genotype, presented with bilateral adrenal masses and resistant hypertension. [ncbi.nlm.nih.gov]

  • Cushingoid

    Abstract We present a 7-year-old girl with a 2-year history of decelerated growth rate and cushingoidal obesity, upon admission presenting with fixed hypertension. [ncbi.nlm.nih.gov]

    […] hypothalamic-pituitary-adrenal axis has proven difficult. 5, 6 The dose of glucocorticoid required to prevent hyperandrogenism in these females is often supraphysiologic and can results in iatrogenic hypercortisolism with its associated obesity and Cushingoid [pediatrics.aappublications.org]

  • Resistant Hypertension

    The second patient, a 23-year-old with XY genotype, presented with bilateral adrenal masses and resistant hypertension. Both the patients were offered bilateral adrenalectomy. [ncbi.nlm.nih.gov]

  • Ankle Edema

    Improvements of hypertension, body weight, Cushingoid appearance, impaired muscle strength, and ankle edema were achieved in 87, 90, 65, 61, and 78% of the patients, respectively. [ncbi.nlm.nih.gov]

  • Hypotension

    After hypotensive pretreatment, a left adrenalectomy was performed, resulting in normalization of corticoadrenal function, blood pressure, Cushing features and growth rate. Histopathology confirmed PPNAD. [ncbi.nlm.nih.gov]

    Post-operative concerns included acute adrenal insufficiency, hypoglycaemia, hypotension and hyperkalemia, which were successfully managed in ICU. Patient was then given oral corticosteroids. [ijaweb.org]

    His hospital course was complicated with tachycardia and hypotension, which was successfully treated with aggressive fluid resuscitation and ileus treated with bowel rest. His hydrocortisone was tapered during the stay based on his clinical status. [edmcasereports.com]

  • Proximal Muscle Weakness

    Validated severity scales were used to calculate metabolic (M) score (hypokalemia, hyperglycemia, hypertension, proximal muscle weakness) and adverse events (AE) score (thrombosis, fracture, infection). [ncbi.nlm.nih.gov]

    She required ventilation for 6 days plus potassium supplementation for persistent hypokalemia, proximal muscle weakness and easy fatigability. Gradually, her ionotropic support was tapered off. On the 6 th postoperative day, she was extubated. [ijaweb.org]

  • Impulsivity

    The introduction of laparoscopic techniques may give an impulse to the application of surgical therapy at a larger scale in patients with 21-hydroxylase deficiency who are difficult to treat with adrenal suppression therapy. [ncbi.nlm.nih.gov]

  • Neck Swelling

    RESULTS: A 59-year-old man presented with nasal congestion and neck swelling and was noted to have hypokalemia, hypertension, and hyperglycemia. A nasal biopsy demonstrated a poorly differentiated carcinoma with neuroendocrine features. [ncbi.nlm.nih.gov]

  • Secondary Amenorrhea

    A 21-year-old woman was referred to Hamamatsu University School of Medicine University Hospital complaining of a deepening voice, hirsutism and secondary amenorrhea. [ncbi.nlm.nih.gov]

Tumor marker CA-125 was elevated and additional ovarian cancer staging workup confirmed stage IIIC due to one lymph node positive for carcinoma. [ncbi.nlm.nih.gov]

Preoperative workup revealed hypokalemia, anaemia, hypertension and hyperglycemia. She was posted for laparoscopic bilateral adrenalectomy. [ijaweb.org]

No hormonal workup was performed by the surgical service evaluating the patient on initial presentation. Treatment The differential diagnosis of these masses included benign lesions such as lipoma, teratoma, or myelolipoma. [edmcasereports.com]

  • Liver Biopsy

    One patient underwent a simultaneous wedge liver biopsy for a right lobar lesion. There were no complications. Each patient resumed a regular diet on the first postoperative day. [ncbi.nlm.nih.gov]

Abstract Up to one-third of subjects who have had bilateral adrenalectomy for treatment of Cushing's disease will develop Nelson's syndrome. [ncbi.nlm.nih.gov]

Metastatic non-small-cell lung cancer is a common condition with a dismal prognosis. Although palliative chemotherapy improves survival and quality of life, nearly all patients die of progressive disease. [ncbi.nlm.nih.gov]

Prognosis after Bilateral Adrenalectomy: The prognosis for a positive end result following bilateral adrenalectomy is good. Recovery from Bilateral Adrenalectomy: The total recovery time for bilateral adrenalectomy is three to six weeks. [orangecountysurgeons.org]

Prognosis Prognosis after treatment is good but quality of life may be affected due to the long-term effects of hypercortisolemia. Without treatment the disease is life-threatening as in the case of manifest hypercortisolism. [orpha.net]

Prognosis The prognosis is good, providing there is early recognition. Co-ordination between surgeons and radiotherapists is important. Postoperative aftercare, with adequate long-term monitoring and replacement of hormones, is vital. [patient.info]

The patient records were analyzed to obtain patient demographics, disease etiology, surgical approach, operating room information, postoperative complications (30 days), hospital length of stay (LOS), and follow-up information. [ncbi.nlm.nih.gov]

Etiology The exact etiology is unknown but the adrenal overgrowth seen in AIMAH may be due to the expression of aberrant membrane receptors found in the adrenal cortex that regulate cortisol secretion and which are stimulated by gastric inhibitory polypeptide [orpha.net]

Some authors suggested that CS should be included in the differential diagnoses of certain high-risk patient populations, including patients who present with diabetes mellitus, hypertension, and early-onset osteoporosis. 85 Quality of Life CS of any etiology [endocrinefacts.org]

Summary Epidemiology Prevalence of endogenous CS is estimated at 1/26,000 and AIMAH represents less than 1% of the cases. [orpha.net]

Epidemiology [ 1 ] Nelson's syndrome is rare. [patient.info]

In patients with a benign adrenal adenoma, SMR 1.90. * Graversen et al. 2012 64 Spain, N 49, 1975-1992 Epidemiological study Overall, SMR 3.8. [endocrinefacts.org]

This Second Edition has been thoroughly updated with the latest information on pathophysiology, treatment, and drug dosing. New chapters cover obesity, vitamin D deficiency, autoimmune polyendocrine syndromes, and endocrine disorders in HIV/AIDS. [books.google.com]

The pathophysiology of Nelson's syndrome and the factors leading to its development are poorly understood. [patient.info]

Laparoscopic bilateral adrenalectomy was offered to both patients to prevent accumulation of adrenal steroid precursors; this would likely restore regular 4-week menstrual cycles, decrease virilization, and decrease dosage of replacement therapy. [pediatrics.aappublications.org]

The exclusion of a pheochromocytoma is crucial, since this tumor must be treated with alpha blockers before surgery to prevent a hypertensive crisis. [urology-textbook.com]

Prevention Bilateral adrenalectomy is said to carry an acceptable risk but follow-up should include awareness of Nelson's syndrome. [ 14 ] Monitoring of ACTH level and pituitary MRI are recommended 3-6 months after surgery and regularly thereafter. [ [patient.info]

Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition) Chest. 2008; 133 (6 Suppl):381S–453S. [ PubMed ] [ Google Scholar ] 38. [ncbi.nlm.nih.gov]

Now, on a maintenance dose; I still have to take extra cortisol during times of physical or emotional stress to prevent my body from going into shock. [cushingsbios.com]