17-ketosteroids and Fever

A patient with adrenocortical carcinoma presented with fever, leukocytosis, and increased acute phase reactants. The tumor was infiltrated with neutrophils. Immunohistochemical staining of the tumor showed positive signal for epithelial neutrophil-activating protein-78, an angiogenic and chemotactic CXC chemokine. Conditioned medium from tumor-derived cells (RL-251) showed high concentration of IL-8, epithelial neutrophil-activating protein-78, Gro alpha, and Gro gamma, angiogenic CXC chemokines with a potential role in tumorigenesis. An adrenal cancer/severe combined immunodeficiency mouse chimera was developed. Mice grew tumors rapidly, and circulating levels of IL-8 and epithelial neutrophil-activating protein-78 were detected. In contrast, animals transplanted with NCI-H295 cells, a nonchemokine-secreting cell line, grew tumors more slowly and did not have detectable chemokine levels. Similar to the patient, mice with RL-251 tumors developed marked leukocytosis and neutrophilia, and their tumors were infiltrated with neutrophils. Mice were passively immunized with epithelial neutrophil-activating protein-78 antisera. A marked decrease in tumor growth was observed. Potential for chemokine production by other adrenocortical tumors was investigated by RT-PCR in archival material. Six of seven adrenal carcinomas and one of three adenomas had cDNA for IL-8; six of seven carcinomas and the three adenomas had cDNA for epithelial neutrophil-activating protein-78. We concluded that the clinical presentation of this case resulted from increased tumor production of chemotactic chemokines. Through their angiogenic and chemotactic properties these chemokines may play an important role in adrenal tumorigenesis.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adenoma; Adrenal Cortex Neoplasms; Adrenocorticotropic Hormone; Aged; Chemokine CXCL5; Chemokines, CXC; Circadian Rhythm; Fever; Humans; Hydrocortisone; Immunohistochemistry; Interleukin-8; Leukocytosis; Male; Neutrophil Activation; Neutrophils; Reverse Transcriptase Polymerase Chain Reaction; Syndrome; Tumor Cells, Cultured

A case of periodic fever is reported in a 28-year-old male. The patient's clinical and laboratory findings fulfilled diagnostic criteria for etiocholanolone fever (EF). The most crucial endocrine data comprised higher values of both urinary etiocholanolone/androsterone ratio and plasma unconjugated etiocholanolone on febrile days, as compared to the values on afebrile days. However, the author hesitates to promptly diagnose him as EF, because of arguments against EF as an isolated clinical entity, and also because of the presence of auto-antibodies suggestive of an early stage of collagen disease(s). If the patient should develop a florid collagen disease in later clinical course, this case could be another evidence against EF as an established clinical entity, thus a careful follow-up is needed.

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Androsterone; Etiocholanolone; Fever; Humans; Male

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adolescent; Adrenal Glands; Adrenocorticotropic Hormone; Adult; Aged; Animals; Bacterial Infections; Female; Fever; Guinea Pigs; Humans; Male; Meningitis; Middle Aged; Time Factors

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adult; Body Temperature; Body Weight; Calcium; Diet; Diuresis; Fever; Humans; Hypothermia, Induced; Leukocytosis; Magnesium; Male; Nitrogen; Phosphorus; Potassium; Pregnanetriol; Sodium; Sweat; Water-Electrolyte Balance

Topics: 17-Ketosteroids; Adolescent; Blood Chemical Analysis; Child; Etiocholanolone; Familial Mediterranean Fever; Fever; Humans; Metabolic Diseases; Pathology; Peritonitis; Prednisone

Topics: 17-Hydroxycorticosteroids; 17-Ketosteroids; Adrenal Cortex Hormones; Adrenal Gland Diseases; Adrenocortical Hyperfunction; Adrenogenital Syndrome; Dexamethasone; Fatigue; Fever; Humans; Hyperplasia; Male; Pituitary-Adrenal Function Tests; Prednisone; Urine

Topics: 17-Ketosteroids; Adrenal Gland Diseases; Adrenal Hyperplasia, Congenital; Adrenogenital Syndrome; Anatomy; Etiocholanolone; Fever; Hyperplasia

Topics: 17-Ketosteroids; Agranulocytosis; Communicable Diseases; Edema; Endocrinology; Etiocholanolone; Familial Mediterranean Fever; Fever; Humans; Joint Diseases; Mononuclear Phagocyte System; Neoplasms; Paralyses, Familial Periodic

Topics: 17-Ketosteroids; Adrenal Cortex; Adrenal Cortex Diseases; Adrenal Hyperplasia, Congenital; Familial Mediterranean Fever; Fever; Humans; Hyperplasia; Hypertrophy; Male; Medical Records

Topics: 17-Ketosteroids; Adrenal Cortex Hormones; Fever; Pyrogens

Topics: 17-Ketosteroids; Adrenocorticotropic Hormone; Dehydroepiandrosterone; Fever; Hydrogen-Ion Concentration; Psoriasis; Steroids

Topics: 17-Ketosteroids; Arthritis; Arthritis, Rheumatoid; Epilepsy; Fats; Fever; Hyperthermia, Induced; Steroids