cosyntropin and Endocrine-System-Diseases

Imatinib mesylate [tyrosine kinase (TK) inhibitor] is a novel medication in the treatment of chronic myelogenous leukaemia (CML). TK is also essential in hypothalamo-pituitary-adrenal (HPA) axis.. The aim of this study was to evaluate HPA axis in patients treated with imatinib. Twenty-five patients were included in this study.. Glucagon stimulation test (GST) and low-dose (1 microg) adrenocorticotropin test (LDSST) were used to assess the HPA gland axis.. Seventeen (68%) subjects had impaired peak response when a cortisol cut-off value is accepted as 500 nmol/L. Twelve (48%) out of 17 subjects also failed to show a response to LDSST. Therefore, 12 patients (48%) were defined as HPA deficient. Only two of these 25 patients had morning serum cortisol < 200 nmol/l (7.22 microg/dl), and failed the GST and/or LDSST, indicating that the majority had partial glucocorticoid deficiency. If the cut-off presume for LDSST is from 500 to 600 nmol/l, 16 patients (64%) would have failed both the GST and LDSST.. Our results indicate an increased prevalence of subclinical glucocorticoid deficiency in patients receiving imatinib mesylate for CML. Therefore under stressed conditions, such as intercurrent illness state, overt and untreated partial glucocorticoid deficiency in CML patients become life threatening.

Topics: Adrenocorticotropic Hormone; Adult; Aged; Antineoplastic Agents; Benzamides; Cosyntropin; Endocrine System Diseases; Female; Glucagon; Glucocorticoids; Hormones; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Imatinib Mesylate; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Male; Middle Aged; Piperazines; Pituitary-Adrenal System; Protein Kinase Inhibitors; Pyrimidines

Topics: Cosyntropin; Endocrine Glands; Endocrine System Diseases; Humans; Hydrocortisone; Insulin

Two men with nervous anorexia were fully investigated and the results were compared with those of 15 healthy men and 19 women with the same disease. A similarity of the hormonal changes in both sexes concerning the somatotropic hormone, thyroid and cortico-suprarenal axis was established. A difference was found between the women and the two men concerning the gonadotropic hormones which in the men showed a well expressed reaction to gonadoliberin with an early maximum.

Topics: Adolescent; Adult; Anorexia Nervosa; Cosyntropin; Delayed-Action Preparations; Endocrine System Diseases; Female; Gonadotropin-Releasing Hormone; Humans; Male; Prolactin; Psychophysiologic Disorders; Thyrotropin; Weight Loss