pituitrin and Adrenocortical-Hyperfunction

Cushing's disease remains a difficult diagnosis in spite of new technical procedures such as pituitary MRI, selective bilateral petrosal or cavernous sampling, (111)In pentreotide scan and 18 Flurodeoxyglucose pituitary PET scan. In this article, we review biological diagnostic procedures of Cushing's disease and corticotroph adenomas. According to our experience and the literature, we summarize the approach in medical treatment of Cushing's disease.

Topics: ACTH Syndrome, Ectopic; Adenoma; Adrenal Cortex Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Algorithms; Carcinoid Tumor; Child; Corticotropin-Releasing Hormone; Cushing Syndrome; Dexamethasone; Diagnosis, Differential; Diagnostic Imaging; Dopamine Agonists; Female; Humans; Hypothalamo-Hypophyseal System; Magnetic Resonance Imaging; Male; Petrosal Sinus Sampling; Pituitary Neoplasms; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Pregnancy; Pregnancy Complications, Neoplastic; Vasopressins

Topics: Adrenocortical Hyperfunction; Adult; Carcinoid Heart Disease; Cushing Syndrome; Endocrine System Diseases; Gynecomastia; Humans; Hypercalcemia; Hyperparathyroidism; Hyperthyroidism; Hyponatremia; Lung Neoplasms; Male; Middle Aged; Osmolar Concentration; Osteoarthropathy, Secondary Hypertrophic; Syndrome; Vasopressins

Topics: Acromegaly; Addison Disease; Adrenocortical Hyperfunction; Cushing Syndrome; Diabetes Insipidus; Endocrine System Diseases; Humans; Hyperaldosteronism; Hyperparathyroidism; Hypopituitarism; Hypothyroidism; Kidney; Vasopressins; Water-Electrolyte Balance

Topics: Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Breast Diseases; Endocrine System Diseases; Gynecomastia; Humans; Lung Diseases; Lung Neoplasms; Male; Neoplasms; Syndrome; Vasopressins

Topics: Adenoma, Islet Cell; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Alkalosis; Cushing Syndrome; Electrolytes; Endocrinology; Humans; Hypernatremia; Hypokalemia; Hyponatremia; Neoplasms; Pancreatic Neoplasms; Vasopressins; Water-Electrolyte Balance

Previous studies have demonstrated that type 1 diabetes is characterized by hypercorticism and lack of periodicity in adrenal hormone secretion. In the present study, we tested the hypothesis that hypercorticism is initiated by an enhanced release of ACTH leading subsequently to adrenocortical growth and increased output of adrenocortical hormones. To test this hypothesis, we used the streptozotocin (STZ)-induced diabetes mouse model and measured hypothalamic-pituitary-adrenal axis activity at different time points. The results showed that the expected rise in blood glucose levels induced by STZ treatment preceded the surge in corticosterone secretion, which took place 1 d after diabetes onset. Surprisingly, circulating ACTH levels were not increased and even below control levels until 1 d after diabetes onset and remained low until d 11 during hypercorticism. In response to ACTH (but not vasopressin), cultures of adrenal gland cells from 11-d diabetic mice secreted higher amounts of corticosterone than control cells. Real-time quantitative PCR revealed increased expression of melanocortin 2 and melanocortin 5 receptors in the adrenal glands at 2 and 11 d of STZ-induced diabetes. AVP mRNA expression in the paraventricular nucleus of the hypothalamus was increased, whereas hippocampal MR mRNA was decreased in 11-d diabetic animals. GR and CRH mRNAs remained unchanged in hippocampus and paraventricular nucleus of diabetic mice at all time points studied. These results suggest that sensitization of the adrenal glands to ACTH rather than an increase in circulating ACTH level is the primary event leading to hypercorticism in the STZ-induced diabetes mouse model.

Topics: Adrenal Glands; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Animals; Blood Glucose; Body Weight; Cells, Cultured; Chronic Disease; Corticosterone; Corticotropin-Releasing Hormone; Diabetes Mellitus, Experimental; Hypothalamo-Hypophyseal System; In Situ Hybridization; Male; Mice; Organ Size; Pituitary-Adrenal System; Radioimmunoassay; Receptor, Melanocortin, Type 2; Receptors, Corticotropin; Receptors, Melanocortin; Receptors, Mineralocorticoid; Reverse Transcriptase Polymerase Chain Reaction; Time Factors; Vasopressins

A double paraneoplasic syndrome with hypersecretion of ADH and ACTH revealed the presence of a small cell bronchial cancer in a man aged 62 years. Water and electrolyte anomalies due to the hypersecretions were of such a degree that an occlusive syndrome occurred. Very high levels of ADH and ACTH were found in the tumoral tissue. The measurement of these levels is rarely conducted at the present time but was able to define the mechanism of abnormal secretion of these two hormones in this case.

Topics: Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; APUD Cells; Carcinoma; Humans; Inappropriate ADH Syndrome; Lung Neoplasms; Male; Middle Aged; Paraneoplastic Syndromes; Vasopressins; Water-Electrolyte Imbalance

Topics: Adenocarcinoma; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Bronchial Neoplasms; Carcinoma; Female; Gastrointestinal Neoplasms; Gonadotropins; Growth Hormone; Hormones, Ectopic; Humans; Hyperparathyroidism; Hyperthyroidism; Lung Neoplasms; Male; Paraneoplastic Endocrine Syndromes; Parathyroid Hormone; Pituitary Hormones; Sex Factors; Thymus Neoplasms; Thyroid Neoplasms; Thyrotropin; Urogenital Neoplasms; Vasopressins

Topics: Adenocarcinoma; Adenoma; Adrenal Cortex Hormones; Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Arginine; Carbon Isotopes; Cushing Syndrome; Growth Hormone; Humans; Hydroxycorticosteroids; Hypoglycemia; Insulin; Luteinizing Hormone; Lysine; Pituitary Irradiation; Stimulation, Chemical; Vasopressins

Topics: 17-Hydroxycorticosteroids; Adenoma; Adrenal Gland Neoplasms; Adrenal Glands; Adrenocortical Hyperfunction; Adult; Depression, Chemical; Dexamethasone; Diagnosis, Differential; Humans; Hydrocortisone; Hyperplasia; Male; Methods; Metyrapone; Phlebography; Stimulation, Chemical; Vasopressins

Topics: Adrenal Glands; Adrenocortical Hyperfunction; Adult; Circadian Rhythm; Cushing Syndrome; Dexamethasone; Electroencephalography; Female; Growth Hormone; Humans; Hydrocortisone; Hydroxycorticosteroids; Hypoglycemia; Hypothalamus; Insulin; Male; Middle Aged; Pituitary Gland; Pituitary-Adrenal Function Tests; Polysaccharides, Bacterial; Sleep Stages; Vasopressins

Topics: Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Brain Injuries; Circadian Rhythm; Humans; Vasopressins

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Adrenocortical Hyperfunction; Bronchial Neoplasms; Carcinoma, Bronchogenic; Female; Hormones, Ectopic; Humans; Hypercalcemia; Hyponatremia; Neoplasm Metastasis; Vasopressins

Ectopic production of polypeptide hormones by tumors of nonendocrine tissues can serve as a clue to diagnosis of the tumor and as a focus for management of the patient with cancer. In the differential diagnosis of syndromes of endocrine hyperfunction, the ectopic hormone syndromes have achieved an increasingly prominent position. Available evidence on the properties of ectopic ACTH, MSH, parathyroid hormone, erythropoietin, gonadotropins, and thyrotropin is consistent with the unifying hypothesis of genetic derepression.

Topics: Abdominal Neoplasms; Adenocarcinoma; Adrenocortical Hyperfunction; Brain Neoplasms; Carcinoma, Bronchogenic; Carcinoma, Hepatocellular; Carcinoma, Small Cell; Cysts; Diagnosis, Differential; Fibroma; Hemangiosarcoma; Humans; Hyperparathyroidism; Hypoglycemia; Kidney Diseases; Kidney Neoplasms; Liver Neoplasms; Lung Neoplasms; Paraneoplastic Endocrine Syndromes; Pheochromocytoma; Polycythemia; Sarcoma; Thoracic Neoplasms; Vasopressins

Topics: Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Cushing Syndrome; Hormones, Ectopic; Humans; Hydrocortisone; Pituitary-Adrenal Function Tests; Vasopressins

Topics: Adrenal Gland Neoplasms; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Cushing Syndrome; Hormones, Ectopic; Hydrocortisone; Vasopressins

Topics: Adrenocortical Hyperfunction; Animals; Body Weight; Diabetes Insipidus; Diuresis; Genes, Dominant; Genes, Lethal; Glomerular Filtration Rate; Hypertrophy; Kidney Concentrating Ability; Kidney Glomerulus; Kidney Tubules; Mice; Organ Size; Syndactyly; Vasopressins

Topics: 17-Hydroxycorticosteroids; Adolescent; Adrenal Cortex Hormones; Adrenal Glands; Adrenalectomy; Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Adult; Aged; Cushing Syndrome; Female; Growth Hormone; Humans; Hypothalamo-Hypophyseal System; Insulin; Male; Metyrapone; Middle Aged; Pituitary-Adrenal System; Pyrogens; Vasopressins

Topics: Adrenocortical Hyperfunction; Adrenocorticotropic Hormone; Aldosterone; Alkalosis; Bronchial Neoplasms; Carcinoma; Endocrine System Diseases; Fludrocortisone; Humans; Hypercalcemia; Hypokalemia; Hyponatremia; Male; Plasma Volume; Vasopressins

Topics: Adrenocortical Hyperfunction; Adult; Cushing Syndrome; Diagnosis, Differential; Female; Humans; Hydrocortisone; Lysine; Male; Middle Aged; Pituitary-Adrenal Function Tests; Vasopressins

Topics: Adrenocortical Hyperfunction; Amenorrhea; Anorexia Nervosa; Diabetes Insipidus; Endocrine System Diseases; Female; Goiter; Graves Disease; Humans; Hypopituitarism; Metabolism; Obesity; Psychology; Psychosomatic Medicine; Psychotherapy; Syndrome; Vasopressins; Water-Electrolyte Balance