For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
13
views
4
references
 Top references
cited by
3
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
2 collections
    0
    shares
      78
      similar
       All similar

          The flagship journal of the Society for Endocrinology. Learn more

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Primary adrenal lymphoma as a cause of adrenal insufficiency, a report of two cases

      research-article
      Author(s): 1 , 1 , 2 , 3 , 4 , 5 , 4 , 5 , 1 , 6
      Publication date (Electronic):
      Journal: Endocrinology, Diabetes & Metabolism Case Reports
      Publisher: Bioscientifica Ltd
      Keywords: Geriatric, Male, White, Norway, Adrenal, Adrenal, ACTH, Cortisol, Adrenal insufficiency, Adrenal lymphoma*, Dizziness, Anorexia, Nausea, Arthralgia, Weight loss, Renal failure, Fatigue, Hyponatraemia, Vomiting, Pyrexia, Tachycardia, Hypotension, Abdominal discomfort, Bowel movements - bleeding, Adrenal antibodies, CT scan, Biopsy, ACTH, Creatinine (serum), Potassium, Sodium, Cortisol, ACTH stimulation, Urine osmolality, MRI, Radiotherapy, Fluid repletion, Glucocorticoids, Sodium chloride, Fludrocortisone, Mineralocorticoids, Cortisone acetate, Doxorubicin, Prednisolone, Vincristine*, Cyclophosphamide*, Hydrocortisone, Rituximab, Oncology, Radiology/Rheumatology, Urology, Unique/unexpected symptoms or presentations of a disease, March, 2020

      Read this article at

      ScienceOpenPublisherPMC
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Summary

          Primary adrenal lymphoma (PAL) is a rare cause of adrenal insufficiency. More than 90% is of B-cell origin. The condition is bilateral in up to 75% of cases, with adrenal insufficiency in two of three patients. We report two cases of adrenal insufficiency presenting at the age of 70 and 79 years, respectively. Both patients had negative 21-hydroxylase antibodies with bilateral adrenal lesions on CT. Biopsy showed B-cell lymphoma. One of the patients experienced intermittent disease regression on replacement dosage of glucocorticoids.

          Learning points:

          • Primary adrenal lymphoma (PAL) is a rare cause of adrenal insufficiency.

          • Bilateral adrenal masses of unknown origin or in individuals with suspected extra-adrenal malignancy should be biopsied quickly when pheochromocytoma is excluded biochemically.

          • Steroid treatment before biopsy may affect diagnosis.

          • Adrenal insufficiency with negative 21-hydroxylase antibodies should be evaluated radiologically.

          Related collections

          Most cited references4

          • Record: found
          • Abstract: found
          • Article: not found

          Clinical, immunological, and genetic features of autoimmune primary adrenal insufficiency: observations from a Norwegian registry.

          Martina M. Erichsen, Kristian Løvås, Beate Skinningsrud … (2009)
          Primary adrenal insufficiency [Addison's disease (AD)] is rare, and systematic studies are few, mostly conducted on small patient samples. We aimed to determine the clinical, immunological, and genetic features of a national registry-based cohort. Patients with AD identified through a nationwide search of diagnosis registries were invited to participate in a survey of clinical features, health-related quality of life (HRQoL), autoantibody assays, and human leukocyte antigen (HLA) class II typing. Of 664 registered patients, 64% participated in the study. The prevalence of autoimmune or idiopathic AD in Norway was 144 per million, and the incidence was 0.44 per 100,000 per year (1993-2007). Familial disease was reported by 10% and autoimmune comorbidity by 66%. Thyroid disease was most common (47%), followed by type 1 diabetes (12%), vitiligo (11%), vitamin B12 deficiency (10%), and premature ovarian insufficiency (6.6% of women). The mean daily treatment for AD was 40.5 mg cortisone acetate and 0.1 mg fludrocortisone. The mean Short Form 36 vitality scores were significantly diminished from the norm (51 vs. 60), especially among those with diabetes. Concomitant thyroid autoimmunity did not lower scores. Anti-21-hydroxylase antibodies were found in 86%. Particularly strong susceptibility for AD was found for the DR3-DQ2/ DRB1*0404-DQ8 genotype (odds ratio, 32; P = 4 x 10(-17)), which predicted early onset. AD is almost exclusively autoimmune, with high autoimmune comorbidity. Both anti-21-hydroxylase antibodies and HLA class II can be clinically relevant predictors of AD. HRQoL is reduced, especially among diabetes patients, whereas thyroid disease did not have an impact on HRQoL. Treatment modalities that improve HRQoL are needed.
          Article 0 comments Cited 121 times – based on 0 reviews     Review now
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Adrenal insufficiency due to bilateral adrenal metastases – A systematic review and meta-analysis

            Philippa Tallis, R Louise Rushworth, David J Torpy … (2019)
            Objective Bilateral adrenal metastases may cause adrenal insufficiency (AI) but it is unclear if screening for AI in patients with bilateral adrenal metastases is justified, despite the potential for adrenal crises. Method A search using PubMed/Medline, ScienceDirect and Cochrane Reviews was performed to collect all original research articles and all case reports from the past 50 years that describe AI in bilateral adrenal metastases. Results Twenty studies were included with 6 original research articles, 13 case reports and one case series. The quality was generally poor. The prevalence of AI was 3–8%. Of all cases of AI (n = 25) the mean pooled baseline cortisol was 318 ± 237 nmol/L and stimulated 423 ± 238 nmol/L. Hypotension was present in 69%, hyponatremia in 9% and hyperkalemia in 100%. Lung cancer was the cause in 35%, colorectal 20%, breast cancer 15% and lymphoma 10%. The size of the adrenal metastases was 5.5 ± 2.8 cm (left) and 5.5 ± 3.1 cm (right), respectively. There was no correlation between basal cortisol, stimulated cortisol concentration or ACTH with the size of adrenal metastases. The median time to death was 5.0 months (IQR 0.6–6.5). However, two cases were alive after 12–24 months. Conclusion The prevalence of AI in patients with bilateral adrenal metastases was low. Prognosis was very poor. Due to the low prevalence of AI, screening is likely only indicated in patients with symptoms and signs suggestive of hypocortisolism.
            Article 0 comments Cited 21 times – based on 0 reviews     Review now
              • Record: found
              • Abstract: found
              • Article: not found

              Clues for early detection of autoimmune Addison's disease - myths and realities

              Å. Saevik, A.-K. Åkerman, K. Grønning … (2018)
              Early detection of autoimmune Addison's disease (AAD) is important as delay in diagnosis may result in a life-threatening adrenal crisis and death. The classical clinical picture of untreated AAD is well-described, but methodical investigations are scarce.
              Article 0 comments Cited 18 times – based on 0 reviews     Review now
                All references

                Author and article information

                Journal
                Journal ID (nlm-ta): Endocrinol Diabetes Metab Case Rep
                Journal ID (iso-abbrev): Endocrinol Diabetes Metab Case Rep
                Journal ID (hwp): EDM
                Title: Endocrinology, Diabetes & Metabolism Case Reports
                Publisher: Bioscientifica Ltd (Bristol )
                ISSN (Electronic): 2052-0573
                Publication date (Electronic): 10 March 2020
                Publication date Collection: 2020
                Volume: 2020
                Electronic Location Identifier: 19-0131
                Affiliations
                [1 ]Department of Endocrinology , Akershus University Hospital, Lorenskog, Norway
                [2 ]Department of Haematology , Akershus University Hospital, Lorenskog, Norway
                [3 ]Department of Radiology , Akershus University Hospital, Lorenskog, Norway
                [4 ]Department of Clinical Science and K.G. Jebsen Center of Autoimmune Disorders , University of Bergen, Bergen, Norway
                [5 ]Department of Medicine , Haukeland University Hospital, Bergen, Norway
                [6 ]Institute of Clinical Medicine , Faculty of Medicine, University of Oslo, Oslo, Norway
                Author notes
                Correspondence should be addressed to K Grønning; Email: kaja.gronning@ 123456gmail.com
                Article
                Publisher ID: EDM190131
                DOI: 10.1530/EDM-19-0131
                PMC ID: 7077515
                PubMed ID: 32163909
                SO-VID: 8b5bc31a-7df9-4344-96ad-aca9f3dc17b6
                Copyright © © 2020 The authors
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License..

                History
                Date received : 17 December 2019
                Date accepted : 14 February 2020
                Categories
                Subject: Geriatric
                Subject: Male
                Subject: White
                Subject: Norway
                Subject: Adrenal
                Subject: Adrenal
                Subject: ACTH
                Subject: Cortisol
                Subject: Adrenal Insufficiency
                Subject: Adrenal Lymphoma*
                Subject: Dizziness
                Subject: Anorexia
                Subject: Nausea
                Subject: Arthralgia
                Subject: Weight loss
                Subject: Renal failure
                Subject: Fatigue
                Subject: Hyponatraemia
                Subject: Vomiting
                Subject: Pyrexia
                Subject: Tachycardia
                Subject: Hypotension
                Subject: Abdominal discomfort
                Subject: Bowel movements - bleeding
                Subject: Adrenal antibodies
                Subject: CT scan
                Subject: Biopsy
                Subject: ACTH
                Subject: Creatinine (serum)
                Subject: Potassium
                Subject: Sodium
                Subject: Cortisol
                Subject: ACTH stimulation
                Subject: Urine osmolality
                Subject: MRI
                Subject: Radiotherapy
                Subject: Fluid repletion
                Subject: Glucocorticoids
                Subject: Sodium chloride
                Subject: Fludrocortisone
                Subject: Mineralocorticoids
                Subject: Cortisone acetate
                Subject: Doxorubicin
                Subject: Prednisolone
                Subject: Vincristine*
                Subject: Cyclophosphamide*
                Subject: Hydrocortisone
                Subject: Rituximab
                Subject: Oncology
                Subject: Radiology/Rheumatology
                Subject: Urology
                Subject: Unique/Unexpected Symptoms or Presentations of a Disease
                Subject: Unique/Unexpected Symptoms or Presentations of a Disease

                Keywords: geriatric,male,white,norway,adrenal,acth,cortisol,adrenal insufficiency,adrenal lymphoma*,dizziness,anorexia,nausea,arthralgia,weight loss,renal failure,fatigue,hyponatraemia,vomiting,pyrexia,tachycardia,hypotension,abdominal discomfort,bowel movements - bleeding,adrenal antibodies,ct scan,biopsy,creatinine (serum),potassium,sodium,acth stimulation,urine osmolality,mri,radiotherapy,fluid repletion,glucocorticoids,sodium chloride,fludrocortisone,mineralocorticoids,cortisone acetate,doxorubicin,prednisolone,vincristine*,cyclophosphamide*,hydrocortisone,rituximab,oncology,radiology/rheumatology,urology,unique/unexpected symptoms or presentations of a disease,march,2020
                Data availability:
                Keywords: geriatric, male, white, norway, adrenal, acth, cortisol, adrenal insufficiency, adrenal lymphoma*, dizziness, anorexia, nausea, arthralgia, weight loss, renal failure, fatigue, hyponatraemia, vomiting, pyrexia, tachycardia, hypotension, abdominal discomfort, bowel movements - bleeding, adrenal antibodies, ct scan, biopsy, creatinine (serum), potassium, sodium, acth stimulation, urine osmolality, mri, radiotherapy, fluid repletion, glucocorticoids, sodium chloride, fludrocortisone, mineralocorticoids, cortisone acetate, doxorubicin, prednisolone, vincristine*, cyclophosphamide*, hydrocortisone, rituximab, oncology, radiology/rheumatology, urology, unique/unexpected symptoms or presentations of a disease, march, 2020

                Comments

                Comment on this article

                Related Documents Log
                scite_

                Similar content78

                See all similar

                Cited by3

                See all cited by

                Most referenced authors136

                See all reference authors