Cortisol Excess and Insufficiency

Description

Disorders associated with cortisol excess and insufficiency, although rare, deserve the attention of the entire medical community because of high associated morbidity and mortality. Both diagnosis and management of hypo- and hypercortisolism are challenging, and disease presentation, at both clinical and laboratory level is not always definite. New tools are available for non-invasive and early diagnosis, and the choice of treatment should be tailored to each patient to improve quality of life through the regulation of the levels and rhythm of hormonal secretion, while limiting complications associated with the disease and therapies. In this new volume, top experts have contributed chapters on the pathognomonic, epidemiological, clinical, radiological, and laboratory aspects of the various disorders associated with altered cortisol secretion. They also present information on still debated standpoints on management. Cortisol Excess and Insufficiency is a valuable reference book for those wishing to have a reasoned and broad overview of the pathophysiology and management of disorders associated with hypo- and hypercortisolism.

Informations

• Publié par: S. Karger AG
• Date de parution: 19 mai 2016
• Nombre de lectures: 0
• EAN13: 9783318058406
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Cortisol Excess and Insufficiency
Frontiers of Hormone Research
Vol. 46
Series Editor
Ezio Ghigo Turin
Co-Editor
Federica Guaraldi Turin
Cortisol Excess and Insufficiency
Volume Editors
Emanuela Arvat Turin
Alberto Falorni Perugia
17 figures, 4 in color, and 20 tables, 2016
Frontiers of Hormone Research Founded 1972 by Tj.B. van Wimersma Greidanus, Utrecht Continued by Ashley B. Grossman, Oxford (1996-2013)
_______________________ Emanuela Arvat, MD Division of Oncological Endocrinology Department of Medical Science University of Turin, Turin, Italy
_______________________ Alberto Falorni, MD Section of Internal Medicine and Endocrine and Metabolic Sciences, Department of Medicine University of Perugia, Perugia, Italy
Library of Congress Cataloging-in-Publication Data
Names: Arvat, Emanuela, editor. | Falorni, Alberto, editor.
Title: Cortisol excess and insufficiency / volume editors, Emanuela Arvat, Alberto Falorni.
Other titles: Frontiers of hormone research ; v. 46. 0301-3073
Description: Basel ; New York: Karger, [2016] | Series: Frontiers of hormone research, ISSN 0301-3073 ; vol. 46 | Includes bibliographical references and index.
Identifiers: LCCN 2016008853| ISBN 9783318058390 (hard cover: alk. paper) | ISBN 9783318058406 (e-ISBN)
Subjects: | MESH: Adrenal Insufficiency--physiopathology | Adrenocortical Hyperfunction--physiopathology | Hydrocortisone--secretion
Classification: LCC RM292.4.C67 | NLM WK 760 | DDC 615.3/64--dc23 LC record available at http://lccn.loc.gov/2016008853

Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents ® and MEDLINE/Pubmed.
Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
© Copyright 2016 by S. Karger AG, P.O. Box, CH-4009 Basel (Switzerland)
www.karger.com
Printed in Germany on acid-free and non-aging paper (ISO 9706) by Kraft Druck, Ettlingen
ISSN 0301-3073
eISSN 1662-3762
ISBN 978-3-318-05839-0
e-ISBN 978-3-318-05840-6
Contents
Preface
Arvat, E. (Turin); Falorni, A. (Perugia); Ghigo, E. (Turin); Guaraldi, F. (Turin)
Chapter 1
Pseudo-Cushing – A Clinical Challenge?
Pecori Giraldi, F.; Ambrogio, A.G. (Milan)
Chapter 2
Cushing's Syndrome: Where and How to Find It
Debono, M.; Newell-Price, J.D. (Sheffield)
Chapter 3
Subclinical Hypercortisolism: How to Deal with It?
Chiodini, I.; Morelli, V. (Milan)
Chapter 4
Etiopathogeny of Primary Adrenal Hypercortisolism
Vélayoudom-Céphise, F.-L. (Pessac; Guadeloupe); Haissaguerre, M. (Pessac; Bordeaux); Tabarin, A. (Pessac; Bordeaux)
Chapter 5
Metabolic Alterations and Cardiovascular Outcomes of Cortisol Excess
Pivonello, R.; De Martino, M.C.; Iacuaniello, D.; Simeoli, C.; Muscogiuri, G.; Carlomagno, F. ; De Leo, M.; Cozzolino, A.; Colao, A. (Naples)
Chapter 6
Skeletal Fragility in Endogenous Hypercortisolism
Mazziotti, G. (Brescia); Delgado, A. (Brescia/Panama City); Maffezzoni, F.; Formenti, A.; Giustina, A. (Brescia)
Chapter 7
Cortisol Excess and the Brain
Resmini, E.; Santos, A.; Webb, S.M. (Barcelona)
Chapter 8
Update on Hypercortisolism Therapy
Arnaldi, G.; Trementino, L. (Ancona)
Chapter 9
Is Adrenal Insufficiency a Rare Disease?
Dahlqvist, P. (Umeå); Isaksson, M. (Uppsala); Bensing, S. (Stockholm)
Chapter 10
From Genetic Predisposition to Molecular Mechanisms of Autoimmune Primary Adrenal Insufficiency
Falorni, A.; Brozzetti, A. (Perugia); Perniola, R. (Lecce)
Chapter 11
From Appearance of Adrenal Autoantibodies to Clinical Symptoms of Addison's Disease: Natural History
Betterle, C. (Padua); Garelli, S.; Presotto, F. (Mestre-Venezia); Furmaniak, J. (Cardiff)
Chapter 12
Is Diagnosis and Subclassification of Adrenal Insufficiency as Easy as It Looks?
Smans, L.C.C.J.; Zelissen, P.M.J. (Utrecht)
Chapter 13
Secondary Adrenal Insufficiency: Where Is It Hidden and What Does It Look Like?
Guaraldi, F.; Karamouzis, I.; Berardelli, R.; D'Angelo, V.; Rampino, A.; Zichi, C.; Ghigo, E.; Giordano, R. (Turin)
Chapter 14
Quality of Life and Life Expectancy in Patients with Adrenal Insufficiency: What Is True and What Is Urban Myth?
Burger-Stritt, S.; Pulzer, A.; Hahner, S. (Würzburg)
Chapter 15
Congenital Adrenal Hyperplasia: Unresolved Issues
Yau, M.; Khattab, A.; Poppas, D. (New York, N.Y.); Ghizzoni, L. (Turin); New, M. (New York, N.Y.)
Chapter 16
Adrenal Insufficiency Therapy: How to Keep the Balance between Good Quality of Life and Low Risk for Long-Term Side Effects?
Simunkova, K.; Husebye, E.S. (Bergen)
Author Index
Subject Index
Preface
Disorders associated with altered cortisol secretion, excessive or insufficient, are associated with important morbidity and mortality.
Cortisol deficiency or Addison's disease was named after the British physician Thomas Addison who, in 1855, first described the typical signs and symptoms of hypoadrenalism, together with autoptic findings, in 11 patients. Almost a century later, the American neurosurgeon Harvey Cushing reported the case of a 23-year-old woman presenting with obesity, hypertrichosis, amenorrhea, overdevelopment of secondary sexual characteristics, abdominal striae rubrae, skin ecchymosis, signs of increased cerebral tension and impaired glucose tolerance, secondary to a corticotroph pituitary adenoma.
Today, hyper- and hypocortisolism are still considered rare disorders; however, because their onset is often insidious with nonspecific signs and symptoms, and the biochemical picture is not so clear, their incidence appears highly underestimated. Hypocortisolism can be life-threatening if not promptly recognized and treated, while detrimental effects of hypercortisolism occur in the long term. Both diagnosis and management are challenging and, even when properly recognized and treated, these disorders still are associated with significant physical and psychological sequelae.
This volume provides a broad overview of the most recent findings – mainly derived from human studies – and present still debated questions for those conditions associated with altered cortisol secretion.
The issue is structured into two main sections. The first 8 chapters focus on hypercortisolism, presenting the new pathophysiology and genetic findings, typical signs, symptoms and comorbidities. They discuss the diagnostic pitfalls and difficulties in the management of chronic hypercortisolism according to the anatomical origin, and look at the long-term impact of the various therapies. Chapters 9–16 are aimed at giving the reader the most recent data on the epidemiology, genetic and molecular mechanisms of autoimmune primary adrenal insufficiency. They focus on the peculiar clinical aspects associated with primary and secondary hypocortisolism, and discuss peculiarities, advantages and limitations of the new cortisone formulations with respect to standard therapy, taking into consideration the balance between good quality of life for the patients and the long-term risk profile, clinical management and costs. Chapters 10 and 15 are also devoted to hypoadrenalism in the context of autoimmune polyendocrine syndromes and congenital adrenal hyperplasia, with a special focus on the new potential in utero diagnostic methods and their impact on patient management.
We hope that this issue of the series Frontiers of Hormone Research will be a valuable tool for endocrinologists, as well as for internal medicine doctors and general practitioners, for a reasoned and comprehensive update on the state of the art in the field of disorders associated with hyper- and hypocortisolism, and act as a guide in their management.
The volume and series editors gratefully thank all of the authors who devoted their time and efforts to contribute to this volume, and the staff at Karger who preciously assisted with its timely completion.
Emanuela Arvat, Turin (Volume Editor) Alberto Falorni, Perugia (Volume Editor) Ezio Ghigo, Turin (Series Editor) Federica Guaraldi, Turin (Series Editor)
Arvat E, Falorni A (eds): Cortis