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We present a case of a woman with a history of Congenital Adrenal Hyperplasia (CAH) diagnosed at the age of 12, who was referred to our unit for surgical treatment. Despite the initial diagnosis was an indirect inguinal hernia, it was a misdiagnosis. Once in our service, this was corrected into clitoromegaly secondary to CAH. Physical examination and imaging test discarded other abnormalities, such as secondary effects androgenization. Regarding surgical treatment, the techniques used were Spencer and Allen combined with Kumar, which are the most used for clitoroplasty but also less used in Peru.

The endogenous catecholamines and their metabolites play an integral role in establishing the presence or absence of a suspected sympatho-adrenal tumor. Highly elevated metabolites excreted in the urine are indicative of a tumor. For this reason numerous analytical methods has been developed to accurately quantify the levels of these compounds. However, current methods usually make use of conventional HPLC methods. Although effective, these methods require tedious sample preparation and are usually plagued by interferences. It was the aim of this work to develop a gas chromatographic – mass spectrometric (GC-MS) method that allow for the simultaneous analysis of the endogenous catecholamines, their basic and acidic metabolites using a single extraction procedure (which is easy to use and not tedious) with minimal derivatization steps. Furthermore, to develop GC-MS methods which do not require tedious sample preparation and yet be sensitive and accurate and allow for rapid analysis in the clinical pathology laboratory. Four different gas chromatographic - mass spectrometric methods were developed for the analysis of the catecholamines and their metabolites and are discussed in detail. / Dissertation (MSc)--University of Pretoria, 2009. / Chemical Pathology / unrestricted

More than 150 years ago, Thomas Addison first described the clinical features and pathogenesis of adrenal insufficiency. At that time, tuberculosis was the most common cause of this disease. The pathway to diagnosis and treatment of Addison's disease has been well described. However, determining the cause of the disorder remains a challenge. It is important to consider recently described infectious agents in the pathogenesis of Addison's disease. Mycobacterial, bacterial, viral, and fungal infections may lead to the development of adrenal insufficiency. Skin, pulmonary, and imaging findings can aid the clinician in making a prompt diagnosis of specific infections, which is crucial because early identification of infectious causes of Addison's disease may enable recovery of adrenal function. This review describes the clinical presentations of the multiple infectious causes of adrenal insufficiency.

No description available.

Controversy exists concerning the possible involvement of serotonin in the pituitary-adrenocortical response to stress. In the present research, a variety of physiological and pharmacological manipulations were used in male rats to study the role of this neurotransmitter in the adrenocortical response to insulin- induced hypoglycemia. First, the effect of insulin stress on hypothalamic 5-HT metabolism was examined, and an increased turnover was found as determined by an enhanced accumulation of 5-HT following monoamine oxidase inhibition. The corticos terone response to insulin was potentiated by prior administration of L-tryptophan, and blocked by pretreatment with valine, an amino acid that competes with tryptophan for transport across the blood-brain barrier. Treatment with the 5-HT receptor blocker methysergide, or serotonin depletion by intraventricular injection of 5 , 7-dihydroxy tryptamine significantly attenuated the insulin- induced rise in circulating corticosterone.

OBJECTIVE: Adrenal steroidogenesis is important for maturation of fetal organ systems and plays a role in triggering parturition in ovine pregnancies. Studies have suggested a differential increase in baseline cortisol between twin gestations near term. Our aim was to further delineate the mechanisms responsible for the differences between the hypothalamic- pituitary-adrenal axes of twin fetuses in vivo. STUDY DESIGN: Surgery was performed on pregnant ewes (n = 6) with twin gestations to implant fetal vascular catheters. After recovery but while the subjects were resting, plasma cortisol concentrations were similar in both fetuses. Fetuses received, intravenously, boluses of adrenocorticotropic hormone at 2 doses, and plasma samples were obtained for analysis of the cortisol response. This stimulation by adrenocorticotropic hormone was then repeated in the same fetuses approximately 4 days later, after the increase of resting daily cortisol values in one but not the other fetus. RESULTS: Cortisol responses to adrenocorticotropic hormone before changes in daily resting cortisol concentrations were indistinguishable between twins. However, after separation of daily resting cortisol values, fetuses in group A (elevated resting cortisol concentration) demonstrated a significantly increased response to stimulation by adrenocorticotropic hormone. CONCLUSION: These results suggest a differential development in response to stimulation by adrenocorticotropic hormone between twin fetuses in vivo as the mechanism responsible for the asynchronous elevation of one twin's resting plasma cortisol concentration.

A review of the literature shows that extensive work has been done on the morphology and histology of the adrenal gland of the domesticated rabbit, but it appears that little or no work has been done on other members of the order Lagomorpha. Approximately one hundred specimens of rabbits of various ages and sizes, and of both sexes, were collected over a period of nine months. All adrenal glands were fixed by immersion and were embedded in paraffin. The majority or the glands were sectioned at eight or twelve miora, and were stained with Mallory's triple stain. This investigation shows that the gross morphological variations of the adrenal gland of' each species of native rabbits examined is almost as extensive as the variation found within the different genera and families of the order Lagomorpha. There are fewer histological Variations within a given species, but more extensive variations within genera and families of this order. It must be emphasized that not all morphological and histological structures found in the adrenal gland of all rabbits are the same. What may appear to be a typical histological structure or arrangement in one species of rabbit is not necessarily the typical structure or arrangement in all species.

No description available.