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.
Chapter
Clinical Features in Patients with Pseudo-Cushing
Differential Diagnosis between Cushing’s Syndrome and Pseudo-Cushing
Management of Pseudo-Cushing
Cushing’s Syndrome: Where and How to Find It
Cushing’s Syndrome: Where and How to Find It
Is There a Clinical Index of Suspicion for Cushing’s Syndrome?
Is There Hypercortisolaemia?
Subclinical Hypercortisolism: How to Deal with It?
Clinical Presentation and Complications
Clinical and Biochemical Follow-Up
Etiopathogeny of Primary AdrenalHypercortisolism
The cAMP/PKA Signaling Pathway
ACTH-Independent Cushing’s Syndrome and Micronodular Adrenal Disease
Primary Macronodular Adrenal Hyperplasia
Cushing’s Syndrome and Adrenocortical Adenomas
Adrenocortical Carcinoma and Cushing’s Syndrome
Metabolic Alterations and CardiovascularOutcomes of Cortisol Excess
Metabolic and Cardiovascular Alterations in Patients with Active Cushing’s Syndrome
Metabolic and Cardiovascular Alterations after Cushing’s Syndrome Remission
Skeletal Fragility in Endogenous Hypercortisolism
Pathophysiological Aspects
Cortisol Excess and the Brain
Structural and Functional Alterations
Cognitive and Psychological Alterations
Update on Hypercortisolism Therapy
Is Adrenal Insufficiency a Rare Disease?
Primary Adrenal Insufficiency
Central Adrenal Insufficiency
Iatrogenic Adrenal Insufficiency
From Genetic Predisposition to Molecular Mechanisms of Autoimmune Primary Adrenal Insufficiency
AIRE and Autoimmune Addison’s Disease
MHC Class I and Class II Polymorphisms and Autoimmune Addison’s Disease
Class II Transactivator and Autoimmune Addison’s Disease
CTLA4 and Autoimmune Addison’s Disease
Other Genes and Autoimmune Addison’s Disease
Implications of Genetic Associations for Pathogenesis of Autoimmune Addison’s Disease
From Appearance of Adrenal Autoantibodies to Clinical Symptoms of Addison’s Disease: Natural History
Adrenal Cortex and 21-Hydroxylase Autoantibodies in Patients with Addison’s Disease
The Role of Adrenal Cortex Autoantibodies and 21-Hydroxylase Autoantibodies in the Pathogenesis of Addison’s Disease
Adrenal Cortex Autoantibodies and 21-Hydroxylase Autoantibodies in Subjects without Addison’s Disease
Natural History of Patients with Adrenal Cortex Autoantibodies and/or 21-Hydroxylase Autoantibodies
What Is the Best Method to Study Adrenal Function in Adrenal Cortex Autoantibodies/21-Hydroxylase Autoantibody-Positive Patients?
Is Progression to Addison’s Disease Mandatory?
Is It Possible to Predict the Onset of Clinical Adrenal Failure with More Precision?
Is Diagnosis and Subclassification ofAdrenal Insufficiency as Easy as It Looks?
Classification of Adrenal Insufficiency
Clinical Presentation of Adrenal Insufficiency
Diagnostic Evaluation of Suspected Adrenal Insufficiency
First Assessment: Hypocortisolism
Second Assessment: To Localize the Level of Dysfunction
Third Assessment: Determining the Etiology of Adrenal Insufficiency
Secondary Adrenal Insufficiency: Where Is It Hidden and What Does It Look Like?
Quality of Life and Life Expectancy in Patients with Adrenal Insufficiency: What Is True and What Is Urban Myth?
Quality of Life in Chronic Adrenal Insufficiency
Impact of Adrenal Insufficiency on Daily and Work Life
New Glucocorticoid Replacement Strategies for Improvement of Quality of Life and Outcome in Adrenal Insufficiency
The Role of DHEA Replacement
Adrenomedullary Insufficiency in Chronic Adrenal Insufficiency
Mortality and Risk of Adrenal Crisis in Chronic Adrenal Insufficiency
How Can We Prevent Adrenal Crisis and Premature Death in Adrenal Insufficiency Patients?
Congenital Adrenal Hyperplasia: Unresolved Issues
Genotype-Phenotype Disconcordance
Glucocorticoid Treatment and Investigational Treatments
Surgical Intervention in Females with Classical CAH
Adrenal Insufficiency Therapy: How to Keepthe Balance between Good Quality of Life and Low Risk for Long-Term Side Effects?
The Hypothalamic-Pituitary-Adrenal Axis
Mortality and Long-Term Side Effects