A Case of Psychosis in a Patient with Secondary Adrenal Insufficiency: A Possible Etiological Role of a Hypocortisolemic-induced Increase in Proinflammatory Cytokines.

Autor:	Spiegel DR; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia., Nelson AB; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia., Lieb DC; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia., Pattison AM; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia., Smith J; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia., Zigrossi P; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia., Godbout E; Dr. Spiegel, Dr. Pattison, Dr. Smith, Dr. Zigrossi, and Dr. Godbout are with the Eastern Virginia Medical School, Department of Psychiatry and Behavioral Sciences in Norfolk, Virginia. Dr. Nelson and Dr. Lieb are with with the Eastern Virginia Medical School, Division of Endocrinology and Metabolism in Norfolk, Virginia.
Jazyk:	angličtina
Zdroj:	Innovations in clinical neuroscience [Innov Clin Neurosci] 2017 Oct 01; Vol. 14 (9-10), pp. 4-10. Date of Electronic Publication: 2017 Oct 01 (Print Publication: 2017).
Abstrakt:	Adrenal insufficiency is divided into three types based on the etiology of its development. In primary adrenal insufficiency, pathology resides in end-organ failure at the level of the adrenal cortex, while in secondary and tertiary adrenal insufficiency, impairment rests in the pituitary gland and hypothalamus, respectively. Regardless of etiology, adrenal insufficiency results in a hypocortisolemic condition. While the relationship between neuropsychiatric symptoms, especially psychosis, and hypercortisolemia has been extensively documented, the development of hypocortisolemia-induced psychosis is less common. We present a case of secondary adrenal insufficiency caused by a pituitary tumor. During the course of evaluation and treatment, the patient developed a psychotic episode. We will briefly review the condition of adrenal insufficiency and propose how hypocortisolemia can result in psychosis. Competing Interests: FUNDING:The authors report no sources of financial support in presentation of this manuscript.
Databáze:	MEDLINE
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