Changes in the fecal concentrations of cortisol and androgen metabolites in captive male jaguars (Panthera onca) in response to stress

In the present study we determined the efficacy of the measurement of fecal cortisol and androgen metabolite concentrations to monitor adrenal and testicular activity in the jaguar (Panthera onca). Three captive male jaguars were chemically restrained and electroejaculated once or twice within a period of two months. Fecal samples were collected daily for 5 days before and 5 days after the procedure and stored at -20ºC until extraction. Variations in the concentrations of cortisol and androgen metabolites before and after the procedure were determined by solid phase cortisol and testosterone radioimmunoassay and feces dry weight was determined by drying at 37ºC for 24 h under vacuum. On four occasions, fecal cortisol metabolite levels were elevated above baseline (307.8 ± 17.5 ng/g dry feces) in the first fecal sample collected after the procedure (100 to 350 percent above baseline). On one occasion, we did not detect any variation. Mean (± SEM) fecal androgen concentration did not change after chemical restraint and electroejaculation (before: 131.1 ± 26.7, after: 213.7 ± 43.6 ng/g dry feces). These data show that determination of fecal cortisol and androgen metabolites can be very useful for a noninvasive assessment of animal well-being and as a complement to behavioral, physiological, and pathological studies. It can also be useful for the study of the relationship between adrenal activity and reproductive performance in the jaguar.

Plasma cortisol response to 1 microgram adrenocorticotropin at 0800 h & 1600 h in healthy subjects.

BACKGROUND & OBJECTIVES: Cortisol response to 250 micrograms adrenocorticotropin (ACTH) exhibits no circadian variation. Information on the circadian variation, if any, in cortisol response to 1 microgram ACTH, which is considered as a physiological dose is not available. As the 1 microgram ACTH stimulation test is projected as an outpatients procedure with no time constraint, this information is very important. Hence, this study was designed to assess whether any circadian variability exists in cortisol response to 1 microgram ACTH in healthy subjects. METHODS: Thirty six healthy volunteers (23 male and 13 female) with mean age of 32.2 +/- 9.0 yr were consecutively studied after obtaining informed consent. On day 1, prestimulated and stimulated plasma cortisol samples were collected at 0800 h and, at 30 and 60 min following an intravenous bolus of 1 microgram ACTH, and on day 3, plasma cortisol samples were similarly collected at 1600 h. Cortisol estimation was done by a sensitive and specific radioimmunoassay. Stimulated plasma cortisol of 500 nmol/1 or more was defined as a normal response. RESULTS: The prestimulated and peak cortisol levels at 0800 h (377.5 +/- 93.3 and 729.1 +/- 183.2 nmol/l) were higher (P < 0.001 and P < 0.01) than those at 1600 h (230.1 +/- 75.7 and 665.8 +/- 138.6 nmol/l). However, a stimulated cortisol response of 500 nmol/l or more was observed at both 0800 h and 1600 h in all subjects at 30 min but not at 60 min. The [symbol: see text] (peak-basal) response was higher at 1600 h than that at 0800 h (432.8 +/- 136.8 vs 351.5 +/- 177.3, P < 0.01). INTERPRETATION & CONCLUSION: The demonstration of normal cortisol response to 1 microgram ACTH both at 0800 h and 1600 h suggests that the test can be performed at any time of the day.

Detección de la deficiencia de 21 hidroxilasa en su forma no clásica en una población argentina de 100 niñas con pubarquia precoz / Detection of non classical 21-O-Hase deficiency in an argentinean population of 100 girls with precocious pubarche

Antecedentes: el déficit no clásico de 21 hidroxilasa es una alteración de la esteroideogénesis adrenal que puede expresarse como pubarquia precoz en la infancia. Para analizar la prevalencia de ésta diferencia en una población argentina con pubarquia precoz, se estudiaron 100 niñas (edad cronológica: 6,55ñ1,62 años) con aparición de vello púbico antes de los 8 años de edad. Métodos: se evaluaron la talla, la edad ósea (EO) y el grado de desarrollo (Tanner). Se efectuó una prueba de estimulación adrenal con ACTH 0,25 mg i.v., determinando 17OH progesterona y cortisol basales y a los 60 min. Los resultados se compararon con el monograma de María New et al. Se midieron las concentraciones basales de sulfato de dehidroepiandrosterona (SDHEA), androstenediona (A), testosterona (T) y proteína ligadora de hormonas sexuales (SHBG). Resultados: clínicamente se distinguieron 2 grupos, 82 niñas con pubarquia precoz aislada (PPA) y 18 con pubarquia precoz asociada con hipertrofia de clítoris (PPH). Tres pacientes PPA y dos PPH presentaron concentraciones elevadas de 17OHP lo que permitió efectuar el diagnóstico de hiperplasia suprarrenal de comienzo tardío. El resto de las pacientes se diagnosticó como pubarquia precoz idiopática. Las concentraciones de T, A y SDHEA en las pacientes con pubarquia precoz idiopática estuvieron en los límites puberales normales, mientras que las concentraciones de SHBG se encontraron en el límite prepuberal. Conclusiones: en nuestra población estudiada se encontró un 5 por ciento de déficit no clásico de 21-hidroxilasa. Esto indicaría la necesidad de solicitar la prueba de estimulación con ACTH en niñas con pubarquia precoz para la detección de ésta deficiencia enzimática

Hipocortisolismo por déficit selectivo de CRH de resolución espontánea: análisis de un caso / Hypocortisolism related to selective deficiency of CRH with spontaneous resolution: a case analysis

Hypocortisolism derived from hypothalamic deficiency of corticotropin releasing hormone is a highly unusual cause of adrenal insufficiency and its pathogenesis is still not fully understood. We report a mildly symptomatic patient having repeated low basal plasma cortisol levels with normal cortisol response to ACTH and lisine-vasopresine; however, she showed a clearly limited response to deep hypoglycemia, while GH reached a normal concomitant response. After 7 years of cortisol replacement the endogenous cortisol returned spontaneously to normality. The rest of pituitary function has been always normal

Síndrome de Cushing: una revisión a propósito de una casuística nacional / Cushing's syndrome: a review apropos of a national series

Cushing's syndrome occurs rarely; in analyzing 50 cases studied at our institution we discuss the following aspects: syndromatic diagnosis, etiologic differentiation into the 3 categories of the syndrome, and therapeutic strategies for each variety. We postulate that non-endocrinologists should be responseible for the syndromatic diagnosis, easily done by using 2 simple tools: the measurement of basal free urinary cortisol and the performance of and overnight suppression of the adrenal axis with 1 mg of dexamethasone (Nugent's test). In contrast, the etiologic diagnosis and the therapeutic interventions should be strictly restricted to highly specialized institutions having well seasoned endocrinologists, a reliable endocrine laboratory, easy access to computed tomographies of the brain and abdomen as well as to nuclear resonance imaging of the brain. The usefulness of our in-house devised vasopressin challenge following overnight dexamethasone suppression for the etiologic diagnosis is highlighted. Neurosurgical expertise in the transphenoidal approach to the pituitary gland as well surgeons well experience in adrenal surgery sre a must to offer a reasonable chance of success to patients with the syndrome. Forty one (82 percent) of the series were female patients, 78 percent were pituitary-depent and 22 percent pituitary-independent Cushings. Six out of 8 (75 percent) of the adrenal tumors were carcinomas. Only 3 patients (6 percent) qualified as ectopic ACTH syndormes. The easiest variety to diagnose and treat was the adrenal adenoma (2 cases); adrenal carcinomas were always incurable. The ectopic ACTH syndrome was amenable to successful medical treatment with ketoconazole or surgical resolution with complete resection od the offending tumor (1 of 3 cases) or bilateral adrenalectomy (2 of 3 cases) Pituitary-dependent Cushing are quite tricky to diagnose and difficult to treat. Transphenoidal resection of the offending microadenoma was successful in only 43.5 percent (10/23) of cases and we experienced 3 recurrences of the syndrome even after 8 years of successful removal of the pituitary adenoma. The remainder had to be cured by bilateral adrenalectomy. Seven out 39 patients with Cushing's disease (18 percent) ultimately died for a variety of reasons; six out of 6 patients (100 percent) with adrenal carcinoma died of dissemination; 2 out of 2 adrenal adenomas cured and 1 out of the 3 ectopic ACTH syndromes died of dissemination of a malignant thymic carcinoma. We conclude that Cushing's syndrome is a serious, underdiagnosed disorder, which should be suspected and diagnosed by the non specialized physician and then referred to a specialized center for expert etiologic diagnosis and surgical therapy

Salivary cortisol in the assessment of adrenocortical function in patients with pulmonary tuberculosis.

Adrenocortical function was assessed on the basis of changes in salivary cortisol in patients with pulmonary tuberculosis and the findings compared with those in healthy subjects. A method of direct radioimmunoassay of salivary cortisol was standardized and the sensitivity was 0.8 nmol/l. Cortisol levels in saliva were significantly higher in the patients than in the healthy subjects (P less than 0.001). The diurnal rhythm of cortisol secretion was disturbed in the patients with a significant increase in salivary cortisol beyond 1800 h. While dexamethasone caused an appreciable suppression (87%), stimulation with ACTH (tetracosactrin) resulted in a marked increase in salivary cortisol, the increase being significantly higher in the healthy subjects than in the patients (P less than 0.001). Attempts to classify subjects as positive or negative responders to tetracosactrin based on increases in salivary cortisol in relation to plasma cortisol changes were however not successful, as the agreement between the two methods ranged from 73 to 80 per cent with various criteria used.

Evaluación dinámica de cortisol libre urinario/hora en pacientes infanto-juveniles normales y obesos / Dinamic Evaluation of urinary/hour cortisol libre in normale and obese infant-juvenile patients

Para evaluar la excreción normal del cortisol libre urinario/hora (CLUh) en pacientes infanto-juveniles y determinar posibles diferencias entre grupos prepuberales y puberales o entre la población normal y obesa, se estudiaron 33 pacientes normales y 18 obesos. El ritmo circadiano se estudió con muestras obtenidas de 7 a 8 h de 21 a 22 h y de 22 a 23 h y la inhibición post-Dexametasona (DXM)(1mg a las 23h) en la muestra de 7 a 8 h del día siguiente. Los resultados obtenidos (ng cortisol/mg creatinina urinaria) expresados en x +- DS fueron: normales de 7 a 8 h; 106+-63, 21 a 22 h; 10+-8, 22 a 23 h; 8+-9, post DXM 8+-10; Obesos de 7 a 8 h; 105+-65, 21 a 22 h; 8+-8, 22 a 23 h; 6+-3, post DXM 5+-3. La población normal mostró diferencias estadísticas significativas entre la muestra horaria matutina vs. las nocturnas, y vs. la muestra post Dxm. No hubo diferencias significativas entre las muestras nocturnas, entre los valores basales de la población prepuberal y puberal, ni entre la población normal y la obesa. En conclusión: 1) La determinación del CLUh permite la evaluación suprarrenal en pacientes infanto-juveniles. 2) Es posible estudiar la variación circadiana realizando la recolección nocturna de 21 a 22 h, sin prolongar la vigilia infantil fuera de sus horarios habituales. 3) E CLUh no permite diferenciar a la población normal de la obesa.

Funçäo da córtex adrenal em pacientes com paracoccidioidomicose: estudo através da dosagem radioimunológica do ACTH plasmático / Function of the adrenal cortex in patients with paracoccidioidomycosis: study by radioimmune assay of plasma ACTH

Foram estudados 15 pacientes com paracoccidioidomicose (PMC), dos quais 14 com a forma disseminada e um com a forma pulmonar progressiva, sendo 10 virgens de tratamento e cinco com recidiva da micose. O diagnóstico micológico foi feito através da evidenciaçäo etiológica em espécimes obtidos das lesöes: exame direto (KOH), histopatológico e/ou cultura. A funçäo adrenocortical foi estudada através das dosagens hormonais basais (cortisol plasmático-ritmo circadiano, ACTH plasmático e 17 OHCS na urina de 24 horas) e pós-teste de estímulo pelo ACTH exógeno (Cortrosina), empregando-se kits comerciais para essas dosagens. O trabalho visou a detecçäo da elevaçäo dos níveis plasmáticos de ACTH, a descoberta de pequenas reservas adrenocorticais e a evidenciaçäo de graus menores de falência adrenal (insuficiência corticoadrenal primária) por meio da dosagem do ACTH plasmático (método radioimunoensaio) em paracoccidioidomicóticos. Os resultados demonstram a presença de três grupos de pacientes: 1) ACTH plasmático < 20pg/ml; 2) ACTH plasmático entre 20 e 50pg/ml; e 3) ACTH plasmático > 58pg/ml. Feita a correlaçäo ACTH-cortisol pós-teste de estímulo pelo ACTH exógeno, oito pacientes situaram-se no grupo 1, sendo que dois deles apresentaram queda menor que duas vezes o basal, enquanto que nos quatro pacientes do grupo 3 ficou bem evidenciada a elevaçäo do ACTH plasmático em níveis superiores ao normal, dos quais dois mostraram resposta nula pós-estímulo, junto a sintomas e sinais de doença de Addison, satisfazendo critérios de insuficiência supra-renal primária. Na correlaçäo ACTH-17 OHCS pós-teste de estímulo pelo ACTH, oito pacientes situaram-se no grupo 1, sendo que sete apresentaram níveis de 17 OHCS menores que duas vezes o basal. Em três dos quatro pacientes do grupo 3, ficou comprovada insuficiência supra-renal primária, ao passo que o quarto paciente do grupo mostrou resposta aos 17 OHCS superior a três vezes o basal