Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma

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dc.contributor.authorRoss, Ian L
dc.contributor.authorMarais, Suzaan
dc.contributor.authorRaubenheimer, Peter
dc.contributor.authorAbratt, Raymond
dc.contributor.authorIsaacs, Sedick
dc.contributor.authorSoule, Steven
dc.date.accessioned2016-07-29T07:22:37Z
dc.date.available2016-07-29T07:22:37Z
dc.date.issued2003
dc.date.updated2015-12-21T12:07:01Z
dc.description.abstractIntroduction. Lung cancer is the leading cause of cancer mortality in most countries. The adrenal glands are common sites of metastatic lung cancer as approximately 40% of subjects with stage 4 bronchogenic carcinoma have adrenal metastases. The prevalence of biochemical hypoadrenalism is, however, remarkably poorly documented. Objectives. Our study aimed to determine the prevalence of primary hypoadrenalism, as defined by a subnormal cortisol response to the 250 µg adrenocorticotrophic hormone (ACTH) stimulation test, in patients with stage 3 and 4 lung cancer. Methods. Thirty patients with stage 3 and 4 bronchogenic carcinoma were prospectively recruited from the bronchus clinic. Demographic data and electrolytes were recorded and each patient had a 250 µg ACTH stimulation test to determine the prevalence of overt adrenal insufficiency, defined as a +30 minute cortisol of less than 550 nmol/l. Results. The median age and quartile deviation was 62 (10) years and the median basal cortisol was 429.5 (321) nmol/l. The median peak cortisol was 828.5 (342) nmol/l (range 536 - 1 675 nmol/l). Twenty-eight patients (93.3%) had an appropriate rise of cortisol to greater than 550 nmol/l following 250 µg ACTH stimulation. Two patients (6.7%) had mild primary adrenal failure with a peak cortisol between 500 and 550 nmol/l associated with a raised plasma ACTH concentration (131.4 and 10.5 pmol/l, normal 2.2 - 10 pmol/l). Twenty-eight patients (92.9%) were normonatraemic, while the two hyponatraemic patients had biochemical evidence of the syndrome of inappropriate antidiuretic hormone secretion. Conclusion. In conclusion, despite evidence that the adrenal glands of patients with disseminated bronchogenic carcinoma are frequently affected by metastatic disease, biochemical evidence of clinically significant hypoadrenalism is relatively uncommon and is not accurately predicted by electrolyte abnormalities.
dc.identifier.apacitationRoss, I. L., Marais, S., Raubenheimer, P., Abratt, R., Isaacs, S., & Soule, S. (2003). Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/21007en_ZA
dc.identifier.chicagocitationRoss, Ian L, Suzaan Marais, Peter Raubenheimer, Raymond Abratt, Sedick Isaacs, and Steven Soule "Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma." <i>South African Medical Journal</i> (2003) http://hdl.handle.net/11427/21007en_ZA
dc.identifier.citationRoss, I. L., Marais, S., Raubenheimer, P., Abratt, R., Isaacs, S., & Soule, S. (2003). Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma: original article. South African Medical Journal, 93(9), p-695.
dc.identifier.issn2078-5135
dc.identifier.ris TY - Journal Article AU - Ross, Ian L AU - Marais, Suzaan AU - Raubenheimer, Peter AU - Abratt, Raymond AU - Isaacs, Sedick AU - Soule, Steven AB - Introduction. Lung cancer is the leading cause of cancer mortality in most countries. The adrenal glands are common sites of metastatic lung cancer as approximately 40% of subjects with stage 4 bronchogenic carcinoma have adrenal metastases. The prevalence of biochemical hypoadrenalism is, however, remarkably poorly documented. Objectives. Our study aimed to determine the prevalence of primary hypoadrenalism, as defined by a subnormal cortisol response to the 250 µg adrenocorticotrophic hormone (ACTH) stimulation test, in patients with stage 3 and 4 lung cancer. Methods. Thirty patients with stage 3 and 4 bronchogenic carcinoma were prospectively recruited from the bronchus clinic. Demographic data and electrolytes were recorded and each patient had a 250 µg ACTH stimulation test to determine the prevalence of overt adrenal insufficiency, defined as a +30 minute cortisol of less than 550 nmol/l. Results. The median age and quartile deviation was 62 (10) years and the median basal cortisol was 429.5 (321) nmol/l. The median peak cortisol was 828.5 (342) nmol/l (range 536 - 1 675 nmol/l). Twenty-eight patients (93.3%) had an appropriate rise of cortisol to greater than 550 nmol/l following 250 µg ACTH stimulation. Two patients (6.7%) had mild primary adrenal failure with a peak cortisol between 500 and 550 nmol/l associated with a raised plasma ACTH concentration (131.4 and 10.5 pmol/l, normal 2.2 - 10 pmol/l). Twenty-eight patients (92.9%) were normonatraemic, while the two hyponatraemic patients had biochemical evidence of the syndrome of inappropriate antidiuretic hormone secretion. Conclusion. In conclusion, despite evidence that the adrenal glands of patients with disseminated bronchogenic carcinoma are frequently affected by metastatic disease, biochemical evidence of clinically significant hypoadrenalism is relatively uncommon and is not accurately predicted by electrolyte abnormalities. DA - 2003 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2003 SM - 2078-5135 T1 - Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma TI - Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma UR - http://hdl.handle.net/11427/21007 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/21007
dc.identifier.urihttp://www.samj.org.za/index.php/samj/article/view/2330/1597
dc.identifier.vancouvercitationRoss IL, Marais S, Raubenheimer P, Abratt R, Isaacs S, Soule S. Overt hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma. South African Medical Journal. 2003; http://hdl.handle.net/11427/21007.en_ZA
dc.language.isoeng
dc.publisherHealth & Medical Publishing Group
dc.publisher.departmentDivision of Radiation Oncologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.subject.otherLung cancer
dc.subject.otherHypoadrenalism
dc.subject.otherPrevalence
dc.subject.otherCancer staging
dc.titleOvert hypoadrenalism is uncommon in patients with stage 3 and 4 bronchogenic carcinoma
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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