Hypercoagulability in Cushing’s syndrome: From arterial to venous disease

St-Jean, Matthieu; Lim, Dawn Shao Ting; Langlois, Fabienne

doi:10.1016/j.beem.2021.101496

Cited by 15 publications

(9 citation statements)

References 83 publications

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“…23 Thus, it was easily speculated that pulmonary embolism was also closely related to hypercoagulability. 24 It has been indicated that the process of the diabetic patients undergoing Charcot foot reconstruction was complicated by the pulmonary embolism initiation. 25 This was in accordance with our result reporting a pulmonary embolism after the surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary embolism following the third thoracic tuberculosis surgery: A case report and literature review

Chen

Liu

Liang

et al. 2022

Clinical Laboratory Analysis

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Background: The study aimed to analyze the clinical effects of pulmonary embolism succeeding a third surgery conducted for multiple recurrences in thoracic tuberculosis (TB). Case report: A 74-year-old female patient developed thoracic tuberculosis and was subsequently treated in our hospital in March 2019, October 2020, and February 2021. The third surgical intervention included anterolateral thoracic lesion resection, internal fixation, posterior spinal tuberculous sinus resection, and debridement with suture. The operative time was 172 min resulting in a substantial intraoperative blood loss (2321 ml). Postoperative re-examination of chest CTPA indicated a strip filling defect and pulmonary embolism in the external branch of the right middle lobe of the lung. After completing the active treatment, the D-dimer quantification, WBC, CRP, and ESR values were 1261 ng/ml, 7.71 × 10 9 /L, 74.66 mg/L, and 63 mm, respectively. Chest CTPA re-examination after the treatment showed no signs of pulmonary embolism. Conclusion:Patients with a long-term history of multiple operations, high BMI, cerebral infarction, diabetes, and older age group were more likely to develop pulmonary embolism after spinal tuberculosis surgery. Thus, the possibility of postoperative pulmonary embolism should be thoroughly analyzed before any subsequent surgical treatment in patients with recurrent spinal tuberculosis.

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Section: Discussionmentioning

confidence: 99%

“… 23 Thus, it was easily speculated that pulmonary embolism was also closely related to hypercoagulability. 24 …”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism following the third thoracic tuberculosis surgery: A case report and literature review

Chen

Liu

Liang

et al. 2022

Clinical Laboratory Analysis

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“…Patients with AI and mHC have a higher risk of cardiovascular events (including coronary artery disease, myocardial infarction, stroke, transient ischemic attack and heart failure) and mortality compared to patients with nonsecreting AI and controls [ 83 , 88 ]. Importantly, the increased cardiovascular risk and mortality in mHC is independent of the presence of diabetes and hypertension [ 89 , 90 , 91 , 92 ].…”

Section: Pathophysiology Of the Systemic Consequences Of Mild Hypercortisolismmentioning

confidence: 99%

Pathophysiology of Mild Hypercortisolism: From the Bench to the Bedside

Favero

Cremaschi

Parazzoli

et al. 2022

IJMS

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Mild hypercortisolism is defined as biochemical evidence of abnormal cortisol secretion without the classical detectable manifestations of overt Cushing’s syndrome and, above all, lacking catabolic characteristics such as central muscle weakness, adipose tissue redistribution, skin fragility and unusual infections. Mild hypercortisolism is frequently discovered in patients with adrenal incidentalomas, with a prevalence ranging between 5 and 50%. This high variability is mainly due to the different criteria used for defining this condition. This subtle cortisol excess has also been described in patients with incidentally discovered pituitary tumors with an estimated prevalence of 5%. To date, the mechanisms responsible for the pathogenesis of mild hypercortisolism of pituitary origin are still not well clarified. At variance, recent advances have been made in understanding the genetic background of bilateral and unilateral adrenal adenomas causing mild hypercortisolism. Some recent data suggest that the clinical effects of glucocorticoid (GC) exposure on peripheral tissues are determined not only by the amount of the adrenal GC production but also by the peripheral GC metabolism and by the GC sensitivity. Indeed, in subjects with normal cortisol secretion, the combined estimate of cortisol secretion, cortisone-to-cortisol peripheral activation by the 11 beta-hydroxysteroid dehydrogenase enzyme and GC receptor sensitizing variants have been suggested to be associated with the presence of hypertension, diabetes and bone fragility, which are three well-known consequences of hypercortisolism. This review focuses on the pathophysiologic mechanism underlying both the different sources of mild hypercortisolism and their clinical consequences (bone fragility, arterial hypertension, subclinical atherosclerosis, cardiovascular remodeling, dyslipidemia, glucose metabolism impairment, visceral adiposity, infections, muscle damage, mood disorders and coagulation).

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“…В настоящее время для пациентов с гиперкортицизмом и COVID-19, поскольку оба состояния связаны с высоким риском тромбоэмболии [40][41][42], рекомендуется коррекция гиперкоагуляции, которая вызывает капиллярный, венозный и/или артериальный тромбоз [43,44]. Наряду с гиперкоагуляцией, пациенты с гиперкортицизмом и COVID-19 подвержены высокому риску вторичных бактериальных или грибковых инфекций [45], поэтому необходима эмпирическая профилактика антибиотиками широкого спектра действия, особенно у госпитализированных пациентов [18].…”

Section: гиперкортицизм и Covid-19unclassified

Pituitary and COVID-19: review

Buyvalenko

Perepelova

Zolotareva

et al. 2022

Probl Endokrinol (Mosk)

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A severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread around the world since was first scientifically described in December 2019. At present approximately 400 million people have suffered from the disease, almost 6 million people have died.SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are expressed in several endocrine glands, including the pituitary, pancreas, thyroid, ovaries, and testes. Thus, the endocrine glands may be a direct target for SARS-CoV-2. The main risk factors for severity of the COVID-19 are obesity, arterial hypertension, diabetes mellitus (DM), vertebral fractures, which potentially predisposes patients to a severe course of COVID-19.In this review, we present current data on the course of COVID-19 in patients with hypothalamic-pituitary diseases, and also discuss treatment for endocrinopathies during to COVID-19.

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Hypercoagulability in Cushing’s syndrome: From arterial to venous disease

Cited by 15 publications

References 83 publications

Pulmonary embolism following the third thoracic tuberculosis surgery: A case report and literature review

Pulmonary embolism following the third thoracic tuberculosis surgery: A case report and literature review

Pathophysiology of Mild Hypercortisolism: From the Bench to the Bedside

Pituitary and COVID-19: review

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