Etomidate in the management of severe Cushing's disease and MRSA bacteraemia in a district general hospital in the United Kingdom
SUMMARY: We report our experience on managing a case of florid Cushing's disease with Methicillin-resistant Staphylococcus aureus (MRSA) sepsis using intravenous etomidate in the intensive care unit of a UK district general hospital.
LEARNING POINTS: Severe Cushing's syndrome is associated with high morbidity and mortality. Etomidate is a safe and effective medical therapy to rapidly lower cortisol levels even in the context of severe sepsis and immunosuppression. Etomidate should ideally be administered in an intensive care unit but is still feasible in a district general hospital. During treatment with etomidate, accumulation of serum 11β-deoxycortisol (11DOC) levels can cross-react with laboratory cortisol measurement leading to falsely elevated serum cortisol levels. For this reason, serum cortisol measurement using a mass spectrometry assay should ideally be used to guide etomidate prescription.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:2019 |
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| Enthalten in: |
Endocrinology, diabetes & metabolism case reports - 2019(2019) vom: 12. Sept. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wong, Stephanie Wei Ping [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 27.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1530/EDM-19-0044 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM30565280X |
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| 100 | 1 | |a Wong, Stephanie Wei Ping |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Etomidate in the management of severe Cushing's disease and MRSA bacteraemia in a district general hospital in the United Kingdom |
| 264 | 1 | |c 2019 | |
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| 500 | |a Date Revised 27.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a SUMMARY: We report our experience on managing a case of florid Cushing's disease with Methicillin-resistant Staphylococcus aureus (MRSA) sepsis using intravenous etomidate in the intensive care unit of a UK district general hospital | ||
| 520 | |a LEARNING POINTS: Severe Cushing's syndrome is associated with high morbidity and mortality. Etomidate is a safe and effective medical therapy to rapidly lower cortisol levels even in the context of severe sepsis and immunosuppression. Etomidate should ideally be administered in an intensive care unit but is still feasible in a district general hospital. During treatment with etomidate, accumulation of serum 11β-deoxycortisol (11DOC) levels can cross-react with laboratory cortisol measurement leading to falsely elevated serum cortisol levels. For this reason, serum cortisol measurement using a mass spectrometry assay should ideally be used to guide etomidate prescription | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 2019 | |
| 650 | 4 | |a ACTH | |
| 650 | 4 | |a ACTH stimulation | |
| 650 | 4 | |a Adrenal | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Bacteraemia | |
| 650 | 4 | |a Blood pressure | |
| 650 | 4 | |a C-reactive protein | |
| 650 | 4 | |a Citalopram* | |
| 650 | 4 | |a Cortisol | |
| 650 | 4 | |a Cortisol (serum) | |
| 650 | 4 | |a Cushing's disease | |
| 650 | 4 | |a Deoxycortisol | |
| 650 | 4 | |a Dexamethasone suppression | |
| 650 | 4 | |a Etomidate | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Glucocorticoids | |
| 650 | 4 | |a Glucose (blood) | |
| 650 | 4 | |a Haematoma | |
| 650 | 4 | |a Haemoglobin A1c | |
| 650 | 4 | |a Histopathology | |
| 650 | 4 | |a Hydrocortisone | |
| 650 | 4 | |a Hypercortisolaemia | |
| 650 | 4 | |a Hyperglycaemia | |
| 650 | 4 | |a Hypertension | |
| 650 | 4 | |a Hypokalaemia | |
| 650 | 4 | |a Hypophysectomy | |
| 650 | 4 | |a Hypoxia | |
| 650 | 4 | |a Immunoassay* | |
| 650 | 4 | |a Insulin | |
| 650 | 4 | |a MRI | |
| 650 | 4 | |a MRSA* | |
| 650 | 4 | |a Mass spectrometry* | |
| 650 | 4 | |a Metyrapone | |
| 650 | 4 | |a Myasthaenia | |
| 650 | 4 | |a Novel treatment | |
| 650 | 4 | |a Obesity | |
| 650 | 4 | |a Olanzapine | |
| 650 | 4 | |a Pituitary | |
| 650 | 4 | |a Pituitary adenoma | |
| 650 | 4 | |a Pneumonia | |
| 650 | 4 | |a Potassium | |
| 650 | 4 | |a Potassium chloride | |
| 650 | 4 | |a Ramipril | |
| 650 | 4 | |a Resection of tumour | |
| 650 | 4 | |a Respiratory failure | |
| 650 | 4 | |a Sepsis | |
| 650 | 4 | |a September | |
| 650 | 4 | |a Spironolactone | |
| 650 | 4 | |a Transsphenoidal surgery | |
| 650 | 4 | |a United Kingdom | |
| 650 | 4 | |a White | |
| 650 | 4 | |a White blood cell count | |
| 700 | 1 | |a Yap, Yew Wen |e verfasserin |4 aut | |
| 700 | 1 | |a Narayanan, Ram Prakash |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Jubouri, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Grossman, Ashley |e verfasserin |4 aut | |
| 700 | 1 | |a Daousi, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Mahgoub, Yahya |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Endocrinology, diabetes & metabolism case reports |d 2013 |g 2019(2019) vom: 12. Sept. |w (DE-627)NLM236279777 |x 2052-0573 |7 nnns |
| 773 | 1 | 8 | |g volume:2019 |g year:2019 |g day:12 |g month:09 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1530/EDM-19-0044 |3 Volltext |
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