Abstract
A case of Cushing’s syndrome in a 24-yr-old homosexual with an AIDS-related complex is reported. In this patient certain symptoms common to both diseases, i.e. weakness, myalgia and muscle atrophy were accentuated, whereas other symptoms pathognomic of the human immunodeficiency virus (HIV) infection, i.e. lymphoadenopathies and weight loss, were less pronounced by the high levels of circulating adrenal steroids. Ketoconazole was administered po in order to block adrenal steroidogenesis, the drug caused a remarkable fall of cortisol serum concentrations, but was unable to modify significantly the immunological pattern of the patient. Our data suggest that changes of serum adrenal steroid levels have little effect on the immune network of patients with AIDS.
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References
World Health Organization Acquired immunodeficiency syndrome (AIDS): 1987 revision of CDC/WHO case definition for AIDS. WKLY Epidemiol. Rec. 63: 1, 1988.
Membreno L., Irony I., Dere W., Klein R., Biglieri E.G., Cobb E. Adrenocortical function in acquired immunodeficiency syndrome. J. Clin. Endocrinol. Metab. 65: 482, 1987.
Biglieri E.G. ACTH effects on aldosterone, Cortisol and other steroids. Hosp. Pract. 24: 145, 1989.
Verges B., Chavanet P., Desgres J., Vaillant G., Waldner A., Brun J.M., Putelat R. Adrenal function in HIV infected patients. Acta Endocrinol. (Copenh.) 121: 633, 1989.
Guenthner E., Rabinowe S.L., Vab Niel A., Dluhy R. Primary Addison’s disease in a patient with acquired immunodeficiency syndrome. Ann. Intern. Med. 100: 847, 1984.
Greene L.W., Cole W., Greene J.B., Lury B., Lowe E. Adrenal insufficiency as a complication of the acquired immunodeficiency syndrome. Ann. Intern. Med. 101: 497, 1984.
Norbiato G., Bevilacqua M., Vogo T., Baldi G., Chebat E., Bertora P., Moroni M., Galli M., Oldenburg N. Cortisol resistance in acquired immunodeficiency syndrome. J. Clin. Endocrinol. Metab. 74: 608, 1992.
Pont A., Williams P.L., Losse D.S., Feldman D., Reitz R.E., Bochra C., Stevens D.A. Ketoconazole blocks adrenal steroids synthesis. Ann. Intern. Med. 97: 370, 1987.
Conch R.M., Muller J., Perry Y.S., Winter J.S.D. Kinetic analysis of inhibition of human adrenal steroidogenesis by ketoconazole. J. Clin. Endocrinol. Metab. 65: 552, 1987.
Sonino N., Boscaro M., Merola G., Mantero F. Prolonged treatment of Cushing’s disease by ketoconazole. J. Clin. Endocrinol. Metab. 61: 718, 1985.
Angeli A., Frairia R. Ketoconazole therapy in Cushing disease. Lancet 1: 821, 1985.
Dlulhy R.G. The growing spectrum of HIV-related endocrine abnormalities (Editorial). J. Clin. Endocrinol. Metab. 70: 563, 1990.
Verges B., Chavanet P., Desgres J., Kisterman J.P., Waldner A., Vaillant G., Portier H., Brun J.M., Putelat R. Endocrine abnormalities in HIV infections. Press Med. 19: 1267, 1990.
Lee M., Ho D.D., Gurney M. Functional interaction and partial homology between human immunodeficiency virus and neuroleukin. Science 51: 1047, 1987.
Koening S., Gendelman H.E., Howard E., Orenstein J.M., Dal Canto M.C., Pezeshkpour G.H., Yungbluth M., Janotta F., Aksqmit A., Martin M.A., Fauci A.S. Detection of AIDS virus in macrophages in brain tissue from AIDS patients with encephalopathy. Science 233: 1089, 1986.
Basedowsky H., Del Rey A., Sorkin E., Dinarello C.A. Immunoregulatory feedback between interleukin-1 and glucocorticoid hormones. Science 233: 652, 1986.
Stosic Griyicic S., Simic M.M. Modulation of interleukin 1 production by activated macrophages: in vitro action of hydrocortisone, colchicine, and cytochalasin B. Cell. Immunol. 69: 235, 1982.
Dupont E., Hnygen K., Schandern L., Vandercruys M., Palfliet K., Wybran J. Influence of in vivo immunosuppressive drugs on production of lymphokines. Transplantation 39: 143, 1985.
Bateman A., Singh A., Krai T., Salomon S. The immune-hypothalamic-pituitary-adrenal axis. Endocr. Rev. 10: 92, 1989.
Fauci A.S. Mechanism of corticosteroid action on lymphocyte subpopulations. I. Redistribution of circulating T and B lymphocytes to the bone marrow. Immunology 28: 669; 1975.
Gatti G., Cavallo R., Sartori M.L., del Ponte D., Masera R., Salvadori A., Carignola R., Angeli A. Inhibition by Cortisol of human natural killer (NK) cell activity. J. Steroid Biochem. 26: 49, 1987.
Bernardinini R., Kamilaris T.C., Calogero A.E., Johnson E. O., Gomez M.T., Gold P.W., Chrousos G.P. Interactions between tumor necrosis factor-α, hypothalamic corticotropin-releasing hormone, and adrenocorticotropin secretion in the rat. Endocrinology 126: 2876, 1990.
Bernardinini R., Calogero A.E., Mauceri G., Chrousos G.P. Rat hypothalamic corticotropin-releasing hormone secretion in vitro is stimulated by interleukin-1 in an eicosanoid dependent manner. Life Sci. 47: 1601, 1990.
Imura H., Fukata J., Mori T. Cytokines and endocrine function: an interaction between the immune and neuroendocrine systems. Clin. Endocrinol. (Oxf.) 35: 107, 1991.
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Rossi, R., Tommaselli, A.P., Panza, N. et al. Hormonal and immunological pattern in a patient with Acquired Immuno Deficiency Syndrome related complex and Cushing’s syndrome. J Endocrinol Invest 15, 849–852 (1992). https://doi.org/10.1007/BF03348818
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DOI: https://doi.org/10.1007/BF03348818