Journal of Endocrinological Investigation

, Volume 15, Issue 11, pp 849–852 | Cite as

Hormonal and immunological pattern in a patient with Acquired Immuno Deficiency Syndrome related complex and Cushing’s syndrome

  • R. Rossi
  • A. P. Tommaselli
  • N. Panza
  • M. R. Ghiggi
  • G. Rezza
  • M. Giuliani
  • B. Suligoi
  • R. De Mercato
  • Gaetano Lombardi
Case Report


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.


A.R.C. A.I.D.S. HIV Cushing’s 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    World Health Organization Acquired immunodeficiency syndrome (AIDS): 1987 revision of CDC/WHO case definition for AIDS. WKLY Epidemiol. Rec. 63: 1, 1988.Google Scholar
  2. 2.
    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.PubMedCrossRefGoogle Scholar
  3. 3.
    Biglieri E.G. ACTH effects on aldosterone, Cortisol and other steroids. Hosp. Pract. 24: 145, 1989.Google Scholar
  4. 4.
    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.Google Scholar
  5. 5.
    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.PubMedCrossRefGoogle Scholar
  6. 6.
    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.PubMedCrossRefGoogle Scholar
  7. 7.
    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.PubMedGoogle Scholar
  8. 8.
    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.CrossRefGoogle Scholar
  9. 9.
    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.Google Scholar
  10. 10.
    Sonino N., Boscaro M., Merola G., Mantero F. Prolonged treatment of Cushing’s disease by ketoconazole. J. Clin. Endocrinol. Metab. 61: 718, 1985.PubMedCrossRefGoogle Scholar
  11. 11.
    Angeli A., Frairia R. Ketoconazole therapy in Cushing disease. Lancet 1: 821, 1985.PubMedCrossRefGoogle Scholar
  12. 12.
    Dlulhy R.G. The growing spectrum of HIV-related endocrine abnormalities (Editorial). J. Clin. Endocrinol. Metab. 70: 563, 1990.CrossRefGoogle Scholar
  13. 13.
    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.Google Scholar
  14. 14.
    Lee M., Ho D.D., Gurney M. Functional interaction and partial homology between human immunodeficiency virus and neuroleukin. Science 51: 1047, 1987.CrossRefGoogle Scholar
  15. 15.
    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.CrossRefGoogle Scholar
  16. 16.
    Basedowsky H., Del Rey A., Sorkin E., Dinarello C.A. Immunoregulatory feedback between interleukin-1 and glucocorticoid hormones. Science 233: 652, 1986.CrossRefGoogle Scholar
  17. 17.
    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.CrossRefGoogle Scholar
  18. 18.
    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.PubMedCrossRefGoogle Scholar
  19. 19.
    Bateman A., Singh A., Krai T., Salomon S. The immune-hypothalamic-pituitary-adrenal axis. Endocr. Rev. 10: 92, 1989.PubMedCrossRefGoogle Scholar
  20. 20.
    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.PubMedCentralPubMedGoogle Scholar
  21. 21.
    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.PubMedCrossRefGoogle Scholar
  22. 22.
    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.CrossRefGoogle Scholar
  23. 23.
    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.CrossRefGoogle Scholar
  24. 24.
    Imura H., Fukata J., Mori T. Cytokines and endocrine function: an interaction between the immune and neuroendocrine systems. Clin. Endocrinol. (Oxf.) 35: 107, 1991.CrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 1992

Authors and Affiliations

  • R. Rossi
    • 1
  • A. P. Tommaselli
    • 1
  • N. Panza
    • 1
  • M. R. Ghiggi
    • 1
  • G. Rezza
    • 2
  • M. Giuliani
    • 2
  • B. Suligoi
    • 2
  • R. De Mercato
    • 3
  • Gaetano Lombardi
    • 1
  1. 1.Cattedra di Endocrinologia, II Facoltà di Medicina e ChirurgiaUniversità di NapoliNapoliItaly
  2. 2.Istituto Superiore SanitàCentro Operativo per l’AIDSItaly
  3. 3.C.N.R.RomaItaly

Personalised recommendations