{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:25Z","timestamp":1784557045433,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Acute illness-related stress can result in severe hypercortisolism and bilateral adrenal enlargement in certain patients. We report a case of stress-induced hypercortisolism and bilateral adrenal enlargement in a patient admitted for acute respiratory distress and cardiogenic shock. Bilateral adrenal enlargement and hypercortisolism found during hospitalization for acute illness resolved 3 weeks later following the resolution of acute illness. Acute illness can be a precipitating factor for stress-induced hypercortisolism and bilateral adrenal enlargement. We hypothesize that increased adrenocorticotrophic hormone mediated by corticotrophin-releasing hormone from physical stress resulted in significant adrenal hyperplasia and hypercortisolism. This mechanism is downregulated once acute illness resolves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>Adrenal enlargement with abnormal adrenal function after stress is uncommon in humans; however, if present, it can have self-resolution after the acute illness is resolved.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Stress induces enlargement of the adrenals, and the degree of cortisol elevation could be very massive. This process is acute, and the absence of cushingoid features is expected.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Treatment efforts should be focused on treating the underlying condition.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-22-0329","type":"journal-article","created":{"date-parts":[[2023,5,22]],"date-time":"2023-05-22T08:05:45Z","timestamp":1684742745000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Stress-induced severe transient hypercortisolism with reversible bilateral adrenal enlargement after cardiogenic shock"],"prefix":"10.1530","volume":"2023","author":[{"given":"Jairo Arturo","family":"Nore\u00f1a","sequence":"first","affiliation":[{"name":"Department of Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medha","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Eastern Virginia Medical School, Section of Endocrinology, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandip S","family":"Rawla","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sentara Leigh Hospital, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Medicine, Eastern Virginia Medical School, Section of Endocrinology, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias S","family":"Siraj","sequence":"additional","affiliation":[{"name":"Department of Medicine, Eastern Virginia Medical School, Section of Endocrinology, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Adrenal Cortex","first-page":"489","article-title":"Endocrinology WTo","unstructured":"Endocrinology WTo. Adrenal Cortex489\u2013555."},{"key":"bib2","series-title":"American Journal of Physiology. Endocrinology and Metabolism","first-page":"E965","article-title":"Chronic stress induces adrenal hyperplasia and hypertrophy in a subregion-specific manner","volume":"291","author":"Ulrich-Lai","year":"2006","unstructured":"Ulrich-Lai YMFigueiredo HFOstrander MMChoi DCEngeland WC & Herman JP. Chronic stress induces adrenal hyperplasia and hypertrophy in a subregion-specific manner. American Journal of Physiology. Endocrinology and Metabolism2006291E965\u2013E973. (https:\/\/doi.org\/10.1152\/ajpendo.00070.2006)"},{"key":"bib3","series-title":"European Journal of Case Reports in Internal Medicine","first-page":"000257","article-title":"Acute transient stress induced adrenal hypertrophy and adrenal medullary hyperactivity","volume":"3","author":"Aarella","year":"2016","unstructured":"Aarella VGMudenha ETOkpe A & Fernando DJ. Acute transient stress induced adrenal hypertrophy and adrenal medullary hyperactivity. European Journal of Case Reports in Internal Medicine20163000257. (https:\/\/doi.org\/10.12890\/2015_000257)"},{"key":"bib4","series-title":"Neuroendocrinology","first-page":"263","article-title":"Evidence that the pituitary-adrenal axis does not cross-adapt to stressors: comparison to other physiological variables","volume":"47","author":"Armario","year":"1988","unstructured":"Armario AHidalgo J & Giralt M. Evidence that the pituitary-adrenal axis does not cross-adapt to stressors: comparison to other physiological variables. Neuroendocrinology198847263\u2013267. (https:\/\/doi.org\/10.1159\/000124921)"},{"key":"bib5","series-title":"American Journal of Physiology. Endocrinology and Metabolism","first-page":"E298","article-title":"Zone-specific cell proliferation during compensatory adrenal growth in rats","volume":"288","author":"Engeland","year":"2005","unstructured":"Engeland WCEnnen WBElayaperumal ADurand DA & Levay-Young BK. Zone-specific cell proliferation during compensatory adrenal growth in rats. American Journal of Physiology. Endocrinology and Metabolism2005288E298\u2013E306. (https:\/\/doi.org\/10.1152\/ajpendo.00307.2004)"},{"key":"bib6","series-title":"Archives of General Psychiatry","first-page":"384","article-title":"Adrenal gland enlargement in major depression. A computed tomographic study","volume":"49","author":"Nemeroff","year":"1992","unstructured":"Nemeroff CBKrishnan KRReed DLeder RBeam C & Dunnick NR. Adrenal gland enlargement in major depression. A computed tomographic study. Archives of General Psychiatry199249384\u2013387. (https:\/\/doi.org\/10.1001\/archpsyc.1992.01820050048008)"},{"key":"bib7","series-title":"Endocrine","first-page":"153","article-title":"Disappearing adrenal masses","volume":"38","author":"Hermsen","year":"2010","unstructured":"Hermsen IGPolak MP & Haak HR. Disappearing adrenal masses. Endocrine201038153\u2013157. (https:\/\/doi.org\/10.1007\/s12020-010-9368-7)"},{"key":"bib8","series-title":"Annals of the Royal College of Surgeons of England","first-page":"W17","article-title":"Diagnostic dilemma of adrenal enlargement after acute pancreatitis","volume":"90","author":"Motallebzadeh","year":"2008","unstructured":"Motallebzadeh RGodfrey E & Jamieson NV. Diagnostic dilemma of adrenal enlargement after acute pancreatitis. Annals of the Royal College of Surgeons of England200890W17\u2013W19. (https:\/\/doi.org\/10.1308\/147870808X303029)"},{"key":"bib9","series-title":"Frontiers in Endocrinology (Lausanne)","article-title":"Attenuation value in adrenal incidentalomas: a longitudinal study","volume":"12","author":"Ceccato","year":"2021","unstructured":"Ceccato FTizianel IVoltan GMaggetto GMerante Boschin IQuaia ECrimi F & Scaroni C. Attenuation value in adrenal incidentalomas: a longitudinal study. Frontiers in Endocrinology (Lausanne)202112 794197. (https:\/\/doi.org\/10.3389\/fendo.2021.794197)"},{"key":"bib10","series-title":"Diagnostics (Basel)","article-title":"Radiomics in cross-sectional adrenal imaging: A systematic review and quality assessment study","volume":"12","author":"Stanzione","year":"2022","unstructured":"Stanzione AGalatola RCuocolo RRomeo VVerde FMainenti PPBrunetti A & Maurea S. Radiomics in cross-sectional adrenal imaging: A systematic review and quality assessment study. Diagnostics (Basel)202212. (https:\/\/doi.org\/10.3390\/diagnostics12030578)"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/2\/EDM22-0329.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/2\/EDM22-0329.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/2\/EDM22-0329.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:02Z","timestamp":1784555282000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3665"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,1]]},"references-count":10,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/edm-22-0329","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,1]]}}}