Gurpreet Anand - Academia.edu (original) (raw)

Papers by Gurpreet Anand

Case Reports, Feb 1, 2019

A 47-year-old Caucasian man was referred to our clinic with a severe clinical and biochemical phe... more A 47-year-old Caucasian man was referred to our clinic with a severe clinical and biochemical phenotype of endogenous hypercortisolism for further evaluation and treatment. In addition to confirming adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome, we found left temporal hemianopsia, massively increased prolactin, increased growth hormone/insulin-like growth factor 1 values, hypogonadotropic hypogonadism and central hypothyroidism. As the cause of these abnormalities we revealed an invasive macroadenoma of the pituitary secreting ACTH, prolactin and growth hormone, resulting not only in a clinically predominant picture of Cushing’s syndrome but also causing hypogonadotropic hypogonadism and central hypothyroidism. The patient responded surprisingly well to dopamine agonist treatment leading not only to normalisation of prolactin levels but also to clinical and biochemical remission of Cushing’s syndrome. Tumour size decreased successively in follow-up MRI scans. Despite lacking immunohistochemical analysis of tumour tissue, we assume plurihormonal secretion of ACTH, prolactin and growth hormone from pituitary macroadenoma, which fortunately responded well to dopamine agonist treatment.

BMJ Case Reports, 2019

World journal of gastrointestinal endoscopy, Jan 16, 2014

To determine whether a newly developed respiratory rate monitor can practically and accurately mo... more To determine whether a newly developed respiratory rate monitor can practically and accurately monitor ventilation under propofol sedation in combination with standard monitoring. Patients [American Society of Anesthesiologists (ASA) Classification I-III] scheduled for elective colonoscopy under propofol sedation were monitored with a new device that measures the respiratory rate based on humidity in expired air. Patients with clinically significant cardiac disorders or pulmonary disease and patients requiring emergency procedures were excluded from study participation. All of the patients also received standard monitoring with pulse oximetry. This was a single-center study conducted in a community hospital in Switzerland. After obtaining written informed consent from all subjects, 76 patients (51 females and 25 males) were monitored during colonoscopy under propofol sedation. The primary endpoint was the occurrence of any respiratory event (apnea or hypopnea). Apnea was defined as ...

Open Journal of Nephrology, 2013

Hypomagnesaemia is a common finding that occurs in hospitalised patients and can be caused by ren... more Hypomagnesaemia is a common finding that occurs in hospitalised patients and can be caused by renal or extrarenal wasting. Because it is not routinely tested, even severe hypomagnesaemia can be missed. In cases of extrarenal wasting, the kidney can decrease its magnesium excretion to very low levels. A systematic diagnostic approach allows the proper diagnosis and treatment of hypomagnesaemia. We report on a 72-year-old Caucasian male patient with repeated drops and amyosthenia caused by severe hypomagnesaemia. In this report, we discuss the pathophysiology, clinical signs, diagnostic investigation and treatment of magnesium depletion.

The Journal of Clinical Endocrinology & Metabolism, 2020

Context Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due ... more Context Appropriate management of adrenal insufficiency (AI) in pregnancy can be challenging due to the rarity of the disease and lack of evidence-based recommendations to guide glucocorticoid and mineralocorticoid dosage adjustment. Objective Multicenter survey on current clinical approaches in managing AI during pregnancy. Design Retrospective anonymized data collection from 19 international centers from 2013 to 2019. Setting and Patients 128 pregnancies in 113 women with different causes of AI: Addison disease (44%), secondary AI (25%), congenital adrenal hyperplasia (25%), and acquired AI due to bilateral adrenalectomy (6%). Results Hydrocortisone (HC) was the most commonly used glucocorticoid in 83% (97/117) of pregnancies. Glucocorticoid dosage was increased at any time during pregnancy in 73/128 (57%) of cases. In these cases, the difference in the daily dose of HC equivalent between baseline and the third trimester was 8.6 ± 5.4 (range 1-30) mg. Fludrocortisone dosage was in...

Experimental and Clinical Endocrinology & Diabetes, 2018

Endocrine active adrenal tumors are associated with a relevant risk of complications during surge... more Endocrine active adrenal tumors are associated with a relevant risk of complications during surgery, either due to direct hemodynamic effects of the hormone excess or due to hormone related comorbidities. Over the last decades, careful preoperative evaluation and improved peri-interventional medical management of affected patients has resulted in a significant reduction of perioperative complications. In addition, improvement in anesthesia and surgical techniques with the feasibility of laparoscopic adrenalectomy have contributed to reduce morbidity. Nevertheless, there are still several challenges to be considered in the perioperative care of these patients. Due to the rarity of functionally active adrenal tumors, there are no prospective data available to guide clinical management. Accordingly, most recommendations are based on retrospective data analysis, expert opinion or carry weak evidence based on small series or case reports. The aim of this review is to summarize the curren...

European journal of endocrinology, Jan 30, 2017

With the introduction of hormonal substitution therapy in the 1950s, adrenal insufficiency has be... more With the introduction of hormonal substitution therapy in the 1950s, adrenal insufficiency has been turned into a manageable disease in pregnant women. In fact, in the light of glucocorticoid replacement therapy and improved obstetric care, it is realistic to expect good maternal and fetal outcome in patients with adrenal insufficiency. However, there are still a number of challenges such as establishing the diagnosis of adrenal insufficiency in pregnant women and optimizing the treatment of adrenal insufficiency and related comorbidities prior as well as during pregnancy. Clinical and biochemical diagnosis of a new-onset adrenal insufficiency may be challenging because of overlapping symptoms of normal pregnancy as well as pregnancy induced changes in cortisol values. Physiological changes occurring during pregnancy should be taken in account while adjusting the substitution therapy. The high proportion of reported adrenal crisis in pregnant women with adrenal insufficiency highlig...

Praxis, 2017

Zusammenfassung. Nebenniereninzidentalome sind Raumforderungen der Nebenniere, welche in einer Bi... more Zusammenfassung. Nebenniereninzidentalome sind Raumforderungen der Nebenniere, welche in einer Bildgebung der Bauchregion unerwartet gefunden werden, ohne dass vorher eine zielführende Klinik und die Labordiagnostik einer Nebennierenerkrankung vorliegen und zur Bildgebung Anlass gegeben hätten. Das Inzidentalom ist keine eigenständige Diagnose. Es sollte grundsätzlich (bereits bei der Erstdiagnose) die Dignität der Raumforderung (benigne versus maligne) festgelegt und eine allfällig relevante Hormonproduktion ausgeschlossen oder nachgewiesen werden. Bei hormoninaktiven Tumoren sowie bei morphologisch eindeutig benignen Tumoren (Dichte <10 Hounsfield-Einheiten, Grösse <4 cm) kann auf eine weitere Nachsorge verzichtet werden, falls auch im Verlauf keine klinischen Verdachtsmomente hinzukommen. Bei unklaren und komplexen Fällen sollte die geeignete Nachsorge in einem interdisziplinären Tumorboard besprochen werden. Wenn die Indikation für eine Operation gestellt wird (z.B. hormon...

BMJ case reports, Jan 13, 2017

Iron deficiency is common and can be effectively treated with parenteral iron infusion. We report... more Iron deficiency is common and can be effectively treated with parenteral iron infusion. We report a case of an iron-deficient and vitamin D-deficient woman who developed severe symptomatic hypophosphataemia following intravenous ferric carboxymaltose administration. We stress the need of increased awareness of this potential complication among physicians. Patients should be informed of this complication and instructed to report for follow-up if they experience new musculoskeletal symptoms or worsening of tiredness. As severe hypophosphataemia is usually symptomatic, we recommend screening symptomatic patients for this complication. Recognising and treating the possible exacerbating factors, especially vitamin D deficiency, might be a simple measure to mitigate this complication.