Endocrine Abstracts

Introduction: Polymorphisms of the glucocorticoid (NR3C1) and mineralocorticoid receptor (NR3C2) have been linked to the regulation of HPA-axis and to glucocorticoid sensitivity. We investigated whether NR3C1 and NR3C2 polymorphisms correlate with the occurence of adrenal crises (AC) in patients with primary adrenal insufficiency (PAI).Material and methods: We investigated 100 patients with PAI (70% women, mean age 51±15 years). DNA was extracted fr...

Available glucocorticoid (GC) replacement regimens in adrenal insufficiency (AI) only roughly correspond to physiological steroid profiles. Control of substitution quality is therefore difficult but significant, as even mild chronic over- or under-replacement may be clinically relevant. FKBP5 regulates GC receptor sensitivity by reducing its affinity to cortisol when bound to the receptor complex. FKBP5 methylation has been inversely correlated with cortisol levels both in hea...

Background: Mitotane is regularly used in patients with adrenocortical carcinoma (ACC) adjuvantly, in patients with high risk of recurrence, and in advanced disease. Multiple effects of mitotane result in adrenal insufficiency in virtually all patients. However, it is unclear how frequently the hypothalamic-pituitary-adrenal (HPA) axis is recovering after treatment discontinuation. Here, we aim to investigate the HPA axis after treatment with mitotane.Me...

Background: Potentially fatal adrenal crises (AC) still occur in educated patients with adrenal insufficiency (AI). Identifying predisposing factors is necessary for prevention in this patient population.Objectives: Investigating clinical and biochemical fingerprints of increased susceptibility to AC.Material and methods: Our study population included 260 patients with chronic AI, classified as high and low risk according to the fr...

Background: The chemokine receptor CXCR4 and its associate receptor CXCR7, that modulates CXCR4 function, have been associated with tumor progression and metastasis in human cancers. In ACC, Ki67 index and ENSAT stage are the most important prognostic parameters.Objective: To assess expression of CXCR4 and CXCR7 in adrenal cancer and correlate results with clinical outcome.Methods: CR expression was assessed by immunohistochemistry...

Introduction: Onset of hyperkalemia has previously been reported during the administration of hypertonic resuscitation solutions. Since the hypertonic saline infusion test has recently been validated for the diagnosis of diabetes insipidus, we aimed to investigate the course of plasma potassium levels during the test.Material and Methods: Data of 144 patients undergoing osmotic stimulation with hypertonic saline infusion at 11 tertiary medical centres in...

Introduction Retrospective analyses suggest that patients with adrenal insufficiency (AI) have an increased risk for cardiovascular diseases which was mainly attributed to non-physiological cortisol profiles and/or supraphysiological replacement doses.Material and methodsWe analyzed the 24-hour blood pressure (BP) profiles in patients with primary (PAI) and secondary (SAI) AI. BP threshold criteria for hypert...

Introduction: Retrospective analyses suggest an increased risk for cardiovascular diseases in patients with adrenal insufficiency (AI), mainly due to supraphysiological replacement doses.Objective: To evaluate the 24-hour blood pressure (BP) profile in patients with primary (PAI) and secondary (SAI) AI.Material and methods: BP threshold criteria for hypertension and dipping status of the 2018 ESC/ESH guidelines were used (24-h: &#8...

Introduction: Glucocorticoid (GC) replacement regimens in adrenal insufficiency (AI) only roughly correspond to physiological steroid profiles. Moreover, control of substitution quality is difficult and signs of clinically relevant mild chronic over- or under-replacement might be omitted. FKBP5 regulates GC receptor sensitivity by reducing its affinity to cortisol when bound to the receptor complex. FKBP5 methylation has been inversely correlated with cortisol levels both in h...

Objective: Glucocorticoid excess impairs immune function, thereby predisposing patients with endogenous Cushing’s syndrome (CS) to infections. However, it is still not clear whether there is a CS-subtype specific pattern in white blood cell (WBC) and WBC differential (WBCD) count.Methods: Retrospective monocentric cohort study in patients with either overt endogenous CS or adrenal adenomas with autonomous cortisol secretion (ACS), with WBC and WBCD ...