Endocrine Abstracts

Introduction: Aggressive ACTH-independent Cushing’s syndrome is rare and frequently related to malignant adrenocortical tumor. However, in exceptional situations, ectopic steroids secretion has been described.Case report: We report the case of an 87 years-old woman referred to our clinic in September 2020 after a low trauma sacral fracture. Her recent medical history revealed the onset, in the previous months, of severe hypokalemia, uncontrolled typ...

Introduction Primary bilateral macronodular adrenal hyperplasia (PBMAH) is potentially responsible for variable degree of cortisol excess. In patients with PBMAH the complete remission of cortisol hypersecretion can be achieved only by performing bilateral adrenalectomy, leading to a persistent hypocortisolism and to a consequent need of a lifelong glucocorticoid replacement therapy. Therefore, bilateral adrenalectomy is worth doing only in patients with severe hypercortisolis...

Background: In the multifarious etiopathogenesis of skeletal fragility, an intriguing novel element is the possible existence of a crosstalk between autonomic nervous system (ANS) function and bone health. Indeed, sympathetic overactivity might stimulate osteoclastogenesis and inhibit osteoblastic proliferation, whereas opposite effects would be exerted by a prevalent parasympathetic activation. Autonomic Nervous System Index (ANSI) is a percent ranked (0–100) unitary pro...

Introduction: Primary aldosteronism (PA) has been described in association with endocrine and non-endocrine neoplasms. Aldosterone-producing adenomas mainly associate with hyperparathyroidism, prolactinomas and pancreatic endocrine tumors, particularly in the context of multiple endocrine neoplasia type 1 MEN1 syndrome. Next-generation sequencing (NGS) studies have shown frequent somatic mutations underlying PA and, rarely, germline mutations of CYP11B1/CYP11B2</e...

Background: The Endocrine Society Guidelines recommend screening for hypercortisolism especially in patients with specific features that best discriminate Cushing’s Syndrome (CS): easy bruising, facial plethora, proximal myopathy and striae. Clinical experience suggests that these features, though suggestive of hypercortisolism, are not enough sensitive. Indeed, patients with hypercortisolism frequently manifest primarily less discriminatory cortisol-related features, suc...

Primary pigmented nodular adrenocortical disease (PPNAD) is a rare form of ACTH-independent Cushing’s syndrome (CS). Approximately 30% of patients with PPNAD are sporadic cases and the other are familial. We describe a case of a patient affected by PPNAD presenting with isolated arterial hypertension. A 19-year-old black female patient was referred to the Endocrinology Unit in september-2021 due to severe arterial hypertension and fatigue. Previous clinical history was un...

Introduction: Dopamine agonists are the first line treatment for prolactinomas. However, some patients may develop dopamine-agonist-resistant hyperprolactinemia, leading to surgery and/or radiotherapy. The persistence of hypogonadism requires testosterone replacement therapy which could theoretically reduce the efficacy of dopamine agonists due to the conversion of testosterone to estradiol, thus, in turn, increasing the resistance to dopamine agonists. Consequently, in these ...

Introduction: Paragangliomas are rare neuroendocrine tumors, that manifest as painless, slow-growing masses, becoming evident only when symptoms of catecholamine overproduction or mass effects emerge. Paragangliomas exhibit a broad spectrum of characteristics, existing as solitary or multiple entities, and may be sporadic or hereditary. These tumors can be either benign or malignant and have origin in the sympathetic or parasympathetic tissues. Paragangliomas are commonly foun...

Glucocorticoids play a significant role in immune modulation and regulation of inflammation. In patients with endogenous glucocorticoid excess (Cushing’s syndrome [CS]) multiple haematological alterations are recognized, such as neutrophil leukocytosis, lymphopenia, and eosinopenia, often leading to severe clinical complications. However, little is known in patients with mild autonomous cortisol secretion (MACS). Serum inflammation-based scores may reliably reflect system...

Background: Serum inflammation-based scores can predict clinical outcomes in several cancer types, including adrenocortical carcinoma (ACC). They may also be altered in benign adrenocortical tumours and correlate with cortisol excess. It is unclear whether the inflammation-based score alterations in ACC reflects malignancy, steroid excess, or both.Methods: A total of 490 patients were included (429 [87.6%] with adrenocortical adenoma [ACA] and 61 [12.4%]...