Endocrine Abstracts

Background: Measurement of steroid metabolite excretion in urine by gas chromatography-mass spectrometry (GC-MS) provides a comprehensive profile of an individual’s adrenal and gonadal steroid production. It has long been acknowledged as a useful tool for diagnosis of inborn disorders of steroidogenesis leading to congenital adrenal hyperplasia and disorders of sex development. Ratios of steroid metabolites can be employed as surrogates for enzymatic activities of distinc...

Background: Adrenal insufficiency (AI) results from deficient production/action of glucocorticoids (GCs), with or without deficiency of mineralocorticoids (MC) and adrenal androgens. GC treatment is essential but some patient needs MC therapy to allow sodium(Na+) retention, potassium(K+) excretion and to maintain normal plasma volume and blood pressure. Much attention has focused on optimization of GC replacement but no consensus exists for optimization o...

Context: Adrenocortical carcinoma (ACC) is an aggressive malignancy with high recurrence rates. Regular post-operative follow-up imaging is essential, but associated with high radiation exposure and frequent diagnostic ambiguity. Urine steroid metabolomics has been described as a novel diagnostic tool for the detection of adrenocortical malignancy. Here we present the first clinical study assessing the performance of this innovative approach in the follow-up of patients with c...

Introduction: The development of accurate non-invasive markers to diagnose and stage non-alcoholic fatty liver disease (NAFLD) is of high importance to reduce the need for an invasive liver biopsy. These markers help to stratify patients at highest risk of hepatic and cardio-metabolic complications and allow tracking of disease progression and treatment response. We have previously described alterations in glucocorticoid metabolism that are differentially regulated across the ...

Background: Adrenocortical carcinoma (ACC) has an aggressive but heterogenous behaviour. ENSAT stage and Ki67 proliferation index are used to predict clinical outcome but are limited in distinguishing patients with best outcome. We aimed to validate the prognostic role of clinical and histopathological parameters alone or combined by applying a previously proposed points-based score (mGRAS, Lippert JCEM 2018) to a large multicentre cohort of ACC patients.<p class="abstext"...

Background: Improved knowledge of the range of anomalies encountered in DSD may improve our understanding of the underlying aetiology. However, given the rarity of these conditions, thorough analysis of congenital anomalies in DSD has not previously been possible.Aims: To discover the frequency of congenital anomalies in DSD, and to identify patterns of anomalies within specific conditions.Methods: 1050 registered cases on The I-DS...

BackgroundThe ESE-ENSAT guidelines suggest adjuvant mitotane for patients with adrenocortical carcinoma (ACC) at high risk of recurrence following radical surgery. This indication has a limited evidence base, lacking results from randomized controlled trials. No suggestion is available in low-risk patients, since studies did not stratify patients for prognosis. The randomized controlled study ADIUVO compared the efficacy of adjuvant mitotane (MIT) treatm...

BackgroundBenign adrenocortical tumours are found in 3–5% of adults and can be non-functioning (NFAT) or associated with cortisol excess. The latter group divides into patients with clinically overt signs (adrenal Cushing’s syndrome, CS) and patients lacking CS signs (mild autonomous cortisol excess, MACE). The 1 mg-overnight dexamethasone suppression test (DST) further differentiates MACE into MACE-1 (possible MACE; post-DST cortisol 50–1...

IntroductionIn response to the COVID-19 pandemic, delivery of medical education has transitioned from predominantly in-person teaching to virtual platforms. Simulation-based learning is a successful teaching modality to develop clinicians’ knowledge and skill, while safeguarding patients. Simulation has traditionally been performed via face-to-face role play, however many of its principles can be adapted for remote use. We explored the effectiveness...

BackgroundPolycystic Ovary Syndrome (PCOS) is a common reproductive, endocrine and metabolic disorder. The UK National Institute of Health and Care Excellence (NICE) recommends evaluating emotional wellbeing in women with PCOS. Therefore, we conducted a health service evaluation to assess emotional wellbeing.MethodsWe invited women with PCOS via social media to complete an online survey in September 2020, sup...