Endocrine Abstracts

Background: ACTH-secreting pituitary adenomas represent two-thirds of Cushing’s syndrome (CS), the so-called Cushing’s disease (CD). These tumors are sometimes >10 mm in maximal diameter (macro-CD), but the majority of them are <10 mm (micro-CD). The aim of this study was to compare baseline characteristics of patients with micro-CD and macro-CD.Materials and methods: Clinical, hormonal and radiological data of 226 patients with CD were...

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder characterized by impaired cortisol secretion and androgen excess. The mainstay of CAH treatment is glucocorticoid (GC) replacement, necessary to avoid adrenal crisis and manage androgen excess. The delicate balance between GC under/overtreatment is crucial to prevent metabolic and cardiovascular complications. Dual-release hydrocortisone (Plenadren®) is once-daily modified-release formulat...

Introduction: Adrenal crisis (AC) is the most severe manifestation of adrenal insufficiency, still responsible for a high mortality of affected patients, especially with primary adrenal insufficiency (PAI). Its presentation is insidious, leading to a delayed diagnosis and treatment. Patient education is crucial in the prevention and self-management of AC.Aim of the study: We want to evaluate the incidence, features (symptoms, signs, laboratory findings),...

Background: The recommended first-line screening tests for Cushing’s syndrome (CS) are serum cortisol after 1-mg dexamethasone suppression test (FDST), urinary free cortisol (UFC), and late-night salivary cortisol (LNSC). CS is often diagnosed late: the clinical presentation of endogenous hypercortisolism overlaps with common clinical conditions.Methods: We analyzed the diagnostic test accuracy of FDST, UFC, and LNSC in patient...

Cushing’s syndrome (CS) is a severe disease associated with elevated morbidity and mortality rates, up to four times higher than those of general population. Whether the positive effects of cortisol-lowering medications is widely documented in overt CS cases, its impact on mild or subclinical CS remains unclear since limited clinical investigations have been performed in patients with subclinical hypercortisolism. In this study, we retrospectively analysed clinical data f...

Objective: This study aimed to evaluate the performance of simple and clinical/imaging-corrected unconventional indices in predicting the selectivity of adrenal vein sampling (AVS) and the lateralization of aldosterone hypersecretion in patients with primary aldosteronism (PA).Methods: Data of all consecutive patients with a proven diagnosis of PA who underwent AVS for subtype differentiation in two Italian referral centers were analyzed retrospectively....

Background: Differential diagnosis of ACTH-dependent hypercortisolism is crucial to indicate a proper treatment and is based on CRH-, high-dose dexamethasone suppression-test (HDDST) and pituitary MRI. However, up to 50% of cases of Cushing’s disease (CD) present a negative MRI or a visible lesion < 6 mm. In these patients, guidelines suggest to perform bilateral inferior petrosal sinus sampling (BIPSS) in order to establish a correct diagnosis. Aim of this study was ...

The association between acromegaly and increased cardiovascular morbidity and mortality is widely recognised. The aim of this retrospective multicentric study is to evaluate the impact of different therapeutic approaches on the progression of cardiovascular risk (CVR) in acromegalic patients. At diagnosis and last follow up (follow up time of 13 ± 8 years),we assessed BMI, blood pressure, glycaemic and lipid profile, GH and IGF1 levels in 199 patients with acromegaly (116...

Ectopic Cushing syndrome (EAS) is a rare condition characterized by ACTH-dependent hypercortisolism resistant to normal physiologic suppression by glucocorticoids. EAS is due to an extra-pituitary tumor producing bioactive molecules generated by post-translational cleavage of the proopiomelanocortin gene (POMC). EAS is associated with significant morbidity and mortality and although surgical resection of the primary ACTH-producing tumor remains the mainstay of therapy, not all...

Background: Familial isolated pituitary adenomas (FIPA) is a rare inherited disorder accounting for about 2% of pituitary adenomas. Mutations in the Aryl hydrocarbon receptor Interacting Protein (AIP) gene have been described in about 15% of FIPA families and rarely in early onset sporadic pituitary adenomas. Among the AIP mutations reported so far, the R304X represents, after the Finnish founder mutation Q14X, the second most common one.Me...