Endocrine Abstracts

Whereas it was previously accepted that patients needed between 20 and 30mg of hydrocortisone daily, current estimates are much lower at approximately 10mg per day. The next question - which appears uncontroversial - is the choice of drug. This is universally accepted as being hydrocortisone. But is it? The adrenal glands secrete both cortisol and cortisone and there is now increasing evidence that 11betaHSD-1 can, in a tissue-specific manner, convert cortisone to cortisol. Th...

Adrenal insufficiency may occur because of primary failure of the adrenal cortex but can also arise through a secondary failure of ACTH drive to the adrenal. 'Endogenous' suppression of the adrenal cortex may occur in patients with structural abnormalities affecting the hypothalamus/pituitary and in other patients with deficiency of pituitary ACTH secretion and action including those recovering from successful treatment of Cushing's syndromes. 'Exogenous' suppression is found ...

Generalized Glucocorticoid Resistance (GR) is rare. Only about 30 patients and (asymptomatic) family members with GR have been described. The molecular basis of GR has been elucidated in nine patients and affected family members: mutations in the hormone binding domain of the glucocorticoid receptor gene were responsible for the clinical manifestations of GR, while in one individual a mutation in the DNA-binding domain was observed. Clinical presentation varied, including hypo...