Endocrine Abstracts

Context: Primary aldosteronism (PHA) is the most common cause of secondary hypertension. Distinguishing unilateral (UAH) from bilateral (BAH) and other causes of PHA is one of the greatest challenges in the diagnostic process. Adrenal venous sampling (AVS) is widely considered to be the gold standard for subtype differentiation.Methods: Technical and diagnostic outcome of AVS was analysed retrospectively in 59 patients with PHA who underwent AVS at the U...

In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism a mutagenesis screen after treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the established mouse lines with hyperaldosteronism was phenotypically and genetically characterized. Affected animals showed an increased aldosterone to renin ratio (males unaffected, 1.1±0.1 pg/ml per ng per ml per hour v...

Glucocorticoid receptor (GR or NR3C1) is a ligand-dependent transcription factor that plays an essential role in differentiation, development, inflammatory responses and energy balance and is implicated in several human diseases. Eleven germinal GR mutations have been described so far, responsible for glucocorticoid resistance with variable clinical presentation.We report original heterozygous GR mutations in three independent patients, which have been i...

Context: Mitotane due to its adrenolytic action is highly effective in long-term management of ACTH-dependent Cushing’s syndrome (CS). However, the slow onset of its anticortisolic effect makes its use problematic in severe CS, when very rapid therapeutic response is required. Association with metyrapone and ketoconazole, rapidly acting steroidogenesis inhibitors, could warrant CS control while waiting for the full efficiency of mitotane and thus avoid urgently performed ...

Testicular adrenal rest tumors (TART), described in patients with classic congenital adrenal hyperplasia (CAH) secondary to 21-hydroxylase deficiency, are responsible for Leydig cell failure and impaired spermatogenesis. These tumors, often unresponsive to intensified glucocorticoid therapy and surgical resection, may lead to infertility or even sterility. Here, we studied the effects of long term treatment with mitotane (Lysodren), a specific adrenolytic agent, on TART in 4 C...

Over the past several years, growing evidence suggested that serum cortisol is associated with increased cardiovascular (CVD) mortality in patients with chronic heart failure. The prognostic significance of serum cortisol concentration (SCC) in patients with acute coronary syndrome (ACS) however is unknown.In the prospective Ludwigshafen Risk and Cardiovascular Health (LURIC) study 3316 patients (median age: 63.5 (56.3–70.6) years; 30.2% women) were...