Endocrine Abstracts

Background: It is controversial whether the attenuated increase of circulating cortisol to ACTH stimulation predicts treatment response to corticosteroids in patients with critical illness. We investigated whether ACTH testing predicts treatment response to corticosteroids in patients with community-acquired pneumonia (CAP).Methods: We performed a low dose (1 μg) ACTH test on admission in a prospective randomised, double-blind, placebo-controlled mu...

Introduction: The clinical outcome of patients with adrenal insufficiency (AI) has been shown to be less favorable than previously thought. Clinical studies have shown increased mortality, reduced cardiovascular and skeletal health and compromised quality of life, but the impact of this upon healthcare burden is unknown. This research utilised real-world evidence to compare comorbidities, healthcare utilization and expenditures in patients with AI.Method...

Adrenal insufficiency (AI) requires life-long glucocorticoid (GC) treatment, which is associated with an increased risk of metabolic syndrome (MS), probably due to cortisol overexposure for multiple drug daily doses, together with an impairment of quality of life (QoL). Moreover treatment compliance (TC) is reported to be suboptimal in AI patients. The current study aimed at investigating the impact of the switch from twice/thrice daily conventional GCs to once daily dual-rele...

ACTH resistance syndromes (ARS) are rare, severe and heterogeneous diseases that include either familial glucocorticoid deficiency (FDG) or Allgrove syndrome (AS). FDG is a rare autosomal recessive disorder resulting from mutation in genes encoding either the ACTH-receptor (ACTHR) in FDG1, or its accessory protein MRAP, in FDG2. AS is characterized by adrenal insufficiency due to ACTH resistance, alacrimia, and achalasia secondary to mutations in the AAAS gene, which ...

Patients with adrenal insufficiency require increased hydrocortisone (HC) replacement doses during surgery, trauma and infection to avoid life-threatening adrenal crisis. However, currently administered HC doses are chosen empirically rather than on rational grounds, with huge variability in administration modes, total dose and dosing intervals. To conclusively determine serum cortisol levels observed under stress conditions, we firstly collected blood samples from healthy con...

Background: The hypothalamic–pituitary–adrenal axis has a pivotal role in combating acute insults. Glucocorticoids play a role directly or indirectly in the maintenance of normal vascular tone and in potentiating the vasoconstrictor action of catecholamine, associated with septic shock.Aims: To determine the incidence of adrenal insufficiency (AI) and its relation to mortality in patients with septic shock.Settings and de...

Background: Hydrocortisone replacement for primary adrenal insufficiency (PAI) is targeted to mimic circadian endogenous cortisol secretion. Nevertheless, patients on stable treatment report impairments in quality of life. The brain is a major target area for cortisol considering it high density of glucocorticoid receptors and previous studies in patients treated for Cushing’s disease (CD) suggest that hypothalamic-pituitary-adrenal axis dysregulation is related to cognit...

Introduction: Autoimmune polyendocrine syndrome 1 (APS1) is an uncommon, serious autosomal recessive disorder, due to AIRE gene mutations which result in impaired central tolerance. India has a complex genetic structure and also communities with high prevalence of consanguinity, which may result in varied clinical manifestations and genetic mutations.Aims: To study clinical features, interferon-α antibodies (IFNA), AIRE mutations, ...