Searchable abstracts of presentations at key conferences in endocrinology
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18th European Congress of Endocrinology

Eposter Presentations

Adrenal cortex (to include Cushing's)

ea0041ep1 | Adrenal cortex (to include Cushing's) | ECE2016

Establishment and characterization of immortalized porcine 11β HSD1-hepatocytes

Kang Hee Young , Hwang Jeong Ung , Lee Myoungho , An Jin Yong , Jeung Eui-Bae

Glucocorticoid, known as cortisol, is a steroid hormone essential to the maintenance of homeostasis, and is released in response to stress and low blood glucose concentration. It is converted from cortisone by 11β hydroxysteroid dehydrogenase type 1 (11β HSD1). The liver plays a major organ in metabolism, has numerous functions, mostly consists of hepatocytes, and is a principal target of cortisol. In murine model, it was observed that too much cortisol or overexpres...

ea0041ep2 | Adrenal cortex (to include Cushing's) | ECE2016

Effect of heterophilic antibody interference in ACTH immunoassay to Subclinical Cushing’s Syndrome screening: A pilot study

Yener Serkan , Ozisik Seciil , Cavdar Umit , Demirpence Mustafa , Comlekci Abdurrahman

Heterophilic antibodies are well-known interferent factors affecting most immunoassays. However, they have been poorly evaluated in routine clinical practice. Definition of Subclinical Cushing’s Syndrome (SCs) has been arbitrary and prevalence has shown significant variations related with the diversity of the diagnostic tests. In most of the guidelines a low or suppressed corticothropin (ACTH) level has been suggested as an important predictor of SCs. Here, we sought to i...

ea0041ep3 | Adrenal cortex (to include Cushing's) | ECE2016

Pro-coagulant imbalance in patients with Cushing disease detected by thrombin generation assay is associated with increased levels of neutrophil extracellular trap-related factors

Verrua Elisa , Sala Elisa , Malchiodi Elena , Ferrante Emanuele , Arnaldi Giorgio , Trementino Laura , Tripodi Armando , Semeraro Fabrizio , Ammollo Concetta T , Colucci Mario , Padovan Lidia , Chantarangkul Veena , Peyvandi Flora , Mantovani Giovanna

Patients with Cushing disease (CD) are at increased risk of venous thromboembolism (VTE). It was surmised, but not conclusively shown that the risk is related to plasma hypercoagulability secondary to the effect of glucocorticoids. This study aimed at investigating the thrombin-forming potential of patients with CD in the presence of a functioning protein C system by adding its main physiological activator, thrombomodulin. Under these experimental conditions, which mimic close...

ea0041ep4 | Adrenal cortex (to include Cushing's) | ECE2016

Missed opportunities for appropriate diagnosis and management of profound hyponatraemia – Audit of District General Hospital experience

Cai Paris Limin , Thomas Christopher James , Zeb Qaiser , Anazodo Cosmas , Malik Mohamed

Population and methodology: Patients with profound hyponatraemia (serum Na ≤125 mmol/l) admitted 1 November 2014 to 30 April 2015 were identified using hospital admission registry, laboratory’s database and qualitative data from the patients’ electronic records. Discharge summaries and death certificates were reviewed.Objectives: This is a retrospective audit set to asses: i) whether initial investigations of hyponatraemia were performed ...

ea0041ep5 | Adrenal cortex (to include Cushing's) | ECE2016

Paradoxical worsening of lipid metabolism after successful treatment of primary aldosteronism

Adolf Christian , Asbach Evelyn , Dietz Anna , Hahner Stefanie , Quinkler Marcus , Rump Lars Christian , Bidlingmaier Martin , Treitl Marcus , Hallfeldt Klaus , Beuschlein Felix , Reincke Martin

Primary aldosteronism (PA) describes the most frequent cause of secondary arterial hypertension. Aldosterone itself represents a BP-independent cardiovascular risk factor associated with increased rates of morbidity and mortality. Recently a worsening of lipid metabolism after treatment has been described.Objective: Our aim was to analyse changes in lipid parameters according to treatment outcome in PA patients. Data of 215 consecutive PA patients with u...

ea0041ep6 | Adrenal cortex (to include Cushing's) | ECE2016

Bilateral adrenalectomy is a safe long-term procedure

Coralie Moutarde , Robert Caiazzo , Catherine Bauters , Christine Cortet , Christine Do Cao , Jean-Louis Wemeau , Francois Pattou , Marie-Christine Vantyghem

The aim of this retrospective study was to compare the long-term evolution of adrenal insufficiency (AI) due to bilateral adrenal surgery (S) or medical cause (M).Seventy AI patients (mean age 41±16 years; 60% female, similar in both groups) were followed during a mean 6-year period (2–16); 38 were AI after bilateral adrenalectomy (60% Cushing), 32 AI of medical origin (62% polyglandular autoimmune syndrome). BMI, blood pressure (BP), fasting b...

ea0041ep7 | Adrenal cortex (to include Cushing's) | ECE2016

Radiological formula for differentiating between secreting and non secreting adrenal adenomas

Vicennati Valentina , Casadio Elena , Pagotto Uberto , Dalmazi Guido Di , Rinaldi Eleonora , Mosconi Cristina , Papadopoulos Dimitris , Golfieri Rita , Pasquali Renato

Introduction: Purpose of this study is to find a radiological score and to correlate radiological characteristics of adrenal adenomas and functional parameters to predict subclinical glucocorticoid secretion.Methods and materials: This retrospective study included 55 patients with adenomas, investigated through CT with adrenal protocol assessing diameters, HU values of the unenhanced and contrast enhanced phases (enhanced–E, and 15 min delayed enhan...

ea0041ep7b | Adrenal cortex (to include Cushing's) | ECE2016

Clinical and metabolic profile of male-to-female transgenders in Zamboanga Peninsula

Pang Alex , Barrera Jerome

Introduction: The effect of self-prescribed cross-sex hormone therapy on Male-to-Female (MtF) transgenders do not appear to have been well investigated and can be associated with potential serious longterm complications. The main purpose of this study is to look at the clinical and metabolic profile, and cardiovascular outcomes of MtF transgenders in Zamboanga Peninsula.Methodology: This is a cross-sectional study, done to determine the clinical and meta...

ea0041ep8 | Adrenal cortex (to include Cushing's) | ECE2016

Serum but not salivary cortisol levels are influenced by daily glycemic oscillations in type 2 diabetes

Bellastella Giuseppe , Maiorino Maria Ida , Bellis Annamaria De , Scappaticcio Lorenzo , Esposito Katherine , Giugliano Dario

Diurnal salivary and plasma cortisol variations are considered valid expression of circadian cortisol rhythmicity. The aim of this study was to assess the reliability of salivary and plasma cortisol evaluating if glycemia and glycemic oscillations may interfere with their concentration.Methods: Forty-seven type 2 diabetic patients and 31 controls were studied for glycemic profile and diurnal salivary and plasma cortisol variations on two contemporary sam...

ea0041ep9 | Adrenal cortex (to include Cushing's) | ECE2016

The use of [131I] 6β-iodomethyl-norcholesterol scintigraphy in evaluation of adrenal tumors

Papierska Lucyna , Rabijewski Michal , Kaminska Anna , Cwikla Jaroslaw , Otto Maciej , Cichocki Andrzej , Samsel Radoslaw , Zgliczynski Wojciech

Adrenal cortex scintigraphy has been used as early as in the 1970s, however, in recent years, it has been a rarely performed and unappreciated examination. In fact, this examination does not provide a perfect view on morphology of adrenal glands, however it provides an assessment of the examined tumor’s function. The aim of this work is to present our experience with adrenal cortex scintigraphy in assessment of adrenal tumors.We present a series of ...

ea0041ep10 | Adrenal cortex (to include Cushing's) | ECE2016

Computerized tomography and magnetic resonance imaging features for differentiating functioning adrenal lesions from non-functioning adrenal lesions

Koseoglu Derya , Tuna Mazhar Muslum , Imga Narin Nasiroglu , Dogan Bercem Aycicek , Basaran Mehtap Navdar , Senel Cagdas , Tuncel Altug , Berker Dilek , Guler Serdar

Aim: The aim of the present study was to evaluate the characteristic features of computerized tomography (CT) and magnetic resonance imaging (MRI) among functioning and non-functioning adrenal lesions.Materials and methods: We retrospectively reviewed the medical records of patients with adrenal mass. CT or MRI findings were available in 89 functioning and 148 non-functioning adrenal lesions (NFAL). Of the patients with functioning adrenal mass, 34 were ...

ea0041ep11 | Adrenal cortex (to include Cushing's) | ECE2016

ARMC5 mutation and Cushing syndrome due to bilateral macronodular adrenal hyperplasia – case report

Manuel Costa Maria , Oliveira Joana , Luis Castedo Jose , Magalhaes Joao , Carvalho Davide

Introduction: Bilateral macronodular adrenal hyperplasia ACTH-independent (BMAH) represents less than 1% of the causes of Cushing’s syndrome (CS). Studies have shown that mutations in the gene ARMC5 are a common cause of family BMAH and are associated with severe clinical disease and the development of meningiomas.Case report: 64-years-old man presented to our consult due to bilateral macronodular adrenal hyperplasia. He had diabetes mellitus, arter...

ea0041ep12 | Adrenal cortex (to include Cushing's) | ECE2016

Nonfunctional adrenal incidentalomas and cardiometabolic risk

Ferreira Lia , Palma Isabel

Background: Incidentally discovered adrenal tumours have become a common clinical problem. The presence of an adrenal incidentalomas has been associated with an increase incidence of several cardiovascular risk factors. These abnormalities are more frequent in patients with clinical and subclinical hypercortisolism, nevertheless some studies have reported an association between nonfunctioning adrenal incidentalomas (NFAIs) with increased insulin resistance and cardiovascular r...

ea0041ep13 | Adrenal cortex (to include Cushing's) | ECE2016

Immunohistochemical characteristics of blood vessels in non-visualized and visualized on MRI pituitary adenomas in patients with Cushing’s disease (pilot study)

Voronkova Iya , Belaya Zhanna , Khandaeva Patimat , Rozhinskaya Liudmila , Vorontsov Alexander , Sitkin Ivan , Grigoriev Andrey , Melnichenko Galina

Introduction: Regardless of improvements in MRI, up to 20% of ACTH-secreting pituitary tumors are only identified at surgical exploration. The objective was to estimate whether there is any difference in blood vessels and the subsequent ability to uptake contrast agent in visualized micro-adenomas as compared to non-visualized on MRI ACTH-secreting pituitary tumors.Materials and methods: Retrospective evaluation of ACTH-positive pituitary tumors from pat...

ea0041ep14 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal crisis and sick day episodes among CAH patients: preliminary report based on international CAH (I-CAH) registry

Karunasena Nayananjani , Daniel Eleni , Bryce Jillian , Jiang Jipu , Faisal Ahmed S , Guran Tulay , Mendonca Berenice B , Bachega Tania A , Blankenstein Oliver , Koehler Birgit , Neumann Uta , Acerini Carlo , Krone Nils , Bonfig Walter , Mohnike Klaus , Elsedfy Heba , Ross Richard

Background: Congenital adrenal hyperplasia (CAH) is a rare condition that is associated with life long risk of adrenal crisis. Management of CAH demands a fine balance between excess glucocorticoid leading to adverse effects and too little glucocorticoid risking adrenal crises. Frequent occurrence of sick day episodes warrants dose adjustment and education regarding adrenal crisis. In a condition such as CAH it is difficult to collect sufficient data from small cohorts at a si...

ea0041ep15 | Adrenal cortex (to include Cushing's) | ECE2016

Impact of the chemokine receptors CXCR4 and CXCR7 on metastatic potential and survival in adrenocortical carcinoma

Chifu Irina , Fusz Carmina , Ronchi Cristina , Marienfeld Katja , Fassnacht Martin , Hahner Stefanie , Heinze Britta

Background: The chemokine receptor CXCR4 and its associate receptor CXCR7, that modulates CXCR4 function, have been associated with tumor progression and metastasis in human cancers. In ACC, Ki67 index and ENSAT stage are the most important prognostic parameters.Objective: To assess expression of CXCR4 and CXCR7 in adrenal cancer and correlate results with clinical outcome.Methods: CR expression was assessed by immunohistochemistry...

ea0041ep16 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal function recovery after adrenalectomy in Cushing syndrome

Radomir Lidia , Mihai Daniel , Caragheorgheopol Andra , Tomulescu Victor , Badiu Corin

Background: First-line therapy of ACTH-independent Cushing’s Syndrome (CS) is the resection of the underlying tumor in all cases. After surgical cure of CS, most patients develop transient secondary adrenal insufficiency with a variable time of recovery. Adrenal function testing can identify patients who may require glucocorticoid replacement.Methods: We reviewed 61 patients diagnosed with ACTH-independent CS excluding 6 with adrenocortical carcinom...

ea0041ep17 | Adrenal cortex (to include Cushing's) | ECE2016

Psychopathology, memory and quality of life in Cushing’s syndrome

Santos Alicia , Resmini Eugenia , Crespo Iris , Valassi Elena , Martinez Maria Antonia , Pires Patricia , Webb Susan

Introduction: Cushing’s syndrome (CS) has been related to higher psychopathology. Psychopathology can be related to poor memory performance, and low quality of life. The aim of this study is to establish the relationship between the three parameters and with subjective symptom perception in CS.Methods/design: Thirty six patients in remission of CS and 36 matched controls for age, sex and education years were included in the study. They completed SCL...

ea0041ep18 | Adrenal cortex (to include Cushing's) | ECE2016

Carotid intima-media thickness as the cardiometabolic risk indicator in patients with nonfunctional adrenal mass and metabolic syndrome screening

Akkus Gamze , Tetiker Tamer , Deniz Ali , Evran Mehtap , Sert Murat

Objective: Nonfunctional adrenal masses are a risk indicator of increased cardiometabolic risk. Especially; increased thrombogenic ambient, insulin resistance, hepatosteatosis and abdominal obesity are determined in these patients with nonfunctional adrenal masses. Our purpose was to show the association of adrenal incidentalome and metabolic syndrome in consideration of the studies and to detect the increase in the carotid intima-media thickness which is regarded as the prece...

ea0041ep19 | Adrenal cortex (to include Cushing's) | ECE2016

Are adrenal incidentalomas components of metabolic syndrome?

Stankiewicz Elzbieta Bandurska , Myszka-Podgorska Katarzyna , Rutkowska Joanna , Matuszewski Wojciech , Jalali Rakesh

Introduction: The aim of the study was to asses frequency of the components of metabolic syndrome (MS) according to the criteria of the International Diabetes Federation (IDF) in patients with adrenal incidentaloma (AI) without hormonal activity.Design: The study comprised of patients with AI without hormonal activity, confirmed in CT. The adrenal function was determined by measuring circadian rhythm of cortisol and/or dexametasone suppression test, aldo...

ea0041ep20 | Adrenal cortex (to include Cushing's) | ECE2016

Congenital adrenal hyperplasia– “natural history of the disease” – very late diagnosis in a series of patients

Ambroziak Urszula , Kepczynska-Nyk Anna , Lenkiewicz-Sidor Maja , Jazdzewski Krystian , Malunowicz Ewa , Bednarczuk Tomasz

Background: Classical congenital adrenal hyperplasia (CAH) is diagnosed mainly in newborns. While patients with salt wasting form cannot survive without timely diagnosis, those with simple virilizing or nonclassical may be diagnosed even in advanced age.Aim: To present clinical, biochemical, radiological and genetic characteristics of series of CAH patients diagnosed in advanced adulthood.Material and methods: Eight patients (F=5, ...

ea0041ep21 | Adrenal cortex (to include Cushing's) | ECE2016

Long-term metabolic evolution of a cohort of patients treated for adrenal insufficiency

Coralie Moutarde , Claire Douillard , Catherine Bauters , Christine Cortet , Christine Do Cao , Laurence Leclerc , Emilie Merlen , Pascal Pigny , Jean-Louis Wemeau , Marie-Christine Vantyghem

The aim of this retrospective study was to compare the long-term metabolic evolution of a cohort of patients treated for adrenal insufficiency (AI), and the best biological parameters of a good balance.Seventy patients with AI (mean age 41 years (±16); 60% female) were followed during a median 6-year period (2–16 years): 38 after bilateral adrenalectomy (60% Cushing) and 32 after AI of medical origin (62% polyglandular autoimmune syndrome). BMI...

ea0041ep22 | Adrenal cortex (to include Cushing's) | ECE2016

Method-specific serum cortisol responses to the ACTH test: comparison of two generations of Roche automated immunoassays using polyclonal vs MABs

Klose Marianne , Hilsted Linda , Feldt-Rasmussen Ulla

Introduction: The plasma cortisol response to the ACTH test is known to vary significantly by assays. An automated cortisol immunoassays with increased specificity due to the shift from polyclonal to MABs, and standardized against mass spectrometry was recently introduced, with an expected decrease in cortisol concentrations by 20%. Cut-offs used in clinical practice for patient evaluation will thus have to be adjusted. We aimed to assess the normal cortisol response to ACTH s...

ea0041ep23 | Adrenal cortex (to include Cushing's) | ECE2016

Ascending aorta dilatation in primary aldosteronism: a new deleterious consequence of aldosterone excess

Vicennati Valentina , Zavatta Guido , Pagotto Uberto , Casadio Elena , Di Dalmazi Guido , Eleonora Rinaldi , Pasquali Renato

Introduction: Primary aldosteronism (PA) features a higher prevalence of cardiovascular events and renal complications as compared with essential hypertension. The effects of aldosterone excess on ascending aorta have never been investigated in human subjects.Methods: From August 2014 to December 2015, we enrolled forty-seven consecutive PA outpatients who had not undergone surgery of the adrenal mass. Hypercortisolism and pheochromocytoma were excluded....

ea0041ep24 | Adrenal cortex (to include Cushing's) | ECE2016

Identified mutations in CYP11B1 gene in two Tunisian patients with 11-beta hydroxylase deficiency

Ennaifer Houda , Kammoun Ines , Kharrat M , Cheikrouhou Nessrine , Khatib Maria , Trabelsi M , Slama Claude Ben

Introduction: 11β-Hydroxylase deficiency (11β-OHD), caused by CYP11B1 mutations, is characterized by hyporeninemic, hypokalemic hypertension and hyperandrogenism. We studied the mutations of CYP11B1 gene in two patients with classic 11β-OHD.Observations: We present the first case of a 23 year old boy with preliminary diagnosis of 21 β-OHD diagnosed at the age of 10. The patient presented with hypertension and hypokalemia which were ag...

ea0041ep25 | Adrenal cortex (to include Cushing's) | ECE2016

Low positive predictive value of midnight salivary cortisol measurement to detect hypercortisolism in type 2 diabetes

Steffensen Charlotte , Thomsen Henrik Holm , Dekkers Olaf M , Christiansen Jens S , Rungby Jorgen , Jorgensen Jens Otto L

Background: Hypercortisolism is prevalent in type 2 diabetes (T2D), but analytical and functional uncertainties prevail. Measurement of salivary cortisol is considered an expedient screening method for hypercortisolism, but its usefulness in the context of T2D is uncertain.Aim: To compare late night salivary cortisol (LNSC) with the 1 mg overnight dexamethasone suppression test (DST), which was considered ‘reference standard’, in T2D.<p cla...

ea0041ep26 | Adrenal cortex (to include Cushing's) | ECE2016

Glucocorticoid axis in patients with primary aldosteronism

Trifanescu Raluca , Smarandoiu Alexandra , Caragheorgheopol Andra , Schipor Sorina , Dumitrascu Anda , Poiana Catalina

Introduction: Primary aldosteronism is associated with increased prevalence of cardiometabolic complications. The mechanisms are not fully elucidated, but an association with autonomous cortisol secretion could increase vascular and metabolic risk.Aims: To assess glucocorticoid axis in patients with primary aldosteronism as compared to patients with ACTH-independent Cushing syndrome and control hypertensive patients without gluco or mineralocorticoid exc...

ea0041ep27 | Adrenal cortex (to include Cushing's) | ECE2016

Bilateral adrenalectomy in Cushing’s syndrome: evaluation of quality of life compared to other treatment options

Sarkis Pauline , Rabilloud Muriel , Siamand Anna , Lifante Jean-Christophe , Chabre Olivier , Raverot Gerald

Context: Bilateral adrenalectomy (BADX) has become an important treatment option of Cushing’s syndrome (CS), especially when other treatments have failed. Long-term outcome is not well known.Objective: To evaluate long-term quality of life (QoL) of patients who underwent BADX for CS compared to other therapeutic options.Methods: Fourty five patients with all cause CS were identified: 23 patients had BADX and 22 underwent one o...

ea0041ep28 | Adrenal cortex (to include Cushing's) | ECE2016

Adenoma size could be an important predictor of Subclinical Cushing’s Syndrome

Yener Serkan , Baris Mustafa , Demirpence Mustafa , Ozisik Secil , Cavdar Umit , Demir Omer , Secil Mustafa , Comlekci Abdurrahman

Subclinical Cushing’s syndrome (SCs) is used to refer to an adrenal incidentaloma with subtle autonomous cortisol secretion and without typical signs and symptoms of hypercortisolism. Diagnostic criteria are uncertain and arbitrary. In this study we aimed to investigate the power of adenoma size as an independent predictor of SCs.Dokuz Eylul University Adrenal Tumours Study Group database includes 596 patients by January 2016. Briefly, there are 332...

ea0041ep29 | Adrenal cortex (to include Cushing's) | ECE2016

Long term folow-up of patients with adrenal incidentalomas and subclinical hypercortisolism: a single center experience

Ivovic Miomira , Marina Ljiljana , Tancic-Gajic Milina , Arizanovic Zorana , Milin-Lazovic Jelena , Rakovic Dragana , Stojanovic Zorana , Paunovic Aleksandra , Vujovic Svetlana

It has been more than 70 years since the first adrenal incidentalomas (AI) were described. Most of these tumors are non-secreting, and are found in 4–7% of adult population. Patients with subclinical hypercortisolism (or autonomous cortisol secretion) (SH) are observed in 1–29% of patients with AIs. Evidence suggests that this condition may be associated with higher prevalence of diabetes, obesity, hypertension and osteoporosis.Between 1999 and...

ea0041ep29b | Adrenal cortex (to include Cushing's) | ECE2016

Long term folow-up of patients with adrenal incidentalomas and subclinical hypercortisolism: a single center experience

Ivovic Miomira , Marina Ljiljana , Tancic-Gajic Milina , Arizanovic Zorana , Milin-Lazovic Jelena , Rakovic Dragana , Stojanovic Zorana , Paunovic Aleksandra , Vujovic Svetlana

It has been more than 70 years since the first adrenal incidentalomas (AI) were described. Most of these tumors are non-secreting, and are found in 4–7% of adult population. Patients with subclinical hypercortisolism (or autonomous cortisol secretion) (SH) are observed in 1–29% of patients with AIs. Evidence suggests that this condition may be associated with higher prevalence of diabetes, obesity, hypertension and osteoporosis.Between 1999 and...

ea0041ep30 | Adrenal cortex (to include Cushing's) | ECE2016

Do lipid profile predict subclinical Cushing’s Syndrome in patients with adrenal incidentalomas?

Mintziori Gesthimani , Georgiou Thomas , Siolos Athanasios , Adamidou Fotini , Efstathiadou Zoe , Anagnostis Panagiotis , Panagiotou Athanasios , Kita Marina

Introduction: Adrenal Incidentalomas (AIs) have been associated with an increased risk of metabolic syndrome and dyslipidemia, though evidence regarding the latter is limited and, sometimes conflicting. Lipid abnormalities in patients with AIs have been described to be associated with subclinical hypercortisolism. Our aim was to test if lipid profile in patients with adrenal incidentalomas may predict subclinical Cushing’s Syndrome (sCS).Material an...

ea0041ep31 | Adrenal cortex (to include Cushing's) | ECE2016

Primary aldosteronism – results from the first Portuguese multicentre study

Nunes da Silva Tiago , Fernandes Vera , Martins Diana , Goncalves Diana , Almeida Raquel , Margarida Monteiro Ana , Neves Carolina , Simoes Helder , Marques Pedro , Alves Filipa , Pereira Maria

Primary Aldosteronism (PA) is the most prevalent cause of secondary hypertension. The aim of this work was to characterize the diagnostic workup, treatment and follow-up of confirmed PA.The adrenal tumour study group of the Portuguese Society of Endocrinology undertook the first retrospective multicentre study of Portuguese PA patients. Data was gathered from nine Portuguese Endocrinology centres (three in the north, one in the centre and five in the sou...

ea0041ep32 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal pigmentation in PPNAD is a result of melanin deposition and associated with upregulation of the melanocortin 1 receptor

Cavlan Dominic , Evagora Chris , Berney Dan , Storr Helen , Drake Will , King Peter

Primary pigmented nodular adrenal disease (PPNAD) is a form of bilateral adrenocortical hyperplasia characterised by small to normal sized adrenal glands containing multiple small cortical pigmented nodules. It may occur independently, but 90% of cases are a manifestation of the Carney complex. Most cases of PPNAD are diagnosed before age 30, and are the result of a germline mutation in PRKAR1A or PDE11A, leading to upregulation of cAMP signalling. It is a cause of ACTH-indepe...

ea0041ep33 | Adrenal cortex (to include Cushing's) | ECE2016

Androgen producing adenoma in a patient with non-diagnosed congenital adrenal hyperplasia

Kosak Mikulas , Hana Vaclav Michlasky David , Kubinyi Jozef , Hana Vaclav

Androgen secreting adrenal tumor is a rare cause of androgen excess in women. There are only few case-reports of androgen producing adenoma in a patient with congenital adrenal hyperplasia.Our patient, 61 year old woman was referred to our department for progressive hirsutism and androgenic alopecia. She did not mention neither excessive facial hair growth nor balding until age of 59 when rapidly progressive balding and overt hirsutism started. She has h...

ea0041ep34 | Adrenal cortex (to include Cushing's) | ECE2016

Menstrual function in women with cushing’s disease (CD)

Komerdus Irina , Akulkina Larisa , Chekanova Anastasiia , Dreval Alexander

Background: Menstrual abnormalities (MA) can be the first sign of the disease.Aim: To assess the structure of MA before and after treatment of CD.Material and methods: Twenty-eight women with CD 39 (31.8;43.5) y.o., were investigated initially and 3.5 (2;5.5) years after treatment. Patients were subdivided into three groups: with normal cycles (NC; 26–30 days), oligomenorrhea (31–120 days), amenorrhea (>120 days)....

ea0041ep35 | Adrenal cortex (to include Cushing's) | ECE2016

The effect of stress, diet and analytical methods on the levels of corticoid metabolites

Duskova Michaela , Sosvorova Lucie , Vitku Jana , Jandikova Hana , Chlupacova Tereza , De Cordeiro Jose , Starka Luboslav

Introduction: A precisely measured corticoid level is important for decision-making in daily clinical practice. These levels can be influenced in the pre-analytical phase, when the effect of stress, timing, and diet can be important.The aim of this study was to elucidate optimal conditions for blood sampling as well as the choice of analytical methods, which they will be used in measuring of corticoids.Methods: By studying ten wome...

ea0041ep36 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenocortical carcinoma: single center experience

Sisman Pinar , Sahin Ahmet Bilgehan , Gul Ozen Oz , Cander Soner , Erturk Erdinc , Ersoy Canan

Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy, with an incidence in the literature of 0.5 to 2 cases per million population per year. The most important prognostic factors are stage of cancer at the time of diagnosis and success of the first surgery. However, advanced age, tumor size, functionality, high Ki-67 index (>10%), necrosis, and high mitotic activity are among poor prognostic factors.Patients and method: Fifteen...

ea0041ep37 | Adrenal cortex (to include Cushing's) | ECE2016

CYP11B2 polymorphism affects the aldosterone – renin ratio?

Zukowski Lukasz , Mysliwiec Janusz , Wawrusiewicz-Kurylonek Natalia , Gorska Maria

Introduction: Nowadays is believed that primary aldosteronism (PA) is the most frequent cause of secondary hypertension and reaches 10% of whole hypertensive population. The activity of the mineralocorticoid hormone may be change by polymorphism of aldosterone synthase gene (CYP11B2) e.g. in promoter -344T/C region. Aim of this study was to find differences in baseline plasma aldosterone concentration (PAC), plasma renin activity (PRA), aldosterone – renin ratio (ARR) and...

ea0041ep38 | Adrenal cortex (to include Cushing's) | ECE2016

Moderate/severe Hypovolemic Hyponatremia with urinary sodium loss secondary to Hypoaldosteronism: analysis of 28 cases

Penso Rona , Ortola Ana , Amengual Angela , Crespo Irene , Ruiz-Gracia Teresa , Cuesta-Hernandez Martin , Gomez-Hoyos Emilia , Marcuello Clara , Calle Alfonso , Runkle Isabelle

Introduction: Hypoaldosteronism (HA), a cause of hypovolemic hyponatremia (HN) with urinary(U) sodium(Na) loss, is often underdiagnosed. We studied 28 patients with an episode of HA-induced moderate/severe hyponatremia.Methods: Retrospective 2012–2015. In all patients, Nadir(N) serum(S) Na <130 mmol/l (corrected for total proteins and glycemia), low internal yugular venous pressure, low ocular pressure. Addison’s Disease ruled (ACTH, cortis...

ea0041ep39 | Adrenal cortex (to include Cushing's) | ECE2016

The classical form of congenital adrenal hyperplasia-clinical characteristics and genetic analysis

Przybylik-Mazurek Elwira , Kurzynska Anna , Skalniak Anna , Piatkowski Jakub , Hubalewska-Dydejczyk Alicja

Classical form of congenital adrenal hyperplasia (CAH) is associated with the impairment of enzymes involved in process of adrenal steroidogenesis. More than 90% of CAH cases are connected with mutations in the 21-hydroxylase gene CYP21A2 in the HLA class III area on the short arm of chromosome 6p21.3. CAH is characterized by a strong correlation between the genotype and the phenotype. Mutations in the CYP21A2 gene can cause different degrees of loss of 21-hy...

ea0041ep40 | Adrenal cortex (to include Cushing's) | ECE2016

Analysis of 176 cases of adrenal incidentaloma investigated in a single clinical center, what are we doing?

Jimenez Maria Maiz , Gutierrez Maria Calatayud , Bracamonte Milagros Sierra , Librizzi Soledad , Nino Virginia Rodriguez , Munoz Myriam Lorena Partida , Carranza Federico Hawkins

Introduction: Patients referred for adrenal incidentalomas (AI) are increasing. Current guidelines are controversial on diagnosis and length of follow-up.Objectives: Analyze clinical, radiologic and hormonal characteristics of patients with AI. Evaluate the number and usefulness of tests needed for diagnosis, clinical outcome and follow up.Material and methods: Observational, retrospective study in patients with AI in our endocrino...

ea0041ep41 | Adrenal cortex (to include Cushing's) | ECE2016

The role of DHEAS in diagnosis of subclinical hypercortisolism in patients with adrenal incidentalomas

Marina Ljiljana , Ivovic Miomira , Tancic-Gajic Milina , Arizanovic Zorana , Milin-Lazovic Jelena , Rakovic Dragana , Stojanovic Zorana , Petkovic Isidora , Petkovic Tijana , Vujovic Svetlana

At present there are no unified diagnostic criteria for subclinical hypercortisolism (SH) in patients with adrenal incidentalomas (AI). Recently it has been proposed that an age and gender specific DHEAS ratio (calculated by dividing DHEAS by the lower limit of the respective reference range) has a significant diagnostic value in detection of SH.The aim was to evaluate the value of DHEAS as a diagnostic tool for SH. Retrospectively we evaluated 140 AI pa...

ea0041ep42 | Adrenal cortex (to include Cushing's) | ECE2016

What can a tissue measured steroid metabolome tell about adrenal tumor? A tissue steroid analysis of cortisol producing adenoma and an androgen producing adenoma in a second patient with CAH, 21-hydroxylase deficiency

Hana Vaclav , Kosak Mikulas , Michalsky David , Hana Vaclav , Hill Martin

Introduction: A key feature of a benign adrenal tumor is its hormonal production. It is reflected by serum steroid levels. A tumoral tissue steroid content is not commonly measured.Methods: A steroid metabolome comprising of 65 steroids was measured in four samples from each of two patients using GC-MS in serum before and after 1mg dexamethasone test, in the tumoral tissue and in the adrenal tissue of two female patients with adrenal adenomas. The first ...

ea0041ep43 | Adrenal cortex (to include Cushing's) | ECE2016

Primary bilateral diffuse large B-cell lymphoma of adrenals presenting as incidental adrenal masses

Silaghi Cristina Alina , Dima Delia , Georgiu Carmen , Lupu Delia , Lungu Ionela , Craciun Anca Elena , Cosma Daniel Tudor , Catana Cristina Sorina , Silaghi Horatiu , Chira Romeo

Primary adrenal non-Hodgkin lymphoma (PANHL) is extremely rare and constitutes <1% of all NHLs and 3% of extranodal lymphoma. PANHL affects predominantly elderly and males and could arises in the presence of a preexisting autoimmune adrenalitis. Diffuse large lymphomas of B-cell origin (DLBCL) histology is reported in 70% of PANHL cases.The present case is a primary, bilateral DLBCL of adrenal in 75-year-old male patient admitted for abdominal pain, ...

ea0041ep44 | Adrenal cortex (to include Cushing's) | ECE2016

A microdeletion of PRKARIA associated with Carney complex

Adamidou Fotini , Mintziori Gesthimani , Lyssikatos Charalampos , Stratakis Constantine

Background: Carney complex (CNC) is a rare multiple neoplasia syndrome, its commonest endocrine manifestation being ACTH-independent Cushing’s syndrome, histologically characterized by primary pigmented nodular adrenocortical disease (PPNAD). There is significant genetic and phenotypic heterogeneity, but deletions at 17q24.2 are rare. We describe the particular characteristics of a patient with a microdeletion in this area.Case report: A 37-year-old...

ea0041ep45 | Adrenal cortex (to include Cushing's) | ECE2016

Prevalence of primary hyperaldosteronism as secondary hypertension; our experience

Nelaj Ergita , Gjata Margarita , Gjika Ariet , Tase Mihal

Background: Primary hyperaldosteronism is one of the major causes of secondary hypertension, with a prevalence rate of about 4–10% in the hypertensive population. Increased secretion of aldosterone usually comes from adrenal adenoma or their hyperplasia (uni or bilateral). Renines plasma levels are reduced as a result of the body’s efforts to curb renine-angiotensin system. It can also be associated with hypokalemi, but not always, more than 60% may not have hypokale...

ea0041ep46 | Adrenal cortex (to include Cushing's) | ECE2016

Ipilimumab immunotheraphy for advanced melanoma induced autoimmune adrenalitis

Silva-Fernandez Julia , Morales-Chamorro Rafael , Gomez-Alfonso Francisco Javier , Val-Zaballos Florentino Del , Garcia-Manzanares-Vazquez de Agredos Alvaro , Lopez-Iglesias Maria , Garcia-Ruiz Rafael , Gomez-Garcia Ines

Introduction: Ipilimumab is a monoclonal antibody against the inhibitory CTLA-4 receptor expressed on T cells. It provokes an upregulation of the immune system. It is known to cause neuroendocrine disorders, such as hypophysitis, hyppothyroidism/thyroiditis and adrenal insufficiency. Althought it is stipulated that thyroid.stimulating hormone (TSH) levels should be evaluated before administration of each dose of ipilimumab as a screen for thyroid diyfunction, there is no reque...

ea0041ep47 | Adrenal cortex (to include Cushing's) | ECE2016

Cardio metabolic parameters in non-functional adrenal adenoma

Atasoy Alp , Cakir Evrim , Ahbab Suleyman , Doventas Yasemin Erdogan , Koldas Macit , Ataoglu Esra , Yenigun Mustafa

Objective: The aim of the present study was to evaluate cardio metabolic risk factors in patients with non-functional adrenal adenoma.Materials and methods: We studied thirty newly diagnosed adrenal adenoma patients and 30 healthy participants. Fasting glucose, insulin, lipid, hormone profile were evaluated from each patient.Results: The frequency of diabetes mellitus and hypertension were statistically higher in adrenal adenoma gr...

ea0041ep48 | Adrenal cortex (to include Cushing's) | ECE2016

Cushings syndrome due to carneys complex – case series and a report of a new mutation from South Indian Tertiary care centre

Jonnalagadda Kavya , Praveen V P , Bhavani Nisha , Jaykumar R V , Nair Vasantha , Kumar Harish , Menon Arun , Menon Usha

Introduction: Carneys complex is an uncommon cause of ACTH independent cushings syndrome which occurs as a combination of myxomas, spotty pigmentation and endocrine overactivity. Primary pigmented nodular adrenocortical disease (PPNAD) is seen in 25–45% of patients with Carneys complex.Methods: Three patients who were suspected with carneys complex were studied to look if their biochemical radiological and clinical characters could predict postopera...

ea0041ep49 | Adrenal cortex (to include Cushing's) | ECE2016

Cushing’ s disease, hasimoto’s thyroiditis and severe hyperandrogenemia

Valea Ana , Ciocan Irina , Carsote Mara , Morar Andra , Pop Dan Dumitru , Ghervan Cristina , Georgescu Carmen Emanuela

Introduction: Cushing’s disease (CD) is caused by high adrenocorticotropic hormone (ACTH), usually by a pituitary microadenoma.Material and method: This is a case report investigated in several Romanian centers by performing: morning plasma cortisol, circadian rhythm of plasma cortisol, plasma ACTH, dexamethasone (DXM) suppression tests.Case data: A 57-year female, known with hypertension and osteopenia, was ...

ea0041ep50 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal infarction in antiphospholipid syndrome despite therapeutic anticoagulation

Wong Eleanor , Watts Michael , O'Hare James A

We report a case of acute adrenal crisis in a patient with the antiphospholipid syndrome in a man who was on a therapeutic dose of warfarin. A 64-year-old man presented with vomiting and abdominal discomfort. Temperature was 37.8 °C, pulse 85/min and BP 100/63 mmHg. On examination, there was generalized hyperpigmentation. He had a history of deep venous thrombosis of the lower limbs on two occasions and was on warfarin. He previously diagnosed primary antiphospho...

ea0041ep51 | Adrenal cortex (to include Cushing's) | ECE2016

Pediatric Cushing’s disease and paraduodenal tumor

Valea Ana , Breaban Maria , Carsote Mara , Morar Andra , Dumitru Pop Dan , Emanuela Georgescu Carmen , Ghervan Cristina

Introduction: Cushing’s disease (CD) in youth represents a challenge especially related to the therapy and long-term management.Materials and methods: We report the medical history of a child with CD who was followed-up for 7 years. Suggestive endocrine panel and imagery is exposed.Case presentation: A 19-year female was diagnosed at age of 12 with CD. Clinical assessment revealed: weight gain, headache, hyperpigmentation pred...

ea0041ep52 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal leiomyoma: a rare cause of adrenal incidentaloma

Manuel Costa Maria , Belo Sandra , Souteiro Pedro , Magalhaes Joao , Carvalho Davide

Introduction: Leiomyomas are benign tumors originating from the smooth muscle cells. They occur more frequently in the uterus and in the gastrointestinal system. Adrenal leiomyomas are rare tumors arising from the smooth muscle of the adrenal vein and its tributaries.Case report: Man, 72-years-old, referred to Endocrinology in the context of an adrenal incidentaloma (20 mm maximum diametre) detected in abdominal-pelvic CT performed for the study of splen...

ea0041ep53 | Adrenal cortex (to include Cushing's) | ECE2016

Ectopic expression of serotonin receptors in adrenocorticotropin-independent macronodular adrenal hyperplasia

Ghada Saad , Molka Chadli , Emna Dendana , Yosra Hasni , Amel Maaroufi , Maha Kacem , Kousay Ach

In ACTH-independent macronodular adrenal hyperplasia (AIMAH) causing Cushing’s syndrome, cortisol secretion is controlled by illegitimate membrane receptors. In the normal adrenal gland, agonists of 5-HT4 receptors have a powerful effect on aldosterone secretion but little effect on cortisol secretion in vitro.The aim of our study is to describe the clinical and hormonal features of patients diagnosed with aberrant serotonin receptor expres...

ea0041ep54 | Adrenal cortex (to include Cushing's) | ECE2016

Cushing’s syndrome in King Chulalongkorn Memorial Hospital: experience from a single tertiary referral hospital

Warachit Wasita , Sunthornyothin Sarat

Objective: To assess clinical characteristics, management and outcome of treatment of Cushing’s syndrome (CS) in King Chulalongkorn Memorial Hospital (KCMH).Method: We performed a retrospective evaluation of 82 patients with CS in KCMH during 2001–2015. Median follow-up time was 36 months [interquartile range 11–35].Results: Of the 82 patients, Cushing’s disease (CD) was diagnosed in 45 patients (55%). Twenty-si...

ea0041ep55 | Adrenal cortex (to include Cushing's) | ECE2016

Outcome with surgical treatment in subclinical hypercortisolism

Moreno Cristina , Paja Miguel , Zabalegui Alba , Dublang Maddalen , Etxeberria Eider , Oleaga Amelia , Teresa Gutierrez M

Introduction: Subclinical hypercortisolism (SH), a condition of biochemical cortisol excess without the classical signs or symptoms of overt hypercortisolism, is thought to be present in the 5–30% of patients with incidentally discovered adrenal mass (adrenal incidentalomas). Some evidence suggest that this condition may lead to long-term consequences of cortisol excess, but indication and potential benefits of adrenalectomy in this state are still in doubt. We analyse a ...

ea0041ep56 | Adrenal cortex (to include Cushing's) | ECE2016

Addison’s disease warrants large package of care costs due to substantial comorbidity

Ross Ian Louis , Biden Cara , Leisegang Rory

Introduction: Patients with Addison’s disease are burdened by substantial comorbidity and likely require a large package of care. There is a proportion of South African patients who can afford private health-care, comparable to health-care offered in a developed country. We hypothesised that comprehensive package of care costs for Addison’s disease is relatively high.Methods: We identifed 131 patients with Addison’s disease within a privat...

ea0041ep57 | Adrenal cortex (to include Cushing's) | ECE2016

Testosterone and cortisol co-secretion by an adrenocortical adenoma presenting as secondary polycythemia

Adamidou Fotini , Mintziori Gesthimani , Vlahaki Efthymia , Kambaroudis Apostolos

Background: Androgen co-secretion in patients with adrenal Cushing’s syndrome is considered a marker of malignancy. Mixed secretion by benign adrenocortical tumors is rare. We describe a case of a middle aged woman presenting with Cushing’s syndrome and polycythemia.Case report: A 57-year-old lady was referred by the Hematology Service to our Endocrine Clinic for evaluation of an adrenal mass found in an abdominal CT in the course of investigat...

ea0041ep58 | Adrenal cortex (to include Cushing's) | ECE2016

Endosonography – an important diagnostic tool in identifying a small aldosterone-producing adenoma in a patient with primary hyperaldosteronism – case report

Bergmann Simona Raluca , Kann Peter Herbert

Introduction: Primary hyperaldosteronism is still an underdiagnosed cause of hypertension. The challenge lies however, not only in diagnosing the primary hyperaldosteronism, but also in the distinction between aldosterone-producing adenoma (APA) and idiopathic adrenal hyperplasia (IHA). Establishing the correct diagnosis is after all essential, because surgery is only effective in patients with adrenal adenoma.Case report: We report about a 67-year-old p...

ea0041ep59 | Adrenal cortex (to include Cushing's) | ECE2016

Retrospective evaluation of adrenal incidentelomas

Kaya Ahmet , Kulaksizoglu Mustafa , Caglayan Melek , Karakurt Feridun

Introduction: Adrenal incidentelomas are new era of the endocrinology. We aimed to see the results of adrenal masses retrospectively.Methods: Patients admitted to the Internal Medicine outpatient clinic for different complaints were retrospectively evaluated. Patients whom abdominal imaging like ultrasonography, magnetic resonance imaging or computed tomography were done and incedentally established adrenal masses were evaluated. Patients with a history ...

ea0041ep60 | Adrenal cortex (to include Cushing's) | ECE2016

Primary hyperaldosteronism: clinical and therapeutic approach of a center

Martins Diana , Moreno Carolina , Baptista Carla , Paiva Isabel , Guelho Daniela , Vicente Nuno , Cardoso Luis , Oliveira Diana , Lages Adriana , Ventura Mara , Carrilho Francisco

Introduction: Primary hyperaldosteronism (HAP) is the main cause of secondary hypertension, with a prevalence estimated between 6 and 20% in resistant hypertension. Clinical suspicion is critical, especially if aldosterone-to-renin ratio (ARR) >25, however the diagnosis is dependent on confirmatory evidence, including aldosterone suppression tests.Methods: Retrospective evaluation of 44 patients with suspected PAH, identified betwee...

ea0041ep61 | Adrenal cortex (to include Cushing's) | ECE2016

Circadian rhythm of salivary cortisol & 6 – sulfatoxy melatonin in night shift nursing professionals and actual day workers

Anjum B , Verma Narsingh , Tiwari Sandeep , Singh Ranjana , Mahdi Abbas

Objectives: The present aimed to investigate the circadian pattern of salivary cortisol & sulfatoxy melatonin level in night shift professionals and actual day workers & to find out these changes in the circadian pattern produce by night shift are reversible in due course of time.Methods: 56 Nursing professionals of both gender who perform day and night shifts and 56 actual controls were also recruited in this study. Saliva and urine samples were...

ea0041ep62 | Adrenal cortex (to include Cushing's) | ECE2016

A case of subclinical primary aldosteronism and subclinical Cushing’s syndrome without risk factors of cardiovascular disease

Kitajima Natsumi , Seki Toshiro , Yasuda Atsushi , Seki Masami , Oki Masayuki , Takagi Atsushi , Fukagawa Masafumi

A 49-year-old woman was referred to our hospital for the evaluation of adrenal incidentaloma. She had no past medical history and no family history of notable illness. The patient was 150 cm tall and weighed 60 kg. Her blood pressure was 103/60 mmHg. She had no Cushingoid features. Osteoporosis was absent. Routine laboratory examinations were within the normal ranges including normokalemia. The hormonal examination revealed normal circadian variation in serum cortisol levels (...

ea0041ep63 | Adrenal cortex (to include Cushing's) | ECE2016

The relationship between androgen levels and NLR in hirsutism

Sayilan Samet , Mert Meral , Sayilan Aylin Aydin , Ozturk Ebru , Okuturlar Yildiz , Kocoglu Hakan

Introduction: Hirsutism is a disease in which, women chin, upper lip, chest, abdomen, showing the terminal structure to increase hair growth in the male pattern of distribution as androgen sensitive back and thighs are seen. Neutrophil/lymphocyte ratio (NLR) has been proposed as a simple inflammatory marker of response. Increased value of NLR cardiovascular venture in patients was found to be an indicator of poor prognosis. In our study, we aimed to determine the association b...

ea0041ep64 | Adrenal cortex (to include Cushing's) | ECE2016

ACTH-independent massive bilateral macronodular adrenal hyperplasia

Marquez-Pardo Rosa , Baena-Nieto M Gloria , Garcia-Garcia-Doncel Lourdes , Cayon-Blanco Manuel , Lopez-Velasco Rosario , Torres-Barea Isabel

Introduction: The estimated annual incidence of Cushing’s disease ranges from 2 to 4 per million. Bilateral macronodular adrenal hyperplasia (BMAH) accounts for <1% of Cushing’s syndrome causes.Case report: We present a case of 58-year-old man who had been suffering typical clinical signs of hypercortisolism for 5 years. He presented hyperglycemia, arterial hypertension, central obesity, thin skin, hemorrhagic diathesis, edemas, weakness an...

ea0041ep65 | Adrenal cortex (to include Cushing's) | ECE2016

Schmidt’s syndrome – case report

Puca Entela , Olldashi Blertina , Lumi Ema , Bitri Sonila , Ylli Agron

Introduction: Polyglandular autoimmune syndrome type II (PGA-II) or Schmidt’s syndrome is a very rare autoimmune disorder and difficult to diagnose because the symptoms of this syndrome depends on the gland which gets involved first. Approximately 14–20 people per million population are affected by polyglandular autoimmune syndrome type II. It is characterised by the obligatory occurrence of autoimmune Addison’s disease in combination with thyroid autoimmune dis...

ea0041ep66 | Adrenal cortex (to include Cushing's) | ECE2016

Iatrogenic Cushing’s syndrome due to misuse of topical corticosteroids: a case report

Ali Acar Emre , Senol Emel , Davarci Sena Ece , Erdem Neslihan , Hekimsoy Zeliha

Introduction: Because of their anti-inflammatory effect, topical corticosteroids are widely used in dermatological diseases. Topical use is typically safe, but serious adverse effects induced by systemic absorption are occasionally reported. We report a patient who developed Cushing’s syndrome due to long-term misuse of topical bethametasone and clobetasol.Case Report: A 24-year-old man presented with rapid weight gain and purple strias in multiple ...

ea0041ep67 | Adrenal cortex (to include Cushing's) | ECE2016

Non-Hodgkins B cell lymphoma presenting as acute adrenal crisis

Wong Eleanor , O'Hare James A

We present a rare case of Non- Hodgkins large B Cell lymphoma presenting as circulatory collapse and acute adrenal insufficiency. A 47 year old woman was referred with a 1 month history of weight loss of 7 kg and vomiting. Shortly after admission her condition deteriorated and she developed acute hypotension, BP was 92/58 mmHg, heart rate 100/mn and required volume resuscitation. Examination revealed a thin woman with generalised hyperpigmentation. Serum sodium was 130 mmol/l,...

ea0041ep68 | Adrenal cortex (to include Cushing's) | ECE2016

The frequency of tissue transglutaminase antibodies in the monoglandular and polyglandular autoimmune endocrine disorders

Kocaeli Aysen Akkurt , Cander Soner , Oz Gul Ozen , Sisman Pinar , Ersoy Canan , Erturk Erdinc

Introduction: Generally, symptoms of celiac disease is not accompanied when present together with autoimmune endocrine diseases. In this study, we aimed to investigate the prevalence of silent celiac disease in the APS and autoimmune monoglandular disorders by measuring tissue transglutaminase antibodies (ttgAb).Methods: A total of 103 patients with monaglandular or polyglandular autoimmune endocrine disorders and 32 control subjects were enrolled in the...

ea0041ep69 | Adrenal cortex (to include Cushing's) | ECE2016

Hyperparathyroidism healing in patients treated for hyperaldosteronism: three cases

Blasco Lourdes Garcia , Garcia Juan Carlos Ferrer , Torrens Mercedes Tolosa , Revert Pablo Sanz , Alacid Cristian Marco , Juan Carlos Sanchez

Introduction: Hyperaldosteronism usually presents with hypertension and hypokalemia; however, there is recent evidence of a relationship with the parathyroid hormone. There are different theories to try to explain this relationship. Hyperaldosteronism treatment is medical or surgical depending upon etiology. We present three cases in which treatment solely for hyperaldosteronism also cured hyperparathyroidism.Materials and methods: We report three patien...

ea0041ep70 | Adrenal cortex (to include Cushing's) | ECE2016

Large aortic aneurism and left coronary artery calcifications: incidental findings at adrenal incidentaloma assessment

Carsote Mara , Dobrescu Mariana , Dumitrascu Anda , Gruia Adriana , Valea Ana , Ghemigian Adina

Introduction: In cases with high-risk metabolic profile the investigations may lead to the discovery of an adrenal tumor (AT). Complex endocrine investigations including computed tomography (CT) scans may point anomalies of the vessels as coronary artery or abdominal aorta.Aim: We report a case associating an AT and severe cardiovascular anomalies which are discovered during endocrine investigations.Case data: A 72-year prior smoke...

ea0041ep71 | Adrenal cortex (to include Cushing's) | ECE2016

From mild abdominal pain to large right adrenal cyst

Moraru Dana , Chirita Corina , Tataru Simona , Trandafir Ioana , Carsote Mara , Valea Ana , Petrescu Razvan

Introduction: Cystic lesions of the adrenals are rare and they may develop asymptomatically for a long period of time. Females seem to be more affected and lesion is typically unilateral.Aim: We report a case of young female case incidentally found with a large adrenal pure cystic mass.Case data: A 24-year non-smoking female patient with regular menses since the age of 14 complained of mild abdominal pain for a few days without cor...

ea0041ep72 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal failure secondary to bilateral adrenal metastasis as a presenting feature of lung cancer – a case report

Sutcuoglu Osman , Bolayir Basak , Yalcin Muhittin , Satis Hasan , Altinova Alev , Akturk Mujde , Balos Toruner Fusun , Cakir Nuri

Metastatic infiltration of the adrenal glands is a common finding of malignancies, but few case reports showed primary adrenal insufficiency being the presenting manifestation of underlying malignant tumors. Here, we report a case of adrenal insufficiency secondary to metastases from lung adenocarcinoma.A 69-year-old man was admitted to emergency department with weakness, altered mental status, hypotension, fever and weight loss. He had 100 pack-year his...

ea0041ep73 | Adrenal cortex (to include Cushing's) | ECE2016

Clinical case of yatrogenic hypercortisolism in pregnant woman with adrenal insufficiency

Volkova Natalya , Porksheyan Mariya , Kanaeva Saida , Davidenko Ilya

Background: Adrenal insufficiency (AI) in pregnant women is difficult to manage because of similarity between clinics of decompensation of AI and gestational toxicosis. Objective difficulty is absence of clinical guidelines of management of pregnant patients with AI. We present a clinical case where the management of pregnant patient was not careful, which led to overdose and iatrogenic hypercortisolism.Clinical case: Pregnant woman, 29years old, asked s...

ea0041ep74 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal insufficiency due to X-linked adrenoleukodystrophy diagnosed in late adulthood

Soledad Gogorza Perez Maria , Serra Soler Guillermo , Jimenez Portilla Ana , Wos Marzena , Garcia Fernandez Honorato , Arguelles Jimenez Inaki , Tofe Povedano Santiago , Codina Marcet Mercedes , Mena Ribas Elena , Pereg Macazaga Vicente

Introduction: X-linked adrenoleukodystrophy (X-ALD) is a rare condition presented mainly in males during childhood and early adulthood. It represents almost 10% of primary adrenal insufficiency (PAI) or Addison’s disease cases.Clinical case: A 67-year-old male was diagnosed at the age of 61 with PAI during testing for mesenteric paniculitis while admitted in Internal Medicine service. He was treated with hydrocortisone and referred to outpatient end...

ea0041ep75 | Adrenal cortex (to include Cushing's) | ECE2016

Massive bilateral pheocromocytomas – a rare case

Martins Diana , Rodrigues Dircea , Baptista Carla , Melo Miguel , Cardoso Luis , Vicente Nuno , Oliveira Diana , Ventura Mara , Lages Adriana , Carrilho Francisco

Introduction: Pheochromocytoma is a rare catecholamine-secreting tumor that arises from the chromaffin tissue of the adrenal medulla. Of the reported cases, only 10% consist in bilateral lesions and the probability of multiple endocrine neoplasia should always be investigated.Case report: Female patient, 19 years old, presented with a clinical history with 2 years of evolution, characterized by episodes of palpitations, headache and abdominal discomfort....

ea0041ep76 | Adrenal cortex (to include Cushing's) | ECE2016

A rare case of ectopic ACTH syndrome originated from malignant renal paraganglioma

Tutal Esra , Yilmazer Demet , Demirci Taner , Cakal Erman , Cakir Evrim , Celep Bahadir , Topaloglu Oya , Delibasi Tuncay

Introduction: Ectopic adrenocorticotropic hormone (ACTH) syndrome is characterized by hypercortisolism due to the hypersecretion of non-pituitary ACTH-secreting tumor leads to the Cushing’s syndrome. Herein, we present a case with Cushing’s syndrome, which is diagnosed ACTH-secreting renal malignant paraganglioma.Case: A 40-year-old woman presented with a 5 month history of newly diagnosed hypertension and diabetes, weakness, hyperpigmentation,...

ea0041ep77 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenal venous sampling is useful for a definitive diagnosis in Cushing’s syndrome with bilateral adrenal tumors

Seki Toshiro , Yasuda Atsushi , Kitajima Natsumi , Seki Masami , Oki Masayuki , Takagi Atsushi , Fukagawa Masafumi

We report three cases of Cushing’s syndrome (CS) with bilateral adrenal tumors. When bilateral adrenal tumors are encountered, the differential diagnosis is difficult, especially in the functioning bilateral adrenocortical adenoma. Adrenal scintigraphy has become a standard technique to determine the laterality of excessive hormone secretion; however, this examination results in bilateral adrenal activity in the functioning bilateral adrenocortical adenoma. Our three pati...

ea0041ep78 | Adrenal cortex (to include Cushing's) | ECE2016

Non functional unilateral giant adrenal myelolipoma: a case report

Gokay Ferhat , Simsek Yasin , Ertan Tamer , Akay Ebru

Introduction: Adrenal myelolipoma is a rare benign tumour composed of mature adipose tissue and hematopoietic tissue. Most lesions are small and asymptomatic, discovered incidentally during autopsy or on imaging studies performed for other reasons. Usually small and asymptomatic, but has been reported to present with symptoms such as abdominal pain resulting from tumour bulk, necrosis or spontaneous retroperitoneal haemorrhage.Case 54-year old woman who ...

ea0041ep79 | Adrenal cortex (to include Cushing's) | ECE2016

Large bilateral adrenal metastatic melanoma

Dyrmishi Blertina , Olldashi Taulant , Rista Elvana , Hoxha Eneida , Puca Entela , Fureraj Thanas , Ylli Agron

Background: Adrenal metastatic melanoma can be found in up to 50% of patients with melanomas. These tumors are not hormone-secreting, and they usually present with locally advanced disease.The case: We report on the presence of a bilateral massive metastatic adrenal melanoma in a 56-year old woman with the initial clinical diagnosis of bilateral adrenal cyst or hemorrhage, and chronic adrenal failure. The patient underwent surgery one month before the ad...

ea0041ep80 | Adrenal cortex (to include Cushing's) | ECE2016

Cushing syndrome with ectopic secretion of ACTH by a lung carcinoma

Moravcikova Elena , Kulich Michal , Urbankova Helena , Gregova Juliana , Vanuga Peter

Introduction: A form of ACTH-dependent Cushing syndrome is an ectopic production of ACTH. The aetiology can by benign lesion or a malignant non-pituitary tumor, which is more common. The prevalence of endogenous Cushing syndrome is 1 in 26 000. Ectopic ACTH secretion is responsible for 7–15% of the cases. Principal position of the ACTH-producing tumor is in lungs – a bronchial endocrine tumor and small cell lung cancer. Small peripheral bronchial carcinoids can easil...

ea0041ep81 | Adrenal cortex (to include Cushing's) | ECE2016

Asynchronous bilateral adrenal masses: from surgery to endocrine follow-up

Valea Ana , Ciocan Irina , Pop Dan Dumitru , Carsote Mara , Muntean Iulia , Ghervan Cristina , Georgescu Carmen Emanuela

Introduction: Cushing’s syndrome (CS) is correlated with prolonged exposure to high levels of glucocorticoid hormones. Although the most common cause is exogenous adrenal tumors incidentally discovered (incidentaloma) may underline CS.Material and method: This is a case presentation of an adult patient. Specific tests for CS have been used: morning plasma cortisol and circadian rhythm, plasma ACTH, testosterone, dexamethasone (DXM) suppression test....

ea0041ep82 | Adrenal cortex (to include Cushing's) | ECE2016

Adrenocortical carcinoma: report of four cases

Fernandez-Ladreda Mariana Tome , Pinillos Guillermo Martinez De , Garcia Fernando

Introduction: Adrenocortical carcinoma (ACC) is a very rare neoplasm with an incidence of about one case per million population. It is an agressive tumor (overall 5-year survival 16–38%) and complete resection is the only curative treatment.Description of methods: We report four cases of ACC. The clinical and biochemical features at diagnosis along with clinical course of the disease are discussed.Results: Four patients (three...

ea0041ep83 | Adrenal cortex (to include Cushing's) | ECE2016

Depression and acute kidney injury – unusual presentation of Addison’s disease

Ahmad Sajjad , Khalily Naveed , Vernavos Petros , Bondugulapati Laxmi Narsimharao

Introduction: Addison’s disease is the commonest cause of primary hypoadrenalism in the western world. Here, we discuss a case of Addison’s with unusual presentation.Case report: A 39-year-old woman with no previous mental health problems was admitted with history of worsening depression over the last 15 months following her divorce. She had low mood and anhedonia in spite of sertraline for more than a year. This was associated with 40 kg weigh...