Endocrine Abstracts

Introduction: Atherosclerosis is a chronic inflammatory arterial disease and is currently one of the most common causes of cardiovascular morbidity and mortality worldwide. Therefore, there is an urgent need to discover new therapeutic targets for treatment of this fatal chronic disease. Fatty acid binding protein 4 (FABP4), a pro-inflammatory adipokine that links obesity with its related metabolic diseases, has been implicated in the development of atherosclerosis. This study...

Limb-girdle muscular dystrophies are a heterogeneous group of disorders regarding both their phenotypes and their underlying genetic causes. One of these defects is limb-girdle muscular dystrophy type 2J (LGMD2J), which has an unknown prevalence. Our aim is to describe clinical features an evolution of a novel case of this rare condition. Our patient is female, aged 29 from a non-consanguine family bearing features of limb-girdle muscular dystrophy. The first signs of this aff...

Context: Adrenocortical carcinoma is a rare cancer with an annual incidence of 0.7-2 cases per million population and 5-year survival of 31.2%. Adrenal insufficiency is a common and life shortening complication of ACC and little is understood about how it impacts on patients.Objective: To understand patients’ experience of the condition, its treatment, care process, impact of AI on ACC wellbeing, self-care needs and support.De...

According to the 4th edition of the WHO classification of endocrine organ tumors (2017), all pheochromocytomas are classified as malignant tumors (ICD-O code 8700/3). However, in the literature there are no unambiguous data on the significance of clinical and laboratory predictors of the aggressiveness of pheochromocytoma. The aim of the study was to verify possible predictors of pheo-progression using clinical data, the results of laboratory and instrumental examination (incl...

Background and Aims: The incidence of adrenal incidentaloma(AI) has been rising sharply due to the increased use of radiologic imaging. It shows evident variation with age, with the majority of the cases presenting in the 5th to 7th decade of life. This study aims to assess the prevalence of AI and its radiological features and hormonal profiles in the geriatric population.Patients and Method: We conducted a retrospective descriptive study including 177 ...

Background: The gradual increase in the detection rate of adrenal incidentalomas makes them a common clinical problem. The vast majority of them are benign adrenocortical adenomas. Nevertheless every patient with adrenal incidentaloma requires performing number of tests to exclude pheochromocytoma, autonomous cortisol secretion, adrenal carcinoma and primary hyperaldosteronism. Evaluation of whether adrenal incidentalomas are malignant or functional and continuing patient foll...

Background and objective: Children with chronic kidney disease (CKD) have impaired growth that leads to short stature in adulthood and treatment with recombinant human growth hormone (rhGH) is associated with improved growth. This study aimed to evaluate the efficacy and safety of daily rhGH (Jintropin®) in children in China with growth failure caused by CKD prior to transplantation.Methods: Prepubertal patients (2–13 years old) with CKD-relate...

Objective: The analysis of the copy number variation of CYP21A2 gene in a cohort of 21-hydroxylase deficiency (21-OHD) pediatric patients in a tertiary referral center from Romania.Methods: A total of 24 patients (21 female and 3 male, 7:1 female to male sex ratio) with previously biochemically and clinically diagnosed 21-OHD were enrolled in this study from October 2020 to October 2021. The age at the diagnosis was 4.6±4.8 years (mean&#177...

Introduction: Pheochromocytoma in pregnancy is rare with an incidence of 0.007%. A timely diagnosis is essential since fetal and maternal mortality depends on the early treatment. Our object is to report a pheochromocytoma diagnosed in a patient at the beginning of the pregnancy and to highlight the particularity in the therapeutic care.Case presentation: A 32-year-old female patient was admitted to our endocrinology department for exploration of palpita...

Introduction: Vaccine-induced thrombosis and thrombocytopenia (VITT) after vaccination against SARS-CoV-2 with the adenoviral vector-based vaccines ChAdOx1 and Ad26.COV2.S has been associated with adrenal pathology, such as bilateral adrenal vein thrombosis, adrenal cortex haemorrhage and adrenal insufficiency in six percent of patients1.Case report: We report the case of a 23-year-old healthy woman who presented at eight days after ChAdOx1 va...

Objectives: Pheochromocytomas are rare neuroendocrine tumors that originate in chromaffin cells of the adrenal medulla and excessively secrete catecholamines, which leads to a multitude of different symptoms. The most common symptoms include headaches, palpitations and sweating. Because of a diverse clinical picture, they pose a major challenge in diagnostics and often go unidentified. The diagnosis is confirmed by measuring plasma and 24-hour urinary metanephrine and normetan...

Introduction: Prolonged QTc interval is a known risk factor for developing ventricular tachyarrhythmias. QTc prolongation is often reported in patients with pheochromocytoma, however the literature data on this issue are rather heterogeneous. Here we report the results of QTc measurement in patients with pheochromocytoma and paraganglioma (PPGL) in comparison to hormonally inactive benign adrenal tumors.Methods: The test group included 204 patients with ...

Pheochromocytoma is a rare catecholamine-secreting tumour arising from chromaffin cells in the adrenal medulla and one of the main causes of endocrine hypertension. We here report the case of a 48-year old man admitted to the Internal Medicine Department for evaluation of resistant hypertension. The patient presented with headache, sweating, palpitations, pitting edema, hypertension and hypokalemia both resistant to conventional polytherapy. He was therefore investigated for e...

Adrenal/periadrenal sarcomas are very rare entity of adrenal tumours. An epidemiological analysis of primary adrenal cancers found prevalence of adrenal sarcoma of 1.3% compared to adrenocortical carcinoma (ACC) 43.8%, neuroblastoma 39.7%, pheochromocytoma 10.9% and non-Hodgkin’s lymphoma 4.3% (1). In 2021, 26 adrenalectomies in adults were performed in our institution. 12/26 had malignant histology. 9/26 lesions were > 6 cm. 7/9 lesions > 6 cm were malignant (2 a...

Introduction: Cardiac paragangliomas are rare endocrine neoplasms. Surgical resection is first line treatment. Here, we describe a case of cardiac paraganglioma where surgical resection was aborted due to involvement of important cardiac structures. Systemic therapy was instead pursued with tyrosine kinase inhibitor cabozantinib.Case: A 64-year-old man with a past medical history significant for tobacco use and poorly controlled type 2 diabetes mellitus ...

Introduction: For the clinical diagnosis of heterozygous familial hypercholesterolemia (HeFH) validated algorithms are used, with the Dutch Lipid Clinic Network (DLCN) Criteria being the most recommended in our environment. One of the items that scores for the system proposed by the DLCN is the value of LDL cholesterol. However, LDLc levels can be distorted by lipoprotein a (Lpa(a)) levels.Objective: To analyze the change in the validity of the DLCN crit...

Background and Aims: Numerous studies have suggested that metabolic syndrome (MetS) is related to adrenal incidentaloma (AI) in young adults. Limited data about MetS in geriatric patients diagnosed with AI are available, despite the high incidence of this adrenal disease in the elderly. This study aims to assess the prevalence of MetS and its associated factors in aged patients harboring AI.Patients and Method: We conducted a retrospective, comparative, ...

Background: Cardiovascular (CVS) risk factors could be present in patients with mild adrenal autonomous cortisol secretion (MACS), which could account for up to 50% of patients with adrenal adenomas. However, the most frequent CVS risk factors in MACS have not been established.Objective: The aim of the present study was to analyse the difference in CVS risk factors in patients with MACS in comparison to those with non-functioning adrenal tumour (NFAT).</...

Introduction: Niemann Pick disease is a rare autosomal recessive lysosomal storage disorder caused by a deficiency in acid sphingomyelinase. Usually discovered in childhood, it can affect liver, spleen and pulmonary function. Here, we report the case of a Niemann Pick type B disease in an adult associated with bilateral adrenal incidentalomas.Observation: A 45-year-old male patient was found to have bilateral adrenal incidentalomas associated with hepato...

Introduction: Adrenal cavernous hemangioma is a rare tumor with few cases reported in the world. Usually this adrenal masses are incidentally discovered and non functional.Case report: We describe the case of a 63 year old male patient with a history of hypertension and treated prostate. He was referred to our endocrinology department with complaints of his left lower back. At the admission the BMI was 21 kg/m2, his blood pressure was 160/90 m...

Introduction: During adrenal insufficiency (AI), glucocorticoid treatment is supposed to be neutral on the metabolic parameters of patients. However, recent data from the literature report that this corticosteroid replacement therapy increases the metabolic risk. The aim of our work was to determine the metabolic and cardiovascular impact of hydrocortisone (HC) replacement therapy during peripheral AI.Patients and methods: This was a descriptive and anal...

Introduction: Adrenal ganglioneuroma (AGN) is a rare (about 470 described cases), benign tumor arising from the neural crest tissue. These tumors are usually asymptomatic and incidentally detected. They have variable radiological features that often raise suspicion of malignancy. AGN are diagnosed at a mean age of 50 years, have no gender preference and are rarely associated with genetic syndromes.Aim: The presentation of two male patients, 24 and 53 yea...

Introduction: Aldosterone synthase participates in the key reactions of aldosterone synthesis – 11-hydroxylation, 18-hydroxylation and, finally, 18-oxidation. In recent works devoted to evaluating the effectiveness of hybrid steroids in the differential diagnosis of subtypes of primary aldosteronism (PA), it is worth emphasizing the experience of using high-performance liquid chromatography – tandem mass spectrometry (HPLC-MS/MS), which allows detecting even very low...

Adrenocortical cancer (ACC) is a tumor of the adrenal cortex, clinical manifestations, recurrence, and progression potential are determined by its biological characteristics. Morphological diagnosis of tumors of the adrenal glands in some cases presents significant difficulties. According to the WHO classification of tumors of the endocrine organs (4th revision, 2017), in addition to the classical one, myxoid, sarcomatoid and oncocytic histological variants of ACC are distingu...

Introduction: 11-Beta-hydroxylase deficiency (11β-OHD) is the second most common cause of congenital adrenal hyperplasia. It leads to the accumulation of steroids precursors prior to the enzyme defect, notably 11-deoxycorticosterone (DOC), leading therefore to low renin hypertension and hypokalemia. Hence, patients with 11β-OHD are reportedly protected from adrenal crisis. Here, we report a case of a male with 11β-OHD presenting with acute adrenal insufficiency....

Introduction: Myxoid adrenocortical adenoma was described by Brown et al. in 2000 (1). Myxoid adrenal cortical adenoma with pseudo glandular structure is a particular histological variant and is extremely rare. Accurate diagnosis is based on the combined evaluation of clinical features, adrenal imaging, and pathological features. Immunohistochemical studies (cytokeratin, melan-A, USP10, chromogranin, vimentin) can distinguish adrenocortical adenoma from other retroperitoneal m...

Introduction: Hydrocortisone (HC) is the most widely used replacement molecule in the treatment of adrenal insufficiency (AI). This substitution treatment is far from ideal especially as it is impossible to reproduce the nycthemeral cycle of cortisol with its current galenic form which has a short half-life. The aim of our work was to determine the impact of HC treatment of peripheral AI on the long-term quality of life and sleep.Patients and methods: Th...

Here we report the case of a woman with first presentation of Addison disease in pregnancy that went undiagnosed until postpartum period. She gave birth to a healthy child by vaginal delivery at 40 weeks of pregnancy. Our patient is a 31 years pregnant woman with unremarkable medical or familial history. At 8 weeks of pregnancy she was complaining of nausea, vomiting, loss of appetite and fatigue, leading to hospitalization. The physical examination revealed a blood pressure o...

Introduction: Pheochromocytoma is a rare neuroendocrine tumor with a prevalence ranging from 0.05% to 0.1%. Those tumors are usually diagnosed in young adults. However, they can also affect children and the elderly, with sporadic cases being more common in older patients. Giving the recent increases in life expectancy and improvements in imaging techniques, there has been an increase in the number of pheochromocytoma in the elderly.Case presentation: An ...

Disorders of sodium metabolism in sarcoidosis are predominated by diabetes insipidus; SIADH is extremely rare, restricted to sporadic case reports. We present the case of a 68 year old South Asian female presenting with a 3 year history of chronic, mild hyponatraemia, which was asymptomatic apart from mild lightheadedness. She had a history of stable sarcoidosis that was not requiring treatment, based on lung pathology. Despite fluid restriction, serum sodium remained around 1...

Introduction: Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells. They are benign endocrinologically inactive tumours with a histological structure consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. Commonly, angiomyolipomas occur in the kidney with few extra renal case reports in adrenals.Case Report: We report the case of a 76-year-old-man with personal history of hyp...

We report an interference in an immunoassay for aldosterone, which potentially could have led to a wrongful diagnosis and unnecessary surgery. The interference was serendipitously recognized due to a preanalytical error. A 59-year-old female patient with hypertension was referred to the department of endocrinology after an adrenal incidentaloma was detected. Because of her hypertensive history, screening for primary hyperaldosteronism was performed. An elevated aldosterone and...

Background: Cushing’s syndrome is represented by the cummulation of signs and symptoms of excess glucocorticoids and has many potential causes. Approximately 20 percent of all cases are represented by ACTH-independent adrenal tumors – with a majority of these being represented by cortisol secreting adrenal adenomas. Generally, a large adrenal tumor has over 5 cm in diameter and the risk of it being malignant raises proportionately with the dimensions. Large adrenal t...

Background: Adrenal incidentalomas (AIs) refer to adrenal masses discovered on imaging performed for conditions unrelated to suspected adrenal diseases. In an ageing population with improving radiological modalities, the detection of AIs has increased. While most are benign, non-functioning adenomas, some may represent functioning and/or malignant disease including adrenal carcinoma. Investigating AIs can be time-consuming and anxiety-inducing for patients, while under-investi...

Introduction: In adults with Addison disease, over glucocorticoid replacement therapy is associated with an increased morbidity and decreased life expectancy, related to low bone mineral density and cardiometabolic outcomes. The aim of our study was to assess the prevalence of carbohydrate metabolism disorders in patients with Addison disease and identify its predictive factors.Patients and methods: A cross sectional study including 50 patients diagnosed...

Context: Osilodrostat (Osi), a potent inhibitor of 11β-hydroxylase, blocks the conversion of 11-deoxycortisol to cortisol and improves hypercortisolism in patients with Cushing’s syndrome (CS). Here, we report a study evaluating the efficacy of Osi in five non-Cushing’s disease (CD) CS patients treated with Osi in Japan.Subjects and Results: Five patients with non-CD CS were treated with Osi at Chiba University [primary disease breakdown: ...

Introduction: The incidence of adrenal incidentaloma (AI) increases with age. According to epidemiological studies they are more frequent in women than in men.Aim: The aim was to determine the possible clinical sexual dimorphism in patients with nonfunctional adrenal incidentaloma (NAI).Patients and methods: This was an observational, cross-sectional study of 381 patients with AI that were functionally assessed in our Clinic. After...

Introduction: Ramadan, the holy month of fasting, is a stressful period that exposes to endocrine disturbances, which may decompensate some endocrinopathies or precipitate their revelation.Objectives: To evaluate the incidence of endocrine emergencies during the month of Ramadan, and thus the risk of endocrine decompensation related to fasting.Materials and methods: This is a prospective study conducted in the department of endocri...

Introduction: Hypertension disorders during pregnancy constitute a significant cause of maternal and perinatal mortality worldwide. Paragangliomas represent a rare cause of hypertension in gestation. The management of these endocrine tumors can be challenging, especially when diagnosed during pregnancy. We describe a case of a paraganglioma discovered in a pregnant woman.Case report: We report the case of a twenty-seven-year-old female patient who presen...

Introduction: Adrenal incidentaloma prevalence is rising with the advancement of imaging techniques. The hormonal work-up should always include free metanephrines for the diagnosis of a pheochromocytoma and 1 mg overnight dexamethasone suppression test for the diagnosis of autonomous cortisol secretion. These tumors have two distinct embryologic origin and don’t usually coexist, and when they do, it occurs in case of an ectopic adrenocorticotropic hormone (ACTH) productio...

Introduction: 11-Hydroxylase deficiency is a rare form of congenital adrenal hyperplasia characterized by glucocorticoid deficiency, hypertension, hypokalemia and virilization in females. We report a case of congenital adrenal hyperplasia due to 11beta-hydroxylase deficiency revealed by bilateral papilledema in the context of arterial hypertension.Case report: A 13-year-old patient, with no medical history, presented with complains of headache, vomiting ...

Adrenocortical carcinoma (ACC) is a rare malignancy with an incidence of 0.7–2.0 cases/million habitants/year, often with a dismal prognosis. Patients present with abdominal symptoms or symptoms of hormone excess. However, 15% are diagnosed incidentally. (1) A 59y male was referred with progressive lethargy, weight loss, dyspepsia and abdominal distension over the past 2 years. He was dismissive of ‘the elephant in the room’ and in denial. He was pushed to seek ...

Introduction: Adrenal cortical carcinoma (ACC) is a rare and aggressive malignancy. Most patients (80%) are asymptomatic at the time of diagnosis. ACC generally has a poor prognosis with a 5-year survival rate of 20–25%.Case: A 37-year-old man came to the Hospital of Lithuanian University of Health Sciences Kaunas Clinics for general weakness, fatigue, intermittent abdominal pain, and weight loss (~ 10 kg in 9 months). During the abdominal US, the m...

Introduction: Long-term glucocorticoid replacement therapy in patients with Addison disease has been linked to an increased cardiovascular risk and consequent mortality. Our objective was to determine the frequency of dyslipidemia in patients with Addison disease and its potential predictive factors.Patients and methods: This was a cross-sectional study, performed in the department of endocrinology in Hedi Chaker hospital –Sfax –Tunisia. Fifty ...

Introduction: Inadequate glucocorticoid replacement therapy in Addison disease leads to an increased risk of both cardiovascular disease and metabolic syndrome. The metabolic effects of long-life corticosteroid exposure are due to physiological mechanisms that are associated with carbohydrate metabolism disorder, dyslipidemia and insulin resistance. In this study, we aimed to determine the prevalence and predictive factors of metabolic syndrome in patients with Addison disease...

Introduction: Mitotane is an adrenolytic drug that is used as an adjuvant to treat adrenocortical carcinoma, The side effects of lysodren are numerous, but some of them are less known. We report a case of ovarian cyst in a woman of childbearing age. It is a 26 years old patient treated with Lysodren® for a locoregional recurrence of an adrenal cacinoma stage II of the ENSAT. After 9 months of treatment, the patient presented an amenorrhea, with the appearance of a large o...

Background: Cortisol is an essential steroid hormone released from the adrenal gland. Plasma cortisol levels follow a circadian rhythm under the control of the Hypothalamic–Pituitary–Adrenal axis, reaching peak levels in the morning. Cortisol has long been known to exert immunosuppressive effects and accordingly, glucocorticoids are central in treating inflammatory disease. Cortisol’s propensity to downregulate certain pro-inflammatory cytokines and upregulate o...

Background: Cushing’s syndrome (CS) and hypertension (HT) are associated with alterations of coagulation. This is the first study that compares parameters of fibrin clot and fibrinolysis in CS with patients with essential hypertension (EHT) and healthy normotensive controls (HC).Methods: The patients were recruited at the university hospital of Ludwig-Maximilians-Universität München (Germany) and the Department of Hypertension, Institute o...

Adrenocortical carcinomas (ACCs) are rare endocrine tumors with poor prognosis. They overexpress the insulin-like growth factor 2 (IGF2), that drives a proliferative autocrine loop by binding to IGF1R and IR. The majority of studies focused on IGF1R as mediator of IGF2 biological effects, but recently a high expression of IR, in particular of the isoform A, was observed in most ACCs, suggesting a potential role of this receptor in modulating IGF2 effects in adrenocortical tumo...

Background: The aim of the study was to evaluate urine steroid profiles by gas chromatography–mass spectrometry (GC–MS) in patients with adrenocortical carcinoma (ACC) to assess therapy efficacy.Patients and Methods: 39 ACC patients were examined before and after treatment. The median age was 47 years (41–60). The Weiss score was no less than 4 points. 10 patients were disease-free in the early postoperative period (up to 12 months after s...

Background: Pheochromocytoma is a rare adrenal tumor that can present with a variety of different symptoms. The cardinal symptoms are paroxysmal palpitations, headaches and sweating together with paroxysmal or persistent hypertension. Increasing use of CT scan contribute to the discovery of more adrenal incidentalomas and therefore more pheochromocytomas due to the workup of the incidentalomas. We intended to investigate if the presentation of the pheochromocytoma was differen...

Background and aims: Lower urinary tract (LUT) symptoms are one of the most common complications related to autonomous diabetic neuropathy. It is responsible for several dysfunctions due to distended bladder with a high risk of contracting retention. The current survey aims to assess the clinical manifestations of neurogenic bladder dysfunction (NBD) and determine its prevalence in patients with type 2 diabetes (T2DM).Patients and method: We conducted a ...

Background: Syncope is common in healthy adolescents and young adults. It can happen due to hypotension secondary to orthostasis. Primary adrenal insufficiency is infrequently reported in patients presenting with syncope and dizziness caused by loss of vasopressor effect of catecholamines and volume depletion.Clinical Case: A 17-year-old boy with a past medical history of learning disability and asthma presented to our health facility with an episode of ...

A 50 year-old lady was referred to the endocrine service for evaluation of significantly elevated 3-methoxytyramine (3-MT) levels. Past medical history included well controlled HIV and hypertension controlled by a single agent only (amlodipine). On one occasion, she was noted to have an elevated systolic blood pressure of 189 mmHg in clinic and therefore 24 h urinary metanephrines were requested. She did not have any other symptoms to suggest excess catecholamines. Systems rev...

Evidence indicates that the adrenals are sexually dimorphic and asymmetric. These differences may have implications for the prevalence and progression of adrenal diseases, which also show asymmetry and sexual dimorphism. The present study aims to characterize the morphological and metabolic differences associated with adrenal sex and asymmetry in mice and humans. Adrenals were compared bilaterally in male and female C57B/6NRj mice with regard to morphological and hormonal char...

Introduction: The occurrence of Cushing’s syndrome in individuals with chronic renal failure is notably rare. It represents a challenging diagnosis in the context of pre-existing chronic kidney disease due to commonly associated alterations in the hypothalamic–pituitary–adrenal axis function. Consequently, the interpretation of standard tests used to detect hypercortisolism can be peculiarly difficult and reveal concrete particularities in comparison to patients...

Introduction: Patients with subclinical Cushing’s syndrome (SCS) are thought to have excess cortisol from an adrenal adenoma, secreting ACTH-independent cortisol that is not fully suppressed by the pituitary feedback system. High cortisol levels may be linked to metabolic complications. There are no specific guidelines on the surgical management of SCS.Objective: To evaluate if patients with SCS are monitored and managed for metabolic complications ...

Introduction: Zellweger Spectrum Disorders, one of the two groups of Peroxisome Biogenesis Disorders (PBD-ZSD) are rare, complex autosomal recessive genetic anomalies characterised by mutations in any of the PEX genes which are responsible for defective peroxisomes activity. The peroxisomes are organelles that play a primary role mainly in the lipid metabolism of almost all the cells of the body, hence their defective biosynthesis, assembly or biochemical functions turn PBD-ZS...

Background: Hypertension is a common condition that affects many people all over the world. It could be associated with several complications especially in cases of resistant hypertension. Many clinical practice guidelines recommend screening for primary aldosteronism especially in persons with resistant hypertension owing to the worse prognosis when compared with blood pressure-matched essential hypertension.Objective: The study aimed to screen for prim...

ObjectiveIn this retrospective study we investigated the clinical and radiological characteristics, hormonal status and metabolic components of the patients with adrenal incidentaloma(AI). Additionally, we investigated whether tumor size or hormonal status changes during long-term follow-up and the effect of these on metabolic parameters.Methods: The data of 384 patients who were followed up with the diagnosis of AI between 2010 an...

Background and Aims: Growing scientific evidence supports the hypothesis of an increased cardiometabolic risk in patients harboring adrenal incidentalomas (AI). This risk would be higher in aging populations and patients with functioning adenomas. The current study aims to determine the clinical and biochemical characteristics of metabloic syndrome(MetS) and assess its prevalence in older patients with AI.Patients and Method: We conducted a retrospective...

We describe the case of a 69-year-old woman with bilateral adrenal incidentalomas identified in CT-scan: on the right, a 57 mm heterogeneous mass with <10 Hounsfield units(HU) with absolute washout of 16%; on the left a 13 mm mass with 35UH, intense contrast enhancement but washout of 66%. She had a recent onset of diabetes, hypertension, androgenic alopecia and facial hair. The systolic blood pressure remained persistently >160 mmHg despite receiving four antihyperten...

Introduction: Pheochromocytomas are rare neuroendocrine tumors whose malignancy is defined by the presence of metastases that may appear several years later. The appropriate follow-up time remains uncertain.Clinical Case: We present the case of a woman with a history of pheochromocytoma who underwent complete resection at 48 years old. The genetic evaluation was negative for mutations on RET, VHL, SDHB or SDHD genes. At 66 years old, a thoracic vertebral...

Aim: This study aims to evaluate patients with a diagnosis of pheochromocytoma.Method: This retrospective case–control study includes data from a tertiary endocrine center from January 1, 2010, to December 31, 2020. Demographic, laboratory, operation/pathology data of patients with pheochromocytoma were recorded.Results: A total of 38 patients (20 patients (52.6%) were male) were included in the study. Median age 48 years (17&...

BackgroundFalse positive results are common in the screening of pheochromocytoma. Even in high risk patients with disorders related to multiple endocrine neoplasia it’s crucial to exclude possible interferences with analytical methods.Clinical caseA 69 year-old man was submitted to total thyroidectomy, due to a 11 mm hypoechogenic nodule suspicious of papillary carcinoma (FNA). Histology confirmed medull...

Background: Corticosteroids suppress the immune system and have been proposed as a treatment for the severe form of (COVID-19) due to their potential ability to inhibit the COVID-19-induced cytokine storm. We aimed to evaluate the effects of cumulative doses of corticosteroids on the recovery of COVID-19 patients.Methods: In this descriptive cross-sectional study, we retrospectively evaluated patients with COVID-19 (confirmed by [PCR]) receiving corticos...

Background and Aims: Arterial hypertension (AH) is one of the most common comorbidities in the elderly. The association of adrenal incidentaloma (AI) with AH in older patients may influence the clinical and therapeutic outcomes of the latter condition. In the current study, we aimed to assess the prevalence of AH and its clinical and therapeutic features in geriatric patients bearing AI.Patients and Method: We conducted a retrospective descriptive study ...

Introduction: Many diseases of the adrenal cortex show a higher prevalence in women than men with incidence increasing with age in both genders.Aim: The aim was to determine the possible sexual dimorphism in patients with adrenal incidentaloma (AI) and (possible) autonomous cortisol secretion ((P)ACS).Methods: This was an observational, cross-sectional study of 381 patients with AI that were functionally assessed in our Clinic. Aft...

Introduction: Hypertension is a very common chronic disease worldwide. Its imbalance is one of the main causes of cardiovascular and neurodegenerative complications.Patients and Methods: We collected data from hypertensive patients who voluntarily presented for screening on both diabetes and hypertension screening days.Poor blood pressure control was defined as systolic blood pressure (SBP) greater than or equal to 140 mmHg and/or diastolic blood pressur...

Objectives: Congenital adrenal hyperplasia (CAH) is a rare condition caused by enzyme deficiency in cortisol biosynthesis. Patients with CAH require lifelong therapy, with the aim of replacing deficient hormones (cortisol +/− aldosterone) and reducing excess androgen production. Guidelines state that the lowest effective glucocorticoid (GC dose) should be used; however, current GC therapy is suboptimal, and supraphysiological GC doses are used to reduce excess androgens....

Background: Adrenal incidentaloma (AI) is described as an adrenal mass detected on imaging not performed for adrenal disease. In coronavirus disease 2019 (COVID-19) pandemic, chest CT evaluation was performed for all ages in adults. In this study, we aimed to detect adrenal adenoma(s) which were identified with chest CT, during COVID-19 diagnostic work-up to find AI prevalence in our population.Methods: All patients who underwent chest CT examination for...

Introduction: The treatment of adrenal insufficiency (AI) is based on long-term glucocorticoid substitution. Hydrocortisone (HC) is the most commonly used substitution molecule. The aim of our work was to determine the long-term bone impact of patients with peripheral AI.Patients and methods: This is a descriptive and analytical study involving 77 patients with peripheral IS (66 women and 11 men), all treated with HC. For each patient, we determined the ...

Introduction: Aggressive ACTH-independent Cushing’s syndrome is rare and frequently related to malignant adrenocortical tumor. However, in exceptional situations, ectopic steroids secretion has been described.Case report: We report the case of an 87 years-old woman referred to our clinic in September 2020 after a low trauma sacral fracture. Her recent medical history revealed the onset, in the previous months, of severe hypokalemia, uncontrolled typ...

To minimise damage to surrounding tissues, targeted delivery of therapeutics to the tumour is highly desirable, and the development of nanotechnology has shown promising results. Magnetic iron oxide nanoparticles (MIONPs) have been gaining traction over the years for applications such as drug delivery, molecular imaging and delivering hyperthermia for treatment of various cancers (1). MIONPs have great therapeutic potential as they can be produced in various sizes and shapes, ...

Introduction: The performance of medical imaging leads to the incidental discovery of many silent and ignored tumor lesions. The term “adrenal incidentaloma” (AI) is a neologism for an adrenal mass discovered incidentally during an abdominal imaging examination, not motivated by the exploration of adrenal pathology, most of the time asymptomatic. Several authors hypothesize that adrenal adenomas could be a manifestation of the metabolic syndrome and that the prevalen...

Cushing’s syndrome (CS) is associated with a considerable risk of complications including thromboembolic events (TE). They occur mostly within the first 2–3 months postoperatively. When present before surgery, CS has high rates of perioperative mortality and morbidity. The benefit of steroidogenesis inhibitors after TE is not fully known. Furthermore, little guidance is available regarding TE assessment/management in CS. We report a case of a 34-year-old male admitte...

Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with poor prognosis. Objective: The aim of this study is to characterize patients with ACC followed at a tertiary center. Material and Methods: Retrospective analysis of clinical records of patients with histopathological diagnosis of ACC followed in our clinic. Results and conclusions: We reviewed 11 patients. The average age at diagnosis was 57.3±15.2 years and 63.6% were females. Seven patients...

Introduction: In Endocrinology, subclinical disorders meet certain diagnostic laboratory thresholds, but are by definition asymptomatic. Subthreshold disorders in Endocrinology have not been defined. We describe two cases of cortisol deficiency, primary and secondary, with normal baseline cortisol, which were by presentation clinical, but could be characterized as subthreshold by biochemical cut-off criteria.Case 1: A 47-year-old woman was referred for a...

Background: Primary hyperaldosteronism (PH) is a syndrome caused by excess aldosterone secretion, which leads to hypertension and hypokalemia and increased risk for target organ damage. The overproduction of aldosterone at the adrenal gland can be unilateral or bilateral. For unilateral disease the best treatment is unilateral adrenalectomy. According to international guidelines, most of the patients should have adrenal venous sampling (AVS) to distinguish between bilateral an...

Introduction: Hypercalcemia is uncommon in patients with adrenal insufficiency. It is common in patients with primary hyperparathyroidism and malignancy.Case: This is a case of primary adrenal insufficiency presenting as acute kidney injury and hypercalcemia. The patient was referred with 10 days history of vomiting, decreased appetite, lethargy and abdominal pain. A week before admission, she developed pleuritic chest pain worsening with inspiration. He...

Introduction: Percutaneous ablation has been used over the years for the minimally invasive treatment of liver, kidney, thyroid and, although less frequent, adrenal cysts. We describe the case of a young patient with a large adrenal cyst treated with ethanol ablation, avoiding adrenalectomy.Clinical case: We present a 32-year-old woman who is referred to Endocrinology due to a 10 cm adrenal incidental finding in an MRI performed due to disc herniation. A...

Background: The presence of Adrenocorticotropic hormone (ACTH)-independent Cushing syndrome that is associated with androgen hypersecretion is extremely rare in benign adrenal tumors. Precise recognition and management of this association will have a great impact on the management of such patient.Clinical case: We describe a case of a 35-year-old lady who presented with 2 years history of difficult-to-control hypertension, symptoms of androgen excess alo...

Introduction: Malignant pheochromocytomas present a real challenge for practitioners. This entity of tumors is rare, with complex characterization, and heterogenocity in their evolution and prognosis. Given the rarity of this tumor group, there is no consensus on the therapeutic management. The management must be in a multidisciplinary framework. Through this illustrative case, we propose a literature review of this rare entity with discussion of the different therapeutic opti...

Introduction: Primary aldosteronism (PA) is a common and potentially reversible cause of secondary hypertension, characterised by resistance to standard antihypertensive therapy and possible hypokalaemia. Lateralisation investigations, including adrenal vein sampling (AVS), are required to distinguish between unilateral or bilateral disease, with unilateral disease representing a potentially surgically curable form of PA. The majority of patients proceeding to adrenalectomy re...

Backgrounds: Based on anthropometry and blood biochemical tests, this study aims to analyze the variation of glucose and lipid metabolism in Cushing’s syndrome (CS) patients caused by adrenal adenoma combining with flash glucose monitoring system (FGMS) and dual-energy X-ray absorptiometry (DEXA).Methods: According to the strict diagnostic and exclusion criteria, seven healthy controls (HCs) and seven CS patients were collected in this study. First,...

Introduction: Paragangliomas (PGLs) are tumors originating from neural crest-derived cells situated in the region of the autonomic nervous system ganglia. Head-and-neck PGLs (HNPGLs) originate from the sympathetic and parasympathetic paraganglia, most frequently from the carotid bodies and jugular, tympanic and vagal paraganglia, and are usually non-catecholamine secreting.Case report: We present the case of a 60 years old male patient, which was admitte...

The introduction of immune checkpoint inhibitors (ICIs) in clinical management of cancer has had an undeniable impact in management of cancer patients. Currently there are several ICIs are used across Europe including but not limited to, pembrolizumab, atezolizumab, and ipilimumab. Even though their clinical efficacy is reputable, they have the potential of causing serious immunotherapy-related adverse events’ (irADRs) in several organ systems including endocrine organs. ...

Background: Primary hyperaldosteronism (PA) is a prevalent, but underdiagnosed syndrome. Diagnosis and treatment have been relatively constant since the development of the latest Endocrine Society guidelines in 2016.Study objective: Baseline characteristics, treatment and follow-up of subjects with PA referred for adrenal venous sampling (AVS) in a tertiary hospital since 2009 are presented.Results: Thirty five subjects (M/F: 17/18...

Bilateral Macronodular Adrenal Hyperplasia (BMAH) is an uncommon cause (<2%) of endogenous Cushing’s syndrome, characterized by enlarged adrenal glands Althought the exact pathogenetic mechanism remains unclear, recently, it has been reported that aberrant expression of ectopic receptors, such as AVP, GIP, angiotensin II (AT1 receptor) catecholamine, LH, 5HT4 agonists, and leptin, evoked cortisol secretion, which escapes from cortisol-mediated feedback in BMAH. Here w...

Aim: The uncertainty on the management of small adrenal incidentalomas (AIs) in guidelines still represents a challenge in real clinical practice. The aim of the study was to identify risk factors for morphological or functional changes during follow-up by using clinical, radiological, and pathological features.Methods: We retrospectively evaluated demographic (gender and age at diagnosis), clinical (weight, height, body mass index, smoking habit, comorb...

Introduction: Carney complex is a rare autosomal dominant genetic disorder which develops secondary to mutation in the PRKAR1A gene located in the 17q22-24 region. It is commonly characterised by the association between spotty skin pigmentation, cardiac myxoma and secretory endocrine tumors.Case presentation: A 15.8-year-old boy known with PRKAR1A mutation diagnosed based on his personal history – cutaneous papiloma of the neck resected at the age o...

Introduction: Pharmacologically induced false positive results in urinary free cortisol levels (UFCL) have been ascribed to 11βHSD-2 inhibition or direct interference on HPLC. Few drugs have been implicated by mechanisms not yet confirmed.Case Reports: We report 3 patients with active pulmonary tuberculosis (TB) and very high UFCL, 2-6× above the upper limit of reference [mean levels 3411 μg/24 h (RR 167-827)]. The 2 males and the woman ag...

Introduction: Non-classical congenital adrenal hyperplasia (NCCAH) is considered to be a common monogenic inherited disease, with an incidence range from 1:500 to 1:100 births worldwide. NCCAH is often peri or post pubertal pauci or even asymptomatic. We report the case of a young girl with severe hirsutism and sexual ambiguity, despite late disclosure.Observation: This is the case of a 16-year-old girl, with a history of menarche at the age of 14, prese...

Objectives: Congenital adrenal hyperplasia (CAH) is a rare condition caused by enzyme deficiency in cortisol biosynthesis. The aim of this study was to evaluate the burden of illness associated with child/adolescent and adult CAH.Methods: A structured, comprehensive literature review was conducted to identify articles describing the burden and treatment landscape of CAH. Literature databases (MEDLINE, Embase, the Cochrane Library and EconLit), websites a...

Introduction: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is the most common of the CAH, it is also the most common of the autosomal recessive diseases. Hypertension is generally absent, and its presence should lead to an investigation of another cause.Observation: We report the case of a 26-year-old young man, descendant from a second-degree consanguineous marriage with a family history of the death of a brother at the age of 2...

Introduction: Ectopic Cushing’s syndrome (ECS) is a condition caused by an ACTH-secreting tumor outside the pituitary or adrenal glands. Most cases are caused by neuroendocrine tumors of the lung, pancreas, thymus or medullary carcinoma of the thyroid. Small-cell carcinomas of the lung are probably the most common cause of biochemical hypercortisolism. About 15% of Cushing’s syndrome cases are due to ECS.Case description: A 27-year-old male pat...

Introduction: Acute adrenal insufficiency (AAI) is a rare but life-threatening condition. It may occur in 50 to 60% of septic shocks (SS). Its diagnosis can be difficult as symptoms are sometimes nonspecific. Herein, we report the case of a female patient with an AAI revealed during SS. A 30-year-old woman with a history of celiac disease since the age of 25 on a gluten-free diet, presented to the emergency department with abdominal pain, vomiting, fever and profound asthenia...

Introduction: Factitious hypoglycaemia in adults is usually due to exogenous intake of insulin or hypoglycaemia sulfonamides. This occult intake is most often voluntary and the diagnosis is not always obvious.Observation: We report the case of a 37-year-old pregnant woman at 15 weeks of amenorrhoea, followed for addisson’s disease since 3 years and not diabetic, was referred to our department for acute adrenal insufficiency following the discontinua...

Introduction: Adrenal myelolipoma is a rare, benign and nonfunctional tumor composed of mature adipose and hematopoietic cells. It is often of incidental finding (8%) and the diagnosis is based on radiological imaging. We report two cases of giant adrenal myelolipoma and discuss the diagnostic and therapeutic aspects of this pathology.Observation: Patient D.K 40 years old, hospitalized for adrenal mass revealed by right back pain radiating to the right h...

Introduction: Pituitary apoplexy is a rare clinical emergency with an incidence of 2–7% in pituitary adenomas. There does not exist any evidence-based standards of optimum care for the patients. A key controversy in management is related to the functioning of acute neurosurgical intervention. The nature of clinical presentation precludes robust randomised controlled trials. Practical guidelines are derived from high-quality observational studies. On this background, we re...

Introduction: There are not many studies specifying the role and contribution of adipocytokines in biology of adrenal gland cancer. Many research show correlation between increased level of serum visfatin and malignant potential, stage progression and prognosis. Visfatin/NAMPT overexpression has been found in a various type of malignances. So far, to the best of knowledge, this is the first research studying the role of visfatin in diagnosis of adrenal cortical carcin...

Introduction: Metabolic Syndrome (MetS) is a bunch of metabolic disturbances related to insulin resistance and is considered a global public health problem. The screening and management of MetS is particularly challenging in psychiatric practice.Objectives: We aim to identify clinical and therapeutic factors associated with MetS in a Tunisian psychiatric population.Methods: We conducted a descriptive and analytical cross-sectional ...

69-year-old male, with a history of bipolar disorder under treatment, smoker and high blood pressure. He is referred for left adrenal injury detected incidentally by secondary hypertension study. Abdominal CT shows a mass of 67.7×51.8×52.3 mm in the left adrenal area, with radiological characteristics of malignancy and aggressive behavior, contacting the left renal pole and upper splenic pole, compatible with adrenal carcinoma vs. metastasis. The functional study is ...

(Aims) Regulation of humoral immunity is important to develop vaccines for infectious disease and cancer. However, human and mouse humoral immune systems contain different molecular mechanisms, and the evaluation of efficacy is difficult in the pre-clinical investigation. Humanized mice with reconstructed human immune system are useful for drug discovery of molecular-targeted drugs related to the immune system, and evaluation of antibody production by vaccines. The development...

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended for the differential diagnosis of Cushing’s syndrome and the investigation of adrenal incidentalomas. However, diagnostic performance of the test relies on accurate methods to quantitate cortisol in serum. Although the variable performance of serum cortisol immunoassays has been well-documented, little has been published on their performance following the ONDST.Aims...

11-deoxycorticosterone (DOC) is an aldosterone precursor synthesized from progesterone and converted to corticosterone in the adrenal cortex. DOC overproduction due to an adrenal lesion is a very rare cause of mineralocorticoid-induced hypertension. The objective of this study is to provide the most relevant clinical features that clinicians dealing with patients presenting with the hallmarks of hypertension due to DOC-producing adrenal lesions should be aware of. We report a ...

Background: Primary bilateral bilateral macronodular adrenal hyperplasia is a cause of Cushing’s syndrome. It is characterised by a large enlargement of the adrenal glands at the expense of multiple non-pigmented nodules. There is inefficient steroidogenesis.Summary of the case: A 58-year-old woman with a history of extreme obesity, type 2 diabetes mellitus, hypertension and dyslipidaemia was admitted to our hospital for cellulitis and anaemia secon...

Introduction: Conventional glucocorticoid replacement therapy has been suggested to increase morbidity in patients with Addison disease and fail to restore their quality of life (QOL). The aim of our study was to assess QOL in patients with Addison disease and to identify factors that determine their QOL.Patients and methods: This cross-sectional study was carried out at the department of Endocrinology in HediChaker hospital-Sfax –Tunisia, from Marc...

Background: Systemic lupus erythematosus (SLE) is an autoimmune disease with multisystem involvement and varied presentation but its association with adrenal insufficiency is rarely reported.Case presentation: A 30-year-old female presented to the emergency department with fever, lethargy and syncopal episodes during the last 48 h. She complained of general weakness, abdominal pain, nausea, vomiting, weight loss and anorexia for five months. Symptoms det...

Introduction: Gayet-Wernicke encephalopathy (WE) is a rare neurological disorder, caused by thiamine (vitamin B1) deficiency. We report a case of tertiary adrenal insufficiency revealing Gayet-Wernicke encephalopathy.Case presentation: A 45-year-old women was admitted with abdominal pain, vomiting and weakness. Her medical history was significant for a long-term self-medication with corticosteroids and chronic vomiting. Clinical examination revealed a cu...

Background: HSD-1, an intracellular enzyme, converts cortisone to cortisol in tissues where cortisol excess is associated with morbidity including liver, adipose, bone, brain, muscle, skin, and eye. SPI-62 is a potent and specific HSD-1 inhibitor in development for treatment of Cushing’s syndrome and autonomous cortisol secretion, and as adjunctive therapy to prednisolone in polymyalgia rheumatica. In Phase 1 clinical trials SPI-62 was generally well tolerated and associa...

Background: HSD-1, an intracellular enzyme, converts cortisone to cortisol in tissues where cortisol excess is associated with morbidity including liver, adipose, bone, brain, muscle, skin, and eye. SPI-62 is a potent and specific HSD-1 inhibitor in development for treatment of autonomous cortisol secretion (ACS) and Cushing’s syndrome, and as adjunctive therapy to prednisolone in polymyalgia rheumatica. In Phase 1 clinical trials SPI-62 was generally well tolerated and a...

Objective: Adrenal venous sampling (AVP) is a reliable procedure to differentiate if in patients with primary aldosteronism (PA) aldosterone production is unilateral or bilateral and guide the treatment of these patients. Our objective was to describe their characteristics and the outcomes of the AVPs.Methods and patients: Observational longitudinal clinical study between July 2020 and September 2021 in patients who underwent AVP in our Hospital.<p c...

Introduction: Adrenoleukodystrophy (ALD) is a rare, X-linked inherited, genetic disease, characterized by a disorder of peroxisome metabolism, leading to the accumulation of very long-chain fatty acids (VLCFAs) mainly at the central nervous system and the adrenal glands. It usually occurs in childhood, but there are types of the disease that manifest later in life.Case: A 57-year-old man with a history of progressive spastic paresis, starting at the age ...

Introduction: Paraneoplastic Cushing’s syndrome is attributed to ectopic ACTH release from a non-pituitary tumor. The lung is frequently the primary site of the underlying neoplasm but sometimes, in cases of advanced metastatic disease, determining the origin may be challenging.Case presentation: A70-year-old man was reffered to our centre for generalised bone pain, lethargy, and important weight loss in the last six months. Before admission, a cont...

Introduction Primary bilateral macronodular adrenal hyperplasia (PBMAH) is potentially responsible for variable degree of cortisol excess. In patients with PBMAH the complete remission of cortisol hypersecretion can be achieved only by performing bilateral adrenalectomy, leading to a persistent hypocortisolism and to a consequent need of a lifelong glucocorticoid replacement therapy. Therefore, bilateral adrenalectomy is worth doing only in patients with severe hypercortisolis...

33-year old obese but otherwise considered ’healthy’ patient was admitted to department of surgery due to wet gangrene of left foot. Lower leg amputation was done. As patient was obese with ITM 44 kg/m2 endocrinologist was consulted. In overnight 1 mg dexamethason supression test cortisol was 72 nmol/l, HbA1c was 5.7%, TSH was 8 mIU/l, level of 25-OH D vitamin below lower range and arterial blod pressure was normal (130/80 mmHg). Patient had central obesit...

Introduction: Oncocytomas of adrenal glands are extremely rare and usually present as incidentally detected masses. The aim of this presentation is to report tow cases of a virilizing androgen-secreting adrenal oncocytoma.Case description: Case 1: A 27-year-old female was admitted to our clinic with a 116 mm left adrenal incidentaloma. The patient’s main symptom was hirsutism. Upon investigation, elevated values of testosterone, and DHEA-S were foun...

Autoimmune polyglandular syndromes (APS) are a group of immune-endocrine syndromes that cause autoimmune destruction of multiple endocrine organs. The most common in this group is APS type 2, which frequently presents with primary adrenal insufficiency with autoimmune thyroid disease and/or type 1 diabetes mellitus. We present a case of 46 year old male, with no significant medical history who presented in our clinic with: weakness, fatigue and weight loss for the preceding la...

COVID-19 pandemic obliged physicians to find out alternative options to classical pathways, to lower viral spread and related dangers as well as to cope with redeployment of personnel and resources. We describe here two cases in whom surgery for adrenal Cushing’s syndrome (CS) and pheochromocytoma (PHEO) was deferred due to the unavailability of surgical facilities.Case no 1: A 69-yo woman was evaluated for CS. Type 2 diabetes mellitus was diagnosed...

Introduction: Primary hyperaldosteronism is a known cause for secondary hypertension. In addition to its effect on blood pressure, aldosterone exhibits proinflammatory actions and plays a role in immunomodulation of autoimmunity. Autoimmune hyperthyroidism (Graves’ disease) and primary hyperaldosteronism rarely coexist but underlying mechanisms associating the two are still unclear.Case report: A 32-year-old female referred to endocrine unit for fur...

Introduction: Pheochromocytoma (PHEO) is an adrenal medulla tumor secreting catecholamines. Malignancy is defined by the presence of metastases in non-chromaffin tissue. Its optimal management requires experienced multidisciplinary teams.We report the case of a patient followed for malignant pheochromocytomaComment: 58-year-old patient operated for a pheochromocytoma in 2016, then lost sight of. The evolution was marked 6 years later by the installation ...

Adrenal lymphangiomatous cysts are rare, often found incidentally, but can also present in association with abdominal/loin pain or hypertension.1 They have occasionally been reported in association with hormone over secretion of either aldosterone, cortisol or catecholamines. We present a case of a 40-year-old serving soldier who was suddenly awoken with severe left sided abdominal and flank pain. Over the course of several months, he was forced to take time off wor...

Introduction: Adrenocortical carcinomas (ACC) are rare and frequently aggressive tumors that may be functional (hormone-secreting) – causing Cushing’s syndrome and/or virilization, or nonfunctional – presenting as an abdominal mass or as an incidental finding. We describe a rare case of stage IV adrenocortical carcinoma which first manifested as treatment resistant Cushing’s syndrome.Case report: In september of 2021, a 24-year-old fe...

Introduction: Cushing’s disease (CD) accounts for approximately 80% of cases of Cushing’s syndrome. Almost all patients with CD have a pituitary adenoma. The tumors are usually microadenomas, only approximately 5 to 10 percent are macroadenomas. Pituitary adenomas arise from epithelial pituitary cells and account for 10–15% of all intracranial tumors. Pituitary imaging is important in confirming the diagnosis of pituitary macroadenoma and also for determining th...

Disorders of sexual development are defined as any congenital condition, in which the development of the chromosomal, gonadal, or anatomical sex is atypical. Congenital adrenal hyperplasia is one of the most common etiology of those disorders, whiwh may be responsible for acute adrenal insufficiency in the neonatal period. The objectives of this case report are to underline the interest of the diagnosis and the genetic counseling for this pathology characterized by an autosoma...

Cushing’s syndrome results from an excess exposure to glucocorticoids which can result from various causes, divided into ACTH-dependent and ACTH-independent etiologies. An example of ACTH-independent causes are adrenal masses which are either benign adenomas, representing the majority of adrenal mass cases, or by malignant neoplasms. We present the case of a 52 yo woman who presented at the Emergency Department (ER) with thoracic pain and palpitations, for which several c...

Introduction: Hormonally active adrenocortical oncocytoma is a very rare neoplasm. Adrenal oncocytomas are mostly considered as non-functioning, benign tumors, with the size of generally >6 cm and lack of pathognomonic features on radiological examinations.Case Report: A 41-year-old woman was referred to the endocrinologist in April 2021 due to weight gain, resistant arterial hypertension and menstrual irregularities for the last several years. She h...

Background: Advancements in medical care have significantly improved survival after major traumatic injury and the main risks are now sepsis and multi-organ failure. An understanding of the hormonal, inflammatory and metabolic changes that occur following trauma is still evolving but it is clear that they impact significantly upon patient prognosis. To date, studies that have examined trauma-induced changes in steroid metabolism have analysed samples taken from patients post-h...

Introduction: Spontaneous coronary artery dissection (SCAD) is an uncommon cause for acute coronary syndrome (ACS). It has been linked to many conditions such as physical exertion, emotional stress, fibromuscular dysplasia, autoimmune diseases. Recent studies suggest high prevalence of hypothyroidism in unselected consecutive patients with SCAD compared with a control group of ACS patients without SCAD with more distal dissections on curly vessels.Case r...

Introduction: Adrenal insufficiency is rarely diagnosed during pregnancy. In the absence of treatment it is associated with high maternal-foetal morbidity and mortality. We report the case of a twenty-one years old female patient, diagnosed with adrenal insufficiency during a diabetic pregnancy of 12 weeks of gestation.Observation: Twenty-one years old female patient, diagnosed with type 1 diabetes since the age of 15, Referred to our department for the ...