Adrenal and Cardiovascular Endocrinology

Familial hyperaldosteronism type I (FH-I) is a rare subset of primary aldosteronism (PA) with an autosomal domintant pattern of inheritance. The molecular basis was determined to be from the unequal crossing over of the 11β-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) genes, resulting in a chimeric gene duplication. This in turn leads to the ectopic synthesis of aldosterone in the zona fasciculata of the adrenal glands under the regulation of adrenocorticotrop...

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ea0081p2 | Adrenal and Cardiovascular Endocrinology | ECE2022

A rare ARMC5 mutation causing bilateral macronodular adrenal hyperplasia and Cushing’s syndrome

Panicker Janki , Waghorn Alison , Ewins David

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a highly heterogeneous disorder and is the cause of <2% of cases of Cushings syndrome. Around 20-25% of patients with primary bilateral macronodular adrenal hyperplasia (PBMAH) have a mutation in ARMC5.Case report: 47 year old gentleman was incidentally found to have bilateral adrenal lesions when he had a CT scan of his chest performed for chest and back pains. He had ...

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ea0081p3 | Adrenal and Cardiovascular Endocrinology | ECE2022

Long-term cardiometabolic morbidity in young adults wWith classic 21-hydroxylase deficiency congenital adrenal hyperplasia

Righi Beatrice , Rashid Ali Salma , Bryce Jillian , Tolinson Jeremy , Bonfig Walter , Baronio Federico , Costa Eduardo C , Guaragna-Filho Guilherme , T'Sjoen Guy , Cools Martine , Markosyan Renata , A S S Bachega Tania , C Miranda Mirela , Iotova Violeta , Falhammar Henrik , Ceccato Filippo , Daniel Eleni , Auchus Richard , Ross Richard , Ahmed Faisal

Background: Congenital adrenal hyperplasia (CAH) and long-term glucocorticoid treatment may be associated with an increased risk of developing cardiometabolic sequelae such as abnormal glucose homeostasis, hyperlipidaemia, hypertension, cardiovascular (CV) disease, obesity and osteoporosis.Objectives: To study the current practice amongst expert centres for assessing cardiometabolic outcomes in adult patients with 21-hydroxylase CAH and to assess the pre...

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ea0081p4 | Adrenal and Cardiovascular Endocrinology | ECE2022

Patients with chronic kidney disease present HPA axis disregulation due to impaired glucocorticoid negative feedback

Boswell Laura , Blasco Miquel , Quintana Luis F. , Vega-Beyhart Arturo , Viaplana Judith , Rodriguez Gabriela , Diaz Daniela , Vilardell Carme , Mora Mireia , Halperin Irene , Amor Antonio J. , Casals Gregori , Hanzu Felicia A.

Aims: A few studies have shown disturbances in the hypothalamic-pituitary-adrenal (HPA) axis in chronic-kidney-disease (CKD), of unknown extent and clinical implications. We aimed to study the HPA axis in patients with CKD and its association with kidney impairment and metabolic disturbances.Methods: Cross-sectional controlled study. Patients with CKD stages I-II (estimated glomerular filtration rate [eGFR] through CKD-EPI equation >60), stage III (e...

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ea0081p5 | Adrenal and Cardiovascular Endocrinology | ECE2022

Group education programme for patients with adrenal insufficiency: evaluation based on patients experiences

Davidse Kirsten , Geilvoet Wanda , Brinkman Lotte , van Eck J.P. , Feelders Richard , Van der Lely Aart Jan

Introduction: Adequate hormone replacement therapy in adrenal insufficiency is essential. Patients should have basic knowledge about their condition and what to do in situations which could trigger an adrenal crisis. Education on how and when hydrocortisone replacement therapy should be adjusted as well as instruction and practice an emergency injection are considered important measures to prevent an adrenal crisis. A standardized nurse-led group-based education programme (GEP...

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ea0081p6 | Adrenal and Cardiovascular Endocrinology | ECE2022

Primary aldosteronism and microprolactinoma: a new syndromic variant?

Parazzoli Chiara , Favero Vittoria , Morelli Valentina , Aresta Carmen , Chiodini Iacopo , Falchetti Alberto

Introduction: Primary aldosteronism (PA) has been described in association with endocrine and non-endocrine neoplasms. Aldosterone-producing adenomas mainly associate with hyperparathyroidism, prolactinomas and pancreatic endocrine tumors, particularly in the context of multiple endocrine neoplasia type 1 MEN1 syndrome. Next-generation sequencing (NGS) studies have shown frequent somatic mutations underlying PA and, rarely, germline mutations of CYP11B1/CYP11B2</e...

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ea0081p7 | Adrenal and Cardiovascular Endocrinology | ECE2022

Waking salivary cortisone as screening test for adrenal insufficiency

Debono Miguel , Elder Charlotte , Lewis Jen , Fearnside Jane , Caunt Sharon , Dixon Simon , Jacques Richard , Newell-Price John , Keevil Brian , Ross Richard

Introduction: In many endocrine centres the 250μg Short Synacthen (Cosyntropin) Test (SST) is the reference standard for the diagnosis of adrenal insufficiency (AI) 1, but it is time consuming, expensive, and requires hospital attendance and venepuncture. The morning physiological peak of cortisol shortly after waking is a good predictor for a negative SST; however, a morning serum cortisol requires venepuncture. Serum cortisol and salivary cortisone correlate ...

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ea0081p8 | Adrenal and Cardiovascular Endocrinology | ECE2022

Pre-, peri- and post-operative characteristics of biochemically silent pheochromocytomas: a case series

Fountas Athanasios , Kanti Georgia , Glikofridi Spyridoula , Kalantzi Athanasia , Giagourta Irini , Markou Athina , Christou Maria , Tigas Stelios , Ntali Georgia , Aggeli Chrysanthi , Zografos Giorgos , Saoulidou Eleftheria , Dimakopoulou Antonia , Kounadi Theodora , Papanastasiou Labrini

Introduction: Pheochromocytomas (PCs) and paragangliomas are rare tumours occurring in about 0.6 cases per 100,000 person-years. Biochemically silent PCs with normal catecholamine levels due to lack of catecholamine secretion or subtle secretion within the established normal levels are even rarer. Up to date, biochemically silent PCs are poorly investigated.Aim: To assess the pre-, peri- and post-operative characteristics of patients with biochemically s...

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ea0081p9 | Adrenal and Cardiovascular Endocrinology | ECE2022

Development and internal validation of a predictive model for the estimation of pheochromocytoma recurrence risk after radical surgery

Lopez Chiara , Parasiliti Caprino Mirko , Bioletto Fabio , Bollati Martina , Maletta Francesca , Caputo Marina , Gasco Valentina , La Grotta Antonio , Limone Paolo , Borretta Giorgio , Volante Marco , Papotti Mauro , Terzolo Massimo , Morino Mario , Pasini Barbara , Veglio Franco , Ghigo Ezio , Arvat Emanuela , Maccario Mauro

Objective: Various features have been identified as predictors of relapse after complete resection of pheochromocytoma, but a comprehensive multivariable model for recurrence risk prediction is lacking. The aim of this study was to develop and internally validate an integrated predictive model for post-surgical recurrence of pheochromocytoma.Methods: The present research retrospectively enrolled 177 patients affected by pheochromocytoma and submitted to ...

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ea0081p10 | Adrenal and Cardiovascular Endocrinology | ECE2022

Comparison of assays for salivary cortisol and cortisone in the diagnosis of Cushing’s syndrome

Backlund Nils , Brattsand Goran , Lundstedt Staffan , Aardal Elisabeth , Bartuseviciene Inga , Katarina Berinder , Burman Pia , Eden Engstrom Britt , Hoybye Charlotte , Isaksson Anders , Ragnarsson Oskar , Ruetschi Ulrika , Wahlberg Jeanette , Olsson Tommy , Dahlqvist Per

Background & Objective: Late night salivary cortisol (LNSC) and 1 mg overnight dexamethasone suppression test (DST) are two of the three recommended screening tests for Cushings syndrome (CS). The classical DST uses serum cortisol, but analysis of salivary cortisol and cortisone has shown high diagnostic accuracy at DST (1). Salivary cortisol can be analysed with immunoassays, which suffer from variable degree of cross reactivity with other steroids, or with LC-MS/MS...

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ea0081p11 | Adrenal and Cardiovascular Endocrinology | ECE2022

Associations of age, BMI, and renal function to cortisol after dexamethasone suppression in patients with adrenal incidentalomas

Olsen Henrik , Puvaneswaralingam Shobitha , Olsen Martin

Introduction: The specificity of cortisol after 1 mg dexamethasone (cortisolDST) ≥50 nmol/l as a criterion for mild autonomous cortisol secretion (MACS) is approximately 80% in patients with adrenal incidentalomas (AI). The aim was to study the associations of cortisolDSTto age, BMI, and renal function. We used machine learning models to uncover potential non-linear associations.Methods: We studied 1129 patients with AI examin...

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ea0081p12 | Adrenal and Cardiovascular Endocrinology | ECE2022

SIMBA for Students: teaching preclinical medical and pharmacy students endocrinology through online simulation - a pilot study

Allison Isabel , Ogiliev Tamzin , Sheikh Jameela , Morgan Georgia , Swaminathan Aditya , Yip Alice , Cooper Catherine , Rezai Fatema , Sheikh Haaziq , Kaur Harjeet , Malhotra Kashish , Melson Eka , Gittoes Neil , Boelaert Kristien , Prete Alessandro , Arlt Wiebke , Robinson Lynne , Chu Justin , Davitadze Meri , Foster Paul , Dhir Vivek , Kempegowda Punith , Team Simba

Introduction: Simulation via Instant Messaging Birmingham Advance (SIMBA) for Students is an online education model used to teach diabetes and endocrine topics to pre-clinical medical and pharmacy students using simulated clinical cases delivered over WhatsApp. It was developed in 2020 to provide an engaging alternative to online small group teaching (SGT). This study investigated the efficacy and acceptability of SIMBA for students compared with traditional SGT.<p ...

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ea0081p13 | Adrenal and Cardiovascular Endocrinology | ECE2022

ARMC5 as a possible regulator of acetylation in the adrenal cortex in partnership with SIRT1

Berthon Annabel , Faucz Fabio , Feldman Benjamin , Drougat Ludivine , espiard Stephanie , Pontes Cavalcante Isadora , Ragazzon Bruno , Bertherat Jerome , Stratakis Constantine

ARMC5 is a tumor suppressor gene responsible for 20 to 40% of Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH) with a function that remains unclear. Based on pathway analysis from RNAseq results obtained on zebrafish models of transient Armc5 up- and down-regulation, we identified transcriptional alterations of several members of SIRT1 (sirtuin (silent mating type information regulation 2 homolog) 1) signaling in our models and hypothesized that ARM...

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ea0081p14 | Adrenal and Cardiovascular Endocrinology | ECE2022

Profound changes of inflammatory and cardiovascular biomarkers in patients with autonomous cortisol secretion and Cushing syndrome

Astrom Ueland Grethe , Methlie Paal , Lovas Kristian , Saevik Ase Bjorvatn , Heie Anette , Sverre Husebye Eystein

Objective: Determine inflammatory and cardiometabolic biomarkers in patients with autonomous cortisol secretion (ACS), compared with healthy controls and patients with overt Cushing syndrome (CS).Method: Serum from prospectively included patients with ACS (n=65), overt CS (n=8), and healthy subjects (n=120) were analysed for 92 different inflammatory biomarkers using proximity extension assay.Results: ACS...

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ea0081p15 | Adrenal and Cardiovascular Endocrinology | ECE2022

Decreased steroidogenic enzymes activity in benign adrenocortical tumors is more pronounced in bilateral lesions as determined by steroid profiling in HPLC-MSMS during ACTH stimulation test

Fideline Bonnet , Barat Maxime , Vaczlavik Anna , Jouinot Anne , Bouys Lucas , Laguillier-Morizot Christelle , Zientek Corinne , See Catherine , Larger Etienne , Guignat Laurence , Groussin Lionel , Assie Guillaume , Guibourdenche Jean , Nicolis Ioannis , Menet Marie-Claude , Bertherat Jerome

Objective: Large response of steroids precursors, including 17-hydroxyprogesterone and 11-deoxycortisol, to ACTH has been described in adrenocortical tumors, suggesting the existence of intra-tumoral enzymatic deficiencies. This study aimed to compare steroidogenic enzymes activity in unilateral and bilateral benign tumors using serum steroid profiling in HPLC-MS/MS in basal state and after ACTH 1-24 stimulation.Design and Methods: A serum profile of sev...

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ea0081p16 | Adrenal and Cardiovascular Endocrinology | ECE2022

Prevalence and clinical features of ARMC5 mutations in a single centre cohort of patients with bilateral adrenal incidentalomas

Frigerio Sofia , Morelli Valentina , Marta Elli Francesca , Vena Walter , Maffini Maria Antonia , Lucca Camilla , Piu Matteo , Mora Nicola , Palmieri Serena , Mantovani Giovanna , Arosio Maura

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of Cushings syndrome (CS). Some familial forms have been associated to gene ARMC5 (Armadillo repeat-containing protein 5) inactivating mutations. This study aimed to evaluate the prevalence and the complications of ARMC5 mutations in our cohort of patients with bilateral adrenal incidentalomas (BAI).Methods: 72 patients, referred to our Center...

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ea0081p17 | Adrenal and Cardiovascular Endocrinology | ECE2022

Bilateral adrenal haemorrhages secondary to Rivaroxaban on a background of p-ANCA vasculitis

Farhan Malik Mohammad , Sivappriyan Siva , Kumar Jesse , Anandappa Samantha , Iqbal Maliha , Khalid Maha

Background: A 73-year-old female presented to the hospital with a 3-day history of right upper quadrant abdominal pain and episodes of vomiting. Her past medical history included insulin treated Type 2 diabetes diabetes, deep venous thrombosis for which she was on rivaroxaban, COPD, right leg angioplasty and previous p-ANCA vasculitis. She also had flank tenderness and was noted to be hypertensive with a blood pressure of 225/93mmHg. A CT scan of the abdomen identified a new 4...

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ea0081p18 | Adrenal and Cardiovascular Endocrinology | ECE2022

Covid-19 infection: incidental diagnosis of pheochromocytoma in an adolescent bearing an uncommon mutation

Efstathiadou Zoi , Gogakos Apostolos , Komzia Paraskevi , Goulopoulou Sophia , Linos Dimitrios , Kita Marina

Introduction: Chest computed tomography imaging in patients with Covid-19 infection often reveals incidental adrenal lesions, which are subsequently investigated, after recession of the infection.Purpose: Description of a pheochromocytoma that was accidentally diagnosed in a teenager, during her hospitalization with Covid-19.Case description: A 17-year-old girl, who was diagnosed with covid-19 infection, by molecular testing 6 days...

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ea0081p19 | Adrenal and Cardiovascular Endocrinology | ECE2022

The endocrine society practice guideline revisited: why do nowadays patients undergo screening for cushing’ syndrome, and with which outcome?

Braun Leah , Vogel Frederick , Zopp Stephanie , Marchant Seiter Thomas , Rubinstein German , Berr Christina M. , Kunzel Heike , Beuschlein Felix , Reincke Martin

Background: Cushings syndrome (CS) is a rare but very severe condition with high morbidity and mortality. Patients are often diagnosed late in the course of the disease, many years after onset of symptoms. New approaches like extended screening of at risk populations, alternative biomarkers and clinical scores have been developed to improve diagnostic accuracy. However, there is still a debate, whether certain patient populations should be screened for CS outside the fra...

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ea0081p20 | Adrenal and Cardiovascular Endocrinology | ECE2022

Characterization of adrenal miRNA-based dysregulations in Cushing’s Syndrome

Zhang Ru , Vetrivel Sharmilee , Watts Deepika , Osswald Andrea , Engel Mareen , Beuschlein Felix , Chen Alon , Sbiera Silviu , Wielockx Ben , Reincke Martin , Riester Anna

Introduction: Transcriptional regulation of gene expression by miRNAs is critical for the fine-tuning of stress response. However, its role in hypercortisolism has not been explored well. After exploring circulating miRNAs in Cushing Syndrome (CS) as biomarkers our aim was to investigate their origin and their role in adrenal tissue.Methods: Next generation sequencing (NGS) based miRNA profiling was performed in adrenal samples from patients of Ger...

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ea0081p21 | Adrenal and Cardiovascular Endocrinology | ECE2022

Time from referral to definitive treatment in Cushing’s syndrome

Coulden Amy , Aylwin Simon , Flanagan Daniel , Mamoojee Yaasir , Pal Aparna , Gittoes Neil , Gleeson Helena

Rapid diagnosis and treatment of Cushings syndrome (CS) is essential for good outcomes. Current standards for appropriate timelines for referral are under review by NHSE. Data are required to substantiate standard setting. Knowledge of current referral pathways/processes are required to explore delays in accessing definitive surgical treatment. An audit of referral processes at Queen Elizabeth Hospital Birmingham was undertaken and further expanded to 4 additional tertia...

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ea0081p22 | Adrenal and Cardiovascular Endocrinology | ECE2022

Mesenchymal Stem Cells exposed to persistently high glucocorticoid levels develop insulin-resistance and altered lipolysis: a promising in vitro model to study Cushing’s Syndrome

Di Vincenzo Mariangela , Martino Marianna , Lariccia Vincenzo , Giancola Giulia , Licini Caterina , Di Benedetto Giovanni Maria , Orciani Monia , Arnaldi Giorgio

Objective: In Cushings Syndrome, chronic glucocorticoid excess and their disrupted circadian rhythm lead to insulin-resistance, diabetes mellitus, dyslipidemia and cardiovascular comorbidities. As undifferentiated, self-renewing progenitors of adipocytes, mesenchymal stem cells may display the detrimental effects of glucocorticoid excess, thus revealing a promising model to study molecular mechanisms underlying metabolic complications of Cushings Syndrome.<p cl...

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ea0081p23 | Adrenal and Cardiovascular Endocrinology | ECE2022

Characterization of cytological assessments of adrenal lesions: A 12-year single center experience

Cristina Carasel Ana Maria , Juhlin C Christofer , Calissendorff Jan , Falhammar Henrik

Background: The accuracy of the radiological and laboratory findings used to investigate adrenal masses are not optimal and therefore additional investigation methods, such as fine needle aspiration (FNA) are sometimes needed. Different methods are used for obtaining FNA such as endoscopic ultrasound (EUS), transabdominal ultrasound and computerized tomography (CT)-guided biopsy.Methods: Using a search function incorporated in our institutional pathology...

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ea0081p24 | Adrenal and Cardiovascular Endocrinology | ECE2022

Midnight ACTH vs morning ACTH levels in Cushing’s syndrome diagnosis

Bahougne Thibault , Homsi Sarah , Ortega Francoise , Munch Marion , Meyer Laurent , Reix Nathalie , Vix Michel , Cebula Helene , Goichot Bernard , Jeandidier Nathalie

Cushings syndrome (CS) is a rare and complex condition. Once the diagnosis of CS is confirmed, repetitive morning ACTH measurement is indicated to assess whether CS is ACTH dependent or independent. ACTH under 2,2 pmol/l characterises ACTH-independent CS and above 4,4 pmol/l ACTH-dependent CS. Some groups recommend midnight ACTH measurement rather than the morning. The purpose of our work was to evaluate 12PM ACTH vs 8AM ACTH measurement in the etiological diagnostic of ...

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ea0081p25 | Adrenal and Cardiovascular Endocrinology | ECE2022

Fibroblast growth factor 21 contributes to adrenal cortex renewal

Diaz Catalan Daniela , Beyhart Arturo , Mora Mireia , Rodrigo Maite , Boswell Laura , Casals Gregori , Alexandra Hanzu Felicia

Objective: After Cushing Syndrome (CS) is cured, up to 70% of patients develop chronic adrenal insufficiency (AI) and hypothalamus-pituitary-adrenal (HPA) axis dysfunction. A long-term treatment with glucocorticoids (GC) is mandatory to overcome AI. However, this treatment implies non-desired complications. Fibroblast growth factor (FGF21), a key regulator of metabolism, has a bidirectional relationship with GC that bypasses the negative feedback of the HPA axis. In this study...

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ea0081p26 | Adrenal and Cardiovascular Endocrinology | ECE2022

Prevalence of NCAH, defined by 17-hyroxyprogesterone levels after ACTH-stimulation test, in a population with adrenal incidentaloma

Sahlander Fredrik , Bensing Sophie , Falhammar Henrik

Background: Nonclassic congenital adrenal hyperplasia (NCAH) is a condition associated with adrenal masses and suggested by current European guidelines to be considered in case of bilateral adrenal lesions. NCAH is caused by different mutations in the CYP21A2 gene coding for the 21-hydoxylase enzyme in the glucocorticoid synthesis leading to mild cortisol deficiency and elevated androgen and steroid precursor levels. 17-hydroxyprogesterone (17OHP) is the most importan...

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ea0081p27 | Adrenal and Cardiovascular Endocrinology | ECE2022

Multiplex serum steroid profiling using liquid chromatography mass spectrometry with post column infusion ammonium fluoride

Schiffer Lina , Shaheen Fozia , Gilligan Lorna , Storbeck Karl , Hawley James M , Keevil Brian , Arlt Wiebke , Taylor Angela

Background: Development of multi-steroid profiling allows comprehensive investigation into the different branches of steroid metabolism. Immunoassays only allow analysis of a single steroid per assay and suffer from problems with specificity due to cross reactivity of similar steroids. Liquid-chromatography mass spectrometry has the specificity to analyse multiple steroids in a single experiment and the dynamic range to quantify steroids at high concentrations such as those ob...

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ea0081p28 | Adrenal and Cardiovascular Endocrinology | ECE2022

Comparison of plasma metanephrines in patients with cyanotic and acyanotic congenital heart disease

Jensterle Mojca , Podbregar Ana , Janez Andrej , Rakusa Matej , Goricar Katja , Prokselj Katja

Background: Pheochromocytomas (PHEO) and paragangliomas (PGL) are rare neuroendocrine tumors that can lead to life-threatening conditions. The diagnosis of PHEO/PGL is established by measuring normetanephrine and metanephrine. Biochemical detection usually precedes clinical diagnosis of PHEO/PGL by several years. Co-occurrence of cyanotic congenital heart disease (CCHD) and PHEO/PGL has been reported but potential association remains unclear. We aimed to compare plasma metanep...

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ea0081p29 | Adrenal and Cardiovascular Endocrinology | ECE2022

The changing face of drug-induced adrenal insufficiency in the food and drug administration adverse event reporting system

Raschi Emanuel , Fusaroli Michele , Massari Francesco , Mollica Veronica , Repaci Andrea , Ardizzoni Andrea , Poluzzi Elisabetta , Pagotto Uberto , Di Dalmazi Guido

Importance: Adrenal insufficiency is a life-threatening condition complicating heterogenous disorders across various disciplines, with challenging diagnosis and a notable drug-induced component.Objective: To describe the spectrum and main features of drug-induced adrenal insufficiency through adverse drug event reports received by the Food and Drug Administration (FDA).Design: We conducted a retrospective disproportionality analysi...

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ea0081p259 | Adrenal and Cardiovascular Endocrinology | ECE2022

Outcome of COVID-19 infections in patients with adrenal insufficiency

Nowotny Hanna , Bryce Jillian , Giordano Roberta , Baronio Federico , Chifu Irina , Cools Martine , van den Akker Erica L.T. , Falhammar Henrik , Appelman-Dijkstra Natasha , Persani Luca , Beccuti Guglielmo , Glasberg Simona , Pereira Alberto M , Sverre Husebye Eystein , Hahner Stefanie , Ahmed Faisal , Reisch Nicole

Background: Only few cases of patients with adrenal disorders affected by coronavirus disease 2019 (COVID-19) have been reported so far. In this study, clinical outcome data of patients with adrenal disorders and COVID-19 infection has been collected by the ESE Rare Disease Committee and ENDO-ERN via the European Registries for Rare Endocrine Conditions (EuRRECa) project.Methods: This questionnaire included 32 questions on collecting quantitative and qua...

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ea0081p260 | Adrenal and Cardiovascular Endocrinology | ECE2022

Menopause and muscle mass of humans and increase in fat mass

Kumar Naween , Singh Siddharth , Prakash A S

Background: Menopause has been related to a deficiency of bulk and an increment in fat mass. Testosterone treatment is being considered to further develop body organization in menopausal women. Notwithstanding, the portion reaction connections among testosterone and the progressions in body structure and muscle strength in women have not been set up. To decide the portion subordinate impacts of reviewed dosages of testosterone on body arrangement and muscle strength in precise...

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ea0081p261 | Adrenal and Cardiovascular Endocrinology | ECE2022

Bilateral adrenal haemorrhage due to e.coli sepsis precipitating adrenal crisis in pregnancy: a case report

Ahmed Nabeel , Nair Sunil

A 25-year-old primi 26 weeks pregnant was admitted with B/L flank pain & pleuritic sounding chest pain. She was septic on initial assessment by the Obstetric team and preliminary investigations revealed high inflammatory markers, raised CRP of 336 & deranged LFTs. Her USS scan suggested possible hepatitis/cholangitis and blood cultures grew E. coli & she was started on IV Ceftriaxone & metronidazole for the same. At day 3 of her admission, she started det...

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ea0081p262 | Adrenal and Cardiovascular Endocrinology | ECE2022

Key role for vasopressin V2 receptors in hypertension development in Spontaneously Hypertensive Rats (SHRs)

Verzicchio Ignazio , Bongrani Alice , Tedeschi Stefano , Graiani Gallia , Cavazzini Stefania , Zappa Jessica , Palladini Barbara , Cremaschi Elena , Calvi Anna , Coghi Pietro , Vicini Vanni , Cannone Valentina , Volpi Riccardo , Borghetti Alberico , Cabassi Aderville

Water and electrolyte balance regulation plays a key role in essential hypertension pathogenesis. Indeed, alterations in kidney ability to excrete sodium and water in relation to intake have been proposed as a basic process of hypertension development. Vasopressin (AVP) acts through V2 receptors on the basolateral membrane of collecting duct principal cells to trigger the phosphorylation of Aquaporin 2 (AQP2) which moves from the cytoplasm to the apical membrane, making the ce...

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ea0081p263 | Adrenal and Cardiovascular Endocrinology | ECE2022

Development of a novel treatment strategy which involves thermal ablation of adrenal adenomas using electromagnetic energy

Farnan Richard , Bottiglieri Anna , Farina Laura , Senanayake Russell , Gurnell Mark , Prakash Punit , O'Halloran Martin , Cappiello Grazia , Newell Caoimhe , Keating Muireann , Rahmani George , Conall Dennedy Michael

Primary aldosteronism (PA) arises from one or both adrenal glands and is a common cause of secondary hypertension accounting for approximately 5-12% of all hypertension. Current therapy involves mineralocorticoid receptor antagonists for bilateral disease (60%) or adrenalectomy for unilateral disease (30%). We investigate treatment planning of percutaneous adrenal ablation as an alternative definitive therapeutic modality for unilateral and bilateral disease. The main objectiv...

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ea0081p264 | Adrenal and Cardiovascular Endocrinology | ECE2022

Mitotane side effects in the treatment of patients with adrenocortical carcinoma - a retrospective study

Barac Nekic Anja , Zibar Tomšić Karin , Sambula Lana , Matas Nino , Jambrović Martina , Petrak Iva , Dusek Tina , Kastelan Darko

Introduction: Mitotane is widely used to treat adrenocortical carcinoma (ACC) and remains the mainstay of treatment along with surgery. The aim of this study is to evaluate the adverse side effects of mitotane treatment.Materials and Methods: This retrospective study included 36 patients with ACC, ENSAT stage I- IV, who were treated with mitotane in an adjuvant or palliative setting. Patients with ENSAT stage IV who died within 6 months after surgery wer...

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ea0081p265 | Adrenal and Cardiovascular Endocrinology | ECE2022

Adrenergic crisis after SARS-COV-2 infection in a patient affected by pheochromocytoma

Novizio Roberto , Emanuele Rizzo Gaetano , Paragliola Rosa Maria , Maggio Ettore , Locantore Pietro , Maria Corsello Salvatore

Background: SARS-CoV-2 infection is characterized by aspecific symptoms (e.g., fever, cough) and can be complicated by viral pneumonia and many other manifestations can occur. Endocrinological complications have also been described. Pheochromocytomas are rare tumors located in the adrenal medulla, causing symptoms due to catecholamines overproduction and abrupt release. Catecholamines release can be continuous or intermittent and there can be several triggers including stress,...

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ea0081p266 | Adrenal and Cardiovascular Endocrinology | ECE2022

WBC count. A potential tool for suspecting Cushing’s syndrome (CS)

Paja Fano Miguel , Merlo-Pascual Ignacio , Rodriguez-Soto Josune , Moure-Rodriguez M. Dolores , Monzon-Mendiolea Andoni , Egana-Zunzunegui Nerea , Elias-Ortega Cristina , Cruz-Iglesias Elena , Oleaga-Alday Amelia

Early diagnosis of CS could reduce the morbidity and mortality associated with endogenous hypercortisolism. Many clinical methods have been proposed to establish suspicion of CS, but they show a poor positive predictive value (PPV) and are sometimes difficult to assess. Assuming the well-known influence of hypercortisolism on white blood cell (WBC) count, we evaluated its potential usefulness as a screening test to trigger this suspicion. We analysed WBC count around the diagn...

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ea0081p267 | Adrenal and Cardiovascular Endocrinology | ECE2022

Screening for non-classic congenital adrenal hyperplasia revisited: proposal for a new serum 17-hydroxyprogesterone threshold for which a cosyntropin stimulation test is indicated

Nakhleh Afif , Saiegh Leonard , Supino-Rosin Lia , Gendelman Raya , Shehadeh Naim , Zloczower Moshe

Introduction: The 250 μg cosyntropin stimulation test (CST) is used to diagnose non-classic congenital adrenal hyperplasia (NCCAH). The current recommendation to perform CST is when follicular morning 17-hydroxyprogesterone (17OHP) is higher than 6 nmol/l, and CST is considered positive for NCCAH diagnosis when the 60-minutes post-CST 17OHP serum level is above 30 nmol/l. These cut offs are mainly derived from radioimmunoassay (RIA) data. Recently, a validated enzyme-link...

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ea0081p268 | Adrenal and Cardiovascular Endocrinology | ECE2022

Almost half of patients using inhaled corticosteroids have secondary adrenal insufficiency

Batheja Vishal , Mittal Neeru , Jagan Jacob Jubbin

Context: Secondary adrenal insufficiency (SAI) has been identified in over 22% of adults using inhaled corticosteroids (ICS).1 This has been co-related with the total daily dose and type of ICS along with individual genetic susceptibility among the subjects using ICS.1,2 Our recent paper suggested that 2.8% of adults with euvolaemic hyponatremia admitted to the hospital had ICS related SAI.3Objective: To determine prevale...

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ea0081p269 | Adrenal and Cardiovascular Endocrinology | ECE2022

Evaluation of a tertiary centre specialist adrenal MDT: The first 900 patients

Child Louisa , Sagar Rebecca , Fraser Sheila , Collins Emma , Frood Russell , Scarsbrook Andrew , Abbas Afroze

Background: Adrenal incidentalomas are common amongst the general population, incidence increases with age. Radiological and biochemical assessment of all lesions >1 cm is standard practice to determine appropriate future management, as per current European guidelines. We report the experiences of a recently formalised adrenal multi-disciplinary pathway in a large UK teaching hospital, where all adrenal incidentalomas are referred and systematically assessed.<p cl...

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ea0081p270 | Adrenal and Cardiovascular Endocrinology | ECE2022

Proposition of the first histopathological classification of primary bilateral macronodular adrenal hyperplasia (pbmah) and its correlation with armc5 and kdm1a status

Violon Florian , Bouys Lucas , Vaczlavik Anna , Gaetan Giannone , Berthon Annabel , Ragazzon Bruno , Terris Benoit , Sibony Mathilde , Bertherat Jerome

Introduction: Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH) is a rare cause of ACTH-independent Cushing syndrome. It is characterized by the development of supracentimetric nodules resulting in increased adrenal volume and weight. Its presentation is clinically, radiologically and biologically heterogeneous. Morphological descriptions of PBMAH are rare. Although the initial description highlights that multinodular hyperplastic adrenal glands are made of a majority...

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ea0081p271 | Adrenal and Cardiovascular Endocrinology | ECE2022

The accuracy of adjusted unconventional indices for the assessment of selectivity and lateralization of adrenal vein sampling in the subtype diagnosis of primary aldosteronism

Bollati Martina , Parasiliti-Caprino Mirko , Bioletto Fabio , Ceccato Filippo , Lopez Chiara , Di Carlo Maria Chiara , Voltan Giacomo , Rossato Denis , Giraudo Giuseppe , Scaroni Carla , Ghigo Ezio , Maccario Mauro

Objective: This study aimed to evaluate the performance of simple and clinical/imaging-corrected unconventional indices in predicting the selectivity of adrenal vein sampling (AVS) and the lateralization of aldosterone hypersecretion in patients with primary aldosteronism (PA).Methods: Data of all consecutive patients with a proven diagnosis of PA who underwent AVS for subtype differentiation in two Italian referral centers were analyzed retrospectively....

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ea0081p272 | Adrenal and Cardiovascular Endocrinology | ECE2022

Characterization of molecular pathway alterations in Cushing’s Syndrome

Vetrivel Sharmilee , Zhang Ru , Khan Ali , Osswald Andrea , Reincke Martin , Sbieria Silviu , Riester Anna

Context: Transcriptomic based characterization of signaling pathways in the adrenals of different subtypes of Cushings syndrome.Patients: For preliminary NGS analyses, a total of 27 adrenal samples were used. The cohort consisted of the following patient groups: Cortisol producing adenoma (CPA, n=9), primary bilateral macronodular adrenal hyperplasia (PBMAH, n=10). The adjacent normal adrenal tissue from pheochromocytoma patients ...

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ea0081p273 | Adrenal and Cardiovascular Endocrinology | ECE2022

Salivary profiles of cortisol and cortisone in patients with primary adrenal insufficiency under replacement therapy: a pilot study

Tucci Lorenzo , Vicennati Valentina , Magagnoli Matteo , Colombin Giacomo , Coscia Kimberly , Rotolo Laura , Fanelli Flaminia , Pagotto Uberto , Di Dalmazi Guido

Background: Evaluation of steroid replacement therapy (SRT) in adrenal insufficiency (AI) is challenging for the lack of reliable parameters. Measurement of salivary cortisol and cortisone emerged as a non-invasive tool for AI management, however poorly investigated. Aim: To analyse the cortisol and cortisone circadian rhythm in normal controls (NC) and patients with primary AI (PAI) under different SRTs, and to identify useful biomarkers. <p class="...

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ea0081p274 | Adrenal and Cardiovascular Endocrinology | ECE2022

Progression of atherosclerosis after the menopause and the role of circulating Amyloid Beta 1-40

Lambrinoudaki Irene , Armeni Elena , Delialis Dimitrios , Georgiopoulos Georgios , Tual-Chalot Simon , Vlachogiannis Nikolaos , Patras Raphael , Aivalioti Evmorfia , Augoulea Areti , Tsoltos Nikolaos , Soureti Anastasia , Stellos Konstantinos , Stamatelopoulos Kimon

Background: A large body of evidence is supporting that the incidence of adverse cardiovascular events is increasing signfiicantly after the menopausal transition. Primary prevention practices continue to propose evolving algorithms, in an attempt to accurately estimate the actual female cardiovascular risk at midlife. Irrespectively of these attempts, considerable unrecognized cardiovascular disease (CVD) risk remains unexplained, beyond traditional risk factors (TRFs). On th...

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ea0081p275 | Adrenal and Cardiovascular Endocrinology | ECE2022

Heat shock protein 60 and Endothelial function in postmenopausal women

Armeni Elena , Soureti Anastasia , Augoulea Areti , Chondrou Asimina , Rizos Demetrios , Kaparos George , Delialis Dimitrios , Stefos Spyros , Angelidakis Lasthenis , Sianis Alexandros , Dimopoulou Aggeliki-Maria , Alexandrou Andreas , Baka Stavroula , Aravantinos Leon , Stamatelopoulos Kimon , Lambrinoudaki Irene

Background: Heat shock protein 60 (HSP60), a potentially homeostatic antigen, has been shown to be involved in physiological and non-physiological conditions. Experimental data is supporting the role of HSP60 in placental and mitochondrial steroidogenesis. Under stress conditions, HSP60 are translocated into the endothelial-cell plasma membrane and the extracellular space, promoting the atherosclerotic process. Aim: We decided to investigate the associat...

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ea0081p276 | Adrenal and Cardiovascular Endocrinology | ECE2022

Adrenal lesions - the importance of a careful evaluation

Dias Daniela , Figueiredo Ines , Duarte Cristina , Serra FIlipa , Leichsenring Carlos , Tavora Isabel , Paulo Fernandes Joao , Sapinho Ines

Most differential diagnoses of unilateral adrenal lesions include non-functional adenoma, adrenocortical carcinoma or pheochromocytoma. Primary adrenal lymphoma(PAL) is an extremely uncommon type of primary extranodal non-Hodgkins lymphoma(<1%). Most cases are bilateral (~75%), being unilateral PAL scarcely reported. The apparent unilateral involvement of this entity at presentation, in the CT scan/MRI may difficult the diagnosis, delaying the start of chemotherapy. ...

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ea0081p277 | Adrenal and Cardiovascular Endocrinology | ECE2022

Presenting clinical features of Cushing’s syndrome and non-classic hypercortisolism

Delle Donne Elisa , Parazzoli Chiara , Favero Vittoria , Chiodini Iacopo , Morelli Valentina , Aresta Carmen

Background: The Endocrine Society Guidelines recommend screening for hypercortisolism especially in patients with specific features that best discriminate Cushings Syndrome (CS): easy bruising, facial plethora, proximal myopathy and striae. Clinical experience suggests that these features, though suggestive of hypercortisolism, are not enough sensitive. Indeed, patients with hypercortisolism frequently manifest primarily less discriminatory cortisol-related features, suc...

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ea0081p278 | Adrenal and Cardiovascular Endocrinology | ECE2022

Success rate of adrenal venous sampling in iceland

Gunnarsdottir Hrafnhildur , Gudmundsson Jon , Birgisson Gudjon , Agusta Sigurjonsdottir Helga

Introduction: Primary aldosteronism is an important cause of hypertension. Adrenal venous sampling (AVS) is the gold-standard investigation to determine whether one or both adrenal glands are affected. AVS is a complicated procedure with success rate varying greatly from one hospital to another.Aims: To investigate the success rate of AVS at Landspitali over a 10-year period and compare it to published results from other hospitals....

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ea0081p279 | Adrenal and Cardiovascular Endocrinology | ECE2022

Effects of FSH on endothelial function

Santa Rocca Maria , Pannella Micaela , Foresta Carlo , Ferlin Alberto

Follicle-stimulating hormone (FSH) is a member of the glycoprotein hormone family that plays a pivotal role in ovarian folliculogenesis and spermatogenesis. FSH receptor (FSHR) is, indeed, highly expressed in granulosa and Sertoli cells respectively. However, recent studies have detected FSHR also in extra-gonadal tissues, such as adipose tissue, bone, endometrium, placenta, endothelium, monocytes, and malignant tissues, suggesting, that the activity of this hormone may not be...

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ea0081p280 | Adrenal and Cardiovascular Endocrinology | ECE2022

Coagulation parameters in asymptomatic patients with adrenal incidentaloma: is mild autonomous cortisol secretion correlated with thromboembolic risk?

Minnetti Marianna , Bonaventura Ilaria , Hasenmajer Valeria , De Alcubierre Dario , Tomaselli Alessandra , Ferrari Davide , Pofi Riccardo , Cozzolino Alessia , Sbardella Emilia , Lenzi Andrea , Isidori Andrea

Background: Overt hypercortisolism is highly associated with venous thromboembolism. Patients with Cushings syndrome (CS) typically show an alteration of the intrinsic coagulation pathway, especially an increase in factor VIII (f-VIII), and increased levels of coagulation inhibitors (i.e., antithrombin III) as a compensatory response. Mild autonomous cortisol secretion (MACS) has been variably associated with higher risk of cardiovascular events and mortality compared to...

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ea0081p281 | Adrenal and Cardiovascular Endocrinology | ECE2022

Management of pheochromocytoma and hyperaldosteronism coexistence

Verissimo David , Ivo Catarina , Duarte Vitoria , Martins Ana Claudia , Silva Joao , Lopes Luis , Passos Dolores , Castro J Jacome , Marcelino Mafalda

Introduction: Primary hyperaldosteronism (PHA) and pheochromocytoma are endocrine causes of secondary arterial hypertension. The association of hyperaldosteronism and pheochromocytoma is rare and the involved mechanisms are poorly understood. Either there is coexistence of the two diseases (pheochromocytoma with PHA) or the pheochromocytoma stimulates the production of aldosterone.Case Report: Male, 54 years old, referred to our department for type 2 dia...

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ea0081p282 | Adrenal and Cardiovascular Endocrinology | ECE2022

Behavior of metastatic paragangliomas and pheocromocytomas: experience from a single center

Verissimo David , damasio ines , Gomes Ana , Simoes-Pereira Joana , Donato Sara , Leite Valeriano

Paragangliomas (PGL) and pheochromocytomas (PHEO) are rare neuroendocrine tumors with an estimated prevalence of 1:6500 and 1:2500, respectively. Although most PGL/PHEO are benign, approximately 10% of PHEOs and 15-35% of PGLs have metastatic disease, which it is main cause of death, with 6 years of median survival. Objective: To characterize the metastatic PHEOs and PGLs from a single center. Methods: Retrospective analysis of clinical records of patients with metastatic PHEO...

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ea0081p283 | Adrenal and Cardiovascular Endocrinology | ECE2022

A single dose of Neutrophil Elastase inhibitor Elafin does not alter CBG cleavage during post-surgical stress in humans in vivo

Boyle Luke D , Nixon Mark , Underhill Caroline , Hill Lesley A , Lewis John G , Hammond Geoffrey L , Wiedow Oliver , Henriksen Peter A , Stimson Roland H , Walker Brian R

Introduction: Corticosteroid Binding Globulin (CBG) binds >85% of plasma cortisol and modulates free cortisol levels. Observations in vitro show that CBG is cleaved by neutrophil elastase (NE), a mechanism proposed to reduce CBG binding affinity and increase free cortisol availability to inflamed tissues. However, detection of cleaved CBG in vivo in human plasma is controversial, and any influence of NE on CBG cleavage has not been tested in vivo...

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ea0081p284 | Adrenal and Cardiovascular Endocrinology | ECE2022

Ang-Tie pathway in adrenocortical tumors angiogenesis

Oliveira Sofia , Pereira Sofia , Costa Madalena M. , Monteiro Mariana P , Pignatelli Duarte

The majority of adrenocortical tumors (ACT) are benign and hormonally non-functioning, in contrast to adrenocortical carcinomas (ACC), which are rare and usually very aggressive tumors. The differential diagnosis between these two entities is mainly based on unspecific and subjective criteria, contributing to the inaccuracy of diagnosis. Due to ACC molecular and biological heterogeneity, prognostic factors have a limited capacity to predict ACC clinical outcomes, leading to an...

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ea0081p285 | Adrenal and Cardiovascular Endocrinology | ECE2022

Prognostic value of endocrine biomarkers in patients admitted to intensive care unit for COVID-19

Varaldo Emanuele , Maria Berton Alessandro , Rosata Andrea , Montrucchio Giorgia , Rumbolo Francesca , Prencipe Nunzia , Ghigo Ezio , Brazzi Luca , Grottoli Silvia

Introduction: To date, there are no clear biochemical parameters to identify early COVID-19 cases at risk of complications in the Intensive Care Unit (ICU). Aim: To evaluate the prognostic potential of endocrine biomarkers associated with acute inflammatory conditions in ICU patients for COVID-19.Methods: Between 1/3/2020 and 31/12/2020 we recruited 126 consecutive patients at the admission to ICU 1U, Molinette University Hospital ...

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ea0081p286 | Adrenal and Cardiovascular Endocrinology | ECE2022

A novel mutation in creb3l1 gene involved in vasopressin synthesis pathway in patients with hypertensive cardiovascular diseases

Rauf Sania , Arshad Abida , Foo Roger , Akram Maleeha , Naz Shumaila , Naseem Afzaal Ahmed , Qayyum Mazhar , Raza Rizvi Syed Shakeel

Arginine vasopressin (AVP) is a neurohormone, which regulates blood and extracellular fluid volume and hence blood pressure (BP). AVP has its chief action in kidneys where it reduces flow of urine, increases permeability of convoluted tubules of kidneys to water and its reabsorption. It binds to receptors on sweat glands and decreases water loss by perspiration from the skin. Also, AVP binds to peripheral arteriolar receptors, causing vasoconstriction and increase in BP. The s...

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ea0081p287 | Adrenal and Cardiovascular Endocrinology | ECE2022

Whole exome sequencing of genes involved in dysfunctional renin-angiotensin-aldosterone system in hypertensive cardiovascular patients

Rauf Sania , Arshad Abida , Foo Roger , Akram Maleeha , Naz Shumaila , Ahmed Naseem Afzaal , Qayyum Mazhar , Raza Rizvi Syed Shakeel

The renin-angiotensin-aldosterone system (RAAS) is an endocrine system within the body that is essential for regulation of blood pressure (BP) and fluid balance. The system is mainly comprised of three hormones renin, angiotensin II (Ang II) and aldosterone. The RAAS pathway is initiated in the kidney with the proteolytic conversion of liver derived angiotensinogen to angiotensin I (Ang I) by renin secreted by juxtaglomerular apparatus of the nephron. Ang I is cleaved by angio...

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ea0081p517 | Adrenal and Cardiovascular Endocrinology | ECE2022

Impact of glucocorticoid-induced adrenal insufficiency on health-related quality of life

Willemoes Borresen Stina , Brun Boesen Victor , Watt Torquil , Bue Bjorner Jakob , Baslund Bo , Locht Henning , Bjork Thorgrimsen Toke , Jensen Bente , Sorensen Soren Schwartz , Lund Hetland Merete , Hansen Annette , Norregaard Jesper , Klose Marianne , Feldt-Rasmussen Ulla

Objective: Glucocorticoid-induced adrenal insufficiency is highly prevalent, but the clinical consequences are not fully understood. Therefore, the indication of adding stress dosages of glucocorticoid during ongoing anti-inflammatory glucocorticoid treatment remains unclear. The aim of this study was to determine the impact of adrenal function on health-related quality of life (HRQoL) in patients receiving ongoing low-dose prednisolone treatment.Methods...

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ea0081p518 | Adrenal and Cardiovascular Endocrinology | ECE2022

Laboratory evidence of hyperaldosteronism is common in patients with kidney stones – a retrospective single-center analysis

Skoberne Andrej , Jensterle Sever Mojca

Background: Kidney stones have been linked to chronic kidney disease and a higher probability of adverse cardiovascular events. Precise mechanisms that lead to these complications have not yet been elucidated. Most cases of kidney stones are idiopathic, related to metabolic disturbances like hypercalciuria, which often have a genetic background. There have been few reports of kidney stones associated with primary hyperaldosteronism (HA); however, the prevalence of HA in patien...

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ea0081p519 | Adrenal and Cardiovascular Endocrinology | ECE2022

Brain Structure in a cohort of young adult patients with Autoimmune Addison’s Disease

van't Westeinde Annelies , Padilla Nelly , Strom Sara , Kampe Olle , Bensing Sophie , Lajic Svetlana

Background: Both cortisol and other adrenal hormones are well known to affect brain structure and function throughout development. Due to destruction of the adrenal cortex, patients with Autoimmune Addisons disease (AAD) lack production of adrenal hormones and therefore receive lifelong replacement of cortisol and aldosterone, and, for some female patients dehydroepiandrosterone (DHEA). However, replicating the natural rhythm of secretion is difficult, and patients are o...

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ea0081p520 | Adrenal and Cardiovascular Endocrinology | ECE2022

Cortical-sparing adrenalectomy for bilateral pheochromocytoma - is it a game worth the candle? Systematic review with meta-analysis comparing total vs partial adrenalectomy in bilateral pheochromocytoma

Zawadzka Karolina , Tylec Piotr , Małłczak Piotr , Major Piotr , Pe¸dziwiatr Michał , Pisarska-Adamczyk Magdalena

Background: Bilateral total adrenalectomy (TA), despite causing persistent adrenal insufficiency with lifetime replacement of corticosteroids, is the method of choice in patients with bilateral pheochromocytoma. Partial adrenalectomy (PA) is an alternative approach that aims to balance tumor removal while maintaining adrenal function, although the oncological completeness of the procedure is questionable.Objective: The aim of this systematic review and m...

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ea0081p521 | Adrenal and Cardiovascular Endocrinology | ECE2022

Inflammation in Hypertensive Patients with Type 2 Diabetes on Stable Therapy with Non-dipper and Dipper Status

Matiashova Lolita , Isayeva Ganna

Background: Hypertension has a negative effect on the cardiovascular system, but the data are limited about the connection between non-dipper hypertension and inflammation in patients with type 2 diabetes (T2D) and without.Aim: To study the effects of dipper and non-dipper hypertension with and without type 2 diabetes on inflammatory factors. Methods: The cross-sectional study included 97 hypertensive patients (57 men) without type...

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ea0081p522 | Adrenal and Cardiovascular Endocrinology | ECE2022

Gastric monomorphic epitheliotropic intestinal T-cell lymphoma with bilateral adrenal metastases

Kaliakatsou Eirini , Markou Athina , Papanastasiou Labrini , Giagourta Irini , Kalantzi Athanasia , Dimitriadi Anastasia , Lenos Michael , Kounadi Theodora , Fountas Athanasios

Introduction: Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), formerly known as type II enteropathy-associated T-cell lymphoma, is a rare and aggressive subtype of lymphoma of the gastrointestinal track typically noted in Asian or Hispanic populations. Adrenal involvement as part of MEITL is extremely rare. Herein we present a patient of Greek origin with MEITL and bilateral adrenal metastases.Case Presentation: A 74-year-old man presente...

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ea0081p523 | Adrenal and Cardiovascular Endocrinology | ECE2022

A retrospective evaluation of the utility of overnight dexamethasone suppression tests in over 500 patients evaluated for hypercortisolism

Sagar Rebecca , Elsabbagh Mohamed , Gibbons Stephen , Abbas Afroze

Background: Overnight dexamethasone suppression tests (ONDST) are conducted to investigate patients with symptoms suggestive of cortisol hypersecretion or if an adrenal incidentaloma is identified. Cortisol levels of 50 nmol/l and above following ONDST may be related to autonomous cortisol secretion (ACS) and require further investigation. Determining likely presence of ACS is essential given reported associations with type 2 diabetes mellitus (T2DM), obesity, cardiovascular d...

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ea0081p524 | Adrenal and Cardiovascular Endocrinology | ECE2022

HIF-2α is detrimental for the functioning of the adrenal medulla

Watts Deepika , Bechmann Nicole , Mohr Hermine , Kruger Anja , Pellegata Natalia S. , Eisenhofer Graeme , Peitzsch Mirko , Wielockx Ben

The adrenal gland is a crucial regulator of numerous fundamental biological processes and its hormones are essential for maintaining homeostasis in normal and stressful situations. However, the impact of hypoxia signalling on the function of the adrenal remains poorly understood. During the past years, our research group has focused on enhancing our understanding of hypoxia pathway proteins (HPPs) in the different areas of the adrenal gland. Firstly, we described a crucial rol...

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ea0081p525 | Adrenal and Cardiovascular Endocrinology | ECE2022

Characterization of angiotensin II-induced dual-specificity MAPK phosphatase gene expression changes in vascular smooth muscle cells

Gem Janka , Kovacs Kinga , Balla Andras , Hunyady Laszlo

Angiotensin II (AngII) is an octapeptide hormone, which participates in physiological and pathological mechanisms. AngII exerts a number of biological effects through the type 1 angiotensin II receptor (AT1R). One of the main targets of AngII are vascular smooth muscle and its stimulation activates numerous signaling pathways that cause contraction and could also result in gene expression changes in vascular smooth muscle cells (VSMCs). Next-generation sequencing (NGS) experim...

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ea0081p526 | Adrenal and Cardiovascular Endocrinology | ECE2022

Testosterone, hypogonadism, and heart failure: a systematic and critical review

Di Lodovico Elena , Facondo Paolo , Delbarba Andrea , Chiara Pezzaioli Letizia , Maffezzoni Filippo , Cappelli Carlo , Ferlin Alberto

Background: Male hypogonadism is defined by low circulating testosterone level associated with signs and symptoms of testosterone deficiency. Although the bidirectional link between hypogonadism and cardiovascular disease has been clarified recently, the association between testosterone and chronic heart failure (CHF) is more controversial. Methods: We critically review published studies relating to testosterone, hypogonadism, and CHF and provide practic...

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ea0081p527 | Adrenal and Cardiovascular Endocrinology | ECE2022

Impact of covid-19 on arterial stiffness

Sadeep Nevin , Sahay Rakesh , K Neelaveni

Introduction: Recently published research works have concluded that Covid-19 infection will result in endothelial dysfunction or worsen it, especially when associated with comorbidities such as diabetes mellitus. Arterial Stiffness is a manifestation of endothelial dysfunction and it can be used as a prediction parameter as well as a target for therapies aimed at ameliorating endothelial cell dysfunction.Aims and Objectives: To compare arterial stiffness...

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ea0081p528 | Adrenal and Cardiovascular Endocrinology | ECE2022

The role of neuropeptide Y in the pathogenesis of vasovagal syncope

Lazurova Zora , Lazurova Ivica , Mitro Peter , Popovnakova Marcela

Introduction: Vasovagal syncope (VVS) is a transient loss of conscioussness due to hypoperfusion of the brain caused by vasodepressoric and/or cardioinhibitory reflex. In the pathogenesis, a dysregulation of autonomic nervous system is playing an important role. There is a growing evidence about more complex neurohumoral background of VVS. Neuropeptide Y (NPY) is hormone involved in the regulation of blood pressure with potent vasoconstriction effect. Moreover, NPY is also a c...

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ea0081p529 | Adrenal and Cardiovascular Endocrinology | ECE2022

Characteristics of patients with life-threatening events in pheochromocytoma

Lider-Burciulescu Sofia-Maria , Gheorghiu Monica Livia , Badiu Corin

Introduction: Pheochromocytomas and paragangliomas (PPGLs) are rare tumors of the chromaffin tissue characterised by catecholamine excess. Cardiovascular complications, such as hypertensive crisis and catecholamine-induced cardiomyopathy, are known to be the most frequent causes of life-threatening events in PPGLs patients.Design: We analysed records of patients diagnosed with PPGLs in one referral centre from Romania between 1976 and 2021 (n= 1...

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ea0081p530 | Adrenal and Cardiovascular Endocrinology | ECE2022

Objective markers and new indicators in adrenal insufficiency- findings from the omni-aid study comparing hydrocortisone and prednisolone replacement therapy

Choudhury Sirazum , Thaventhiran Thilipan , Lazarus Katharine , Tan Tricia , Meeran Karim

Background: Adrenal insufficiency (AI) is a life-threatening condition if left unmanaged. Despite treatment patients can expect a life expectancy that is shortened by 12 years secondary to probable inherent over-replacement associated with oral glucocorticoid regimens. Thrice-daily hydrocortisone is the most common regimen used. Very low-dose prednisolone (2-4 mg) is an alternative with lower uptake due to the absence of evidence for its use. This study fills this literature g...

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ea0081p531 | Adrenal and Cardiovascular Endocrinology | ECE2022

Long-term efficacy and safety of pasireotide in patients with Cushing’s disease: a monocentric experience

Alessi Ylenia , Luisa Torre Maria , Giovinazzo Salvatore , Giuffrida Giuseppe , Giandalia Annalisa , Casablanca Rosalinda , Flavio Angileri Filippo , Ragonese Marta , Ferrau Francesco , Cannavo Salvatore

Pasireotide is the first pituitary-directed approved therapy for Cushings disease (CD), effective in reducing UFC >50% in about half of patients, and with a good tolerability profile but associated with a relatively high incidence of hyperglicemia. The aim of this study was to evaluate efficacy and safety of long-term treatment with pasireotide (PAS) in patients with CD. Methods: We retrospectively evaluated 17 consecutive patients (11 females) with CD treated with P...

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ea0081p532 | Adrenal and Cardiovascular Endocrinology | ECE2022

Covid-19 in patients with hypocortisolism: clinical syndrome, disease duration and glucocorticoid replacement therapy

Simeoli Chiara , Schettino Serafina , La Rocca Angelica , Di Paola Nicola , Massimo Crescenzo Erminio , Ciardella Francesco , Mazzarella Alessandro , Pivonello Claudia , Colao Annamaria , Pivonello Rosario

Coronavirus disease caused by SARS-CoV-2 virus (Covid-19) is associated with a variable clinical syndrome, ranging from a mild-moderate to a severe disease, progressing towards acute respiratory distress syndrome. Hypocortisolism is associated with a depletion of innate immunity and disruption of immune response, which could contribute to an increased risk of infection and development of a severe disease. Glucocorticoid (GC) replacement therapy(GCRT), especially if administere...

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ea0081p533 | Adrenal and Cardiovascular Endocrinology | ECE2022

Renin indicates the mineralocorticoid activity of fludrocortisone: a 6-year study in primary adrenal insufficiency

Ceccato Filippo , Torchio Marianna , Tizianel Irene , Barbot Mattia , Sabbadin Chiara , Betterle Corrado , Scaroni Carla

Context: Fludrocortisone (FC) is the mineralocorticoid (MC) replacement treatment for patients with primary adrenal insufficiency (PAI). Objective: To explore the dose of FC treatment and its relationship with glucocorticoid therapy, sodium, potassium, renin and clinical parameters. Design: Longitudinal study.Setting: Monocentric cohort.Patients: Data of 193 patients with PAI (130 autoi...

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ea0081p534 | Adrenal and Cardiovascular Endocrinology | ECE2022

Reevaluation of the 1-mg overnight low-dose dexamethasone suppression test in the diagnosis of Cushing’s syndrome

Chehaider Cyrine , Oueslati Ibtissem , Terzi Amani , Yazidi Meriem , Chihaoui Melika

Introduction: The 1-mg overnight low-dose dexamethasone suppression test is used as a screening tool when Cushings syndrome is suspected. However, the biological confirmation of this syndrome is based upon the measurement of 24-hour urinary free cortisol and low-dose dexamethasone suppression test (Liddle test). The aim of this study was to assess the performance of the 1-mg overnight low-dose dexamethasone suppression test in the diagnosis of Cushings syndrome.</p...

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ea0081p535 | Adrenal and Cardiovascular Endocrinology | ECE2022

Minimally invasive treatment of conn’s adenoma: real world cases in tertiary oncology center

Costa Claudia , Franco Sara , Santos Ana Paula , Goncalves Belarmino , Gil-Santos Sara , Oliveira Joana , Souteiro Pedro , Jose Sousa Maria , Torres Isabel

Introduction: Primary aldosteronism (PA) is a rare but underestimated cause of hypertension. PA has been associated with increased risk of malignancy through mechanisms involving up-regulation of the renin angiotensin system (RAS) promoting an enzymatic cascade influencing carcinogenesis. Recently, Microwave Ablation (MWA) has been established as an effective and safe minimal invasive treatment for Conns Disease.Aim: The authors present four clinic...

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ea0081p536 | Adrenal and Cardiovascular Endocrinology | ECE2022

Glucocorticoid resistance syndrome : Case report

Settai Yousra , Essabah Haraj Nassim , El Aziz Siham , Chadli Asma

Introduction: Glucocorticoid resistance syndrome is a rare disease, sporadic or familial, of autosomal dominant or recessive inheritance. It is a partial or complete inability of glucocorticoids to exert their effects on target tissues. Associated with compensatory increases in corticotropin and circulating cortisol with excessive secretion of adrenal androgens and mineralocorticoids.Observation: A 67-year-old patient, having recently discovered diabetes...

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ea0081p537 | Adrenal and Cardiovascular Endocrinology | ECE2022

Management of persistent subclinical hypercortisolism post left adrenalectomy in a patient with primary bilateral macronodular adrenal hyperplasia with aberrant receptors

Moustaki Melpomeni , Papadimitriou Kasiani , Papanikolaou Vasiliki , Cherolidi Eleni , Rigana Maria , Kyriakopoulos Georgios , Kalogeris Nikolaos , Vryonidou Andromahi

Introduction: Endogenous subclinical hypercortisolism occurs in 5-30% of patients with adrenal incidentalomas. Adrenal adenoma is the commonest cause of autonomous cortisol secretion (ACS), while primary bilateral macronodular adrenal hyperplasia (PBMAH) is rare. In both, ACS results from activation of the cAMP/PKA pathway. This may be triggered by ligands, other than ACTH, acting upon aberrant G-protein coupled receptors (GPCRs), which may also control locally produced ACTH i...

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ea0081p538 | Adrenal and Cardiovascular Endocrinology | ECE2022

Primary adrenal angiosarcoma within a hematoma

Rodrigues Elisabete , Oimenta Tiago , Pinheiro Jorge , Carvalho Davide , Manuel Lopes Jose

Introduction: Angiosarcomas account for < 1% of all sarcomas, and are highly agressive neoplasms whose clinical course is striking: local recurrence, metastasis, and a high mortality rate. Primary angiosarcoma of the adrenal gland was first described in 1988 by Kareti et al. and is very rare with, so far, only 51 reported cases. Case report: A 49-year-old male, without prior malignancy, presented with a 4.9x5.9 cm right adrenal nodule and a 2.4 cm le...

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ea0081p539 | Adrenal and Cardiovascular Endocrinology | ECE2022

Hypertension of adrenal origin - a never-ending story

Popa Miruna Maria , Cristina Pascu Raluca , Lucian Pavel Mihai , Malinici Elisabeta Andreea , Sirbu Anca , Simona Fica

Background: Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors characterized by a high degree of variability and unpredictability. Coexistence of PPGLs and adrenocortical adenomas is an uncommon occurrence that can further complicate the clinical course. Objective: We describe the diagnostic and management challenges of a patient with a history of surgically removed pheochromocytoma, presenting with symptoms of catecholamine exce...

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ea0081p540 | Adrenal and Cardiovascular Endocrinology | ECE2022

Challenges and anxiety of fluctuating normal to mild/moderate elevations of urinary catecholamines and metanephrines in clinical practice

Grant Bonnie , Emami Mohammadreza , Adam Siraj , Casey Edel , Tanday Raj , Hawkins Anna , Stojanovic Nemanja , Syed Imran , Nikookam Khash

We present a 70-year-old female who was initially referred to the endocrinology clinic for an assessment of her type 2 diabetes mellitus. She has a complex medical history including treated hypothyroidism, mastectomy for breast cancer and ongoing yearly surveillance for an excised benign lung lesion. On further questioning she acknowledged feeling generally unwell in the days prior to her appointment and had self-presented to the emergency department with undiagnosed hypertens...

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ea0081p541 | Adrenal and Cardiovascular Endocrinology | ECE2022

Gender and age-matched case control study of a cohort of adrenal adenomas

Imbroll Miriam Giordano , Agius Stefanie , Craus Sarah , Gruppetta Mark

Background: The majority of adrenal incidentalomas are benign and patients can be reassured, but a personalized and multidisciplinary approach is required when dealing with these lesions, since they might be linked with various comorbidities. The aim of our study was to carry out an in-depth analysis of the biochemical workup of adrenal incidentalomas and comparing the results with controls. Methods: 252 patients with an incidentally discovered adrenal a...

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ea0081p542 | Adrenal and Cardiovascular Endocrinology | ECE2022

Mortality in patients with non-functional adrenal tumors: a swedish population-based national cohort study

Patrova Jekaterina , Mannheimer Buster , Lindh Jonatan D , Falhammar Henrik

Background: It is not known if non-functional adrenal adenomas (NFAA) are associated with increased mortality.Objective: To investigate mortality in patients with NFAA and compare with matched controls. Design: Retrospective register-based national cohort study.Methods: Patients diagnosed with NFAA in Sweden 2005-2019 were identified and followed until death or 2020. For each case, four age/sex/municipality-m...

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ea0081p543 | Adrenal and Cardiovascular Endocrinology | ECE2022

Whole blood transcriptomic profile of Cushing’s syndrome

Armignacco Roberta , Daniel De Murat , Jouinot Anne , Bouys Lucas , Perlemoine Karine , Letourneur Franck , Adoux Lucie , Zennaro Maria-Christina , Bertherat Jerome , Assie Guillaume

Background: Cushings syndrome, caused by an excess of circulating glucocorticoids, is associated with high morbidity and presents high inter-individual variability. The earlier the diagnosis, the better the treatment effectiveness and the prognosis. Hormone assays, routinely used, contribute to identify Cushings syndrome. However, no biomarker is currently available to directly quantify the biological action of glucocorticoids. Blood samples represent an easily obt...

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ea0081p544 | Adrenal and Cardiovascular Endocrinology | ECE2022

Adrenal incidentaloma follow-up

Ivo Catarina , Duarte Vitoria , Verissimo David , Claudia Martins Ana , Silva Joao , Lopes Luis , Passos Dolores , Jacome Castro Joao , Marcelino Mafalda

Introduction: About 5% of the adult population has adrenal incidentaloma(AI) and its incidence increases with age. AACE guidelines recommend image and hormonal evaluation during 5 years in non functioning AI. The europeans guidelines advise against repeat evaluation in non-secretory AI that present with <4 cm and had benign features. According to recent studies, the risk of developing clinically relevant hormone secretion is <0.3%, in patients with previous non-f...

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ea0081p545 | Adrenal and Cardiovascular Endocrinology | ECE2022

Abstract Withdrawn...

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European Congress of Endocrinology 2022

BiosciAbstracts