Adrenal and Cardiovascular Endocrinology

ea0090ep1 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal Haemorrhages: A review of cases presenting to University Hospital Southampton over six-year period

Umer Muhammad , Bujanova Jana , Al-Mrayat Ma'en , Aslam Hina

Introduction: Adrenal haemorrhage (AH) carries high mortality and morbidity. It can be unilateral or bilateral (BAH), trauma or non-trauma (NT) related. The predisposing factors include adrenal tumours, anticoagulation, thrombocytopenia, sepsis, thromboembolic disease, pregnancy, liver transplant and vaccine-induced-immune-thrombocytopenia-and-thrombosis. BAH can result in an adrenal crisis in up to 15%. BAH is usually associated with conditions contributing to adrenal vein sp...

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ea0090ep2 | Adrenal and Cardiovascular Endocrinology | ECE2023

A Case of Ectopic Adrenocortical Cancer Originating from the Pancreas

İşler Alperen Onur , Akkapulu Nezih , Kavuncuoğlu Altan , Fırlatan Buşra , Unluturk Uğur

Background: Ectopic malignancies arising from adrenal rests are extremely rare. Localization has been reported in the retroperitoneum, testis/scrotum, ovary, kidney, anterior abdominal wall, spinal cord, and liver associated with embryological development 1-3.Objective: This report presents a case of ectopic adrenocortical cancer (ACC) localized to the pancreas. An exciting feature of the case was the simultaneous presence of breast cancer.</p...

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ea0090ep3 | Adrenal and Cardiovascular Endocrinology | ECE2023

A rare case of slowly progressing myopathy of unknown origin in a patient with Autoimmune polyglandular syndrome type 1 (APS-1)

Bondarenko Axenia , Belaya Zhanna , Rozhinskaya Liudmila , Fadeyev Valentin

We report a 53-year-old man. At age 3, the patient was diagnosed with chronic mucocutaneous candidiasis. At age 41 the patient started losing all hair on the body with total boldness. At age 43, he first complained of muscle weakness resulting in difficulty walking, back pain and difficulties holding his head in an upright position. At age 49, he was diagnosed with chronic primary adrenal insufficiency and hypoparathyroidism. Genetic analysis confirmed APS-1 (c.769C>T p.R2...

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ea0090ep4 | Adrenal and Cardiovascular Endocrinology | ECE2023

A case report of a single patient with a dual-functioning incidental adrenal tumor

Lackovic Milena , Samardzic Vladimir , Joksimovic Bojan , Sinik Marija , Tomasovic Martina , Isenovic Esma R. , Gluvic Zoran

Introduction: An undefined lesion detected by imaging methods in one or both adrenals is known as an incidentaloma. The size and capacity of the secretion are evaluated to determine its definitive management. It is extremely uncommon for a mixed adrenal incidentaloma to appear with elevated cortisol and medullar hormone output.Case report: A 21-year-old woman was admitted to the hospital with intermittent palpitations, headaches, and chest pain. She was ...

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ea0090ep5 | Adrenal and Cardiovascular Endocrinology | ECE2023

A case of Conn syndrome presenting as persistent post-partum hypertension

Aung Ei Thuzar , Kejem Helmine , Khan Muhammad Ilyas , Thondam Sravan

Introduction: Conns syndrome is a well-known cause of secondary hypertension; however, its association with pregnancy is rare. We discuss an interesting case of Conn syndrome presented with severe hypertension 8 weeks post-partum.Case report: A 34-years-old lady, previously fit and well, presented with severe hypertension (blood pressure189/115 mmHg) and hypokalaemia (K-2.5 mmol/l) at 8 weeks post-partum. Antenatal records indicated she was n...

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ea0090ep6 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cushing syndrome due to ACTH-secreting pheochromocytoma

Pana Monica-Mirela , Tudorancea Ancuta

Introduction: Pheochromocytomas are neuroendocrine tumors derived from chromaffin cells which secrete catecholamines. Cushing syndrome due to ACTH-secreting pheochromocytomas is a rare condition and early recognition and treatment is important to decrease morbidity and mortality.Case presentation: We present the case of an 53 years-old man who arrived at the hospital for pain in the right scapula agravated in the last three months with iradiation in the ...

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ea0090ep7 | Adrenal and Cardiovascular Endocrinology | ECE2023

Clinical symptoms, imaging and hormonal tests that suggest phaeochromocytoma in a patient with a solitary fibrous tumor incidentally discovered in the adrenal gland

Kurzyńska Anna , Nowak Andrzej , Ulatowska-Białas Magdalena , Sierżęga Marek , Bobrzyński Łukasz , Przybylik-Mazurek Elwira , Hubalewska-Dydejczyk Alicja

The solitary fibrous tumor is a rare spindle cell neoplasm, originally described in the pleural cavity. However, it can occur in other locations. SFTs that originate from the adrenal gland tissue are extremely rare. To date, only single cases have been described in the literature. We present a case of a 61-year-old Caucasian man with a SFT of the left adrenal gland. The patient was hospitalized in the internal medicine department due to paroxysmal hypertension (up to 190/100 m...

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ea0090ep8 | Adrenal and Cardiovascular Endocrinology | ECE2023

Metabolic changes in transgender people after gender-affirming hormone therapy

Toscano Esteban Sanchez , Gavira Isabel Mateo , Riscart Jesus Dominguez

Introduction: Demand for health care for transsexual people has increased exponentially in last years, especially among adolescents and young adults. Gender-affirming hormones (GAHs) are initiated to accommodate secondary sexual characteristics to the desired sex. Published studies about metabolic repercussion of GAHs are heterogeneous and report diverse results. Our objective is to evaluate the effect of GAHs on cardiovascular risk factors in transsexual population treated in...

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ea0090ep9 | Adrenal and Cardiovascular Endocrinology | ECE2023

The role of early postoperative aldosterone in saline infusion test in the prediction of primary aldosteronism remission

Mandic Ante , Tomšić Karin Zibar , Kraljevic Ivana , Kastelan Darko

Objectives: This study aimed to assess the ability of aldosterone in saline infusion test (SIT) to predict biochemical remission of primary aldosteronism.Methods: We retrospectively analysed 42 patients (19 (45%) females, mean age 49&pm;12 years) with primary aldosteronism who underwent adrenalectomy (after adrenal vein sampling confirmation of unilateral disease) from 2017 to 2022. Aldosterone in SIT was determined on the fifth postoperative day, as wel...

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ea0090ep10 | Adrenal and Cardiovascular Endocrinology | ECE2023

Hair cortisol measurement in the diagnosis and management of adrenal disorders

Abu-Lebdeh Haitham , Heshmati Hassan

Introduction: The acute status of the hypothalamic-pituitary-adrenocortical (HPA) axis is routinely assessed by the measurements of cortisol in blood, saliva, and urine. Because cortisol is continuously deposited in the growing hair shaft, hair cortisol can serve as a practical measure of long-term retrospective HPA axis activity. The purpose of this review is to present the relevance of hair cortisol measurement in the diagnosis and management of Cushings syndrome and a...

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ea0090ep11 | Adrenal and Cardiovascular Endocrinology | ECE2023

Carriers of a pathological variant in CYP21A2 gene– clinical and hormonal status

Schipor Sorina , Procopiuc Camelia , Stancu Cristina , Vintila Madalina , Brehar Andreea Cristiana , Muresan Andrei , Manda Dana , Caragheorgheopol Andra , Elena Dumitrica Alina , Udrea Luminita , Vladoiu Suzana , Gherlan Iuliana

Introduction: 21-hydroxylase deficiency (21OHD) is an autosomal recessive disorder and the diagnosis is confirmed by the presence of at least two biallelic pathogenic variants. The phenotype is determined by the less deleterious variant. The relevance of hormonal assessment to distinguish between heterozygote carriers of pathologic mutations and non-carriers or genetically defined 21OHD patients is still a matter of debate. Identifying the heterozygous genotype is important in...

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ea0090ep12 | Adrenal and Cardiovascular Endocrinology | ECE2023

Myocardial Infarction with non-obstructed coronaries: uncommon presentation of pheochromocytoma

Alexandrino Jorge Henrique Carmona , Almeida Ferreira Marta , Ramalho Diogo , Ferreira Diogo Santos , Silva Gualter Santos , Almeida Joao Goncalves , Oliveira Maria Joao

Background: Pheochromocytoma (PHEO) is a rare neuroendocrine tumour, classically presenting with hypertension, palpitations and headaches. Some patients have atypical presentations. We report a case of Myocardial Infarction with non-obstructed coronaries (MINOCA) as the key to unravel the diagnosis of PHEO.Clinical case: A 53-year-old man with type 2 diabetes mellitus and hypertension (under gliclazide MR 60 mg id, bisoprolol 5 mg id, ramipril 5 mg id an...

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ea0090ep13 | Adrenal and Cardiovascular Endocrinology | ECE2023

Evaluating the diagnostic capacity of the saline infusion and captopril challengetests for primary aldosteronism

Gonzalez Isabella Mantellini , Valencia Sime Rogic , Soriano Ines Borrego , Perez Paula Vazquez , Moreno Rosa Maria Garcia , Catalan Arturo Lisbona , Vazquez Gumersindo Fernandez , Dominguez Oscar Moreno , Alcala Beatriz Barquiel , Larrauri Miriam Zapatero , Casaus Maria Luisa Gonzalez , Garcia Irene Aguilera , Valderrama Alexa Pamela Benitez , Lobo Ines , Escola Cristina Alvarez , Rojas-Marcos Patricia Martin , Ramirez Paola Parra

Introduction: Primary aldosteronism (PA) is the most common cause of secondary hypertension. Guidelines recommend a confirmatory test in the majority of suspected cases: oral sodium loading, saline infusion test (SIT), captopril challenge test (CCT), or fludrocortisone suppression test. The SIT and CCT are most commonly used in clinical practice to study autonomous aldosterone secretion.Objectives and Methods: We compared the CCTs diagnosis perform...

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ea0090ep14 | Adrenal and Cardiovascular Endocrinology | ECE2023

Paraganglioma mimicking a tumor of the liver in an elderly patient

Pana Monica-Mirela , Sirbu Anca , Popa Miruna Maria , Fica Simona

Introduction: Paragangliomas are neuroendocrine tumors that are derived from the embryonic neural crest cells. Because the paraganglia are widespread through the body, paragangliomas can be found in unusual anatomic locations and the diagnosis can be hard to establish. Case presentationWe present the case of an 72 year-old, hypertensive woman who arrived at the hospital for pain in the right hypochondrium. General examination revealed an abdomen without signs of peritoneal irr...

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ea0090ep15 | Adrenal and Cardiovascular Endocrinology | ECE2023

A single center experience of extraadrenal paragangliomas–clinical and molecular analysis

Kurzyńska Anna , Opalinska Marta , Skalniak Anna , Rzepka Ewelina , Gilis-Januszewska Aleksandra , Przybylik-Mazurek Elwira , Hubalewska-Dydejczyk Alicja

Paragangliomas are rare neuroendocrine neoplasms that arise from chromaffin tissue commonly located in the adrenal medulla, pre-aortic and paravertebral sympathetic plexus or skull base. About 30% of paragangliomas have a genetic basis. They may be associated with autosomal dominant inheritance of variants in the gene encoding succinate dehydrogenase or may coexist in genetically determined endocrine syndromes. The study aim was to analyse clinical and molecular data of patien...

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ea0090ep16 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal venous sampling in tertiary centre from 2015. to 2022

Matas Nino , Tomšić Karin Zibar , Sambula Lana , Nekic Anja Barac

Background: Adrenal venous sampling (AVS) is considered the gold standard for differentiating an aldosterone- producing adenoma (aPA) from bilateral adrenal hyperplasia (BAH)Objective: The aim of this study is to present our experience with this method in our hospital.Methods: We performed a retrospective analysis of 105 patients who underwent the AVS protocol at our centre between 2015 and 2022 for PA.Result...

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ea0090ep17 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal lesions in patients with familial adenomatous polyposis

de Carlos Joaquin , Zabalza Lucia , Oquinena Susana , Irigaray Ana , Anda Emma

Introduction: Familial Adenomatous Polyposis (FAP) is an autosomal dominant disease classically characterized by the development of hundreds or thousands of adenomas in the rectum and colon during the second decade of life. Almost all patients will develop colorectal cancer (CRC) if not identified and treated at an early stage. It is a multisystem growth disorder so there is an increased risk of developing extraintestinal manifestations. In this context, an increase in adrenal...

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ea0090ep18 | Adrenal and Cardiovascular Endocrinology | ECE2023

Insulin Signaling in Hyperactivation of the HPA Axis in Metabolic Diseases

Cozma Diana , Siatra Panagiota , Oikonomakos Ioannis , Bornstein Stefan , Andoniadou Cynthia , Steenblock Charlotte

Stress can lead to an increase in body fat and obesity as main clinical conditions preceding the metabolic syndrome. In metabolic stress, hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis has been observed, resulting in increased steroidogenesis and alteration of cortisol secretion1. This increased sensitivity of the HPA axis may be related to the development of comorbidities or severe illness in patients with metabolic diseases and vice ...

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ea0090ep19 | Adrenal and Cardiovascular Endocrinology | ECE2023

21-hydroxylase deficient congenital adrenal hyperplasia in adult endocrinology clinics of turkey: A nationwide multicenter study

Ertorer Melek Eda , Anaforoglu İnan , Yilmaz Nusret , Akkus Gamze , Turgut Seda , Unluhizarci Kursad , Selcukbiricik Ozlem Soyluk , Merdin Fatma Avcı , Karakilic Ersen , Pehlivan Esma , Yorulmaz Goknur , Gul Ozen Oz , Emral Rifat , Kebapci Medine Nur , Acubucu Fettah , Tuzun Dilek , Gorar Suheyla , Topuz Emek , Bagir Gulay Simsek , Genc Selin , Demir Kezban , Tamer Gonca , Yaylali Guzin , Omma Tulay , Firat Sevde Nur , Koc Gonul , Saygili Emre Sedar , Yurekli Banu Sarer

Introduction: Congenital adrenal hyperplasia (CAH) is a group of autosomal recessively inherited disorders that are characterised by inactivating mutations at various steps of adrenal steroidogenic pathways causing defective cortisol biosynthesis. 21-Hydroxylase enzyme deficiency (21-OHd) constitutes more than 95% of all CAH cases.Material & Methods: Medical records of patients with all forms of CAH from 19 adult endocrinology clinics located at six ...

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ea0090ep20 | Adrenal and Cardiovascular Endocrinology | ECE2023

Increased sclerostin concentration in patients with primary adrenal insufficiency

Zdrojowy-Welna Aleksandra , Halupczok-Żyła Jowita , Kuliczkowska-Płaksej Justyna , Jawiarczyk-Przybyłowska Aleksandra , Bolanowski Marek

Background: Sclerostin is a protein secreted by osteocytes, that inhibits Wnt/ βcatenin signaling and was suggested to play a role in glucocorticoid-induced osteoporosis in mice. In humans data are inconsistent. Patients with primary adrenal insufficiency need lifelong replacement therapy with glucocorticoids and mineralocorticoids, which may influence their bone quality.Aim: The aim of the study was to evaluate sclerostin concentrations, densitomet...

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ea0090ep21 | Adrenal and Cardiovascular Endocrinology | ECE2023

Aldosterone/direct renin ratio (ADRR) in the screening of patients with primary aldosteronism

Szatko Alicja , Leszczynska Dorota , Badura Barbara , Barczak Szymon , Filipek Kinga , Hempel Justyna , Ostrowska Magdalena , Papierska Lucyna , Zgliczyński Wojciech , Glinicki Piotr

Background: Primary aldosteronism (PA) is the most common endocrine cause of secondary hypertension. It occurs in 5%-10% of hypertensive patients. PA is a group of disorders associated with semi-autonomous hypersecretion of aldosterone. Laboratory diagnosis in patients with suspected PA consists of screening tests aimed at determination of serum/plasma aldosterone concentration, direct renin concentration (DRC) and calculation of the aldosterone/direct renin ratio (ADRR). The ...

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ea0090ep22 | Adrenal and Cardiovascular Endocrinology | ECE2023

Clinical presentation and cardivascular events in primary hiperaldosteronism

Vujacic Natasa , Ciric Jasmina , Zivaljevic Vladan , Slijepcevic Nikola , Stojanovic Milos

Introduction: Primary aldosteronism (PA) is characterized by symptoms caused by hypertension and hypokalemia. Some cardiovascular events are found to be more common due to the additional negative effect of aldosterone. The aim of the study was to analyse clinical characteristics of the PA due to adenoma (APA) and to compare the frequency of cardiovascular diseases with those found in adrenal Cushing syndrome (CS) and adrenal adenoma associated with essential hypertension...

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ea0090ep23 | Adrenal and Cardiovascular Endocrinology | ECE2023

REPLACE: Effect of hydrocortisone and placebo in patients with partial adrenal insufficiency after cessation of glucocorticoid treatment; A study protocol for a multi-centre, randomised, double-blinded, placebo-controlled clinical trial

Dreyer Anja Fenger , Borresen Stina Willemoes , Hansen Simon Boggild , Al-Jorani Hajir , Bislev Lise Sofie , Boesen Victor Brun , Christensen Louise Lehmann , Glintborg Dorte , Jensen Richard Christian , Jorgensen Nanna Thurmann , Klose Marianne , Lund Marie Louise , Stankovic Jelena , Tei Randi , Watt Torquil , Feldt-Rasmussen Ulla , Jorgensen Jens Otto , Andersen Marianne

Background: Glucocorticoid (GC) formulations are widely used as anti-inflammatory treatment, and synthetic GC, e.g. prednisolone, is the cornerstone treatment of polymyalgia rheumatic (PMR) and giant cell arteritis (GCA). Long-term pharmacological GC treatment may induce adrenal insufficiency (GIA). Adrenal function is, however, not routinely assessed after discontinuation of long-term GC treatment, and it is unknown, if hydrocortisone replacement is beneficial. This study aim...

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ea0090ep24 | Adrenal and Cardiovascular Endocrinology | ECE2023

Addison’s disease with preserved glucocorticoid function in the Type 1 diabetes population: a diagnosis not to miss during routine diabetes follow-up

Bond Zoe , Rashid Razan Ali , Pearce Simon , Napier Catherine , Mitchell Anna , Mamoojee Yaasir

Background: Prevalence of Addisons disease (AD) among patients with Type 1 diabetes mellitus (T1DM) is estimated at 0.2%, whilst prevalence of T1DM among patients with AD can be up to 14%. Residual adrenal function in patients with established AD may be present in up to 30% of cases but its clinical significance is not fully clear.Aims: To evaluate the prevalence of AD with preserved glucocorticoid function in patients with T1DM at Newcastle Diabet...

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ea0090ep25 | Adrenal and Cardiovascular Endocrinology | ECE2023

Endocannabinoids in patients with adrenal incidentalomas. A new prognostic biomarker?

Mytareli Chrysoula , Athanasouli Fani , Karampela Athina , Papalexis Petros , Siampanopoulou Vasiliki , Lafioniatis Alexandros , Mantzourani Marina , Angelousi Anna

Background: The majority of adrenal incidentalomas (AIs) are benign non-functioning adrenocortical adenomas (NFAIs), yet not clinically silent. Possible autonomous cortisol secretion (PACS) can also be diagnosed in up to 50% of patients. Endocannabinoids (ECs) have recently been studied regarding their role in the hypothalamo-pituitary-adrenocortical (HPA) axis; however, data are scarce in humans.Aim: We aimed to assess hair EC [anandamide (AEA) and 2-ar...

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ea0090ep26 | Adrenal and Cardiovascular Endocrinology | ECE2023

Optimal application of captopril challenge test in the diagnosis of primary aldosteronism

Chen Wenzhan , Chen Nan , Yu Shuang , Zeng Rui , Chen Li , Xu Changliu , Li Yanbing , Xiao Haipeng , Cao Xiaopei

Objective: To evaluate the optimal parameters and the cut-off points of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA) using chemiluminescence immunoassays (CLIA).Methods: Patients with clinically suspected PA who admitted to our hospital between July 2021 and December 2021 were recruited. Both supine and upright aldosterone to renin ratio (ARR) were calculated in all the participants and 21 healthy volunteers. CCT was perf...

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ea0090ep27 | Adrenal and Cardiovascular Endocrinology | ECE2023

Metanephrines work-up in patients diagnosed with incindentaloma - the influence of commonly used drugs on results interpretation

Kokoszka Joanna , Opalinska Marta , Kolasa Magdalena , Szewczyk Monika , Sitarz Katarzyna , Bugajska Jolanta , Berska Joanna , Sztefko Krystyna , Hubalewska-Dydejczyk Alicja

Introduction: Due to the frequent occurrence of adrenal incidentalomas, diagnosis of their hormonal activity is a significant clinical concern. Approximately 7-10% of adrenal tumors are pheochromocytomas, which even in silent form can lead to hemodynamic instability during surgery. According to the ESE and ENSAT guidelines in any case of adrenal tumors greater than 1 cm pheochromocytoma should be excluded based on plasma metanephrines level and urinary metanephrines excretion....

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ea0090ep28 | Adrenal and Cardiovascular Endocrinology | ECE2023

Novel high resolution mass spectrometry profiling of free cortisol, cortisone, 6β- and 18-hydroxycortisol for the evaluation of glucocorticoid and mineralocorticoid disorders

Casals Gregori , Ballesteros Maria Antonieta , Zamora Angielys , Martinez Irene , Ruiz Montserrat , Fernandez-Varo Guillermo , Mora Mireia , Morales-Ruiz Manuel , Hanzu Felicia A

Introduction: Urine free cortisol measurements are routinely performed to evaluate hypercortisolism. Despite their analytical inaccuracy, immunoassay-based methods are frequently used. Advances in liquid chromatography high resolution mass spectrometry (LC-HRMS) facilitate the incorporation of powerful diagnostic tools into clinical laboratories with high analytical specificity that also allow simultaneous quantification of different metabolites and untargeted compound identif...

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ea0090ep29 | Adrenal and Cardiovascular Endocrinology | ECE2023

A new LC-MS/MS method for simultaneous determination of six steroids in urine for the diagnostic workup of primary aldosteronism

Vogg Nora , Kuerzinger Lydia , Remde Hanna , Kendl Sabine , Fassnacht Martin , Kurlbaum Max

Background: The diagnostic workup of primary aldosteronism (PA) is challenging and the current screening tool, aldosterone-renin ratio, is increasingly challenged. Due to interference with immunoassays and the general high variability of plasma aldosterone levels false-positive as well as false-negative results are probably more frequent than previously assumed. Therefore, we aimed at the establishment of a reliable LC-MS/MS method to analyze aldosterone and related steroids i...

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ea0090ep30 | Adrenal and Cardiovascular Endocrinology | ECE2023

The adrenal glands mass and hypertension with elevated levels of aldosterone: is there an association?

Malakhava Darya , Shyshko Volha

Introduction: The effect of aldosterone levels on the severity of arterial hypertension was established in many studies. Changes in the level of aldosterone can lead to disorders of the cardiovascular, nervous, excretory systems. One of the factors affecting the fluctuation of aldosterone is the presence of adrenal gland mass.Aim: To check for a correlation between the identified adrenal masses and the severity of arterial hypertension against the backgr...

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ea0090ep31 | Adrenal and Cardiovascular Endocrinology | ECE2023

Exploring experiences of patients with Adrenal insufficiency (AI) in managing adrenal crisis using parenteral hydrocortisone: A qualitative study

Chua Aldons , Cartwright Martin , Drake William , Llahana Sofia

Background: Adrenal insufficiency (AI) poses a significant health burden on patients, their families, and the healthcare system. Cost of illness for this patient population is four times higher than the general population. Hospital admissions due to adrenal crisis (AC) form a considerable proportion of this cost. Almost 1 in 200 patients die from AC. One in 12 patients with AI are hospitalised at least once a year following an acute AC episode if not treated promptly with pare...

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ea0090ep32 | Adrenal and Cardiovascular Endocrinology | ECE2023

Hereditary and sporadic pheochromocytoma: Comparison of clinical and biological features

El Amel Rania , Rachedi Hanae , Imane Rami , Rouf Siham , Latrech Hanane

Introduction: Pheochromocytoma is a rare neuroendocrine tumor derived from the adrenal medulla characterized by a high potential of production of catecholamines. The majority of pheochromocytomas are sporadic. However, recent studies show an increasing incidence of hereditary forms.Patients and methods: This is a retrospective descriptive study including 30 patients with pheochromocytoma followed-up in the Endocrinology-Diabetology and Nutrition Departme...

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ea0090ep33 | Adrenal and Cardiovascular Endocrinology | ECE2023

A case of Merkel cell carcinoma in the CNC 1 (Carney complex 1) gene positive family with a rare component of the Carney complex

Nasrullayeva Fidan , Bayraktar Fırat , Unal Mehmet Cağrı , Semiz Gokcen Gungor

Introduction: CNC (Carney complex) is a rare inherited autosomal dominant syndrome characterized by prominent pigmented lesions on the skin and mucosal surfaces, cardiac and noncardiac myxomatous tumors, and multiple endocrine neoplasms. About 70% of cases have a family history, while the remaining 30% occur sporadically as a result of de novo mutation. Two genetic loci linked to CNC have been found: the CNC1 gene on chromosome 17q22-24, which encodes the regulatory subunit (R...

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ea0090ep34 | Adrenal and Cardiovascular Endocrinology | ECE2023

Incidental diagnosis of bladder paraganglioma: A case report

Chanez Kalboussi , Benchhida Annam , Najla Bchir , Chadia Zouaoui , Ouertani Haroun

Introduction: Paraganglioma is a rare neuroendocrine neoplasm which tends to develop in the extra-adrenal glands. Paraganglioma in the bladder is extremely rare and accounts for 0.06% of all bladder tumors Herein we report a case of paraganglioma that was mistaken for urothelial carcinoma and revealed by an intra-operative hypertensive crisis with bradycardia.Case presentation: A 48-year-old woman was referred to the urology department for intermittent t...

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ea0090ep35 | Adrenal and Cardiovascular Endocrinology | ECE2023

A patient guide for pregnancy in 21-hydroxylase deficiency

Welp Ann-Christin , Nowotny Hanna F. , Reisch Nicole

Background: Affected patients with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) are often insufficiently informed about disease-specific aspects of reproduction. Reasons for lower fertility rates in female patients with CAH are hormonal dysregulations, anatomical changes resulting from virilized genital surgeries and psychosocial and psychosexual factors. Fecundity, however, is comparable to the normal population. Male patients with CAH also ha...

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ea0090ep36 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal incidentaloma revealing a cystic pheochromocytoma

Dounia Talbi , Zakaria Cheibete , Elmoatamid Kaoutar , Rifai Kaoutar , Hinde Iraqi , Gharbi Mohamedelhassan

Introduction: Pheochromocytomas are rare neuroendocrine tumors producing catecholamines, they are usually unilateral. However, they can be located bilaterally. They still pose several problems in their diagnosis if they are associated with an adrenal cyst, which is the case in our patient.Case Report: A 34-years-old male patient, his medical and family histories were non specific, admitted to the emergency room for lumbar pain, with no other associated s...

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ea0090ep37 | Adrenal and Cardiovascular Endocrinology | ECE2023

Giant Cystic Asymptomatic Pheochromocytoma

Kanburoglu Meletli Ozlem , Birinci Cigdem , Bilginer M. Cuneyt , Coskun Hulya , Nuhoglu Irfan , Ucuncu Ozge , Kocak Mustafa

Introduction: Giant and cystic catecholamine-secreting tumors are usually asymptomatic and detected incidentally during imaging. A simple mobilization of the tumor can cause the release of catecholamines into the blood and is therefore associated with high morbidity and mortality. Here, we aimed to present a patient with a 13 cm mass in the left adrenal gland and diagnosed as giant cystic pheochromocytoma.Case Report: A 62-year-old male patient presented...

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ea0090ep38 | Adrenal and Cardiovascular Endocrinology | ECE2023

Bilateral pheochromocytomas-recurrence and adrenal insufficiency rate related to surgical technique and genetic status

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

Introduction: Bilateral pheochromocytomas (PHEOs) most often occur as components of hereditary syndromes: MEN2A, VHL disease or neurofibromatosis. The best surgical technique in such cases is yet disputed between cortical sparing or total adrenalectomy. Two important complications are related to each surgical technique: adrenal insufficiency (AI) or recurrence-which one is more harmful for the patient?Aim: To evaluate the complications (recurrence, AI) r...

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ea0090ep39 | Adrenal and Cardiovascular Endocrinology | ECE2023

“Adrenal Giants” Review of adrenal masses ≥ 10 cm detected and treated during a 10- year period at the University Hospital Southampton NHS Foundation Trust, United Kingdom

Galides Chloe , Hayes Matthew , Douglas James , W C Richard , crabb Simon , Chance Thomas , King Alexander , Al-Mrayat Ma'en , Bujanova Jana

Introduction: The aim of this project was to review all adrenal masses ≥ 10 cm managed in our organisation over a 10-year period (2012-2022).Results: 20 adrenal masses ≥10 cm in maximal diameter were identified (range 10-32 cm, average 16.6 cm, 6 above 20 cm and one above 30 cm). Age at presentation was 17-80 y (mean 56.3 y, 50% F). Duration of symptoms: 1 day-18 months, mean 7.5 months with 6 presenting acutely. Follow-up period: 1 month-122...

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ea0090ep40 | Adrenal and Cardiovascular Endocrinology | ECE2023

Effects of high-dose atorvastatin treatment on adrenal steroidogenesis in type 2 diabetes patients

Terzi Ameni , Khessairi Nadia , Oueslati Ibtissem , Yazidi Meriem , Bassem Hammami , Chaker Fatma , Moncef Feki , Chihaoui Melika

Introduction: Statins are widely used to prevent cardiovascular diseases. Nonetheless, reducing cholesterol, the main substrate for steroidogenesis, may impair cortisol production. The aim of our study was to assess the effect of high dose statin therapy on cortisol and dehydroepiandrosterone-sulphate (DHEA-S) levels in type 2 diabetes male patients.Methods: This was a single-center, prospective study, during the period march 2021 - July 2022, including ...

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ea0090ep41 | Adrenal and Cardiovascular Endocrinology | ECE2023

The role of CRH test in predicting the efficacy of unilateral adrenalectomy in Bilateral Macronodular Adrenal Hyperplasia

Tizianel Irene , Detomas Mario , Deutschbein Timo , Carla Scaroni , Ceccato Filippo

Background and Aim: Bilateral Macronodular Adrenal Hyperplasia (BMAH) is a rare form of adrenal Cushings syndrome (CS). The treatment of choice in patients with BMAH and overt CS is bilateral adrenalectomy (B-Adx), which however implies lifelong glucocorticoid and mineralocorticoid replacement therapy. Unilateral adrenalectomy (U-Adx) has been proposed as an alternative to B-Adx, especially in case of clearly asymmetric adrenal size. Our aim was to determine predictive f...

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ea0090ep42 | Adrenal and Cardiovascular Endocrinology | ECE2023

Circadian fluctuations of acylcarnitines and sphingomyelins when measured in serum and in dried blood spots

Bissi Valentina , Improta Ilaria , Galante Greta , Tucci Lorenzo , Vicennati Valentina , Pagotto Uberto , Dalmazi Guido Di , Fanelli Flaminia

Background: Acylcarnitines and sphingomyelins are key players of lipid metabolism at cytosolic, vesicular and cell membrane level. Their metabolism was found deranged in diseases of the hypothalamus-pituitary-adrenal axis. Little information is available about levels of these compounds in the bloodstream and their circadian fluctuations. Dried blood spots (DBS) allow multiple autonomous and painless collections per day. However, poor biological validation data are available ab...

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ea0090ep43 | Adrenal and Cardiovascular Endocrinology | ECE2023

The effect of long-term treatment of glucocorticoid in adipogenesis/turnover in epididymal cells

Salgueiro Rafael , Lima Fabio Bessa

Cushing syndrome is a comorbid condition resulting from long-term exposure to glucocorticoids (GC). It affects body fat composition in various parts of the body. Since each fat depot has a distinct response to glucocorticoid exposure, we wanted to understand adipose tissue turnover. In order to reproduce the disease state, we used a rodent model recapitulating Cushing syndrome. We inserted subcutaneous mini pumps in the dorsal area of rats to infuse Dexamethasone at a rate of ...

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ea0090ep44 | Adrenal and Cardiovascular Endocrinology | ECE2023

Implementation of a new adrenal venous sampling (AVS) protocol for primary aldosteronism: early data from a single tertiary centre

Green Deirdre , Farnan Vanessa , McDonnell Tara , Abdelfadil Sabah , Heverin Karen , Carthy Claire , Srinivasan Shari , Hill Arnold , Dugal Neal , Morrin Martina , Dunne Ruth , Mulholland Douglas , Agha Amar , Sherlock Mark , O'Reilly Michael

Primary aldosteronism (PA) is the most common cause of endocrine hypertension. Following biochemical confirmation of aldosterone excess, adrenal venous sampling (AVS) is the gold standard investigation to lateralise the source of aldosterone hypersecretion in patients deemed suitable for potential adrenalectomy. AVS has been performed for all suitable patients with a diagnosis of PA in Beaumont Hospital since implementation of a new protocol involving collaboration between End...

2 shares

ea0090ep45 | Adrenal and Cardiovascular Endocrinology | ECE2023

A rare case of a juxta-adrenal schwannoma presenting as an adrenal mass

Prats Custal Ariadna , Alevras Theodora Michalopoulou , Borras Cristina Franco , Martinez Carlos Jareno , Bernal Marc Vallve , Muro Laura Nevot , Aixala Anna Magarolas , Guasch Laia Martinez , Cortes Silvia Naf , Megia Ana

Background: Retroperitoneal Schwannomas are rare and generally benign tumors originating from the neural sheath. In particular, juxta-adrenal schwannomas may be misdiagnosed as adrenal tumors due to their location and radiological characteristics.Case Presentation: A 40-year-old female patient referred to our outpatient clinic owing to a left suprarenal mass of 35 mm incidentally discovered in an enhanced CT. She was asymptomatic and the clinical examina...

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ea0090ep46 | Adrenal and Cardiovascular Endocrinology | ECE2023

Acute Bilateral Non-Traumatic Adrenal Haemorrhage; a case series

Saqlain Muhammad , Ali Fayad , Krishnan Singhan , Khan Sidrah

Adrenal haemorrhage is a serious condition that can result in adrenal insufficiency, shock, acute adrenal crisis, and mortality if not managed with adequate treatment. Hereby we present two cases of non-traumatic bilateral adrenal haemorrhage highlighting their management during the acute phase.Case 1: 57 year old female presented due to chest pain, palpitations and troponin rise with a background history of antiphospholipid syndrome on anticoagulation. ...

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ea0090ep47 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary hypoadrenalism and thyroiditis in metastatic renal carcinoma in Pembrolizumab (PD-1inhibitor) and Axitinib (VEGFR inhibitor) therapy

Lio Serafino , Paolello Concetta , Lamon Stefano

The association of immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) are widely and to with good effect used in the treatment of many neoplasms. Much evidence of endocrine side effects has been reported for both ICIs and TKIs especially to the pituitary and thyroid functions; however, there are few records of primary adrenal insufficiency. We report the case of a 44-year-old soldier, examined for elevated hematocrit findings. Abdominal ultrasound and th...

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ea0090ep48 | Adrenal and Cardiovascular Endocrinology | ECE2023

Chronic hypopituitarism as a rare first presentation of euvolaemic hyponatraemia

Coe Calvin , Jude Edward , Mathew Susan

Background: Hyponatraemia is the most common electrolyte abnormality encountered in hospitals and has been independently associated with increased morbidity and mortality1. An appropriate work-up with guideline-based investigations and management is, therefore, crucial to allow accurate diagnosis and optimisation of patient care.Case Presentation: A 49-year-old with no significant past medical history presented with 2 weeks of persistent nause...

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ea0090ep49 | Adrenal and Cardiovascular Endocrinology | ECE2023

Rare case of Munchausen Syndrome in endocrinology: artificial hypokalemia

Aboishava Lizaveta , Eremkina Anna , Ioutsi Vitaly , Bibik Ekaterina , Mirnaya Svetlana , Mokrysheva Natalia

Introduction: An atypical manifestation of disease combined with inconsistent results of examination, long history of multiple past health care services without effect requires to consider factitious disorders.Case report: A 46 year-old woman was suffering from episodes of severe hypokalemia (K+ 1.9 - 3.4 mmol/l (ref. 3.5-5.1 mmol/l) and hypertensive crises up to 240/145 mm Hg for 4 years. She stated that there was no clear provoking factor for these epi...

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ea0090ep50 | Adrenal and Cardiovascular Endocrinology | ECE2023

Autonomic Cortisol-Secreting Adrenal Mass Containing Extramedullary Hematopoiesis Foci

Kanburoglu Meletli Ozlem , Birinci Cigdem , Bilginer M. Cuneyt , Coskun Hulya , Nuhoglu Irfan , Ucuncu Ozge , Kocak Mustafa

Introduction: Extramedullary hematopoiesis (EMH) is most commonly seen in reticuloendothelial system tissues such as liver, spleen and lymph nodes. Rarely, it can be detected in non-hepatosplenic atypical localizations such as the adrenal glands. Although the underlying mechanism is not clearly elucidated, it is suggested that the adrenal glands have hematopoietic activity in the fetal period and EMH may develop from the remains here due to chronic anemia. We aimed to present ...

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ea0090ep51 | Adrenal and Cardiovascular Endocrinology | ECE2023

A primary adrenal lymphoma with a puzzling evolution: A case report

Missaoui Abdel Mouhaymen , Hamza Fatma , Soomauroo Siddiqa , Ahmed Khawla Ben , Belabed Wafa , Abid Mohamed

Introduction: Primary adrenal lymphoma (PAL) is a very rare entity. Less than 200 cases have been reported. Its evolution is unfavourable even under treatment. We report a case of PAL with a falsely reassuring course unmasked by 18F-FDG PET-CT.Observation: This is a 48-year-old female patient hospitalized with altered general condition, weight loss, fever and cytopenias. The initial thoraco-abdomino-pelvic CT scan revealed two large bilateral adrenal tum...

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ea0090ep52 | Adrenal and Cardiovascular Endocrinology | ECE2023

Hyperpigmentation leading to depression in Addison’s disease: Case report

Masood Faryal

Addisons disease (AD) occurs when 90% of the cortex of Adrenal Glands is affected. Most common causes of AD are autoimmune destruction, tuberculosis, hemorrhage due to meningococcal meningitis, metastatic cancers and adrenoleukodystrophy. AD is associated with other autoimmune disorders e.g., vitiligo, type-1 diabetes or hypothyroidism. Due to non-responsiveness of adrenals to Adrenocorticotrophic hormone (ACTH), α-melanocyte stimulating hormone levels increases and...

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ea0090ep53 | Adrenal and Cardiovascular Endocrinology | ECE2023

Metabolic syndrome and primary bilateral macronodular adrenal hyperplasia

Matias Alexandra Abegao , Bouca Bruno , Gutu Olga , Prokop Joanna , Sabino Teresa , Silva-Nunes Jose

Introduction: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare entity. Up to 1/3 of patients with incidental bilateral adrenal nodules presents biochemical evidence of hypercortisolism responsible for obesity, diabetes mellitus (DM), arterial hypertension or dyslipidemia. Its insidious course and nonspecific signs explain the underdiagnosis of this entity.Objective: To describe the case of a patient with metabolic syndrome (MS) with h...

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ea0090ep54 | Adrenal and Cardiovascular Endocrinology | ECE2023

The overproduction of interleukin-6 in pheochromocytoma and its impact on systemic inflammation compared to other types of adrenal tumors

Wannachalee Taweesak , Sirinvaravong Sirinart , Pengkhum Pornrumpa , Uasuwannakul Alisa

Background: The circulating inflammatory markers and cytokines are associated with unfavorable cardiovascular and metabolic outcomes in patients with primary hypertension. Few reports demonstrated that some adrenal tumors can produce various markers of inflammation, acute phase protein and cytokines, contributing to hemodynamic and metabolic disturbances.Objective: We aimed to study the differences in the levels of inflammatory parameters and interleukin...

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ea0090ep55 | Adrenal and Cardiovascular Endocrinology | ECE2023

Effect of long-term atorvastatin treatment on serum vitamin D levels in type 2 diabetes patients

Terzi Ameni , Kamoun Elyes , Yazidi Meriem , Bassem Hammami , Khessairi Nadia , Oueslati Ibtissem , Chaker Fatma , Moncef Feki , Chihaoui Melika

Introduction: Statins are widely used in primary and secondary prevention of atherosclerotic cardiovascular diseases. The effects of statins on vitamin D are unclear. The reduction of cholesterol synthesis, a substrate for vitamin D synthesis and the decrease of LDL, the major carrier of vitamin D in the blood, can affect vitamin D metabolism. We aimed to evaluate the effect of high dose statin therapy on serum vitamin D levels.Methods: This was a single...

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ea0090ep56 | Adrenal and Cardiovascular Endocrinology | ECE2023

What is the diagnostic serum ACTH threshold in adrenal Cushing?

Naveen Aishwarya , Guma Muna , Mamoojee Yaasir , Bliss Richard , Ramsingh Jason , Truran Peter

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Once steroid excess is biochemically confirmed, the diagnostic serum ACTH threshold for determining ACTH-independent Cushing is debatable. A threshold of less than 15 ng/l has been adopted in our regional guidelines.Aims: To investigate serum ACTH levels in patients with proven adrenal Cushing and to assess the clinical utilit...

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ea0090ep57 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal venous sampling in patients with hyperaldosteronism

Moyano-Sanchez Ana Maria , Rebollo-Roman Angel , Serrano Laguna Ma del Carmen , Moreno-Moreno Paloma , Galvez Moreno Maria Angeles

Objective: Adrenal venous sampling (AVS) is a reliable procedure to differentiate if in patients with primary aldosteronism (PA) aldosterone production is unilateral or bilateral and guide treatment of these patients. Our objective was to describe their characteristics and the outcomes of the AVS.Methods and patients: Observational longitudinal clinical study between July 2020 and November 2022 in patients who underwent AVS in our Hospital.<p class="...

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ea0090ep58 | Adrenal and Cardiovascular Endocrinology | ECE2023

Unusual “Square Wave” Presentation of Severe Prolonged Hypercortisolemic Followed by Eucortisolemic Phases in Patients with Cyclical Cushing Syndrome

Yuen Kevin , Smith Elizabeth , Cossio Frank Jesus , Rodriguez Monica

Background: Cyclical Cushing syndrome (CCS) is a rare variant of Cushing syndrome (CS) characterized by periodic cycles of cortisol excess. Diagnosis of CCS is difficult because cortisol excess occurs unpredictably and often limited to short periods. We present 2 unusual cases where the patients developed severe prolonged life-threatening square wave hypercortisolemic phase followed by eucortisolemia, both phases extending > 3 months. Case 1: A 75 year old male...

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ea0090ep59 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenocortical Oncocytoma: A bout 7 cases

Mezoued Mouna , Khadidja Bessaid , Azzouz Malha

Introduction: Adrenal oncocytomas are rare and usually present as incidentally detected masses. The aim of this study is to evaluate the clinical characteristics of a series of patients with adrenal oncocytoma.Material and Methods: we retrospectively collated all patients admitted to Bologhine Hospital between 2010 and 2020 for adrenal masses and who underwent surgery and a diagnosis of adrenal oncocytoma at the anathomo-pathological study (n=07...

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ea0090ep60 | Adrenal and Cardiovascular Endocrinology | ECE2023

A pheochromocytoma revealing a neurofibromatosis type 1: A case report

Meryem Karimi , Azagouagh Hajar , Qasdi Ikrame , Moussaid Nawal , Rifai Kaoutar , Hinde Iraqi , Gharbi Mohamedelhassan

Introduction: Neurofibromatosis type 1(NF1) is an autosomal dominant genodermatosis that affect multiple organs. It represents one of the most frequent genetic diseases. The diagnosis is primarily clinical and is based on the NIH criteria (National Institutes of Health) established in 1988, and revised in 2021. We report a case of male patient with NF1 revealed by a pheochromocytoma.Case Report: A 26-years-old man patient with no previous medical history...

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ea0090ep61 | Adrenal and Cardiovascular Endocrinology | ECE2023

Pheochromocytomas, a series of 68 cases

Aghrabatt Sidi Mohamed , Haraj Nassim Essabah , El Aziz Siham , Chadli Asma

Introduction: Pheochromocytoma is a rare endocrinopathy, most often benign. Early and multidisciplinary management of this disease allows to avoid its dreadful complications.Objective: To describe the epidemiological, clinical and biological characteristics of patients with pheochromocytoma.Patients and Methods: Retro-prospective descriptive study, including patients hospitalized in the Endocrinology Department of CHU Ibn Rochd of ...

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ea0090ep62 | Adrenal and Cardiovascular Endocrinology | ECE2023

Consanguineous marriage and 5 triple a syndrome

Ozturk Sadettin , Imre Eren , Ozenmis Tahsin

Aim: Triple-A Syndrome (TAS) is a rare autosomal recessive disorder characterized by three cardinal symptoms: alacrimia, achalasia and adrenal insufficiency due to ACTH insensitivity. The disease is caused by mutation in the AAAS gene on chromosome 12q13. Mutations in AAAS were identified in more than 90% of individuals and families with TAS. The aim of this study is to discuss the clinical, laboratory and molecular genetic analysis results of 5 patients with TAS.<p class=...

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ea0090ep63 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenocortical vascular network and hormonal output after daidzein application in a rat model of the mild andropause

Kokoris Jovana Cukuranovic , Djordjevic Miodrag , Miler Marko , Živanović Jasmina , Marković-Filipović Jelena , Đorđević Dobrila Stanković , Čukuranović Rade , Milošević Verica , Filipović Branko , Ajdžanović Vladimir

Soy isoflavone daidzein exerts some beneficial effects in different ageing-related, chronic diseases and may represent a promising alternative to classical estrogenization of the prostate cancer suffering subjects. The aim of this study was to examine the effects of daidzein on the adrenocortical vascular network and hormonal output in a rat model of the mild andropause. Adult (3 months old) Wistar rats were divided into sham-operated (SO; n=7), orchi...

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ea0090ep64 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cushing’s Syndrome due Primary bilateral macronodular adrenal hyperplasia–a case series from a tertiary hospital

Goncalves Juliana , Ferreira Helena Urbano , Pedro Jorge , Carvalho Davide , Freitas Paula

Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of Cushings syndrome (CS). It is a highly heterogeneous disease with multiple adrenal macronodules and variable levels of cortisol excess. The pathogenesis is complex and different mechanisms such as aberrant hormone receptors, local production of ACTH in adrenal tissues and genetic mutations have been identified. The approach is not well established. Nine patients with PBMAH who are currently fol...

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ea0090ep65 | Adrenal and Cardiovascular Endocrinology | ECE2023

Bilateral primary aldosteronism prediction by Integer scoring system

Sambula Lana , Matas Nino , Nekic Anja Barac , Tomšić Karin Zibar

Background: Adrenal venous sampling (AVS) is the gold standard to differentiate patients with unilateral primary aldosteronism (UPA) from those with bilateral disease (BPA). As this is an invasive method, there are a lot of different scoring systems developed for primary aldosteronism (PA) subtyping. Integer scoring system is one of those established for BPA subtyping.Objective: The aim of this study was to evaluate the efficiency of using the online Int...

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ea0090ep66 | Adrenal and Cardiovascular Endocrinology | ECE2023

Overview and factors that impact quality of life in patients with Cushing’s syndrome

Nacu Miruna-Viorela , Martin Carmen Sorina , Sirbu Anca , Barbu Carmen , Fica Simona

Background: Quality of life (QoL) has become a useful outcome in recent studies among different specialties. In Cushings syndrome, elevated cortisol levels result in a decreased QoL, the cause for this impairment being multifactorial. More studies are necessary to find modifiable factors where doctors could intervene and thus improve QoL.Objective: To evaluate QoL in a group of Romanian patients with Cushings syndrome. Design: We performed a ...

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ea0090ep67 | Adrenal and Cardiovascular Endocrinology | ECE2023

Effect of glucocorticoid replacement dose on bone mineral density in patients with Addison disease: A cross-sectional Tunisian-based study

Boujelben Khouloud , Salah Dhoha Ben , Frikha Hamdi , Elleuch Mouna , Mnif Mouna , Mnif Fatma , Charfi Nadia , Majdoub Nabila Rekik , Kacem Akid Faten Haj , Abid Mohamed

Introduction: Addison disease (AD) is associated with high risk of decreased bone mineral density (BMD) and osteoporosis. Causes are complex, including lifelong glucocorticoid replacement therapy. Several studies have pointed a significant relationship between glucocorticoid dose and low BMD in patients with AD. The aim of our study is to assess the impact of glucocorticoid replacement dose on BMD among Tunisian patients with AD.Patients and Methods: We ...

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ea0090ep68 | Adrenal and Cardiovascular Endocrinology | ECE2023

Health state utility value of Cushing syndrome patients after bilateral adrenalectomy–systematic literature review and mapping to EQ-5D

Schmidt Fabian , Pedroncelli Alberto , Marks Muriel , Szewczuk Dominik , Kalinowska Agnieszka , Binowski Grzegorz

Background: Bilateral adrenalectomy (BLA) is a treatment option for patients suffering from endogenous Cushing syndrome (CS). It consists of the surgical removal of both adrenal glands. Even though BLA offers immediate control of cortisol excess, given the risk of adrenal insufficiency, it requires life-long glucocorticoid and mineral corticoid replacement. It may lead to perioperative and long-term complications which affect patients quality of life (QoL). Health state ...

6 shares

ea0090ep69 | Adrenal and Cardiovascular Endocrinology | ECE2023

Effects of Osilodrostat and Metyrapone on steroidogenesis in adrenocortical H295R tumor cells in vitro

Thomeret Louis , Berthon Annabel , Perlemoine Karine , Poirier Jonathan , Blanchet Benoit , Puszkiel Alicja , Bertherat Jerome , Fideline Bonnet

Introduction: Osilodrostat and Metyrapone are two CYP11B1 inhibitors used for the treatment of patients with Cushing syndrome. Despite their common suspected mechanism of action, the comparison of serum steroid profiles determined in HPLC-MS/MS in patients treated by either Osilodrostat or Metyrapone for an ACTH-dependent Cushing syndrome identified higher levels of 11-deoxycortisol and androgens in patients treated by Metyrapone than in those treated by Osilodrostat (F. B...

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ea0090ep70 | Adrenal and Cardiovascular Endocrinology | ECE2023

Glycerophospholipid circadian profiles in serum and dried blood spot in healthy subjects

Galante Greta , Bissi Valentina , Improta Ilaria , Tucci Lorenzo , Vicennati Valentina , Pagotto Uberto , Dalmazi Guido Di , Fanelli Flaminia

Introduction: Lipidomics is an emerging approach to characterize circadian rhythm alterations due to diseases of the hypothalamus-pituitary-adrenal axis. Glycerophospholipids are membrane structural constituents and key players in cell signalling, homeostasis and inflammatory and immune responses. Among blood derivatives, serum may reflect the soluble fraction, whereas dried blood spot (DBS) may reflect the cell membrane fraction of these lipids. However, little information is...

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ea0090ep71 | Adrenal and Cardiovascular Endocrinology | ECE2023

Small Cell Neuroendocrine Carcinoma of the Larynx: A Case Report

Elgharroudi Farah , El Ansari Nawal , El Mghari Ghizlane

We report a case of small cell neuroendocrine carcinoma of laryngeal localization. The involvement of the larynx still exceptional. We present in this paper the radiological, pathological and therapeutic aspects of this tumor that was diagnosed in a 48-year-old man. A 59 years old male patient, chronic smoker, with 10 packs per year; without any particular medical history. he consulted for a rapidly progressive cervical swelling since one year, associated with dysphonia. The w...

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ea0090ep72 | Adrenal and Cardiovascular Endocrinology | ECE2023

Characteristics of Hypertension in patients with pheochromocytomas

Abidi Sahar , Mekni Sabrine , Essayeh Sawsen , Hilel Wafa Ben , Faten Cherchir , Mehuirgui Nadia , Nacef Ibtissem Ben , Rojbi Imen , Khiari Karima

Introduction: Pheochromocytomas are rare catecholamine-secreting tumors presenting with various clinical manifestations. Hypertension is the most common finding in pheochromocytomas. It can be either persistent or paroxysmal. Study Design: We conducted a retrospective study of 34 patients who were admitted into the endocrinology department of Charles Nicolle hospital, with a diagnosis of a pheochromocytoma from January 2005 to November 2022.Results: Twen...

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ea0090ep73 | Adrenal and Cardiovascular Endocrinology | ECE2023

«Non-classical» pheochromocytoma, clinical case

Motrenko Anna , Gurevich Larisa , Britvin Timur , Ilovayskaya Irena

Neuroendocrine neoplasias (NENs) are a heterogeneous group of tumors that differ in appearance, growth patterns, and clinical symptoms and develop from neuroendocrine cells and, accordingly, unusually similar cytological characteristics. Pheochromocytoma is considered as not epithelial type of NENs. We would like to present a clinical case of pheochromocytoma with difficulties in laboratory diagnosis and morphological verification. Female patient P., 60 years old, for 10 years...

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ea0090ep74 | Adrenal and Cardiovascular Endocrinology | ECE2023

Malignant pheochromocytoma : A therapeutic challenge !

Sara Chtioui , Boukhalfa Ahmed , Rafi Sana , Tabib Ghizlane El Mghari , El Ansari Nawal

Introduction: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors that are usually benign, but which may also present as or develop into a malignancy. Predicting such behavior is notoriously difficult and there are currently no curative treatments for malignant tumors.Case Report: A male patient aged 23 years old who was investigated for headaches, flushing and palpitations. The patient presented with classic clinical features of NF-...

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ea0090ep75 | Adrenal and Cardiovascular Endocrinology | ECE2023

Abstract withdrawn...

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ea0090ep76 | Adrenal and Cardiovascular Endocrinology | ECE2023

Impact of long-term atorvastatin use on renal function in type 2 diabetes patients

Terzi Ameni , Khessairi Nadia , Yazidi Meriem , Oueslati Ibtissem , Bassem Hammami , Chaker Fatma , Moncef Feki , Chihaoui Melika

Introduction: Statins are widely used in primary and secondary cardiovascular prevention. They have been described to improve renal function. We aimed in this study to evaluate the effect of high dose atorvastatin therapy on renal outcome in type 2 diabetes patients.Methods: This was a single-center, prospective study, including 60 men with type 2 diabetes mellitus, aged between 40 and 65 years, statin-free, in whom the indication of a high dose statin t...

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ea0090ep77 | Adrenal and Cardiovascular Endocrinology | ECE2023

VCAM-1 concentration in patients 6 months after SARS-Cov2 infection

Jawiarczyk-Przybyłowska Aleksandra , Kuliczkowska-Płaksej Justyna , Zdrojowy-Wełna Aleksandra , Kolačkov Katarzyna , Zembska Agnieszka , Bolanowski Marek

Objectives: The excessive production of pro-inflammatory cytokines has been previously reported in the severe form of COVID-19. The cytokine storm is responsible for the induction of an inflammatory endothelial cell phenotype which is associated with the shedding of adhesion molecules. VCAM-1 is an endothelial adhesion protein that belongs to the immunoglobulin superfamily. Pro-inflammatory cytokines lead to the induction of VCAM-1 in the endothelium of blood vessels which is ...

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ea0090ep78 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary bilateral macronodular adrenal hyperplasia: Is unilateral adrenalectomy enough?

Lopes-Pinto Mariana , Fialho Mafalda Pinho , Ricca Lacerda Nobre M Caetano Ema Paula , Rocha Jose , Barbosa Ana Paula

Introduction: Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH) represents <2% of causes of Cushings Syndrome (CS). Clinical course is insidious, with adrenal bilateral macronodules and gradual cortisol excess, only rarely presenting with overt CS. The pathophysiology remains unclear, however, hyperactivation of the cAMP/PKA pathway, in 77-87% of cases through aberrantly expressed G-protein coupled receptors (GPCRs), has been described. Despite being a benig...

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ea0090ep79 | Adrenal and Cardiovascular Endocrinology | ECE2023

Preoperative management of Pheochromocytoma with fluctuation of Blood Pressure: A case report

Ismail Zahra , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Pheochromocytoma is a rare tumor of chromaffin cells localized in the adrenal gland. It is responsible of secretion of catecholamines in a supra physiologic amount, leading to hypertension. Some patients may present with hypotension despite having high circulating levels of catecholamines. The challenge is to stabilize blood pressure by medication in cases with fluctuation of blood pressure.Case presentation: 49-year-old woman suffered from...

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ea0090ep80 | Adrenal and Cardiovascular Endocrinology | ECE2023

Impact of glucocorticoid replacement therapy on anthropometric parameters in patients with Addison disease

Boujelben Khouloud , Salah Dhoha Ben , Frikha Hamdi , Elleuch Mouna , Charfi Nadia , Mnif Fatma , Mnif Mouna , Majdoub Nabila Rekik , Kacem Akid Faten Haj , Abid Mohamed

Introduction: Inappropriate glucocorticoid replacement therapy results in higher mortality rates in patients with Addison disease (AD), predominantly due to higher prevalence of cardiovascular diseases, disturbed glycometabolic state and altered anthropometric parameters. The aim of this study was to assess the impact of life-long corticosteroid exposure on anthropometric parameters in patients with AD.Patients and Methods: This Tunisian cross-sectional ...

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ea0090ep81 | Adrenal and Cardiovascular Endocrinology | ECE2023

Successful management of adrenal Cushing’s syndrome associated with androgen co-secreting adenoma during pregnancy: a case report

Rodriguez Arrieta Luis Antonio , Hoyos Valdelamar Juan Carlos , Restrepo Johnayro Gutierrez , Mejia Sanjuanelo Ana Milena , Rueda Galvis Myriam Vanessa , Corrales Santander Hugo Rafael

Introduction: Adrenal Cushings syndrome during pregnancy is rare, and few cases have been reported. It is infrequent to identify pregnant women with adenomas that have cortisol and androgen co-secretion. The diagnosis and treatment of excess cortisol during pregnancy is challenging when the patient does not want a pregnancy interruption.Case Report: 38-year-old woman with arterial hypertension for four years. During her working days, she remained u...

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ea0090ep82 | Adrenal and Cardiovascular Endocrinology | ECE2023

Black adrenal adenoma mimicking an oncocytoma–a case report

Urbano Ferreira Helena , Goncalves Juliana , Belo Sandra , Carvalho Davide , Freitas Paula

Introduction: Black adrenal adenomas are rare and benign. They are named after their black appearance, due to lipofuscin pigment. Most frequently black adenomas are associated with ACTH-independent Cushings syndrome. They can also cause primary hyperaldosteronism or be nonfunctioning. Unlike most other adrenal adenomas, black adenomas exhibit high Hounsfield units (>30) on CT, and high standard uptake value on FDG-PET.Case presentation: A 67-ye...

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ea0090ep83 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary adrenal insufficiency in the context of small-cell neuroendocrine prostate cancer

de Brito Marques Francisca , Magalhaes Helena , Ferreira Joana Lima , de Carvalho Francisco Simoes , Marques Ana Paula

Introduction: The small-cell neuroendocrine prostate carcinoma (SCPC) is rare, highly aggressive and usually transforms from prostate adenocarcinoma (PAC) after androgen deprivation therapy (ADT).Case Report: A 66-year-old man had a three-year history of high-grade PAC with high burden disease (abdominal lymph node and bone metastasis) at presentation (09/2019). On the initial staging evaluation, the CT scan documented a 20 mm left adrenal nodule compati...

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ea0090ep84 | Adrenal and Cardiovascular Endocrinology | ECE2023

Addison disease in type 2 auto immune polyglandular syndrome

Laamouri Rihab , Sarah Mansour , Niculina Racolta

Introduction: Autoimmune polyglandular syndrome APS type 2 is a rare polygenic disease associationg endocrine autoimmune affection but also other auto immune diseases. The chronology is variable. We report in this context a case of APS associating a Hashimoto thyroiditis, a premature ovarian deficiency and an Addison disease revealed later.Case Report: A 33 year-old women consulted in 2018 for asthenia and spaniomennorrhea. The diagnosis of peripheral hy...

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ea0090ep85 | Adrenal and Cardiovascular Endocrinology | ECE2023

Late-onset 21-hydroxylase deficiency: A case report

Guissi Loubna , Halouache Ali , Gorgi Khaoula , Rifai Kaoutar , Iraqi Hinde , Gharbi Mohamed Elhassan

Introduction: Partial 21-hydroxylase deficiency is a genetic autosomal recessive disorder responsible for accumulation of the precursor upstream of the enzyme block, 17-hydroxyprogesterone (17OHP), and excessive androgen production.Observation: A 29-year-old woman consulted for hirsutism with a FerrimanGallwey score of 25. There were no signs of Cushing syndrome and no abnormalities of sexual development. The Laboratory results revealed testosteron...

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ea0090ep86 | Adrenal and Cardiovascular Endocrinology | ECE2023

Addisonian crisis unmasked by levothyroxine replacement in a patient admitted with suspected septic shock

Ahuja Sanjali , Mlawa Gideon , English Robert , Lowe Miriam , Khan Alaina , Hayat Maisha

Hypothyroidism due to autoimmune aetiology can be associated with other autoimmune conditions such as Type 1 Diabetes Mellitus (T1DM) and primary adrenal insufficiency. Ruling out primary adrenal insufficiency is important in any patient with suspected autoimmune hypothyroidism.Case: 43-year-old female complaining of general lethargy, sore throat, and neck pain. She was found to be hyponatraemic (Na+ 130) after being reviewed by the GP and was advised to...

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ea0090ep87 | Adrenal and Cardiovascular Endocrinology | ECE2023

The VON Hippel-Lindau Disease, report of two cases and literature review

Katia Benabdelatif , Lachkhem Aicha , Hassiba Khaldi , Meriem Bensalah , Samia Ould Kablia

Background: Von HippelLindau (VHL) is a rare, autosomal dominant syndrome characterized by the development of highly vascularized tumors in multiple organs. VHL affects approximately 1 in 35,000 live births. Tumors associated with VHL include hemangioblastom of the retina and central nervous system, pheochromocytomas, endolymphatic sac tumors of the middle ear, and epididymal or round ligament cysts. In 80% of patients, VHL disease is familial caused by mutations in the ...

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ea0090ep88 | Adrenal and Cardiovascular Endocrinology | ECE2023

Descriptive analysis of pheochromocytomas and paragangliomas in the southern area of Granada

Garcia Javier , Redondo Enrique , Aviles Perez Maria Dolores , Andreo-Lopez Maria del Carmen , Martinez Elena , Lopez- Ibarra Lozano Pablo J

Introduction and Objectives: Pheochromocytomas and paragangliomas are rare neuroendocrine tumors derived from enterochromaffin tissue, mostly catecholamine-producing, adrenal gland (PCC) or extra-adrenal paraganglia (PGL). We were struck by the high incidence of these in our health care area, so we decided to study them. The aim of this work is to evaluate the clinical characteristics and epidemiological factors of patients diagnosed with PCC or PGL.Mate...

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ea0090ep89 | Adrenal and Cardiovascular Endocrinology | ECE2023

Pheochromocytomas: presentation and diagnosis

Abidi Sahar , Mekni Sabrine , Essayeh Sawsen , Faten Cherchir , Hilel Wafa Ben , Mchuirgui Nadia , Nacef Ibtissem Ben , Rojbi Imen , Khiari Karima

Introduction: Pheochromocytomas are rare, mostly benign catecholamine-producing neuroendocrine tumors. Clinical manifestations are heterogenous, including persistent or paroxysmal hypertension, sweating, palpitation and headaches known as Menard triad. Diagnostic approach is based on demonstration of catecholamine excess and tumor localization. Our study aimed to describe clinico-biological and radiological features of pheochromocytomas.Methods: We condu...

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ea0090ep90 | Adrenal and Cardiovascular Endocrinology | ECE2023

Multifocal paraganglioma due to SDHB mutation: On purpose of one clinical case

Ferreira-Ocampo Pablo , Doejo Marciales Sandra Carolina , Barra Malig Solange Fabiola , Astunague Condori Remy Edward , Chicharro Pablo Lois , Ruiz Francisca Almodovar , Gorgojo Martinez Juan Jose , Salinas Helena Requejo

The mutations of succinate dehydrogenase subunits (SDHA, SDHB, SDHC, SDHD) are linked with a predisposition to develop pheochromocytoma and paraganglioma, often in diferent locations of the body. With greater acces to genetic tests, current estimations suggest that 40-50% of pheocromocytoma and paraganglioma cases are inherited and half of them are due to SDH mutations. These mutations can be associated with other tumours like renal carcinomas, gastrointestinal stroma tumours ...

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ea0090ep91 | Adrenal and Cardiovascular Endocrinology | ECE2023

Connshing syndrome: A case of late appeal and dilemmas in the diagnosis

Kolpakova Evgeniia , Krainyaya Arina , Tskaeva Alla , Yukina Marina , Platonova Nadezhda , Troshina Ekaterina

Introduction: Connshing syndrome is a rare disease characterized by mixed overproduction of mineralocorticoids and glucocorticoids from adrenal adenoma. We will describe a clinical case that illustrates a rare combination of aldosterone-cortisol co-secreting formation of the left adrenal gland against a background of bilateral macronodular adrenal hyperplasia, and the role of diagnostic methods in determining appropriate tactics for patient treatment.Cas...

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ea0090ep92 | Adrenal and Cardiovascular Endocrinology | ECE2023

A case of a black adrenal adenoma with autonomous cortisol secretion

Cidade-Rodrigues Catarina , de Brito Marques Francisca , Palma Isabel

Introduction: Adrenal incidentalomas are a frequent finding (1.4-7.3% on abdominal CT) and increasingly common with age, obesity, diabetes and hypertension. When approaching adrenal masses, clinicians should exclude malignancy and hormonal hypersecretion. Black adrenal adenomas (BAA), first reported in 1938, are rare benign adrenocortical tumours with black/brown appearance, containing lipofuscin. Most are non-functional, rarely inducing hypercortisolism. We present a case of ...

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ea0090ep93 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal Venous Sampling in a patient with bilateral adrenal adenomas and Cushing’s syndrome

Limniati Christina , Nikolaou Vasileios , Georgiadou Magdalini , Vellios Maria , Moustaka Aikaterini , Rizopoulou Parthena , Tsentidis Charalampos

Introduction: Adrenal Cushings syndrome accounts for 15-20% of all the causes of endogenous hypercortisolism, mainly due to unilateral adenomas and adrenal cancer. Approximately 9-17% of patients with ACTH-independent Cushings syndrome have bilateral adrenal adenomas. Subsequently, their management is quite demanding. The main difficulty lies in distinguishing between a functional and a non-functional adrenal mass, since this cannot be reliably achieved by routine ...

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ea0090ep94 | Adrenal and Cardiovascular Endocrinology | ECE2023

Case report: Management of Mild Autonomous Cortisol Secretion

Bammou Sanaa , Rudy Ekoundzola Joel , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Mild autonomous cortisol secretion (MACS) is a term used to describe biochemical evidence of abnormal cortisol secretion in patients with adrenocortical adenomas (ACA), but without the classical external manifestations of overt Cushings syndrome (CS).Materials and Methods: In this study, we report a case of patient who presents mild autonomous cortisol secretion among incidentally discovered adrenal masses; followed in unit of the end...

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ea0090ep95 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary hyperaldosteronism and renal failure: Diagnostic challenges, a case study

Khadidja Bessaid , Mezoued Mouna , Azzouz Malha

Introduction: The diagnosis of primary hyperaldosteronism (PAH) is based on the realization of the renin aldosterone ratio (RAR). The presence of renal insufficiency (RI) in a hypertensive patient complicates this diagnosis by affecting various biological assays.Observation: We report the case of 25-year-old female, with a personal history of primary hypothyroidism, hypertension diagnosed at age 21 and severe renal insufficiency developed during a pregna...

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ea0090ep96 | Adrenal and Cardiovascular Endocrinology | ECE2023

Retrospective Evaluation and Characteristics of Bilateral Adrenal Masses Followed Up in the Endocrinology Clinic of Ondokuz Mayıs University Hospital Between 2008 and 2022

Turk Sema Capkinoğlu , Gunduz Betul , Kayhan Yusuf , Kan Elif Kılıc , Atmaca Aysegul , Colak Ramis

Background: Adrenal incidentalomas are defined as clinically silent adrenal masses >1 cm in size and are detected in up to 10% of patients during imaging procedures performed for unrelated conditions. 17% and 23% of incidentally detected adrenal lesions were reported to be bilateral. The bilateral adrenal tumors include metastasis, lymphoma, neuroblastoma, pheochromocytoma, adenoma and myelolipoma. Non-neoplastic bilateral adrenal masses include infectious processes and he...

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ea0090ep97 | Adrenal and Cardiovascular Endocrinology | ECE2023

Exogenous hypercortisolism after long-term transcutaneous use of clobetasol propionate in the treatment of psoriasis (a clinical case)

Darashkevich Ina , Mokhort Tatsiana , Martinkevich Olga , Cossack Ina , Nikonova Lola , Litvinova Tatiana , Ershova Marina

The use of topical corticosteroids in the treatment of dermatosis, which includes psoriasis, is a common approach. With local use of corticosteroids, an increase in the concentration of corticosteroids in the area of the inflammatory process is noted, therefore local corticosteroids are believed not to have a suppressive effect on the function of the adrenal glands.Purpose: To demonstrate a side effect of hypercortisolism after uncontrolled long-term use...

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ea0090ep98 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal insufficiency secondary to steroid withdrawal: A Case Report

Gvazava Qetevan , Zavrashvili Nino , Chanturishvili Ketevan , Margvelashvili Natia , Shonia Natia

Introduction: Glucocorticoids are widely used for their anti-inflammatory and immunosuppressive properties. Prolonged administration of synthetic glucocorticoids is one of the most common cause of ACTH deficiency and consequent adrenal insufficiency. Exogenous glucocorticoids interfere with and suppress HPA axis and abrupt steroid withdrawal leaves body susceptible to adrenal insufficiency. Symptoms can range from adrenal crisis to nonspecific complains of fatigue, nausea and ...

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ea0090ep99 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cardiovascular repercussions of glucocorticoid replacement therapy in patients with Addison disease

Boujelben Khouloud , Salah Dhoha Ben , Frikha Hamdi , Kacem Akid Faten Haj , Mnif Mouna , Mnif Fatma , Charfi Nadia , Majdoub Nabila Rekik , Elleuch Mouna , Abid Mohamed

Introduction: Glucocorticoid replacement therapy may result in long-term morbidities, including cardiovascular diseases which can increase cardiovascular risk. The study was aimed to assess the impact of life-long glucocorticoid replacement therapy on cardiovascular parameters in patients with Addison disease (AD).Patients and Methods: This cross-sectional study was conducted assess cardiovascular events in patients followed for AD for at least 5 years, ...

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ea0090ep100 | Adrenal and Cardiovascular Endocrinology | ECE2023

Delayed partial primary hypoadrenalism following therapeutic and imaging radiation exposure of the adrenal glands

Tellier Genevieve , Berkeley Rhiannon , Searell Catrin , Wood Ffion , Wilton Anthony

A 73 year old female presented with a 5-year history of fatigue, anorexia and weight loss of 15 kg. Her primary care physician recorded a 09:00 h cortisol of 163 nmol/l. Previous medical history was one of abdominal diffuse B-cell lymphoma 9 years earlier treated with 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin and prednisolone) followed by CT-guided radiotherapy. Medications were transcutaneous buprenorphine 20 mg/hour, aspirin 75 mg od and omeprazole 20 mg o...

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ea0090ep101 | Adrenal and Cardiovascular Endocrinology | ECE2023

Aggravation of depressive symptoms after biochemical cure of Cushing syndrome

Arbunea-Ghenoiu Sandra , Piser Alexandra , Capatina Cristina , Poiana Catalina

Introduction: Endogenous Cushing syndrome (CS), is associated with significant morbidity (metabolic, cardiovascular, bone, psychiatric complications among others). Most complications tend to improve if hypercortisolism is controlled but some are only partially reversible or even experience temporary exacerbation.Patients and Methods: We report 2 cases of adrenal Cushing Syndrome (CS). The first is a 72 years-old female with CS caused by bilateral macrono...

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ea0090ep102 | Adrenal and Cardiovascular Endocrinology | ECE2023

The coexistence of primary adrenal insufficiency and systemic diseases: About two cases

Dorraelguiche Dorra , Najla Bchir , Chehida Annaam Ben , Salhi Salma , Chadia Zouaoui

Introduction: The majority of systemic diseases result from an autoimmune process. Primary adrenal insufficiency (Addissons disease AD) is also frequently caused by an autoimmune process. Their association is rare but can be seen in the framework of autoimmune polyendocrinopathies. We report 2 observations associating an autoimmune adrenal insufficiency with a systemic disease.Observation 1: We describe the case of a 50-year-old patient initially a...

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ea0090ep103 | Adrenal and Cardiovascular Endocrinology | ECE2023

Steroid hormone withdrawal and autoimmunity induction

Athanassiou Lambros , Athanassiou Panagiotis , Kalavri Eleni , Tsakiridis Pavlos , Fortis Athanasios , Mascha Olga , Ifigenia Kostoglou Athanasiou

Introduction: Pregnancy is characterized by increased secretion of estrogens and cortisol. Estrogen is used to prepare the maternal environment for the fetus. Cortisol induces a state of immunosuppression to avoid loss of the fetus, which, by definition, is at least partly a foreign organism. Parturition is characterized by estrogen and cortisol withdrawal. It leads to a rebound in immunity and may be accompanied by the development of autoimmune disease. Autoimmune thyroid dis...

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ea0090ep104 | Adrenal and Cardiovascular Endocrinology | ECE2023

When pheochromocytoma occurs in the elderly: A case report

Toulali Fatima , El Hafiani Asmae , Echchad Lamya , Rifai Kaoutar , Hinde Iraqi , Gharbi Mohamedelhassan

Introduction: Pheochromocytoma is a rare neuroendocrine tumor. It is usually diagnosed in subjects between 40 and 50 years of age. The occurrence of pheochromocytoma in the elderly is much rarer and has its own particularities. We report the case of a 70-year-old female patient with invasive pheochromocytoma.Case presentation: A 70-year-old female patient with a history type 2 diabetes for 18 years on oral antidiabetics and insulin. The history of his di...

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ea0090ep105 | Adrenal and Cardiovascular Endocrinology | ECE2023

Clinical and biological features of late-onset congenital adrenal hyperplasia

Ben Hadj Slama Nassim , Ach Taieb , Saad Ghada , Asma Gorchene , Abdelkarim Asma Ben

Introduction: 21-hydroxylase deficiency represents 95% of congenital adrenal hyperplasia. The non-classical form manifests in women mainly by hirsutism, menstrual disorders, or infertility. We present three patients cases.Observations: Patient N.C., 17 years old, who presented with hirsutism beginning at the age of 8 years and progressively worsening after puberty. The patient had her menarche at the age of 9 years, with short and irregular menses....

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ea0090ep106 | Adrenal and Cardiovascular Endocrinology | ECE2023

Comparison of The Clinical Course, Mortality and Morbidity Rate of the Covid 19 Disease in Patients with Cushing" s Syndrome and Patients with Non-functional Incidentaloma

Huseynli Narmin , Yener Abdulla Serkan

Objective: Subclinical Cushings Syndrome is defined as the condition of detecting moderate autonomic cortisol secretion, and it has many conditions such as diabetes, obesity, hypertension, osteoporosis, cardiovascular events, thromboembolic disease, dyslipidemia and immunosuppression comorbidities and with mortality having a relationship shown. Declared a global pandemic COVID-19 infection rapidly spreading with symptoms characterize andmortal one who can watch is a dise...

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ea0090ep107 | Adrenal and Cardiovascular Endocrinology | ECE2023

Acute adrenal insufficiency revealed by a convulsive crisis

Besrour Chayma , Nacef Ibtissem Ben , Mekni Sabrine , Essayeh Sawsen , Mchirgui Nadia , Rojbi Imen , Khiari Karima

Introduction: Adrenal insufficiency is defined as a deficit in the functioning of the adrenal cortex. The acute form represents a diagnostic and therapeutic emergency, but the clinical presentation is sometimes misleading.Observation: We report the case of a 57-year-old patient with a personal history of vitiligo, who was suffering for two months from asthenia with abdominal pain and vomiting, then he presented with a generalized tonic-clonic convulsive ...

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ea0090ep108 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenocortical Carcinoma presenting as florid Cushing’s Syndrome

Islam Quazi , Armeni Eleni , Naeem Ammara , Nwokolo Munachiso , Shekhda Kalyan , Karra Efthimia , Khoo Bernard , Patel Dipesh , Sahoo Saroj Kumar , Yousseif Ahmed

Introduction: Adrenocortical Carcinoma (ACC) is a rare endocrine neoplasm with poor prognosis, and an estimated incidence of approximately 2.5/1,000,000 patients. The functional state of these tumors varies from non-secretory (20%) to non-secretory. The latter category is subdivided into glucocorticoid-producing (45%) or glucocorticoid-androgen producing (45%) or androgen-producing only (10%). We report a case of a 35-year-old lady who initially presented with symptoms of Cush...

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ea0090ep109 | Adrenal and Cardiovascular Endocrinology | ECE2023

It hit two targets with one arrow. A case report of Cushing’s syndrome as a contributing cause for osteoporosis and thrombosis in a 64-year-old female

Iliescu Marina , Mitrache Marius , Stan Raluca , Zubaci Ana , Dumitrache Sabina , Grosu Iustina , Tarna Mihaela , Bancu Alexandra , Dinu Horatiu , Barsan Sergiu , Cima Luminita , Fica Simona

Cushings syndrome, whether it is ACTH-dependent or ACTH-independent, causes many complications due to chronic exposure of tissues to a glucocorticoid excess. Some of these are arterial hypertension, obesity, osteoporosis, coagulopathies, impaired glucose tolerance and diabetes. We present a case of Cushings syndrome diagnosed in a 64-year-old female that was referred to the Endocrinology Department from the Physical Medicine and Rehabilitation Department due to mul...

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ea0090ep110 | Adrenal and Cardiovascular Endocrinology | ECE2023

Relationship between megaloblastic anemia and ischemic stroke in a patient with adrenocortical carcinoma

Boubagura Imane , Hassan Neima , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: The prevalence of megaloblastic anemia in the adult population is poorly documented, but in the elderly, it has been clearly shown that the prevalence of macrocytic anemia increases after the age of 65 years especially in men. The most frequent etiology of vitamin B12 and folate deficiency is malabsorption. They have an action in the conversion of homocysteine to methionine: an increase in homocysteinaemia is currently considered a cardiovascular risk factor. Str...

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ea0090ep111 | Adrenal and Cardiovascular Endocrinology | ECE2023

Coexistence of adrenocorticotropic hormone-dependent Cushing’s syndrome and papillary thyroid carcinoma

Sliman Chayma Bel Hadj , Najla Bchir , Chehaider Cyrine , Benchhida Annam , Chadia Zouaoui , Ouertani Haroun

Introduction: Papillary thyroid carcinoma is one of the most prevalent endocrine tumors. Adrenocorticotropic hormone (ACTH) dependent Cushings syndrome is a rare disease. We report a rare case of coexistence of papillary thyroid carcinoma and ACTH-dependent Cushings syndrome.Observation: A 59-year-old man, was admitted to our endocrinology department for exploration of bilateral adrenal incidentalomas discovered in an abdominal CT scan done i...

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ea0090ep112 | Adrenal and Cardiovascular Endocrinology | ECE2023

Rare etiology of a voluminous adrenal incidentaloma: ganglioneuroma

Ouakrim Hind , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Ganglioneuroma (GN) is a benign, well-differentiated nerve tumor composed of mature sympathetic ganglion cells and nerve fibers, and most commonly located in the posterior mediastinum and retroperitoneum. GNs are rarely found in the adrenal gland. This tumor is usually asymptomatic and, in the majority of cases, detected incidentally. The diagnostic confirmation is histologic. We report a case of adrenal GN revealed by an adrenal incidentaloma.<p class=...

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ea0090ep113 | Adrenal and Cardiovascular Endocrinology | ECE2023

A case of autoimmune polyglandular syndrome type 2 unmasked after treating subclinical hypothyroidism

Bashir Mahamud , Oyesanya Ayodeji , Mohammed Mohammed , Mohamed Ayan , Etbinah Lubna , Ramachandran Kirtanya , Mlawa Gideon

Background: Autoimmune polyglandular syndrome type 2 is an autoimmune disorder that affects many hormone-producing (endocrine) glands. It is characterized by the presence of Addisons disease along with autoimmune thyroid disease and/or type 1 diabetes. The initial presentation can be varied but some patient maybe present with subclinical hypothyroidism and later develop Addisonian crisis. The pathogenesis of Autoimmune polyglandular syndrome type 2 remains unclear, altho...

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ea0090ep114 | Adrenal and Cardiovascular Endocrinology | ECE2023

The importance of under-treating adrenal failure in order to allow normal adrenal function following unilateral adrenalectomy for Cushing’s syndrome

Narula Kavita , Lazarus Kate , Qureshi Asjid , Palazzo Fausto , Meeran Karim

A 26-year-old woman presented to the Endocrine clinic with features of Cushings syndrome (CS). Investigations revealed a non-suppressible cortisol in low dose Dexamethasone suppression test with a suppressed ACTH, and two positive 24-hour urine cortisol collections, indicating CS. CT imaging revealed a left adrenal adenoma of 3.4 cm. Following a left adrenalectomy, she was discharged on once daily Prednisolone 3 mg. She was well for a year except for one occasion where s...

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ea0090ep115 | Adrenal and Cardiovascular Endocrinology | ECE2023

Adrenal adenomas in untreated Klinefelter syndrome is a frequent finding : Case report

Yamna Hadami Ben , Najla Bchir , Abadlia Salma , Benchhida Annam , Zouaoui Chedia , Ouertani Haroun

Introduction: Adrenal adenomas development has been partially explained by aberrant adrenal expression of some hormone receptors. Klinefelters syndrome is a common cause of hypergonadotropic hypogonadism, which is characterized by increased serum LH level. In this case, we report a patient with Klinefelter syndrome, who was later diagnosed with a non secreting adrenal adenoma.Case presentation: We report the case of a 57 years old patient, diagnose...

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ea0090ep116 | Adrenal and Cardiovascular Endocrinology | ECE2023

Pheochromocytoma associated with von Hippel-lindau disease

Faki Sevgul , Arifoglu Unzile , Dibeklioğlu Bilge , Tuncel Altuğ , Keskin Muge , Tam Abbas Ali , Topaloglu Oya , Ersoy Reyhan , Cakir Bekir

Von Hippel-Lindau (VHL) syndrome is a pathological condition that causes various clinical symptoms and is difficult to diagnose. The most common pathological lesions are hemangioblastomas of the central nervous system, retinal angiomas, renal clear cell carcinomas, and pheochromocytomas. Here we reposrt a case of likely to be VHL due to his family history.Case: A 33-year-old male suffering from hypertension and a history of hemangioblastoma operated in 2...

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ea0090ep117 | Adrenal and Cardiovascular Endocrinology | ECE2023

17 Alpha Hydroxylase Deficiency in congenital adrenal hyperplasia revealed by a ruptured cerebral aneurysm

Sara Chtioui , Rafi Sana , Tabib Ghizlane El Mghari , El Ansari Nawal

Background: A 17 alpha-hydroxylase deficiency (17OHD) is a rare form of congenital adrenal hyperplasia (CAH). Congenital adrenal hyperplasia (CAH) is a group of disorders resulting from defect of one of enzymes necessary for biosynthesis of cortisol.Case Report: A 33-year-old female suffered from 17OHD. She presented with primary amenorrhea, lack of secondary sexual characteristics, and hypertension complicated by ruptured cerebral aneurysm. Laboratory t...

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ea0090ep118 | Adrenal and Cardiovascular Endocrinology | ECE2023

Coexistence of Gilbert’s disease, thyroid nodule, parathyroid adenoma, and Cushing’s syndrome: A rare presentation

Sliman Chayma Bel Hadj , Najla Bchir , Dorraelguiche Dorra , Benchhida Annam , Chadia Zouaoui , Ouertani Haroun

Introduction: Gilbert syndrome is a common autosomal dominant hereditary condition characterized by intermittent unconjugated hyperbilirubinemia in the absence of hepatocellular disease or hemolysis. Multiple endocrine neoplasia (MEN) is defined by the association of a neoplasia or hyperplasia of at least two endocrine glands and caused by multiple mutations. Rare cases of atypical MEN were reported in the literature. We report the case of a patient with a history of gilbert&#...

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ea0090ep119 | Adrenal and Cardiovascular Endocrinology | ECE2023

Intermittent cushing’s syndrome: diagnostic challenges

Boubagura Imane , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Cushings syndrome (CS) is typically characterized by faciotronic obesity with signs of protein hypercatabolism, which may be iatrogenic or endogenous (adrenal or ATCH dependent). We report a case of CS of unusual presentation.Case Report: We report the case of a 45-year-old patient, referred for etiological assessment and management of an atypical cushing syndrome. Symptomatology dates back to 2007, by the appearance of abdomina...

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ea0090ep120 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary Aldosteronism and Cortisol Cosecretion in a Patient with Adrenal Adenoma

Zavrashvili Nino , Shonia Natia , Chanturishvili Ketevan , Gvazava Qetevan , Margvelashvili Natia

Background: Primary aldosteronism (PA) is a group of disorders characterized with inappropriately high adrenal aldosterone production, suppressed renin and hypertension. Prevalence of PA is approximately 5-10% in people with hypertension and up to 20-50% in those with resistant hypertension. PA is associated with increased cardiovascular and cerebrovascular morbidity and mortality rates compared with patients with essential hypertension when matched with age, sex and blood pre...

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ea0090ep121 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cushing’s disease in children: about a case

Bouzid Aicha , Meriem Kolli

Cushings disease (CD) is rare in paediatric practice but requires prompt investigation, diagnosis and therapy to prevent longterm complications. We report the case of a young 12-year-old patient who presented with probable Cushings disease complicated on the bone level by osteopenia. Cushings syndrome seems to have been evolving for 2 years, i.e. at the age of 10, manifesting itself by a weight gain of 20 kg in 18 months. Clinically, she presents clear signs ...

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ea0090ep122 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary Aldosteronism due to Adrenal Adenoma

Tchelidze Nazi , Vashakmadze Natia

A patient, 24 y/o male, presented with the regular occurrence of severe hypertension for past two years: 150-170/100 mmHg. He complained of occasional vertigo, fatigue, and rare muscle cramps. The laboratory findings showed marked hypokalemia2.7 mmol/l. Thyroid function tests, creatinine, magnesium levels were normal. Heart US showed septal thickening. He had been taking spironolactone 50 mg/day according to the prescription of his cardiologist for the last 2 weeks. Base...

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ea0090ep123 | Adrenal and Cardiovascular Endocrinology | ECE2023

Congenital adrenal hyperplasia due to 21-hydroxylase deficiency

Sara Chtioui , Midhat Ilham , Rafi Sana , Tabib Ghizlane El Mghari , Nawal El Ansari

Introduction: Congenital Adrenal Hyperplasia (CAH) are any of several autosomal recessive diseases resulting from mutations of genes for enzymes mediating the biochemical steps of production of mineralocorticoids, glucocorticoids or sex steroids from cholesterol by the adrenal glands (steroidogenesis).Case Report: We describe a case report of a 20 year-old female with congenital adrenal hyperplasia (CAH). The 20-year-old female patient was born with geni...

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ea0090ep124 | Adrenal and Cardiovascular Endocrinology | ECE2023

Young man with back pain, is it Cushing’s

Kanaan Aida , Gupta Rajinder , Kannappan Daniel

Introduction: Cushings syndrome is rare disease with annual incidence 2/ million. It carries a high mortality rate if untreated. ACTH independent Cushings with Adrenal adenoma is responsible for 10% of cases. This is a case of a young gentleman with back pain, vertebral fracture, in presence of left adrenal incidentaloma, normal MRI pituitary, and hormonal profile indicative of possible non-detectable central pituitary lesion, diagnosis of likely adrenal Cushing&#1...

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25th European Congress of Endocrinology

BiosciAbstracts