Searchable abstracts of presentations at key conferences in endocrinology
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25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

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ECE 2023 will be held in Istanbul, Turkey from 13-16 May 2023. Istanbul is known for its rich culture, historical sites and dynamic nightlife, and we are excited to come together in this city, and look forward to meeting old friends, making new ones, and sharing science, collaborations and ideas.

Poster Presentations

Adrenal and Cardiovascular Endocrinology

ea0090p1 | Adrenal and Cardiovascular Endocrinology | ECE2023

Crinecerfont (NBI-74788), a Novel CRF1 Receptor Antagonist, Lowers Adrenal Androgens and Precursors in Adolescents with Classic Congenital Adrenal Hyperplasia

Newfield Ron , Sarafoglou Kyriakie , Fechner Patricia Y. , Nokoff Natalie J. , Auchus Richard , Vogiatzi Maria , Giri Nagdeep , Roberts Eiry , Sturgeon Julia , Chan Jean L. , Farber Robert

Introduction: Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) is a rare autosomal recessive disorder characterized by deficiency of cortisol and oftentimes aldosterone, with elevated adrenocorticotropic hormone (ACTH) and steroid precursors that are shunted toward excess androgen production. A phase 2 study of adults with classic 21OHD demonstrated that crinecerfont–an oral, non-steroidal, selective corticotropin-releasing factor type...

ea0090p2 | Adrenal and Cardiovascular Endocrinology | ECE2023

Pivotal Role of miRNAs during Establishment of the Mineralocorticoid Signaling Pathway and Kidney Development

Imene Hani , Thi An VU , Riwan Brillet , Julie Perrot , Bouligand Jerome , Justine Guegan , Cherradi Nadia , Kamenicky Peter , Marc Lombes , Laetitia Martinerie , Viengchareun Say

The Mineralocorticoid Receptor (MR, NR3C2) mediates sodium-retaining action of aldosterone. Recently, we have shown that the physiological sodium loss observed in newborns in their first days of life is due to a low renal MR expression. However, the underlying molecular mechanisms remain unknown to date. In the adult renal KC3AC1 cell line, we demonstrated that variations in extracellular tonicity, which exist in the nephron, modulate MR expression by posttranscriptio...

ea0090p3 | Adrenal and Cardiovascular Endocrinology | ECE2023

Late onset congenital adrenal hyperplasia after the fifth decade of life: case series

Zaifu Laura , Dusceac Roxana , Naglabeala Laura , Niculescu Dan , Poiana Catalina

Introduction: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder that is caused by mutations of genes involved with adrenal steroidogenesis. The mutations mostly occur in the 21-hydroxylase gene and rarely in the 3β-hydroxysteroid dehydrogenase gene or 11β-hydroxylase genes. Our aim is to present a series of 3 cases of patients with late onset CAH, probably due to 21-hydroxylase deficiency, after 50 years of age.Case series...

ea0090p4 | Adrenal and Cardiovascular Endocrinology | ECE2023

Hypogonadism in men with congenital adrenal hyperplasia. A retrospective longitudinal analysis with a special focus on testicular adrenal rest tumors and 11-oxygenated androgens

Auer Matthias , Lottspeich Christian , Bidlingmaier Martin , F. Nowotny Hanna , Tschaidse Lea , Auchus Richard , Reisch Nicole

Background: Hypogonadism is frequent in men with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD). It has recently been demonstrated that testicular adrenal rest tumors (TART) are a source of 11-oxygenated androgens that might impair testicular function, in addition to their local compressive effects. Data on long-term course of testicular function in men with 21OHD and the role of potential influential factors such as presence of TART and 11-oxyge...

ea0090p5 | Adrenal and Cardiovascular Endocrinology | ECE2023

Catestatin is associated with the impairment of carbohydrate metabolism

Pankova Olena , Korzh Oleksii

Background: Arterial hypertension (AH) and 2 type diabetes mellitus (2TDM) are the critical risk factors for the development of cardiovascular diseases. Catestatin (CTS) is known as a marker of AH via its antiadrenergic and vasodilating actions, but also can improve insulin sensitivity.Objective: To investigate the relations between CTS levels and parameters of carbohydrate metabolism in patients with AH, including AH with 2TDM, and establish the prognos...

ea0090p6 | Adrenal and Cardiovascular Endocrinology | ECE2023

Patients with NF1 need routine hormonal screening towards pheochromocytoma

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

Up to 40% of pheochromocytoma cases have a genetic background. The prevalence of pheochromocytoma in neurofibromatosis type 1 (NF1) was reported to be from 0.1 to 5.7%. However, the actual incidence of pheochromocytoma in NF1 seems to be underestimated. Current recommendations on NF1 do not include systematic biochemical screening for the presence of pheochromocytoma. Our aim was to analyse clinicopathological characteristics of pheochromocytoma in the course of NF1 syndrome w...

ea0090p7 | Adrenal and Cardiovascular Endocrinology | ECE2023

Treatment compliance affects the reliability of clinically and biochemically important variables used for the titration of mineralocorticoid treatment in primary adrenal insufficiency

Pofi Riccardo , Bonaventura Ilaria , Duffy Joanne , Maunsell Zoe , Shine Brian , Isidori Andrea , Tomlinson Jeremy

Background: There is currently no agreed consensus for the optimization and titration of mineralocorticoid (MC) therapy in patients with primary adrenal insufficiency (PAI).Objective: To measure serum (sFC) and urine (uFC) fludrocortisone levels and explore their relationship with biochemically and clinically important variables (including treatment compliance) in order to evaluate their usefulness as markers to guide the MC replacement titration.<p ...

ea0090p8 | Adrenal and Cardiovascular Endocrinology | ECE2023

SARS-CoV-2 provoked acute adrenal crisis with severe hypovolaemic hyponatraemia

Kyaw Kyaw Naychi , Mullins Kieran , Sirkova Aneliya , Mlawa Gideon

Hyponatraemia is the commonest electrolyte disturbance among inpatients. Prompt diagnosis and management of the underlying cause is important. A 49-year-old Caucasian male presented to the emergency department with a two-day history of fever, altered mental status, vomiting, diarrhoea and postural dizziness. A rapid point of care RT-PCR test resulted positive for the SARS-CoV-2. A provisional diagnosis was presented of COVID-19 encephalopathy. The patient was usually fit and w...

ea0090p9 | Adrenal and Cardiovascular Endocrinology | ECE2023

Determination of dexamethasone level by liquid chromatography with tandem mass spectrometry after low-dose dexamethasone suppression test

Brutvan Tomas , Kotasova Marcela , Sevcik Jan , Springer Drahomira , Ježkova Jana

Introduction: Low-dose dexamethasone suppression test is used to screen for excess cortisol production (Cushing’s syndrome). It is recommended to use cut-off for suppression of serum cortisol (SC) < 50 nmol/l after 1 mg dexamehason suppression test (DST). Plasma dexamethasone levels are affected by many factors resulting in lower test specificity. Simultaneous analysis of dexamethasone and cortisol levels can improve diagnostic accuracy of DST. We used cut-off level o...

ea0090p10 | Adrenal and Cardiovascular Endocrinology | ECE2023

Prevalence and incidence of type 2 diabetes mellitus in patients with adrenal incidentalomas: A study of 709 cases

Brox Torrecilla Noemi , Garcia Cano Ana , Escobar-Morreale Hector F. , Valderrabano Pablo , Tobar Alejandra , Araujo-Castro Marta

Aim: To evaluate the prevalence and incidence of type 2 diabetes in patients with nonfunctioning adrenal incidentalomas (NFAI) and autonomous cortisol secretion (ACS) coming from a cohort of adrenal incidentalomas consecutively evaluated in a tertiary hospital in a predefined period (2013-2020).Methods: In this retrospective study, adrenal incidentalomas ≥1cm with ACS and NFAI were included. ACS was defined by a post-dexamethasone suppression test ...

ea0090p11 | Adrenal and Cardiovascular Endocrinology | ECE2023

Diagnostic accuracy of 18F-FDG PET/TC for the characterization of adrenal lesions in a heterogeneous population

Romanisio Martina , Daffara Tommaso , Pitino Rosa , Ferrero Alice , Zavattaro Marco , Biello Federica , Gennari Alessandra , Mauro Sacchetti Gian , Aimaretti Gianluca , Prodam Flavia , Caputo Marina

Purpose: Diagnosis of adrenal lesions requires hormonal investigation and morphological characterization; when CT and MRI imaging are equivocal, 18F-FDG-PET/CT could be a useful tool, although sensitivity and specificity varied among cohorts. The use of tumour-to-liver maximum standardized uptake values (SUVratio) was found to be accurate, but the best threshold value has not been identified yet. A SUVratio > 1.5 was associated with malignancy with a good performance. The ...

ea0090p12 | Adrenal and Cardiovascular Endocrinology | ECE2023

HPA axis suppression in patients treated with glucocorticoids: relationship to dose, duration and likelihood of recovery

Gregori Maria , Carroll Paul , Thakali Sonu , Breen Louise , Velusamy Anand , McGowan Barbara , Kariyawasam Dulmini , Tremble Kathryn , Saqib Aaisha

Background: Tertiary adrenal insufficiency (TAI) is a complication of long-term exogenous steroid use which results in suppression of the hypothalamic-pituitary-adrenal (HPA) axis. The short synacthen test (SST) is used to assess HPA axis function and recovery during glucocorticoid weaning. This study examined the effect of steroid preparation, dosage and therapy duration on HPA axis suppression.Method: A retrospective analysis of 950 SSTs performed betw...

ea0090p13 | Adrenal and Cardiovascular Endocrinology | ECE2023

Prolonged Adrenocortical Blockade Following Interruption of Osilodrostat in ACTH-dependent Cushing’s syndrome

Poirier Jonathan , Bonnet-Serrano Fideline , Thomeret Louis , Bouys Lucas , Bertherat Jerome

Introduction: Osilodrostat is the newest approved steroidogenic inhibitor drug for the treatment of Cushing’s syndrome (CS). In this presentation, we describe 3 patients who experienced an unexpectedly prolonged adrenal insufficiency following interruption of this treatment.Methods: A monocentric retrospective analysis (October 2019 to January 2023) of ACTH-dependent CS patients controlled with Osilodrostat was performed to identify patients with pr...

ea0090p14 | Adrenal and Cardiovascular Endocrinology | ECE2023

Opioid Use and Adrenal Insufficiency in Olmsted County, MN, USA: A Population-Based Study

Moazzami Mitra , J. Achenbach Sara , J. (Beth) Atkinson Elizabeth , Bancos Irina

Background: Chronic opioid use may lead to adrenal insufficiency (AI) due to suppression of the hypothalamic-pituitary-adrenal axis. We aimed to determine incidence of AI and mortality in patients treated with chronic opioid therapy in a standardized geographically well-defined population.Methods: In this population-based cohort study we assessed the standardized incidence rate of first time met chronic opioid use and adrenal insufficiency in adult resid...

ea0090p15 | Adrenal and Cardiovascular Endocrinology | ECE2023

Neonatal endotoxin exposure alters glucocorticoid levels in lymphoid organs of adult mice

Salehzadeh Melody , Mazurenko Anna , Lim Sarah , Soma Kiran

The neonatal immune system is not fully developed, making neonates more susceptible to early-life infection. Early-life activation of the immune system has lasting implications for health and disease. Glucocorticoids (GCs) are steroid hormones that modulate the immune response and increase in response to immune activation. GCs are produced by the adrenal glands and also by lymphoid organs (e.g., bone marrow, thymus, spleen). In neonatal mice, GC levels increase acutely in bloo...

ea0090p16 | Adrenal and Cardiovascular Endocrinology | ECE2023

Immunophenotypic differences in patients with primary adrenal insufficiency of different etiology

Nowotny Hanna F. , Marchant Seiter Thomas , Ju Jing , Gottschlich Adrian , Schneider Holger , Zopp Stephanie , Vogel Frederick , Tschaidse Lea , Auer Matthias , Lottspeich Christian , Kobold Sebastian , Rothenfuszer Simon , Beuschlein Felix , Reincke Martin , Braun Leah , Reisch Nicole

Background: Primary adrenal insufficiency (PAI) has been associated with increased risk of infection, adrenal crises and a higher mortality rate. This is caused by altered circadian cortisol profiles, which ultimately lead to immune cell dysregulation. In this study, we aim to characterize differences in immunophenotype of PAI patients of three different etiologies.Methods: Cross-sectional single center study including 28 patients with congenital adrenal...

ea0090p17 | Adrenal and Cardiovascular Endocrinology | ECE2023

What are the lived experiences of family and carers for adults during an acute episode of adrenal crisis: A qualitative analysis using focus group interview

Patel Deepa , Llahana Sofia

Purpose: To gain an understanding of lived experiences of the role of family and carers during an acute episode of adrenal crisis through qualitative interviews with family carers. To gain an understanding of the role of family members and cares during an acute episode and to make recommendations for future standards of care in supporting family and carers to support self-management for loved ones, and health care professionals.Methods: This study used t...

ea0090p18 | Adrenal and Cardiovascular Endocrinology | ECE2023


Saraiva Miguel , Palma Isabel

Introduction: Some studies have already described an association between mild autonomous cortisol secretion and poorer bone quality and increased risk of fracture. However, no consensus exists on this topic and currently there are no guidelines recommending bone status evaluation in patients suffering from this condition.Aims: To evaluate bone mineral density in patients diagnosed with autonomous cortisol secretion (ACS) and possible autonomous cortisol ...

ea0090p19 | Adrenal and Cardiovascular Endocrinology | ECE2023

RESCUE: Effect of supplemental hydrocortisone during stress in glucocorticoid-induced adrenal insufficiency; A study protocol for a multicentre, randomised, double blinded, placebo-controlled clinical trial

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

Background: Long-term, low-dose prednisolone treatment (≤5mg/day) is associated with adrenal insufficiency in >33% of patients. Nevertheless, the clinical consequences of glucocorticoid-induced adrenal insufficiency in patients receiving ongoing low-dose glucocorticoid treatment are unknown. Current clinical guidelines do not recommend routine evaluation of adrenal function during low-dose glucocorticoid treatment, and patients are not routinely instructed to increase gl...

ea0090p20 | Adrenal and Cardiovascular Endocrinology | ECE2023

Reduction of albuminuria after surgical and medical treatment of primary aldosteronism

Sng Gerald , Zhang Meifen , Puar Troy

Introduction: Primary aldosteronism (PA) is a common cause of secondary hypertension that can lead to renal sequelae. Treatment of hyperaldosteronism leads to reductions in albuminuria and glomerular hyperfiltration. We aimed to evaluate the effect of treatment on albuminuria and temporal changes in renal function after treatment with both surgery and medications.Methods: We prospectively recruited patients with PA over three years. Spot urine samples fo...

ea0090p21 | Adrenal and Cardiovascular Endocrinology | ECE2023

Transfer Of Congenital Adrenal Hyperplasia Patients From The Pediatric ClinicTo The Adult Clinic: A Single Center Experience

Bilik Oyman Gamze , Kandemir Tuğce , hacisahinogullari hulya , yenidunya yalin gulsah , Yıldız Melek , Gul Nurdan , Kubat Uzum Ayse , Poyrazooglu Sukran , Soyluk Selcukbiricik Ozlem , Bas Firdevs , Darendeliler Feyza

Introduction: Effective management of the transition from childhood to adulthood in congenital adrenal hyperplasia (CAH) can reduce the problems that may arise in the follow-up during adulthood.Aim: Evaluation of the clinical characteristics and sociodemographic data of CAH patients transferred from the Pediatric Endocrinology Clinic to the Adult department of our hospital and the comparison of the 2 transition models carried out during this period was t...

ea0090p22 | Adrenal and Cardiovascular Endocrinology | ECE2023

A Case of Orbital and Adrenal Masses

Al-Qaysi Amina , Spiliotis Ioannis , Ali Asif

Introduction: Adrenal incidentalomas (AIs) are increasingly being identified due to more frequent use of cross-sectional imaging modalities. Recent studies reported AIs being identified in 7.3% of abdominal CT imaging. Most adrenal incidentalomas are adenomas that may have secretory activity.Case Report: An 80-year-old lady presented to our Emergency department with one week’s history of worsening right eye bulging and discomfort. She was found to h...

ea0090p23 | Adrenal and Cardiovascular Endocrinology | ECE2023

Insulin-like growth factor 2 (IGF2) system role in promoting cell growth in different adrenocortical carcinoma (ACC) cell models

Catalano Rosa , Nozza Emma , Esposito Emanuela , Maria Barbieri Anna , Marra Giusy , Treppiedi Donatella , Di Muro Genesio , Mangili Federica , Constanze Hantel , Sigala Sandra , Cassinotti Elisa , Baldari Ludovica , Morelli Valentina , Palmieri Serena , Frigerio Sofia , Ferrante Emanuele , Arosio Maura , Mantovani Giovanna , Peverelli Erika

The majority of adrenocortical carcinomas (ACC) overexpress insulin-like growth factor 2 (IGF2). Although IGF2 drives a proliferative autocrine loop by binding to IGF1R and the isoform A of the insulin receptor (IRA), most studies focused on IGF1R. Recently, a high expression of IRA was observed in ACC vs normal adrenal tissues (NA), suggesting its potential involvement in modulating IGF2 effects in adrenocortical tumorigenesis. Aim of this study was to investigate the specifi...

ea0090p24 | Adrenal and Cardiovascular Endocrinology | ECE2023

Whole Exome Sequencing Identified Mutations in Genes Involved in the Synthesis of Atrial Natriuretic Peptide from the Heart in Hypertensive Cardiovascular Disease Patients

Rauf Sania , Arshad Abida , Foo Roger , Akram Maleeha , Naz Shumaila , Shakeel Raza Rizvi Syed

The heart not only has a mechanical function of pumping blood through vessels but also acts as an endocrine gland. In its endocrine function, the heart releases atrial natriuretic peptide (ANP), a hormone of a large family of natriuretic peptides. ANP is secreted from cardiac atria as an inactive preprohormone. In post-translational modification, 25-amino acid signal sequence is cleaved from preprohormone to produce proANP of 126-amino acid, which is the major form of ANP stor...

ea0090p273 | Adrenal and Cardiovascular Endocrinology | ECE2023

Pregnancy outcomes in women with classic and non-classic congenital adrenal hyperplasia

Minea Clara , Auer Matthias , Quinkler Marcus , Meyer Gesine , Bancos Irina , Beuschlein Felix , Bothou Christina , Pivonello Rosario , Simeoli Chiara , Falhammar Henrik , Reisch Nicole

Background: There have been conflicting reports on fertility, reproduction rates and pregnancy outcomes in women with congenital adrenal hyperplasia (CAH). Identification of potential modifiable influential factors of pregnancy outcomes in these women has been hampered in the past by either small sample sizes or data derived from epidemiological samples.Methods: Retrospective multi-center study including a total number of 72 women with CAH (n=34...

ea0090p274 | Adrenal and Cardiovascular Endocrinology | ECE2023

Response to Crinecerfont Treatment in Adults with Classic Congenital Adrenal Hyperplasia Is Correlated with Elevated Baseline Hormone Levels But Not Glucocorticoid Dose

Auchus Richard , Sarafoglou Kyriakie , Y. Fechner Patricia , Vogiatzi Maria , Giri Nagdeep , Roberts Eiry , Sturgeon Julia , Chan Jean L. , Farber Robert

Introduction: Corticotropin-releasing factor type 1 (CRF1) receptor antagonists, such as crinecerfont, have recently been investigated for the treatment of classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD), a rare autosomal disease characterized by cortisol deficiency, elevated adrenocorticotropic hormone (ACTH), and excess androgen production. In a study of adults with 21OHD, treatment with crinecerfont for 14 days led to median ...

ea0090p275 | Adrenal and Cardiovascular Endocrinology | ECE2023

Can Inflammation-Based Scores Help Predict Treatment Response in Advanced Adrenocortical Carcinoma?

Mangone Alessandra , Altieri Barbara , Detomas Mario , Prete Alessandro , Abbas Haider , Felicitas Asia Miriam , Elhassan Yasir , Mantovani Giovanna , Ronchi Cristina

Background: Treatment for advanced adrenocortical carcinoma (ACC) consists of mitotane alone or combined with etoposide, doxorubicin and cisplatin (EDP), yet their efficacy is limited and burdened with significant toxicity. Moreover, markers of response are lacking. Inflammation-based scores have been proposed as prognostic factors in several malignancies including ACC, and recently also as predictors of gemcitabine+capecitabine efficacy, second-line treatment in progressive d...

ea0090p276 | Adrenal and Cardiovascular Endocrinology | ECE2023

The impact of Bariatric Surgery on the 1mg Dexamethasone Suppression Test in patients with Severe Obesity

Casteras Anna , Fidilio Enzamaria , Comas Marta , Michael Ortiz Angel , Biagetti Betina , Zabalegui Alba , Filippi Francesca , Giralt Marina , Ferrer Roser , Vilallonga Ramon , Ciudin Andreea

Background: The cortisol suppression test with 1 mg dexamethasone (DST) is a screening test for hypercortisolism with high sensitivity (95%) for serum cortisol cut-off <1.8 μg/dl. However, cortisol tests may give false positive in patients with severe obesity (SO). On the other hand, bariatric surgery (BS) is the most effective treatment for SO, and the operated population is growing. At present there is no reliable data regarding the impact of BS on DST results in pa...

ea0090p277 | Adrenal and Cardiovascular Endocrinology | ECE2023

Role of macrophages in zona glomerulosa differentiation

Garcia Diana , Wilmouth James , Olabe Julie , Martinez Antoine , Val Pierre

Maturation of the definitive adrenal cortex occurs between 3 and 6 weeks post-partum and involves onset of CYP11B2 expression and establishment of the laminin-encased 3D structure of glomeruli that contain rosettes of 10 to 15 zona glomerulosa (zG) cells that work in coordination to produce optimal amounts of aldosterone. Although this process is dependent on canonical WNT/b-catenin signaling, cellular sources of WNT ligands remain elusive and the mechanisms involved in the ex...

ea0090p278 | Adrenal and Cardiovascular Endocrinology | ECE2023

Bone metabolism and dual-release Hydrocortisone: results from a real-life study

Ferrari Davide , Sada Valentina , Hasenmajer Valeria , De Alcubierre Dario , Puliani Giulia , Minnetti Marianna , Cozzolino Alessia , Bonaventura Ilaria , Tomaselli Alessandra , Pofi Riccardo , Lenzi Andrea , M. Isidori Andrea

Background: Patients with adrenal insufficiency (AI) require long-term glucocorticoid (GC) replacement therapy and generally show an increased prevalence of bone metabolism alterations. Only few data are available on bone safety of dual-release Hydrocortisone (DR-HC) therapy.Objective: To evaluate bone metabolism in both primary AI (PAI) and secondary AI (SAI) during long-term therapy with DR-HC.Methods: We studied patients with AI...

ea0090p279 | Adrenal and Cardiovascular Endocrinology | ECE2023

Inflammation-based scores in benign adrenocortical tumours are related to the degree of cortisol excess

Favero Vittoria , Mangone Alessandra , Elhassan Yasir , Felicitas Asia Miriam , Hardy Rowan , Chiodini Iacopo , Prete Alessandro , Ronchi Cristina

Glucocorticoids play a significant role in immune modulation and regulation of inflammation. In patients with endogenous glucocorticoid excess (Cushing’s syndrome [CS]) multiple haematological alterations are recognized, such as neutrophil leukocytosis, lymphopenia, and eosinopenia, often leading to severe clinical complications. However, little is known in patients with mild autonomous cortisol secretion (MACS). Serum inflammation-based scores may reliably reflect system...

ea0090p280 | Adrenal and Cardiovascular Endocrinology | ECE2023

Primary hyperparathyroidism and bilateral pheochromocytoma with MAX mutation: Case report

Benabid Chaima , Achir Safia , Nebti Numydia , Arbouche Zakia

Introduction: Pheochromocytomas(PC)are rare catecholamine-producing neuroendocrine tumors. Germline variants of the MYC-associated factor (MAX) gene have been associated with familial PC and paragangliomas (PGL) with an autosomal dominant pattern of inheritance and an overall frequency estimated at 1.9%. Other endocrine and non endocrine tumors can be associated to germline MAX mutations.Case presentation: We report a case of a 37 years old male patient,...

ea0090p281 | Adrenal and Cardiovascular Endocrinology | ECE2023

The cardiometabolic risk in patients with non-functioning adrenal incidentaloma: an observational, retrospective and propensity score matched study

Parasiliti Caprino Mirko , Bioletto Fabio , Tomaiuolo Gabriella , Roux Anna , Lopez Chiara , Bollati Martina , Procopio Matteo , Arata Stefano , Ghigo Ezio , Arvat Emanuela , GIORDANO Roberta , Maccario Mauro

Introduction: Recent studies found an increased cardiometabolic risk in patients with Non-Functioning Adrenal Incidentaloma (NFAI), but all these data have low quality of evidence.Objective: To establish whether cardiometabolic risk and complications in NFAI patients can be associated to the presence of a non-secreting adrenal tumor, independently from potential confounding factors.Subjects and Methods: In this cross-sectional and ...

ea0090p282 | Adrenal and Cardiovascular Endocrinology | ECE2023

Characterisation of a Three-Dimensional (3D) Cell Culture Model of Adrenocortical Carcinoma

Feely Sarah , Donlon Padraig , Mullen Nathan , Sorushanova Anna , P Finn David , Hernan Brendan , Carroll Oliver , Owens Peter , Pandit Abhay , Hantel Constanze , C Dennedy Michael

Adrenocortical carcinoma (ACC) is a rare malignancy associated with a poor prognosis (1). Current treatments are limited with surgical resection the only option for a complete cure (2). The development of translational therapies is limited by pre-clinical disease models. Three-dimensional (3D) cell culture models can accurately reflect the tumour micro-environment but are lacking in ACC (3). In the current study, we developed and characterised novel 3D models of MUC-1, HAC15 a...

ea0090p283 | Adrenal and Cardiovascular Endocrinology | ECE2023

Comparison of Plasma Levels of Metanephrines Obtained by Direct Venipuncture vs Indwelling Intravenous Cannula in Hypertensive Patients

Pisutsawat Wannida , Snabboon Thiti , Santisitthanon Prangareeya , Houngngam Natnicha , Yimnoi Parichat

Background: The diagnosis of pheochromocytoma and paraganglioma (PPGL) requires the measurement of plasma metanephrines; however, several pre-analytical parameters can lead to false positive test results. During venipuncture, pain perception may activate the sympathetic nervous system, increasing catecholamine metabolite levels. Furthermore, hypertension patients exhibit sympathetic hyperactivity compared to normotensive subjects. The purpose of this study was to compare the p...

ea0090p285 | Adrenal and Cardiovascular Endocrinology | ECE2023

Predictive performance of aldosterone-to-renin ratio in the diagnosis of primary aldosteronism in patients with resistant hypertension

Bioletto Fabio , Lopez Chiara , Bollati Martina , Arata Stefano , Procopio Matteo , Ponzetto Federico , Beccuti Guglielmo , Mengozzi Giulio , Ghigo Ezio , Maccario Mauro , Parasiliti Caprino Mirko

Background: The systematic use of confirmatory tests in the diagnosis of primary aldosteronism (PA) increases costs, risks and complexity to the diagnostic work-up. In light of this, some authors proposed aldosterone-to-renin (ARR) cut-offs and/or integrated flow-charts to avoid this step. Patients with resistant hypertension (RH), however, are characterized by a dysregulated renin-angiotensin-aldosterone system, even in the absence of PA. Thus, it is unclear whether those str...

ea0090p286 | Adrenal and Cardiovascular Endocrinology | ECE2023

Regulation of stem/progenitor cells of the HPA axis during stress adaptation

Siatra Panagiota , Cozma Diana , Berger Ilona , Oikonomakos Ioannis , Theodoropoulou Marily , Bornstein Stefan , Andoniadou Cynthia , Steenblock Charlotte

Chronic stress is a pervasive concern in the modern society. A long-term hyper activation of the hypothalamic-pituitary-adrenal (HPA) axis leads to elevated amounts of stress hormones [e.g. ACTH and glucocorticoids (GCs)]. This can incur maladaptation that eventually contributes to mental illness, cardiovascular dysfunctions, diabetes, cancer and autoimmune diseases. Emerging key players for stress adaptation of the HPA axis are stem/progenitor cell populations. In this study,...

ea0090p287 | Adrenal and Cardiovascular Endocrinology | ECE2023

Perception of female patients with congenital adrenal hyperplasia and their parents on genital surgery: a retrospective survey

Tschaidse Lea , Sappl Andrea , Auer Matthias , Lottspeich Christian , Nowotny Hanna F. , Reisch Nicole

Background: Congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) is associated with ACTH-driven adrenal androgen excess. In women with classic CAH, this regularly causes prenatal virilisation of the external genitalia, commonly corrected by genital surgery during the first years of life. This practice, however, has been questioned and is discussed highly controversial. The aim of this study was to retrospectively assess the perspective of affected patients and...

ea0090p288 | Adrenal and Cardiovascular Endocrinology | ECE2023

Symptoms and Steroid Dose Adjustments Associated with the SARS-CoV-2 Vaccine in Patients with Adrenal Insufficiency

McLaren David , Crowe Grace , Cassidy Christine , Rasool Irum , elsabbagh mohamed , Eyadeh Ahmad , Poe Poe Han Htwe Nang , Gerrard Melinda , Ward Emma , Kassim Saifuddin , Abbas Afroze , Al-Qaissi Ahmed , M Orme Steve , Seejore Khyatisha , Kyriakakis Nikolaos , Maguire Deirdre , Lynch Julie , D Murray Robert

Background: Following vaccination for SARS-CoV-2 a significant proportion of individuals experience moderate to severe symptoms. In patients with adrenal insufficiency (AI) this has been reported to translate in to need for increased glucocorticoids and incipient or frank adrenal crises. We assessed occurrence of symptoms, need for glucocorticoid dose adjustment and crises in a large cohort of patients with AI following vaccination for SARS-CoV-2.Methods...

ea0090p289 | Adrenal and Cardiovascular Endocrinology | ECE2023

Atorvastatin use is associated with decreased testosterone levels in type 2 diabetes men

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

Introduction: Statins are used in the management of hypercholesterolemia and the prevention of cardiovascular diseases. However, by reducing cholesterol biosynthesis, steroidogenesis and particularly testosterone synthesis may be affected. The aim of our study was to assess the effect of high doses of statin therapy on testosterone levels in type 2 diabetes male patients.Methods: This was a single-center, prospective study, during the period march 2021 -...

ea0090p290 | Adrenal and Cardiovascular Endocrinology | ECE2023

Differences in the extracellular matrix protein signature of the outermost zone of the rat adrenal gland

Lucas Kremer Jean , Feijoli Santiago Veronica , Bongiovani Rodrigues Fernanda , Palmisano Giuseppe , Ferini Pacicco Lotfi Claudimara

Changes in the composition of the extracellular matrix (ECM) induce different cell signaling in normal tissues and in pathological conditions. ECM alteration in the adrenal microenvironment may contribute to both the development and function of adrenal gland. The adrenal gland consists of a cortex, with three concentric zones, glomerulosa (ZG), fasciculata (ZF) and reticularis (ZR), and the medulla (M), surrounded by a capsule. Here, we describe the differences among the ECM s...

ea0090p291 | Adrenal and Cardiovascular Endocrinology | ECE2023

ARMC5 regulates SIRT1 expression in adrenocortical cells

Berthon Annabel , Fabio Faucz , Benjamin Feldman , Ludivine Drougat , Stephanie Espiard , Bertherat Jerome , Stratakis Constantine

Pathogenic ARMC5 variants are the main genetic cause of Primary Bilateral Macronodular Adrenal Hyperplasia (PBMAH) explaining roughly 20% of index cases. These variants found both at germline and somatic level are mostly frameshift and nonsense leading to a loss of its function. ARMC5 acts then, as a tumor suppressor gene but little was initially known on its function. Using an RNAseq analysis on transient zebrafish models of Armc5 up- and d...

ea0090p292 | Adrenal and Cardiovascular Endocrinology | ECE2023

Significance of exogenous estradiol on plasma cortisol during ACTH stimulation in women with pituitary insufficiency

Aagaard Laura , Krogh Jesper , Klose Marianne , Andreassen Mikkel

Objective: Exogenous estradiol increases cortisol binding globulin (CBG) and total cortisol (TC), and therefore it is debated if estradiol supplementation should be paused before evaluation of the adrenal axis. The aim was to evaluate how oral and transdermal estradiol influence TC in hypogonadal women with, or at risk of developing, adrenal insufficiency (AI)Methods: This was a crossover study in 17 women with secondary hypogonadism who were tested with...

ea0090p293 | Adrenal and Cardiovascular Endocrinology | ECE2023

Modulation of calcium signaling ‘on demand‘ in adrenocortical cells to decipher the molecular mechanisms responsible for primary aldosteronism

Bakhta Fedlaoui , Teresa Cosentino , Sayed Zeina Al , Isabelle Giscos-Douriez , Jean-Sebastien Hulot , Fernandes-Rosa Fabio , Simon Travers , Stephanie Baron , Maria-Christina Zennaro , Boulkroun Sheerazed

Introduction: Primary aldosteronism (PA) is the most frequent form of secondary hypertension. Over the past 10 years, important discoveries have been made regarding the genetic basis of aldosterone producing adenoma and familial forms of primary aldosteronism. In most cases, genetic abnormalities are found in genes coding for ion channels (KCNJ5, CACNA1D, CACNA1H, CLCN2) and pumps (ATP1A1, ATP2B3). These mutations affect intracellular ion homeostasis and/or c...

ea0090p294 | Adrenal and Cardiovascular Endocrinology | ECE2023

Relative adrenal insufficiency in liver cirrhosis: a common but often forgotten critical condition

Petkovic Tijana , Marina Ljiljana , Petkovic Dunja-Simona , Martinov Nestorov Jelena , Culafic Djordje , Jovanovic Jelena , Ivovic Miomira , Stefan Sojat Antoan , Antic Natalija , Saravinovska Kristina , Arizanovic Zorana , Vujovic Svetlana

Introduction: Relative adrenal insufficiency (RAI) is common in critically ill patients and is characterized by the normal adrenal reserve for homeostatic demands and inadequate cortisol response in acute stress situations. RAI can also occur in patients with liver cirrhosis, both compensated and decompensated. However, it is often forgotten and difficult to diagnose due to the overlap between clinical symptoms of adrenal insufficiency and decompensated liver disease. Also, hy...

ea0090p295 | Adrenal and Cardiovascular Endocrinology | ECE2023

Metastatic composite pheochromocytoma manifesting as severe bone pain

Minasyan Mair , Rzepka Ewelina , Gilis-Januszewska Aleksandra , Hubalewska-Dydejczyk Alicja

Composite pheochromocytomas (CP) are rare and constitute 3% of pheochromocytomas. So far, less than 100 cases were described in the literature. We present a case of 60 years old man. He was admitted to ER department due to severe bone pain around chest, ribs and vertebra. CT scan showed expansive, 100x87 mm, non-homogenic left adrenal gland tumour as well as metastatic bone lesions. The 24-hour urinary fractionated metanephrines were significantly elevated - 86195 ug/24h (norm...

ea0090p296 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cardiometabolic and Kidney Biomarker Effects of Gender-affirming Hormone Therapy in Transgender Males

Filipa Araujo Barbara , Lopes Sofia , Ferreira Mafalda , Ruas Luisa , Paiva Sandra , Paiva Isabel

Introduction: Testosterone-based gender-affirming hormone therapy (GAHT) may have negative consequences on cardiovascular risk, with reported increased blood pressure, decreased HDL-cholesterol, and weight gain. Still, data on cardiometabolic changes in transgender men on GAHT remain controversial. Testosterone-based GAHT also modifies body composition and lean muscle mass, but the degree to which affects serum creatinine and other measures of kidney function is still not clea...

ea0090p547 | Adrenal and Cardiovascular Endocrinology | ECE2023

Safe observation of early recurrence of asymptomatic pheochromocytomas in MEN2 patients

Puerto Marie , Buffet Alexandre , Haissaguerre Magalie , Nunes Marie-Laure , Mathilde Duval , Haythem Najah , Amar Laurence , Tabarin Antoine

Controlateral recurrence of pheochromocytoma is frequent in MEN2 patients. Cortical sparing adrenalectomy is currently recommended in this situation, but conveys a risk of adrenal insufficiency in up to 45 % of patients. The natural history of recurrent pheochromocytome is poorly known. Thus, appropriate timing of surgery and the possibility to postpone safely surgery remain debatable. We report our experience of long-term follow up of non-operated 16 pheochromocytomas in 13 M...

ea0090p548 | Adrenal and Cardiovascular Endocrinology | ECE2023

Pheochromocytomas in patients with Parkinson’s disease: a diagnostic and therapeutic challenge

Calvo Latorre Julia , Patel Bharat , Sheikh Anum , Radia Florika , Ali Tauni Rahat

Dopamine agonists can falsely elevate plasma and urinary metanephrines, thus making the diagnosis of pheochromocytomas in patients taking these medications challenging. We present the case of an 80-year-old female care home resident with a background of hypertension, Parkinson’s disease (PD), dementia and pernicious anaemia. She presented with weight loss, unilateral leg swelling and abdominal distension. A computed tomography (CT) showed a 5.6 cm heterogeneously enhancin...

ea0090p549 | Adrenal and Cardiovascular Endocrinology | ECE2023

Differentiation of Pluripotent Stem Cells into Steroidogenic Cells with the Application of Artificial Intelligence

Oikonomakos Ioannis , Sanabria Melissa , Neirijnck Yasmine , Bornstein Stefan , Schedl Andreas , Steenblock Charlotte

Adrenal insufficiency is a life-threatening condition in which the adrenal glands fail to produce adequate amounts of steroid hormones thus leading to severe disturbances of body homeostasis. Today’s treatment options are limited to hormone replacement therapies that are, however, hampered by serious side effects. Cell replacement therapies with adrenocortical stem cells could present a potential cure, but the culture of such stem cells has proven difficult. We have devel...

ea0090p550 | Adrenal and Cardiovascular Endocrinology | ECE2023

Is there any link between non-classic adrenal hyperplasia (NCAH) and glucose metabolism?

Domagała Bartosz , Gamrat Aleksandra , Skalniak Anna , Przybylik-Mazurek Elwira , Trofimiuk-Muldner Malgorzata , Hubalewska-Dydejczyk Alicja

Introduction: There are data reporting an increased risk of cardiovascular and metabolic complications in patients with NCAH. This is frequently attributed to glucocorticoid (over)use. It seems that long-term exposure to increased androgens concentration may also itself lead to diminished insulin sensitivity and increased risk of prediabetes and diabetes.Aim: The aim of the study was to assess the link between NCAH diagnosis and glucose metabolism distur...

ea0090p551 | Adrenal and Cardiovascular Endocrinology | ECE2023

Does this patient really have a pheochromocytoma? A retrospective analysis of patients undergoing adrenalectomy overdiagnosed with pheochromocytoma

Zawadzka Karolina , Małczak Piotr , Wysocki Michał , Major Piotr , Pędziwiatr Michał , Pisarska-Adamczyk Magdalena

Background: Pheochromocytoma and paraganglioma (PPGL) are rare endocrine tumours that secrete catecholamines. Methoxycatecholamines in free plasma or fractionated methoxycatecholamines in 24-hour urine collections are the recommended tests for the diagnosis of pheochromocytoma, based on which patients are referred for surgical removal of the adrenal gland. However, false-positive results from these tests remain a problem and some patients are referred for adrenalectomy due to ...

ea0090p552 | Adrenal and Cardiovascular Endocrinology | ECE2023

Non-specific uptake of magnetic iron oxide nanoparticles by Adrenocortical carcinoma and Endothelial cells

Sorushanova Anna , Donlon Padraig , Mullen Nathan , Covarrubias-Zambrano Obdulia , Covarrubias Jose , Varghese Sunitha , Hantel Constanza , Owens Peter , O'Halloran Martin , Prakash Punit , Bossman Stefan , Conall Dennedy Michael

Adrenocortical carcinoma is a rare malignant tumour that starts in the adrenal gland, accounting for 4% of all adrenal tumours. Functioning ACC can cause symptoms related to the overproduction of hormones and large tumours can press on nearby organs. Primary treatment for ACC tumour is surgery to remove the tumour, and may also include Chemotherapy or Radiation to stop the cancer cells from spreading. Therefore, more affective therapies for delivering therapeutics to the tumou...

ea0090p553 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cushingoid features in a patient with adrenal insufficiency secondary to combined inhaled steroid and Itraconazole therapy

Nagarajah Kalyani , George Lindsay , Lansdown Andrew

Background: Iatrogenic adrenal insufficiency (AI) refers to primary, secondary, or tertiary hypoadrenalism associated with drug administration, surgery, or irradiation. The most common cause of secondary adrenal insufficiency is exogenous glucocorticoids. Hepatic metabolism of inhaled corticosteroids (ICS) takes place via cytochrome P450 3A4. Nevertheless, it can be decreased by enzyme inhibitors such as itraconazole or ritonavir, thus leading to an increase in the bioavailabi...

ea0090p554 | Adrenal and Cardiovascular Endocrinology | ECE2023

Unexpected cause of hypertension associated with hypokalemia

Trifanescu Raluca , Toma Iustin-Daniel , Mohora Maria-Alexandra , Popescu Ileana , Nitu Ileana , Poiana Catalina

Background: Prolonged ingestion of licorice has been known to cause hypokalemia and resistant hypertension amongst other disturbances. This is due to glycyrrhizin that inhibits the 11-β-hydroxysteroid dehydrogenase enzyme type 2 which results into increased plasma cortisol levels that stimulate the mineralocorticoid receptors resulting into apparent mineralocorticoid excess.Case report: A 45-year-old woman resident in an iodine sufficient area, heav...

ea0090p555 | Adrenal and Cardiovascular Endocrinology | ECE2023

Coagulation parameters in patients with adrenal incidentalomas and mild cortisol secretion: sex difference matters

Bonaventura Ilaria , Minnetti Marianna , De Alcubierre Dario , Tomaselli Alessandra , Ferrari Davide , Sada Valentina , Angelini Francesco , Hasenmajer Valeria , Cozzolino Alessia , Sbardella Emilia , Pofi Riccardo , Lenzi Andrea , Isidori Andrea M.

Background: Patients with Cushing’s syndrome (CS) typically show an alteration in the intrinsic coagulation pathway, leading to an increased risk of venous thromboembolism. Cortisol autonomy has been variably associated with higher risk of cardiovascular events and mortality compared to patients with non-functioning adrenal adenomas (NFA), particularly in women younger than 65 years. However, dedicated studies describing coagulation status in patients with adrenal inciden...

ea0090p556 | Adrenal and Cardiovascular Endocrinology | ECE2023

Cardiometabolic and bone health in postmenopausal women with glucocorticoid replacement therapy due to adrenal insufficiency; where do we stand

Kardalas Efstratios , Angelousi Anna , Argyro Vassiliadi Dimitra , Tsagarakis Stylianos

Background: Individuals with adrenal insufficiency (AI) receive life-long glucocorticoid (GC) replacement therapy (CGRT), which often exceeds normal daily physiological GC production, leading to detrimental effects on cardiometabolic parameters and bone health.Objective: Assessment of glucose, lipid and bone metabolism in AI postmenopausal patients in relation to the cause of AI and the CGRT dose.Methods: 114 AI postmenopausal wome...

ea0090p557 | Adrenal and Cardiovascular Endocrinology | ECE2023

Retrospective study of steroid weaning in tertiary adrenal insufficiency comparing prednisolone and hydrocortisone

Fahad Arshad Muhammad , Elder Charlotte , Newell-Price John , Ross Richard , Debono Miguel

Background: The hypothalamic-pituitary-adrenal (HPA) axis can be suppressed by long-term exogenous glucocorticoids, resulting in tertiary adrenal insufficiency (AI). International expert consensus suggests that during weaning, prednisolone be converted to hydrocortisone to allow HPA axis reactivation(1). There is, however, little evidence to support this practice.Aim: To compare HPA axis recovery during treatment with prednisolone and immediat...

ea0090p558 | Adrenal and Cardiovascular Endocrinology | ECE2023

Description of 38 novel ARMC5 variants and review of the literature: the updated mutational landscape of ARMC5 in Bilateral Macronodular Adrenocortical Disease

Bouys Lucas , Vaczlavik Anna , Pontes Cavalcante Isadora , Violon Florian , Jouinot Anne , Berthon Annabel , Vaduva Patricia , Espiard Stephanie , Perlemoine Karine , Kamenicky Peter , Vantyghem Marie-Christine , Tabarin Antoine , Raverot Gerald , Ronchi Cristina , Dischinger Ulrich , Reincke Martin , Candida Barisson Villares Fragoso Maria , Stratakis Constantine , North Marie-Odile , Pasmant Eric , Ragazzon Bruno , Bertherat Jerome

Introduction: Bilateral Macronodular Adrenocortical Disease (BMAD) is a rare cause of Cushing syndrome due to bilateral adrenocortical macronodules. Germline inactivating variants of the tumor suppressor gene ARMC5 have been described by our group 10 years ago and are responsible for 20-25% of apparently sporadic BMAD cases and 80% of familial presentations. ARMC5 patients present with a more pronounced phenotype than wild-type patients, in terms of cortisol ...

ea0090p559 | Adrenal and Cardiovascular Endocrinology | ECE2023

Anxiety, depression, quality of life and sleep: new insights in adrenal insufficiency care through salivary cortisol and cortisone diurnal rhythm measurement

Tucci Lorenzo , Vicennati Valentina , Bissi Valentina , Galante Greta , Colombin Giacomo , Coscia Kimberly , Improta Ilaria , Rotolo Laura , Fanelli Flaminia , Pagotto Uberto , Di Dalmazi Guido

Background: Adrenal insufficiency patient (AIP) care is mostly based on symptoms or clinical signs of inadequate glucocorticoid replacement treatment (GRT). Salivary cortisol (F) and cortisone (E) recently emerged as new tools for AIP management, although poorly employed in clinical practice.Aim: To assess associations between salivary glucocorticoid measures and life quality, anxiety depressive symptoms, sleep quality in AIP.Metho...

ea0090p560 | Adrenal and Cardiovascular Endocrinology | ECE2023

Genetic Aetiology of Primary Adrenal Insufficiency in Sudan

Smith Chris , Abdullah Mohamed , Hassan Samar , Qamar Younus , Hall Charlotte , Maitra Saptarshi , Maharaj Avinaash , Mariela Marroquin Ramirez Lucia , Read Jordan , Chan Li , Metherell Louise , Musa Salwa

Primary adrenal insufficiency (PAI) in children is usually congenital with more than 25 causal genes leading to overlapping phenotypes. A genetic diagnosis is helpful to guide management and genetic counselling but can be challenging in resource limited settings where facilities for antibodies and genetic testing may be unavailable. Studies from Africa are rare but, in Sudan, the most common genetic aetiologies for PAI are congenital adrenal hyperplasia (CAH; mostly CYP21A...

ea0090p561 | Adrenal and Cardiovascular Endocrinology | ECE2023

UK Lung cancer screening guidelines; are functional adrenal lesions being missed?

Sagar Rebecca , Scarsbrook Andrew , Callister Matthew , Abbas Afroze

Background: Adrenal incidentalomas are common and require investigation to exclude malignancy and evidence of hormone overproduction. Prospective screening programmes are essential for early detection of cancer but often lead to incidental findings which have potential health economic implications and may increase patient anxiety. With regards to investigation of incidental adrenal nodules, current national lung cancer screening recommendations are not in keeping with current ...

ea0090p562 | Adrenal and Cardiovascular Endocrinology | ECE2023

The Relationship Between Autonomic Cortisol Secretion and Metabolic Diseases in Cases with Adrenal Incidentaloma

Turan Erdogan Beril , Evranos Ogmen Berna , Sacikara Muhammed , Aydin Cevdet , Topaloglu Oya , Ersoy Reyhan , Cakir Bekir

Backgorund: Adrenal incidentalomas (AI) are lesions discovered incidentally on imaging without clinical symptoms or examination findings. AI can produce hormones in 5-30% of cases. Autonomic cortisol secretion (ACS) is the most common of these. Although ACS is asymptomatic, it increases the risk of metabolic disorders.Methods: Patients aged ≥18 years with adrenal adenoma and upper abdominal MRI who presented and were examined in the endocrinology o...

ea0090p563 | Adrenal and Cardiovascular Endocrinology | ECE2023

Influence of liver steatosis and fibrosis on cardiovascular function and prognosis of HFpEF patients

Rita Leite Ana , Borges-Canha Marta , Angelico-Goncalves Antonio , Vasques-Novoa Francisco , Saraiva Francisca , Cristina Oliveira Ana , von Hafe Madalena , Vale Catarina , Carvalho Davide , Sergio Neves Joao , Leite-Moreira Adelino F.

Introduction: Non-alcoholic fatty liver disease (NAFLD) and Heart Failure with Preserved Ejection Fraction (HFpEF) are two syndromes with increasing clinical relevance, mainly due to the rising prevalence of metabolic syndrome. Despite sharing a common metabolic background, the association between NAFLD severity and HFpEF has not yet been well explored.Aim: To evaluate the association of NAFLD steatosis and fibrosis scores with cardiovascular function an...

ea0090p564 | Adrenal and Cardiovascular Endocrinology | ECE2023

Glucocorticoid-induced adrenal insufficiency: Identification of diagnostic and prognostic biomarkers based on two randomized controlled trials - REFINE

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

Background: The risk and course of glucocorticoid-induced adrenal insufficiency (GIA) are unclear and current evidence is retrospective and based on small and selected study populations. However, the prevalence of glucocorticoid use is at least 3 %, which underscores the need for unbiased and prospective assessment of the prevalence and clinical consequences of GIA.Objectives: To identify biomarkers of GIA as regards diagnosis, prognosis and responsivene...

ea0090p565 | Adrenal and Cardiovascular Endocrinology | ECE2023

The degree of cortisol secretion is associated with cardiometabolic complications in patients with nonfunctioning adrenal tumors

Favero Vittoria , Aresta Carmen , Parazzoli Chiara , Cairoli Elisa , Eller Vainicher Cristina , Palmieri Serena , Salcuni Antonio , Arosio Maura , Persani Luca , Scillitani Alfredo , Morelli Valentina , Chiodini Iacopo

Most adrenal incidentalomas are benign and can be divided into nonfunctioning adrenal tumors (NFAT) and tumors with mild autonomous cortisol secretion (MACS). Several studies suggest that MACS may result in an increased risk for mortality and cardiometabolic disease. The cardiometabolic risk in MACS is possibly related to the increased frequency of cardiovascular risk factors such as diabetes mellitus (DM) and hypertension (HT) induced by cortisol excess. This is confirmed by ...

ea0090p566 | Adrenal and Cardiovascular Endocrinology | ECE2023

Evaluation of CYP11B2 immunostaining findings and cure rates of primary aldosteronism subtyped by anatomical imaging and functional methods

Viukari Marianna , Leijon Helena , Vesterinen Tiina , Porsti Ilkka , Nevalainen Pasi I. , Matikainen Niina

Background: The best lateralization method to ascertain cure after surgery in unilateral primary aldosteronism (PA) is debated. Risk of persistent of PA in those with non-classical adrenal histopathology remains poorly characterized.Objective: We examined the value of anatomical compared with functional subtyping and the significance of immunohistochemical analysis of CYP11B1 and CYP11B2 for the outcome and histopathological diagnosis of primary aldoster...

ea0090p567 | Adrenal and Cardiovascular Endocrinology | ECE2023

A case of bilateral adrenal haemorrhages

Qazi Umer

Background: Adrenal haemorrhage is a rare clinical presentation with an incidence of only 5 in 1,000,000 [1]. 10% of these are bilateral adrenal haemorrhages, which has very high mortality rate of 15 % [2]Case summary: 22 years old female had C-section for persistent to breech presentation at term. She has a history of preterm delivery due to chorioamnionitis during previous pregnancy. Patient had about 1.2L post-partum haemorrhage....

ea0090p568 | Adrenal and Cardiovascular Endocrinology | ECE2023

Assessment of Practice around Corticosteroid Sick Day Rules in Transplant and Oncology Services of a Tertiary Hospital in UK

Naeem Ammara , Yousseif Ahmed , Khoo Bernard , Karra Efthimia , Armeni Eleni

Introduction: Long term treatment with corticosteroids has been widely used, due to the well documented immunosuppressive and anti-inflammatory activity. Corticosteroids are among the most widely prescribed drugs in oncology and post-transplant patients. However, long-term treatment with a dose of corticosteroids, which equals prednisolone 5mg/day for at least 4 weeks, is very likely to result in suppressed function of the hypothalamic pituitary adrenal (HPA) axis, a condition...

ea0090p569 | Adrenal and Cardiovascular Endocrinology | ECE2023

An Analysis of Genes Involved in Vasoconstriction Causing Hypertension and Related Cardiovascular Diseases Using Whole Exome Sequencing

Rauf Sania , Arshad Abida , Foo Roger , Akram Maleeha , Naz Shumaila , Shakeel Raza Rizvi Syed

Hypertension is associated with vascular changes characterized by endothelial dysfunction, increased vascular contraction, and arterial remodelling. Vascular smooth muscle (VSM) cells, which constitute bulk of vascular wall, are critically involved in these processes through their highly plastic and dynamic features and ability to undergo phenotypic differentiation. Stimulation of VSM cells by pro-hypertensive neurohumoral stimuli such as acetylcholine and norepinephrine, and ...

ea0090p570 | Adrenal and Cardiovascular Endocrinology | ECE2023

An Unexpected Enzyme in Vascular Smooth Muscle Cells: Angiotensin II Upregulates Cholesterol-25-Hydroxylase Gene Expression

Bernadett Kovacs Kinga , Borbala Gem Janka , Balla Andras , Hunyady Laszlo

Angiotensin II (AngII) is a vasoactive peptide hormone and the effector of the renin-angiotensin-aldosterone system. It exerts its main physiological effects through type 1 angiotensin II receptor (AT1R), but it can also contribute to the development of cardiovascular diseases. Likewise, oxysterols such as 25-hydroxycholesterol (25-HC), the product of cholesterol-25-hydroxylase (CH25H), can have harmful effects on the vasculature since they affect vascular smooth muscle cells ...