Searchable abstracts of presentations at key conferences in endocrinology
Previous issue | Volume 99 | ECE2024

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

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We are pleased to announce that ECE 2024 will be held in Stockholm, Sweden from 11-14 May 2024. We will, once again, be offering the hybrid format next year so you can join us in person in Sweden or remotely with ECE@Home.

Eposter Presentations

Adrenal and Cardiovascular Endocrinology

ea0099ep13 | Adrenal and Cardiovascular Endocrinology | ECE2024

Implication of serotonin in the physiopathology of aldosterone-producing adenoma

Duparc Celine , D'Agostino Margot , Lopez Antoine-Guy , Renouf Sylvie , Manceau Gilles , Meatchi Tchao , Amar Laurence , Louiset Estelle , Lefebvre Herve

In the human adrenal gland, serotonin (5-HT), released by subcapsular mast cells strongly stimulates aldosterone production via activation of the type 4 serotonin receptor (5-HT4R). Consistently, plasma aldosterone levels increase after administration of 5-HT4R agonists like cisapride to healthy volunteers. Previous studies performed in aldosterone producing adenomas (APA) have shown an increase in mast cells density and an overexpression of HTR4 gene, encoding 5-HT4R...

ea0099ep15 | Adrenal and Cardiovascular Endocrinology | ECE2024

Gender-affirming hormone therapy and its impact on myocardial mass and cardiac function: a prospective magnetic resonance study on transgender men and women

Deischinger Carola , Slukova Dorota , Harreiter Jurgen , Nopp Stephan , Just Ivica , Krssak Martin , Trattnig Siegfried , Kosi-Trebotic Lana , Kaufmann Ulrike , Kautzky-Willer Alexandra

Background: The differences in cardiac parameters such as myocardial mass, left ventricular ejection fraction (LVEF), cardiac output, and brain natriuretic peptide (NT-proBNP) levels between cisgender men and women are well-established. However, no evidence exists regarding changes in myocardial mass or cardiac function parameters in transgender individuals undergoing gender-affirming hormone therapy (GAHT).Patients and method: A prospective study enroll...

ea0099ep48 | Adrenal and Cardiovascular Endocrinology | ECE2024

Assessing atherosclerotic risk: carotid intima-media thickness in non-functional adrenal incidentalomas

Ayari Sabrina , Khessairi Nadia , Faten Cherchir , Kamoun Elyes , Ibtissem Oueslati , Melika Chihaoui

Introduction: Carotid intima-media thickness (CIMT) is a simple and non-invasive method used to detect atherosclerosis. This measure could predict future cardiovascular events. Some studies have showed an increased cardiovascular in non functional adrenal incidentalomas (NFAI). The aim of this case control study was to determine the relationship between NFAI and CIMT.Methods: This case control study included 40 NFAI patients (16 men, 24 women, mean age 5...

ea0099ep89 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pheochromocytoma associated with pregnancy. Diagnostic difficulties and management

Ismail Zahra , ibrahim Fod moustapha , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Pheochromocytoma is a rare cause of hypertension in pregnancy. Its prevalence ranges from 0.2% to 0.002% of cases of hypertension in pregnancy. Early diagnosis and appropriate management can reduce mortality and morbidity. Were report a case of pheochromocytoma diagnosed during pregnancy.Observation: 34-year-old diabetic patient, 29 weeks pregnant. Admitted for hypertensive peaks up to 170 mmHg of systolic, initially mistaken for pre-eclamp...

ea0099ep90 | Adrenal and Cardiovascular Endocrinology | ECE2024

Familial glucocorticoid deficiency type 2 – a case report

Chelaru Nicoleta , Cretu Cristina , Cabac Mariana , Cristea Cristina

Background: Mutations in the ACTH receptor (MC2R) gene or in its melanocortin accessory protein (MRAP) gene disrupt receptor expression, signaling, and constitutive activity of the MC2R, leading to familial glucocorticoid deficiency (FGD) type 1 and type 2 respectively. FGD is a life-threatening, rare autosomal recessive disorder characterized by impaired cortisol synthesis and classically preserved mineralocorticoid production. There have also been described other mutations t...

ea0099ep91 | Adrenal and Cardiovascular Endocrinology | ECE2024

Identification of lipid profiles and fatty acid abundances associated with histopathology and subtypes of primary aldosteronism

Yang Yuhong , Liu Yuqing , Zhou Haifeng , Gao Maoting , Yan Yutong , Ma Guodong , Wang Min , Bao Meiling , Yang Tao , Sun Min

Background: Primary aldosteronism (PA) is mainly caused by unilateral (unilateral PA) or bilateral aldosterone-producing lesions of adrenals (bilateral PA). Accumulating findings suggest distinct metabolic profiles between patients with unilateral and bilateral PA. However, the link between the metabolic features and histopathologic findings of adrenals from patients with PA remains largely unknown.Objective: To characterize metabolic profiles with a foc...

ea0099ep113 | Adrenal and Cardiovascular Endocrinology | ECE2024

Audit of clinical outcomes from our nurse-led adrenal nodule clinic in a London hospital

Efthymiadis Agathoklis , Pua Dannah , Sharma Sangita , Solomon Andrew , Hui Elaine , Seechurn Shivashankar , Rahman Mushtaqur , Qureshi Asjid , Seetho Ian , Deore Mahesh

Introduction: There is an increased number of referrals to endocrinology for adrenal nodules found on imaging. This is due to increased use and advancement in imaging modalities. Adrenal nurse-led clinics are cost-effective and safe. We established an adrenal nodule nurse-led clinic at Northwick Park Hospital in September 2022.Methods: Retrospective data collection and analysis of patients reviewed at the clinic between September 2022-2023.<p class="...

ea0099ep114 | Adrenal and Cardiovascular Endocrinology | ECE2024

Presentation and management of adrenal masses in a large tertiary care centre: a longitudinal study

Suntornlohanakul Onnicha , Mandal Sumedha , Saha Pratyusha , Saygili Emre , Asia Miriam , Arlt Wiebke , Elhassan Yasir , Prete Alessandro , Ronchi Cristina

Background: Adrenal masses are detected in 5-7% of adults. The European guidelines on managing adrenal incidentalomas published in 20161 have standardised the management of these patients. However, evidence of the guidelines’ impact on clinical care is still lacking.Methods: We conducted a retrospective, comprehensive review of clinical presentation, radiological characteristics, final diagnosis, and outcome of a large cohort of patients ...

ea0099ep115 | Adrenal and Cardiovascular Endocrinology | ECE2024

Dyslipidemia unveiled in non functional adrenal incidentalomas

Ayari Sabrina , Khessairi Nadia , Abidi Sahar , Kamoun Elyes , Ibtissem Oueslati , Melika Chihaoui

Background: Non functional adrenal incidentalomas (NFAI) constitute the majority of adrenal tumors. This entity is a result of advances in imaging techniques and their prevalent use in clinical practice. Among the associated metabolic effects of NFAI, dyslipidemia emerges as a key factor, stimulating growing interest in understanding the link between these two entities.Methods: This case control study included 40 NFAI patients (16 men, 24 women, mean age...

ea0099ep182 | Adrenal and Cardiovascular Endocrinology | ECE2024

Predicting postoperative hypocortisolism in patients with non-aldosterone-producing adrenocortical adenoma: a retrospective single centre study

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

Background: Limited information exists on postoperative hypocortisolism and hypothalamuspituitary-adrenal axis recovery in patients with adrenal incidentaloma following unilateral adrenalectomy. We evaluated frequency of postoperative hypocortisolism and predictors for recovery in non-aldosterone- producing adrenocortical adenoma patients after unilateral adrenalectomy.Methods: A retrospective analysis of 32 adrenal incidentaloma patients originally incl...

ea0099ep186 | Adrenal and Cardiovascular Endocrinology | ECE2024

Undetermined masses in adrenal topography: experience of a compound by a tertiary health center

Weber kuhn Aliny , Srougi Victor , Brondani Vania , Tanno Fabio , de Freitas Ricardo , Coelho Fernando , Pereira Maria , Almeida Madson , Claudia Latronico Ana , Chambo Jose , Mendonca Berenice , Candida Barisson Villares Fragoso Maria

Introduction: Masses in adrenal topography have been diagnosed frequently due to more available access to radiological imaging. Adrenal incidentalomas occur around 5% to 7% of patients undergoing abdominal imaging mainly over 50 years of age. The HCFMUSP is a complex tertiary center, a national reference to adrenal disorders and since 2006 around 300 adrenalectomies were performed; 8% of them corresponded to undetermined masses in adrenal topography.Obje...

ea0099ep195 | Adrenal and Cardiovascular Endocrinology | ECE2024

Are comorbidities of patients with adrenal incidentaloma tied to sex? Results from a multicenter longitudinal study

Puglisi Soraya , Barac Nekic Anja , Morelli Valentina , Alessi Ylenia , Fosci Michele , Pani Angelo , Zibar Tomšić Karin , palmieri serena , Ferrau Francesco , Pia Anna , Reimondo Giuseppe , Chiodini Iacopo , Kastelan Darko , Terzolo Massimo

Background: A recent cross-sectional study showed that both comorbidities and mortality in patients with adrenal incidentaloma (AI) are tied to sex. However, only few longitudinal studies evaluating the development of arterial hypertension, hyperglycemia, dyslipidemia and bone impairment in patients with AI are available. The aim of this study is to analyze the impact of sex in the development of these comorbidities during long-term follow-up.Patients an...

ea0099ep196 | Adrenal and Cardiovascular Endocrinology | ECE2024

Metabolic impact of dual-release hydrocortisone in patients with congenital adrenal syndrome: a retrospective study

Mazzeo Pierluigi , Ceccato Filippo , Voltan Giacomo , Tizianel Irene , Mondin Alessandro , Lazzara Martina , Bavaresco Alessandro , Barbot Mattia

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder characterized by impaired cortisol secretion and androgen excess. The mainstay of CAH treatment is glucocorticoid (GC) replacement, necessary to avoid adrenal crisis and manage androgen excess. The delicate balance between GC under/overtreatment is crucial to prevent metabolic and cardiovascular complications. Dual-release hydrocortisone (Plenadren®) is once-daily modified-release formulat...

ea0099ep215 | Adrenal and Cardiovascular Endocrinology | ECE2024

Circulating micro-RNAs are valuable biomarkers for the diagnosis and surveillance of adrenocortical tumors

Mytareli Chrysoula , Kalotychou Vasiliki , Lafioniatis Alexandros , Siampanopoulou Vasiliki , Zografos Giorgos , Markou Athina , Papanastasiou Labrini , Fountas Athanasios , Mantzourani Marina , Kassi Eva , Kaltsas Gregory , Angelousi Anna

Introduction: Tumor-derived material, particularly micro-RNAs, have been identified in the bloodstream and hold promise as molecular markers for diagnosing and monitoring adrenocortical incidentalomas (AIs).Purpose: We examined selected circulating microRNAs (miR-483-5p, miR-210, miR-335, miR-22-3p), identified from microRNA profiling studies, as markers of malignancy or cortisol hypersecretion in a cohort of patients with AIs and controls in a clinical ...

ea0099ep217 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal phenotype in multiple endocrine neoplasia type 1

Cremaschi Arianna , Mungari Roberta , Mangone Alessandra , Del Sindaco Giulia , Sala Elisa , Carosi Giulia , Lotito Veronica , Ferrante Emanuele , Mantovani Giovanna

Background: Adrenal involvement in multiple endocrine neoplasia type 1 (MEN1) has been reported, its prevalence varying from 9 to 73%. The aim of this study was to characterize the adrenal phenotype and the prevalence and clinical significance of cortisol hypersecretion in a cohort of MEN1 patients.Methods: We retrospectively analyzed data of 36 adult patients with germline menin mutation (20 females; mean age 50&pm;17.4 years) in regular follow-up at ou...

ea0099ep232 | Adrenal and Cardiovascular Endocrinology | ECE2024

The diagnostic dilemma of benign adrenal endothelial tumors: clinical, radiological, and pathological analysis of 20 rare cases

Coscia Kimberly , Mosconi Cristina , Tucci Lorenzo , Colombin Giacomo , Donnarumma Francesca , Balacchi Caterina , Selva Saverio , Di Dalmazi Guido , Vicennati Velentina , Pagotto Uberto , De Leo Antonio

Background: Adrenal endothelial tumors are mainly represented by adrenal cavernous hemangiomas (ACHs) and adrenal cystic lymphangiomas (ACLs). They are rare incidental findings, with about 160 cases of both ACHs and ACLS reported in the literature. They are usually unilateral, benign, non-functioning, and asymptomatic, although abdominal pain and life-threatening retroperitoneal hemorrhage may occur if tumor size increases. Radiological features often overlap with malignant ad...

ea0099ep233 | Adrenal and Cardiovascular Endocrinology | ECE2024

Appropriateness of patient selection for inpatient short synacthen testing in a tertiary hospital

Tan Lyeann , Ramadoss Vijay , Teo Ada , Narula Kavita , Lazarus Katharine , Srinivasa Deepak Doddabele , Zhen Ong Li , Meeran Karim , Meng Khoo Chin , Chia Eng Pei

Background: The Short Synacthen test (SST) is commonly used in clinical practice to evaluate adrenal function. Appropriate patient selection for SST is needed to ensure accurate interpretation of the results and to mitigate increased healthcare costs associated with unnecessary testing and inappropriate glucocorticoid (GC) steroid replacement. This study aimed to investigate the indications of inpatient SSTs over a one-year period, to determine the accuracy of testing.<p c...

ea0099ep234 | Adrenal and Cardiovascular Endocrinology | ECE2024

The effect of adrenalectomy on metabolic parameters in patients with primary aldosteronism

Zibar Tomšić Karin , Đukić Mirjana , Solak Mirsala , Kaštelan Darko

Background: A few studies have shown that aldosterone has negative impact on metabolic parameters.Objectives: The aim of the study was to evaluate metabolic parameters in patients with primary aldosteronism (PA) before and one year after adrenalectomy.Methods: In this retrospective study, we examined 51 patients (median age 50 years, IQR 43–55; 55% male) who underwent adrenalectomy for PA between 2016 and 2022. Patients with d...

ea0099ep239 | Adrenal and Cardiovascular Endocrinology | ECE2024

Remission rate of primary aldosteronism after unilateral adrenalectomy

Đukić Mirjana , Zibar Tomšić Karin , Knežević Nikola , Kaštelan Darko

Background: The existing consensus for patients with primary aldosteronism (PA) after unilateral adrenalectomy recommends annual follow-up to rule out persistence or recurrence of the disease.Objectives: The aim of the study was to assess the remission rate in patients with PA ≥1 year after adrenalectomy.Methods: Of the 41 patients who underwent adrenalectomy for PA between 2016 and 2021, 24 had available follow-up data and w...

ea0099ep240 | Adrenal and Cardiovascular Endocrinology | ECE2024

Reninoma: a rare cause of hypertension in pregnancy

Green Deirdre , Plant Liam , O'Halloran Domhnall

A reninoma is a tumour of the afferent arteriolar juxtaglomerular cells that secretes the enzyme renin, leading to hyperactivation of the renin-angiotensin-aldosterone system. It is a cause of pathological secondary hyperaldosteronism that results in severe hypertension and hypokalaemia. Fewer than 200 cases have been described, seven of which were associated with pregnancy. We present the case of a 29-year-old woman referred with hypertension and hypokalaemia at 10 weeks&#146...

ea0099ep252 | Adrenal and Cardiovascular Endocrinology | ECE2024

Biochemical diagnosis of pheochromocytoma/paraganglioma in children and adolescents

Potthoff Kristin , Prodanov Tamara , Knigge Lara , Talvacchio Sara , Hubner Angela , Bornstein Stefan , Lenders Jacques , Peitzsch Mirko , Pacak Karel , Eisenhofer Graeme , Pamporaki Christina

Introduction: Currently, it is unclear whether plasma free or 24-hour urinary metanephrines are preferable for diagnosis of pheochromocytoma/paraganglioma (PPGL) in children.Objectives: To investigate whether measurements of plasma free or 24-hour urinary fractionated metanephrines is a reliable test for screening for PPGL in children.Methods: This retrospective study included data from 60 children with and 78 without PPGL. Data in...

ea0099ep254 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical utility of S-GRAS prognostic system in adrenocortical carcinomas: confirmatory results from a single-centre institutional registry

Benyei Erik , Tőke Judit , Huszty Gergely , Borka Katalin , Sapi Zoltan , Jakab Zsuzsanna , Kiss Gergely , Kalina Ildiko , Resimann Peter , Uhlyarik Andrea , Igaz Peter , Toth Miklos

Introduction: Adrenocortical carcinoma (ACC) is a rare tumor known for its diverse biological behaviour and generally poor prognosis. Recently, the S-GRAS scoring system has emerged as an accurate prognostic model, incorporating the most frequently used clinicopathological parameters: ENSAT stage, grade, resection status, age at diagnosis, and tumor symptoms. So far, this system’s efficacy has only been validated in extensive multicenter studies, proposing it as a reliabl...

ea0099ep258 | Adrenal and Cardiovascular Endocrinology | ECE2024

Psychometric parameters and quality of life in patients with adrenal tumours

Charikleia Tasouli Elisavet , Mytareli Chrysoula , Andreadaki Evangelia , Thanasoula Foteini , Siampanopoulou Vasiliki , Karabela Athina , Papalexis Petros , Lafioniatis Alexandros , Angelousi Anna

Introduction: Neuropsychiatric disorders are common and well-studied in patients with overt hypercortisolism. However, data regarding patients with adrenal incidentalomas (AIs) are limited. The aim of our study is to assess the psychometric and quality of life status in individuals with benign adrenal tumours.Methods: Eighty-two patients diagnosed with AIs, encompassing 53 females and 29 males, with a total mean age of 64 years and 52controls (without AI...

ea0099ep266 | Adrenal and Cardiovascular Endocrinology | ECE2024

In vitro differentiation of mouse pluripotent stem cells into glucocorticoid-producing adrenocortical cells

Oikonomakos Ioannis , Neirijnck Yasmine , Tedesco Melina , Jian Motamedi Fariba , Nef Serge , Bornstein Stefan , Steenblock Charlotte , Schedl Andreas

The adrenal cortex, a pivotal endocrine regulator governing body homeostasis, metabolism, and stress response through steroid hormone synthesis, presents formidable challenges for effective replacement in disorders like adrenal insufficiency and congenital adrenal hyperplasia. The limitations of current hormone replacement strategies stem from the intricate dynamics of hormonal release. This study harnesses insights derived from the analysis of a recently published single-cell...

ea0099ep267 | Adrenal and Cardiovascular Endocrinology | ECE2024

Chronotype and sleep parameters are different in patients with primary adrenal insufficiency compared to controls

Kalathinkunnath Lakshmi , Arato Jozsef , Beiglbock Hannes , Krebs Michael , Sentinella Jerbic Fani , Roenneberg Till , Kautzky-Willer Alexandra , Leder Helmut , Tessmar-Raible Kristin , Wolf Peter

Background: Human chronotypes can be defined as the natural preference for specific wake and sleep times, as measured by the start and end of sleep on days without temporal restrictions. They are a consequence of the circadian clock individual periods. Cortisol is a key mediator for the rhythmic expression of circadian signals in almost all tissues. Physiological timing of cortisol levels is strictly regulated by the hypothalamic-pituitary-adrenal (HPA) axis. Diseases affectin...

ea0099ep282 | Adrenal and Cardiovascular Endocrinology | ECE2024

Description of the x-linked adrenoleukodystrophy cohort from the csur unit of adult metabolic disorders at virgen del rocio university hospital (seville)

Gonzalez Gracia Lucia , Dios Fuentes Elena , Benitez Avila Rosa , Oulad Ahmed Bothayna , Soto Moreno Alfonso , Venegas Moreno Eva

Introduction and Objective: X-linked adrenoleukodystrophy (X-ALD) is a rare disease caused by a mutation in the ABCD1 gene (Xq28). It is characterized by the absence of very long-chain fatty acids (VLCFAs) degradation, leading to their accumulation primarily in the central and peripheral nervous system, adrenal cortex, and gonads. It presents a variable clinical spectrum and prognosis. The aim of our study is to describe the characteristics of all X-ALD patients under follow-u...

ea0099ep287 | Adrenal and Cardiovascular Endocrinology | ECE2024

Redefining diagnostic cut-offs for the indirect water deprivation test

Akkara Yash , Lazarus Kate , Narula Kavita , Choudhury Sirazum , Papadopoulou Debbie , Martin Niamh , Meeran Karim

Background: The water deprivation test serves as a key diagnostic test to differentiate between Arginine Vasopressin Deficiency (AVP-D), Arginine Vasopressin Resistance (AVP-R), and Psychogenic Polydipsia (PP) in patients presenting with symptoms of polydipsia and polyuria, when common causes such as diabetes mellitus have been excluded. This study evaluated the established diagnostic values for serum osmolality, serum sodium, and urine osmolality.Method...

ea0099ep294 | Adrenal and Cardiovascular Endocrinology | ECE2024

Jaw Tumor syndrome revealing hyperparathyroidism: about a case report

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

Introduction: Hyperparathyroidism is a common medical condition, but in 5-10% of cases, it is part of Jaw Tumor syndrome, an autosomal dominant syndrome linked to a mutation in the HRPT2 gene. This syndrome is characterized by the presence of mandibular brown tumors and primary hyperparathyroidism.Case report: A 24-year-old patient with a history of severe chronic renal failure in the left single kidney, presenting ureterohydronephrosis, underwent mandib...

ea0099ep296 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal insufficiency due to adrenal involvement in non-hodgkin’s lymphoma

Ait Si Ali Zineb , oussama jaddi , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: The non-Hodgkin lymphomas (NHL) involve extralymphatic sites more often than does Hodgkin lymphoma; consequently, tumor involvement of almost every abdominal organ has been recorded. Adrenal involvement in patients with NHL may be present at the time of initial assessment. however, adrenal insufficiency as a consequence of adrenal invasion is rare. We report a case of a patient diagnosed with NHL with breast and bilateral adrenal involvement.<p class="abstext...

ea0099ep297 | Adrenal and Cardiovascular Endocrinology | ECE2024

A rare case of antiphospholipid syndrome presenting as primary adrenal insufficiency

Dias Gama Catarina , Oliveira Margarida , Leonor Guia Lopes Maria , Monteiro Antunes Carolina , Sprovera Paula , Pimentel Bruna , Santos Mariana , Marques Bernardo , Manuel Sequeira Duarte Joao

Introduction: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder known for recurrent arterial and venous thrombotic events. It may involve multiple organ systems, but its impact on the endocrine system is rare. However, the adrenal glands are one of the most susceptible endocrine organs to APS, due to thrombosis, leading to primary adrenal insufficiency (PAI). Most cases are diagnosed in patients with known history of APS.Case Report: We r...

ea0099ep298 | Adrenal and Cardiovascular Endocrinology | ECE2024

Knowledge assessment of patients followed for adrenal insufficiency: a study of 54 cases

Ismael Mbossa Lembopo Prince , Essabah Haraj Nassim , El aziz Siham , Chadli Asma

Introduction: Adrenal insufficiency (AI) can pose a life-threatening risk in case of acute decompensation. The absence of specific signs of acute adrenal insufficiency (AAI) and lack of awareness about this medical emergency may lead to diagnostic and therapeutic delays, jeopardizing the patient’s prognosis. Hence, the importance of well-conducted therapeutic education for adrenal-insufficient patients. The objective of this study is to assess the level of knowledge among...

ea0099ep299 | Adrenal and Cardiovascular Endocrinology | ECE2024

Prevalence and significance of hypokalemia in primary aldosteronism: a retrospective study

Soomauroo Siddiqa , Hadjkacem Faten , Missaoui Abdelmuhaymen , Ridwaan Auckburally Ahmad , Maalej Souhir , Feki Wiem , Mnif Zeinab , Mnif Mouna , Abid Mohamed , Rekik Nabila

Introduction: Primary hyperaldosteronism (PA) is the autonomous production of aldosterone by a disease primarily affecting the glomerular zone of the adrenal gland. It is one of the most frequent causes of secondary hypertension. The diagnosis should be suspected in the presence of the classic clinico-biological triad in patients presenting with hypertension, low plasma renin activity (PRA), with or without hypokalemia.Patients and Methods: Retrospective...

ea0099ep300 | Adrenal and Cardiovascular Endocrinology | ECE2024

Primary aldosteronism: insights from a single center cohort

Soomauroo Siddiqa , Hadjkacem Faten , Missaoui Abdelmuhaymen , Ridwaan Auckburally Ahmad , Maalej Souhir , Feki Wiem , Mnif Zeinab , Mnif Mouna , Abid Mohamed , Rekik Nabila

Introduction: Primary aldosteronism (PA) is commonly identified as the main cause of secondary hypertension. It is becoming increasingly wide-spread, affecting between 1 and 30% of people suffering from hypertension. We aim to describe the epidemiological, clinical and paraclinical characteristics of PA and to analyse its therapeutic and evolutionary aspects.Patients and methods: Retrospective and descriptive study concerning 40 patients with PA, collect...

ea0099ep304 | Adrenal and Cardiovascular Endocrinology | ECE2024

Do non-functional adrenal incidentalomas present a higher cardiovascular risk?

Ayari Sabrina , Khessairi Nadia , Faten Cherchir , Kamoun Elyes , Chaker Fatma , Yazidi Meriem , Ibtissem Oueslati , Melika Chihaoui

Introduction: Non-functioning adrenal incidentaloma (NFAI) is a frequently diagnosed since the increased use of radiological examinations. The recent studies have shown that NFAI might have negative cardiometabolic effects and increased cardiovascular risk. The aim of this case control study was to determine the relationship between NFAI, CRP-hs, uric acid and cardiovascular risk (CVR) based on GLOBORISK algorithm of Tunisia.Methods: This case-control st...

ea0099ep311 | Adrenal and Cardiovascular Endocrinology | ECE2024

Impact of 10 years of conventional steroids vs dual-release hydrocortisone on metabolic, cardiovascular, and bone outcomes in treatment-naïve patients with adrenal insufficiency

Guarnotta Valentina , Di Stefano Claudia , Tomasello Laura , Pizzolanti Giuseppe , Arnaldi Giorgio , Giordano Carla

Patients with adrenal insufficiency show higher mortality than in the general population, mainly due to non-physiological daily glucocorticoid overexposure and to inadequate cortisol exposure during stress-related events and illness. The aim of the current study is to compare the impact of 10 years of conventional glucocorticoid (GC) replacement treatment and dual-release hydrocortisone (DR-HC), on anthropometric, metabolic, cardiovascular and bone outcomes in treatment-na&#23...

ea0099ep315 | Adrenal and Cardiovascular Endocrinology | ECE2024

Incidence and features of adrenal crisis in patients with Addison’s Disease

Scala Alberto , Torchio Marianna , Presotto Fabio , Mian Caterina , Ceccato Filippo , Carla Scaroni , Betterle Corrado , Sabbadin Chiara

Introduction: Adrenal crisis (AC) is the most severe manifestation of adrenal insufficiency, still responsible for a high mortality of affected patients, especially with primary adrenal insufficiency (PAI). Its presentation is insidious, leading to a delayed diagnosis and treatment. Patient education is crucial in the prevention and self-management of AC.Aim of the study: We want to evaluate the incidence, features (symptoms, signs, laboratory findings),...

ea0099ep325 | Adrenal and Cardiovascular Endocrinology | ECE2024

Circadian fluctuation of amino acids and biogenic amines in health and in hypercortisolism states

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

Background: Chronic hypercortisolism is known to alter the circadian rhythm and to impair protein metabolism. Altered amino acid (AA) and biogenic amine (BA) levels were found in basal blood in patients with hypercortisolism. However, poor information is available on the physiologic circadian fluctuation of these molecules. Furthermore, the potential derangement caused by hypercortisolism was never investigated.Aim: To characterize diurnal levels and flu...

ea0099ep326 | Adrenal and Cardiovascular Endocrinology | ECE2024

Radiomics for immunohistochemistry prediction in pheochromocytoma: a pilot study

Tucci Lorenzo , De Leo Antonio , Vara Giulio , Coscia Kimberly , Selva Saverio , Ricci Claudio , Alberici Laura , Balacchi Caterina , Santini Donatella , Vicennati Valentina , Pagotto Uberto , Mosconi Cristina , Tallini Giovanni , Di Dalmazi Guido

Background: Radiomics, or texture analysis, is gaining growing interest for its high prediction performances, mainly for clinical purposes. Radiomics application for pheochromocytoma immunohistochemistry (IHC) and molecular biology prediction is still unexplored.Aim: To evaluate radiomics ability to predict pheochromocytoma IHC.Methods: We retrospectively enrolled 38 pheochromocytoma who underwent surgery at Sant’Orsola-Malpig...

ea0099ep327 | Adrenal and Cardiovascular Endocrinology | ECE2024

Emerging role of IGF1R and IR expression and localisation in adrenocortical carcinomas (ACC)

Catalano Rosa , Nozza Emma , Esposito Emanuela , Maria Barbieri Anna , Croci Giorgio , Altieri Barbara , Angelousi Anna , Luconi Michaela , Constanze Hantel , Sigala Sandra , Landwehr Laura-Sophie , Di Dalmazi Guido , Cassinotti Elisa , Baldari Ludovica , Palmieri Serena , Mangone Alessandra , Ferrante Emanuele , Ronchi Cristina , Mantovani Giovanna , Peverelli Erika

Adrenocortical carcinomas (ACC) overexpress the insulin-like growth factor 2 (IGF2) that drives a proliferative autocrine loop by binding both IGF1R and isoform A of insulin receptor (IRA). However, the contribution of these receptors in mediating ACC cell growth has been poorly investigated. The aim of this study was to investigate IGF1R and IR expression and localisation in ACC and adrenocortical adenomas (ACA) samples, and to test their involvement in mediating IGF2 tumorig...

ea0099ep328 | Adrenal and Cardiovascular Endocrinology | ECE2024

Low sodium diet affects microbiome and immunophenotype in patients with primary aldosteronism in a sex-dependent manner

F. Nowotny Hanna , Zheng Tingting , Marchant Seiter Thomas , Ju Jing , Schneider Holger , Matthias Kroiss , Sarkis Anna-Lina , Sturm Lisa , Britz Vera , Lechner Andreas , Potzel Anne , Kunz Sonja , Bidlingmaier Martin , Neuhaus Klaus , Gottschlich Adrian , Kobold Sebastian , Reisch Nicole , Schirmer Melanie , Reincke Martin , Adolf Christian

Background: It is known that excessive dietary sodium intake increases cardiovascular risks and contributes to elevated blood pressure. Additionally, a high-salt diet is linked to unfavorable inflammatory immune responses. Notably, individuals with primary aldosteronism (PA) commonly exhibit elevated sodium intake. Despite treatment with mineralocorticoid receptor antagonists (MRA), PA patients do not experience a complete reduction in excess cardiovascular risk compared to hy...

ea0099ep329 | Adrenal and Cardiovascular Endocrinology | ECE2024

Phenotype variability in intron2 splice variant of CYP21A2 gene – a single-centre pilot study on children and adolescents

Gherlan Iuliana , Cameliua Procopiuc , Vintila Madalina , Lidia Radomir , Cristiana Brehar Andreea , Braha Elena , Vladoiu Suzana , Manda Dana , Muresan Andrei , Catalina Poalelungi , Schipor Sorina

Introduction: Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21OHD) is caused by mutations in the CYP21A2 gene, located on the short arm of chromosome 6. Approximately 11 point mutations are responsible for over 90% of cases, with good genotype-phenotype correlations. Depending on the residual 21-hydroxylase activity, three distinct phenotypes (classic salt wasting – SW, classic simple virilising – SV and non-classic - NC) with 4 corresponding...

ea0099ep372 | Adrenal and Cardiovascular Endocrinology | ECE2024

Association of X-linked adrenoleukodystrophy with gitelman syndrome: a hypothesis to be confirmed by genetics

Lassoued Najoua , Yassmine Elloumi , Zantour Baha , Wafa Alaya , Habib Sfar

Background: X-linked adrenoleukodystrophy (X-ALD) is the most common peroxisomal disorder. The clinical spectrum in males with X-ALD ranges from isolated adrenal insufficiency (AI) and slowly progressive myelopathy to devastating cerebral demyelination. Gitelman syndrome (GS) is a rare autosomal recessive inherited tubular disease which is caused by mutation in the SLC12A3 gene. It is characterized by hypokalemic alkalosis with hypomagnesemia and hypocalciuria. We report the a...

ea0099ep375 | Adrenal and Cardiovascular Endocrinology | ECE2024

Backpain as first manifestation of malignant pheochromocytoma. Could stable adrenal incidentaloma transform into malignant pheochromocytoma?

Czapla-Iskrzycka Aleksandra , Babińska Anna , Szmuda Tomasz , Śledziński Maciej , Romanowicz Grzegorz , Lewczuk-Myślicka Anna , Świątkowska-Stodulska Renata

Malignant pheochromocytomas (MP) are rare form of catecholamine-producing tumours that are usually associated with tachycardia, hypertension and diaphoresis. MP are typically diagnosed by symptoms, elevated catecholamine levels and characteristic radiological imagining. Metastases to the vertebrae are extremely rare and usually appear at late stage of the disease, sometimes years after the diagnosis. Backpain as a first manifestation of MP is unusual, especially with history o...

ea0099ep376 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pembrolizumab-induced secondary adrenal insufficiency and thyroid dysfunction in an 81 year old male with metastatic cutaneous melanoma - A Case Report

Bryan Tolentino Kurt , Tugna Sheryl , So Edison

Immune-checkpoint inhibitors have been increasing used in the field of medical oncology for treatment of various early to late-stage malignancies, however, rare occurrences of adrenal insufficiency and thyroid dysfunction may occur. Pembrolizumab, a PD-1 inhibitor, has been associated with adrenal insufficiency in 1-2% of patients, while thyroid related adverse events occurred in 3.2-10.1%. This is a case report of an 81 year-old male, known to have a cutaneous melanoma stage ...

ea0099ep385 | Adrenal and Cardiovascular Endocrinology | ECE2024

A case of ectopic adrenal tissue in the fallopian tube

Pimentel Bruna , Oliveira Margarida , Gama Catarina , Sprovera Paula , Monteiro Antunes Carolina , Leonor Guia Lopes Maria , Cunha Clara , Brandao Ana , Oliveira Helena , Manuel Sequeira Duarte Joao

Introduction: Ectopic adrenal tissue (EAT) occurs in less than 1% of adults, more commonly in males. It may be found anywhere along the path of embryogenic migration, usually in the kidney and retroperitoneal fat. We report a case of EAT in the fallopian tube, a particularly rare localization.Case: We present a 57-year-old female with a known medical history of nephrolithiasis and previous ectopic pregnancies. The patient was submitted to a laparoscopic ...

ea0099ep387 | Adrenal and Cardiovascular Endocrinology | ECE2024

Patient with immune checkpoint inhibitor Pembrolizumab associated endocrine dysfunctions: a report of clinical case

Preobrazenska Viktorija , Stirane Laura , Gailisa Una

A 38–year-old female was diagnosed with right breast cancer cT2mN0M0G3 with positive BRCA+ gene mutation. The patient was treated with neoadjuvant chemotherapy plus one dose immune checkpoint inhibitor Pembrolizumab following bilateral radical mastectomy, extirpation of the right sentinel lymph nodes and bilateral reconstruction with an implant. Approximately one month after using Pembrolizumab the patient noticed extreme fatigue, decreased blood pressure, accelerated pul...

ea0099ep389 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenocortical carcinoma and addison’s disease. Is it possible?: a case report

Antonio Ariza Jimenez Jose , Manoja Bustos Isabel , Marin Martin Jorge

Introduction: Adrenocortical carcinoma is a rare tumour, with an annual incidence of 1 to 2 case per million. Hypercortisolism constitutes the predominant clinical manifestation in patients with hormone excess, presenting in 50% to 80% of all adrenocortical carcinomas. Non-functioning tumors are even rarer, comprising only 20% of adrenal carcinomas in the largest reported series. Conversely, Addison’s disease is also an infrequent disorder, with estimated incidence rates ...

ea0099ep390 | Adrenal and Cardiovascular Endocrinology | ECE2024

Endocrinopathys in poems syndrome – what’s its clinical implications?

Peixe Carolina , Vicente Rocha Jose , De Grine Severino Mariana , Lopes Marta , Raquel Gomes Ana , Ines Alexandre Maria , Paula Barbosa Ana

Introduction: POEMS syndrome is a rare multisystem disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma-proliferative disorder and skin changes. Different endocrinopathies are found in 58-80% of patients, however, its pathophysiology remains unknown. Hypogonadism (primary and secondary) is the most common endocrinopathy (79% of patients), with other abnormalities including hyperprolactinemia (56%), primary hypothyroidism (54%), abnormal glu...

ea0099ep391 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pheochromocytomas are most commonly detected as Adrenal Incidentalomas

Wissame Debbah , Mouna Mezoued , Khadidja Bessaid , Malha Azzouz

Introduction/objective: Pheochromocytomas are increasingly diagnosed in incidentally detected adrenal masses, with the advent of modern imaging modalities and increased access to imaging. The proportion of pheochromocytomas in adrenal incidentalomas is relatively low, ranging from 7% to 25% of cases recently. Given the evolution of the presentation of pheochromocytomas, we sought to evaluate the proportion and clinical, biochemical and radiological characteristics of incidenta...

ea0099ep392 | Adrenal and Cardiovascular Endocrinology | ECE2024

Stress cardiomyopathy secondary to pheochromocytoma

Losada Gata Isabel , Garcia Piorno Alberto , Gomez-Gordo Hernanz Monica , Collado Gonzalez Gloria , Jimenez Hernando Ignacio , Perez Noguero Marta , Morales Jaurrieta Amaya , Farache Suberviola Blanca , Gonzalez Fernandez Laura , Gonzalez Albarran Olga

Introduction: Pheochromocytoma, a rare catecholamine-secreting tumor, typically presents with paroxystic hypertension, tachycardia, headache, and diaphoresis. Less frequently, symptoms imply substantial hemodynamic compromise and cardiogenic shock may occur. The delay time in diagnosis is approximately 3 years.Case Presentation: This is a 41-year-old woman with no relevant history or cardiovascular risk factors, who presented with stress-induced cardiomy...

ea0099ep393 | Adrenal and Cardiovascular Endocrinology | ECE2024

Solitary abdominal pain unveiling pheochromocytoma in a young patient: a case report

Marušić Romana , Bilić-Ćurčić Ines , Prpić-Križevac Ivana , Schonberger Ema , Steiner Kristina , Ormanac Klara , Canecki-Varžić Silvija

Introduction: Pheochromocytomas are rare neuroendocrine tumors originating from chromaffin cells in the adrenal medulla, secreting catecholamines and causing symptoms such as hypertension, anxiety, panic attacks, palpitations, and headaches. An adrenal gland incidentaloma is identified as an unintentional discovery in approximately 3 - 4 % of computed tomography (CT) abdomens performed. Pheochromocytoma is diagnosed in about 5% of adrenal incidentalomas. Diagnosing pheochromoc...

ea0099ep394 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal incidentalomas and arterial hypertension

Zarrouk Oumayma , Taieb ACH , Saad Ghada , Ben Abdelkarim Asma , Chadli Chaieb Molka , Ach Koussay

Introduction: Endocrine hypertension is the most common cause of secondary hypertension affecting nearly 3% of the population. Adrenal etiologies play a significant role in these cases. An adrenal incidentaloma is an asymptomatic adrenal tumor, at least one cm in diameter, discovered incidentally during a medical imaging examination. It requires an investigation into its secretory or malignant nature leading to the development of arterial hypertension.Ma...

ea0099ep405 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal lesions in in patients with MUTYH syndrome

de Carlos Joaquin , Zabalza Lucia , Irigaray Ana , Rosario Aznarez Maria , Yoldi Jon , Marti Miguel , Ayarza-Marien Xabier , Anda Apinariz Emma

Introduction: MUTYH (MutY homolog Escherichia coli, homolog of MYH, hMYH) is a repair enzyme with a crucial role in the correction of DNA errors, being considered a protective factor of the cell. MUTYH mutations have been linked to MUTYH-associated polyposis syndrome (MAP), an autosomal recessive disorder characterized by multiple colorectal adenomas. Patients with MAP show a much higher lifetime risk of gastrointestinal cancers as an additional role of MUTYH, it appears to co...

ea0099ep406 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal venous sampling in patients with bilateral adrenal lesions and ACTH-independent cushing’s sydrome

Visockiene Zydrune , Gudaite Jogaile , Naskauskiene Gintare , Jakubkevicius Valentinas , Jugulyte Nida , Grigoravicius Domas , Kurminas Marius

Background: ACTH-independent Cushing’s syndrome (AICS) due to bilateral adrenal lesions (BAL) is a challenge as determining whether autonomous cortisol secretion is unilateral or bilateral is crucial in guiding the treatment strategy.Aim: To analyse the usefulness of adrenal venous sampling (AVS) in differentiating between unilateral and bilateral cortisol secretion in patients with AICS and BAL.Methods: We performed a retrosp...

ea0099ep407 | Adrenal and Cardiovascular Endocrinology | ECE2024

Unusual cause of cushing’s syndrome

Roxana Padilla Segura Mayet , del Carmen De Mingo Alemany Maria , Francisca Moreno Macian Maria , Pla Peris Begona , Abellan Galiana Pablo , Rizo Gellida Alicia , Serisuelo Meneu Esther , Bono Velilla Angela , Javier Maravall Royo Francisco , Angel Merchante Alfaro Agustin

Introduction: Carney Complex (CNC) is a rare syndrome characterized by multiple endocrine and non-endocrine tumors, which may be accompanied by macular pigmentation of the skin. This is an autosomal dominant disorder with high penetrance and heterogeneous expression. It is caused by inactivating pathogenic variants in the PRKAR1A gene in over 70% of cases which encodes the regulatory type 1 alpha subunit of protein kinase A. Diagnosis is made by identifying specific criteria. ...

ea0099ep408 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pseudo cushing syndrome with gastrointestinal sarcoidosis: case report

Al Hadad Hemmet , Fayed Ahmed , Sameh Ihab , Nagy Mohamed , Hamdy Sheriff , El Makzangy Hesham , Hamdy Reem , makram mirette , Salam Randa

Introduction: Pseudo Cushing syndrome (PCS) is caused by non-neoplastic over activity of the hypothalamic-pituitary-adrenal axis. Differentiating between PCS and Cushing disease (CD) can be challenging because of their overlapping clinical and biochemical features.Case presentation: 15 year old male presenting with watery diarrhea of 2 months duration occurring 3 times per day with lower limb weakness No rectal bleeding, fever, or weight loss<p class...

ea0099ep410 | Adrenal and Cardiovascular Endocrinology | ECE2024

Impact of sampling device on quantification of 11-oxygenated androgens in saliva by liquid chromatography tandem mass spectrometry

Kunz Sonja , Dubinski Ilja , Schiergens Katharina , Hawley James , Keevil Brian , Reisch Nicole , Reincke Martin , Schmidt Heinrich , Bidlingmaier Martin

Introduction: 11-ketotestosterone (11KT) and 11β-hydroxyandrostenedione (11OHA4) are new biomarkers for hyperandrogenic disorders. Steroids can be measured in saliva, allowing non-invasive sampling by patients. We modified a published LC-MS/MS method1 for quantification of 11-oxygenated androgens in saliva with respect to sample volume, extraction procedure and equipment, and assessed the potential impact of different sampling devices on results.<p class="a...

ea0099ep412 | Adrenal and Cardiovascular Endocrinology | ECE2024

The incidence of cancers in patients with non-functional adrenal tumors: a swedish population-based national cohort study

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

Importance: It is unclear if non-functional adrenal tumors (NFAT) are associated with higher cancer incidence.Objective: To analyze the cancer incidence in patients with NFAT.Design, Settings and Participants: A national retrospective register-based study involving cases with NFAT diagnosed in Sweden 2005-2019 and controls was conducted. Both cases and controls were followed until death or 2020. Individuals with diagnosed adrenal h...

ea0099ep413 | Adrenal and Cardiovascular Endocrinology | ECE2024

Modified release hydrocortisone, a new treatment for congenital adrenal hyperplasia due to 21-hydroxylase deficiency: a single center ‘real-world evidence’ preliminary study

Simeoli Chiara , M. Crescenzo Erminio , M. Pulci Doria Augusta , Larocca Angelica , Di Paola Nicola , Pivonello Claudia , Negri Mariarosaria , Colao Annamaria , Pivonello Rosario

Life-long glucocorticoid (GC) treatment is needed in patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, to replace GC deficiency and to control androgens excess. Multiple daily immediate-release-hydrocortisone (IR-HC), characterized by GC overexposure, peaks and troughs, is frequently associated with a suboptimal androgen control, due to ACTH overnight increase. Once daily dual-release-HC (DR-HC), approved for adrenal insufficiency and, despit...

ea0099ep414 | Adrenal and Cardiovascular Endocrinology | ECE2024

Osilodrostat in cushing’s disease: Risk of adrenal insufficiency should be monitored

Ben Abdessalem Fatma , Elfekih Hamza , Saad Ghada , Aich Koussay , Chadli-Chaieb Molka

Introduction: Endogenous Cushing’s disease is a serious and rare endocrine disorder. Medical therapy is mostly used as second-line treatment after failed surgery or recurrence and comprises several pituitary-directed drugs, glucocorticoid receptor blocker and adrenal steroidogenesis inhibitors such as osilodrostat. We here describe a case of a Tunisian patient with uncured cushing’s disease who developed iatrogenic adrenal insufficiency in the setting of Osilodrostat...

ea0099ep415 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal specific functional imaging with 123I-IMAZA for non-invasive diagnostic evaluation of TART - a case series

Hahner Stefanie , Andreas Schirbel , Wiebke Schlotelburg , Teresa Fuss Carmina , Welp Ann-Christin , Auer Matthias , Lottspeich Christian , Heinze Britta , Reisch Nicole

Background: Distinction of benign testicular adrenal rest tumours (TART) and potentially malign Leydig cell tumors (LCT) is challenging but important to prevent unnecessary surgery of TART. Ultrasound or magnetic resonance imaging can reliably detect but not distinguish between both tumour entities.Methods: Functional imaging results using the specific CYP11B1/2-inhibitor 123I-IMAZA were investigated in seven adult male patients with classic c...

ea0099ep416 | Adrenal and Cardiovascular Endocrinology | ECE2024

Idiopathic unilateral genycomastia in a child

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

Introduction: Gynecomastia, marked by mammary gland hypertrophy, arises from an imbalance between androgens and estrogens. Notable etiologies include hypogonadism, tumors, iatrogenic causes, and idiopathic factors.A case report: A patient aged 8 years and 10 months, with no pathological history, was admitted for further management of right unilateral gynecomastia. The functional signs included unilateral right hypertrophy in the retroareolar region. On p...

ea0099ep417 | Adrenal and Cardiovascular Endocrinology | ECE2024

Plasma cortisol measurement: ordering practices

Chaher Rabah Mohamed , Marrakchi Rim , Zouari Dhouha , Boudaya Mariem , Jamoussi Kamel , Abid Mohamed , Turki Mouna

Introduction: Cortisol level measurement is required in the diagnosis and management of adrenal, pituitary and hypothalamic pathologies.Aim: The aim of this study was to evaluate clinician’s practice in ordering cortisol test.Methods: A retrospective study concerning 63 cortisol requests data collected by the laboratory computer system (Health Lab) between January 2024 and February 2024. Only requests of 0800 hours plasma cort...

ea0099ep418 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical and hormonal characterisation of 71 patients with bilateral macronodular adrenocortical disease (BMAD)

Vladan Andreea , Baciu Ionela , Baculescu Nicoleta , Burcea Iulia , Capatana Cristina , Dobre Ramona , Dusceac Roxana , Galoiu Simona , Iorgulescu Radu , Niculescu Dan , Trifanescu Raluca , Dumitrascu Anda , Buduluca Larisa , Diculescu Mircea , Radian Serban , Poiana Catalina

Background: BMAD is defined as development of multiple large nodules, >1 cm diameter, with bilateral involvement of the adrenal glands. It is typically associated with endogenous Cushing’s syndrome (CS) and occurs in adults, in the 4th-7th decade of life.Aim: To describe the clinical presentation, the biochemical peculiarities and the management of 71 patients diagnosed with BMAD in a tertiary endocrinology centre.Results:...

ea0099ep419 | Adrenal and Cardiovascular Endocrinology | ECE2024

Correlation of hypothalamic-pituitary-adrenal axis parameters with the size of adrenal incidentaloma

Ognjanovic Sanja , Popovic Bojana , Elezovic Kovacevic Valentina , Ilic Dusan , Opalic Palibrk Milica , Radic Lena , Krstic Katarina , P. Macut Djuro

Introduction: The majority of adrenocortical incidentalomas (AIs) are nonfunctional adenomas. Some of them demonstrate an autonomous cortisol secretion (ACS), a pathologic condition defined as biochemical evidence of hypercortisolism without typical signs or symptoms of Cushing’s syndrome.Subjects and methods: In this cross-sectional study, we evaluated 152 consecutive patients, aged 58.3 years (range, 25-84 years) of whom 105 (69.1%) with unilatera...

ea0099ep420 | Adrenal and Cardiovascular Endocrinology | ECE2024

Does tenascin-X correlate with adrenal dysfunction in patients with Ehlers–Danlos syndrome?

Jan Domański , Emilia Babula , Iga Poprawa , Aleksandra Żuk-Łapan , Jakub Podstawka , Latocha Julia , Szymańska Zuzanna , Małgorzata Zagozda , Juliusz Wilk , Tomasz Korcz , Małgorzata Cicha-Brzezińska , Anna Siejka , Bartosz Mruk , Jerzy Walecki , Kaluza Bernadetta , Edward Franek

Background: Ehlers–Danlos syndrome is a group of genetic conditions characterized by alterations in connective tissue structure, which produces various symptoms. Some subtypes of this syndrome are associated with structural alterations of tenascin-X, an extracellular matrix glycoprotein encoded by the TNXB gene, which partially overlaps the CYP21A2 gene, which encodes adrenal 21-hydroxylase. The purpose of this study was to assess the relationship between tenascin-X level...

ea0099ep540 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical, biological, radiological and therapeutic profiles of pheochromocytomas/paragangliomas

Wissame Debbah , Mouna Mezoued , Khadidja Bessaid , Malha Azzouz

Introduction: Pheochromocytomas-paragangliomas are rare neuroendocrine tumors that secrete catecholamines from chromaffin cells of the adrenal medulla, sympathetic or parasympathetic ganglia. Unrecognized pheochromocytomas are associated with high mortality, most often due to cardiovascular disorders.Objective of the study: The objective of our work is to study the clinical, biological, radiological and therapeutic characteristics of pheochromocytomas/pa...

ea0099ep541 | Adrenal and Cardiovascular Endocrinology | ECE2024

Management of adrenal incidentalomas: a single-centre experience

Hussein Furhana , Eltayeb Haneen , Ejaz Samrah , Akter Ani Alida , Mlawa Gideon , Hossain Belayet , Casey Edel

Introduction: An adrenal incidentaloma is an adrenal mass lesion greater than 1 cm in diameter, which is incidentally discovered by radiological investigation. The prevalence of adrenal incidentalomas increases with age, increasing to around 3% at aged 50years and 10% in the elderly. The majority of these lesions are benign >80%. Adrenal incidentalomas fall into one of three categories: Non-functioning tumours: these lesions are benign e.g. adenomas, adrenal cysts, haemato...

ea0099ep560 | Adrenal and Cardiovascular Endocrinology | ECE2024

How concordant is cardiovascular risk stratification using various risk scoring system compared with coronary artery calcium scoring in asymptomatic Thai people with diabetes mellitus?

Thewjitcharoen Yotsapon , Chatchomchuan Waralee , Nakasatien Soontaree , Krittiyawong Sirinate , Himathongkam Thep

Background: People with type 2diabetes (T2D) often referred as cardiovascular disease (CVD) risk equivalent. However, CVD risk in diabetes varies greatly and substantial proportion of people with T2D have low CVD risk as with the general healthy population. The latest European Society of Cardiology (ESC) guidelines 2023 endorsed the T2D-specific CVD risk score (SCORE2-Diabetes) for people with T2D. However, current prediction models are developed from non-Asian populations, an...

ea0099ep582 | Adrenal and Cardiovascular Endocrinology | ECE2024

Lipid risk factors for cardiovascular mortality and chronic inflammation in functionally dependent elderly persons

Vasovic Olga

Introduction: Many studies have pointed to the importance of chronic inflammation and dyslipidemia in the development of atherosclerosis, but data related to the elderly population are still inconsistent. The aim of the work: To determine the importance of determination of markers of inflammation (C-reactive protein - CRP) and lipid status in elderly (≥65 years), functionally dependent persons.Methods: A prospective study that included 257 patients...

ea0099ep593 | Adrenal and Cardiovascular Endocrinology | ECE2024

Safety and efficiency of short-term glucocorticoid treatment in laryngological patients – pilot study

Papierska Lucyna , Miechowski Wiktor , Dżaman Karolina , Zgliczynski Wojciech

Patients with chronic sinusitis with polyps are prepared for surgery (FESS) in one of two ways: through intranasal steroid therapy or oral preparation. The high-dose oral glucocorticoids are not often used in Poland, because of the due to the risk of developing side effects including pituitary-adrenal axis inhibition with the need for steroid cover during surgery. The 30 patients before FESS were randomly divided into two equal-sized groups. Patients in the first group receive...

ea0099ep599 | Adrenal and Cardiovascular Endocrinology | ECE2024

Ophthalmic artery doppler as a test for gut-brain axis modulation: feasibility study

Bubnov Rostyslav , Spivak Mykola

Introduction: The Gut-Brain Axis (GBA) is implicated in various conditions, including migraine, headache disorders, Irritable Bowel Syndrome (IBS), hypertension, and vascular dysregulation. While ophthalmic artery Doppler shows promise in conditions like migraine and stroke prevention [2], effective treatments targeting these mechanisms are still under exploration. Probiotic therapy, as a potential molecular and cellular modulator, may balance regulatory systems leading to pat...

ea0099ep629 | Adrenal and Cardiovascular Endocrinology | ECE2024

Epidemiological data of primary and secondary adrenal insufficiency in southern province of seville

Puzigaca Pavle , Arturo Cuellar Lloclla Eyvee , Alvaro Romero Porcel Jose , Hami Gil Sara , Victoria Cozar Leon Maria

Objective: Evaluate the prevalence of adrenal insufficiency (AI) in Southern Province of Seville that comprises around 400.000 people.Materials and methods: Retrospective descriptive study that includes patients diagnosed with primary (PAI) and secondary (SAI) adrenal insufficiency that are followed up at Virgen de Valme University Hospital.Results: Out of the 125 patients with AI, 51 patients (40,8%) had PAI and 74 patients had SA...

ea0099ep630 | Adrenal and Cardiovascular Endocrinology | ECE2024

Long term management of adult bilateral adrenal hyperplasia with mild autonomous cortisol secretion - data from a Romanian tertiary center

Radulescu Vlad , Stanescu Anastasia , Stancu Cristina , Gheorghiu Monica , Manda Dana , Dumitrascu Anda , Badiu Corin

Introduction: Adrenal hyperplasia is found in more than 15% of abdominal imaging procedures in adults, unrelated to endocrine disorders, especially after the COVID era. Adrenal management is consequently recommended.Aim: To retrospectively evaluate the adrenal status in terms of morphological progression and functional impairment of adrenal function, in a cohort of cases admitted at least yearly in the National Institute of Endocrinology, Bucharest, Roma...

ea0099ep631 | Adrenal and Cardiovascular Endocrinology | ECE2024

Haematuria as an atypical presentation of pheochromocytoma: a case report

Matijaca Ana , Kujundžić Magdalena

Pheochromocytomas are rare catecholamine-producing tumors that arise from chromaffin cells located in the adrenal medulla. They are usually benign, but approximately 10% of pheochromocytomas are malignant. The most common clinical features include Menard triad: headache, sweating and palpitations, and permanent or paroxysmal hypertension. Haematuria as a presenting feature of adrenal pheochromocytoma is rarely seen. We report a case of pheochromocytoma in a 61-year-old female ...

ea0099ep632 | Adrenal and Cardiovascular Endocrinology | ECE2024

A thousand faces of pheochromocytoma: Insights from a case series

Marušić Romana , Bilić-Ćurčić Ines , Schonberger Ema , Steiner Kristina , Ormanac Klara , Oštarijaš Eduard , Canecki-Varžić Silvija

Introduction: Pheochromocytomas, rare neuroendocrine tumors originating from adrenal medulla chromaffin cells, excessively secrete catecholamines, manifesting diverse symptoms. With an incidence of 2-9 per million inhabitants, these tumors pose diagnostic challenges due to their varied clinical presentation.Case Description: We present five patients diagnosed with pheochromocytoma at the Clinical Hospital Center Osijek. The incidentaloma of the adrenal g...

ea0099ep633 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pseudopheochromocytoma in a patient with depression: a case report

Nouira Sawsen , Elfekih Hamza , Ben Abdessalem Fatma , Gorchene Asma , Ach Kussay , Hasni Yosra , Chaieb Molka

Introduction: Pseudopheochromocytoma is a poorly comprehended entity believed to arise from an overstimulated sympathetic nervous system. Individuals with pseudopheochromocytoma seem to demonstrate heightened cardiovascular reactivity to catecholamines, along with an increased release of epinephrine from the adrenal glands in response to stimulation from the sympathetic nervous system. This clinical report presents an observation of pseudopheochromocytoma in a patient diagnose...

ea0099ep703 | Adrenal and Cardiovascular Endocrinology | ECE2024

Vitamin D status in young healthcare workers: association with lipid parameters

Rekaya Zeineb , Mekaouer Samir , Yazidi Meriem , Khessairi Nadia , Kammoun Elyes , Oueslati Ibtissem , Chaker Fatma , Chihaoui Melika

Introduction: Vitamin D deficiency is an emerging concern that has the potential to impact one’s health, even in sunny Mediterranean countries like Tunisia. This issue is particularly notable among indoor workers in the healthcare sector, who experience minimal sun exposure. The aim of this study was to describe the Vitamin D profile within this specific population and to establish its association with lipid parameters.Methods: This cross-sectional ...

ea0099ep705 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical significance of adrenal venous sampling in primary hyperaldosteronism: a case report

Katamadze Natia

Primary hyperaldosteronism represents a current and underdiagnosed cause of secondary hypertension, characterized by inordinate and independent aldosterone production. While adrenal venous sampling (AVS) has surfaced as the gold standard for lateralization of aldosterone excess, its operation in cases of grueling primary hyperaldosteronism remains less explored. In this unique case history, we present the clinical script of a case with suspected primary hyperaldosteronism, fla...

ea0099ep707 | Adrenal and Cardiovascular Endocrinology | ECE2024

Primary adrenal carcinoma: review and experience of 8 cases in the hospital of málaga

Jose Vallejo Herrera Maria , Vallejo Herrera Veronica , Gonzalez Romero Stella , Kishore Doulatram Gamgaram Viyey

Introduction: Primary adrenal carcinoma is a very rare pathology, its treatment is fundamentally surgical and adjuvant treatment with mitotane can prevent recurrences. The prognosis varies depending on the patient, the stage and the histopathological diagnosis. We present the case mix of patients diagnosed with adrenal cortex carcinoma in our center between 2012-2022 and review the management of this pathology.Patients and Methods: Retrospective study on...

ea0099ep708 | Adrenal and Cardiovascular Endocrinology | ECE2024

Familial congenital adrenal hyperplasia (CAH) presenting as addisonian crises – case series

Yan Hamilton Man , Hussein Furhana , Carter Keiko , Mahamud Bashir , Saleki Mohammad , Mohamed Ayan , Mlawa Gideon

Introduction: This case series consist of three brothers who are aged 24, 27 and 28. The eldest brother was diagnosed with CAH at 18 days when he presented with poor weight gain, vomiting and persistent jaundice with hyponatraemia. The parents received genetic counselling for the next two pregnancies and all three children were managed with hydrocortisone and fludrocortisone maintainence therapy. They were closely monitored for their growth rates, signs of precocious puberty a...

ea0099ep717 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenocortical carcinoma revealed by pulmonary embolism

Trimeche Oumeyma , abid sana , Bayar Ines , Ben Amor Bilel , Hajji Ekram , Marmouch Hela , Sayadi Hanene , Khochteli Ines

Introduction: Adrenocortical carcinoma is a very rare tumor with a heterogenous prognosis.Case report: Patient R.B is a 58-year-old female patient with no particular familial history. She had a personal history of hypertension, discovered 6 months ago well controlled with beta blockers and amlodipine. Two weeks before her admission to the hospital, she reported having constantly worsening abdominal pain followed by frequent vomiting few days later. The p...

ea0099ep720 | Adrenal and Cardiovascular Endocrinology | ECE2024

Emerging endocrine complications in cancer immunotherapy

Paula Ristea Ruxandra , Puscas Teodora , Zaharia Claudiu , Tutovan Serghei , Stanciu Mihaela

Introduction: Immune-checkpoint inhibitors (ICIs) have revolutionised cancer treatment, offering superior efficacy compared to traditional chemotherapy. The use of immune checkpoint inhibitors has been associated with the occurrence of multiple endocrine immune-related adverse events (irAEs), such as primary hypothyroidism, thyroiditis, primary adrenal insufficiency, type 1 diabetes mellitus, and hypophysitis. In certain instances, these irAEs may necessitate the discontinuati...

ea0099ep721 | Adrenal and Cardiovascular Endocrinology | ECE2024

ACTH-independent cushing’s syndrome in a patient with bilateral adrenal tumors: complete remission after unilateral adrenalectomy

Nicoleta Chetan Larisa , Vladan Andreea , Rebeca Cretoiu , Iorgulescu Radu , Radian Serban , Catalina Poiana

Introduction: Bilateral adrenal tumors in patients with adrenal Cushing’s syndrome (CS) are rare, lending to differential diagnosis which includes bilateral macronodular adrenal disease (BMAD), synchronous adrenal adenomas and even adrenocortical carcinoma. The treatment consists of unilateral adrenalectomy, followed by contralateral adrenalectomy, if warranted by persistent significant CS.Aim: To present a case highlighting unilateral adrenalectomy...

ea0099ep723 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pericarditis as a presentation of adrenal crisis in non compliante patient with congenital adrenal hyperplasia

Bystrianska Marianna , Bystriansky Adrian , Sykorova Marcela , Opravilova Lydia , Kapusta Dušan , Skladany Ľubomir

Background: Pericarditis as a presentation of sever adrenal insufficiency (AI) is very rarely documented. We would like to present a rarely case of sever AI whose first clinical presentation was pericarditis with heart failure and cardiac tamponade.Case presentation: A 35 years old man was hospitalized on Department of Internal Medicine for chest pain, shortness of breath and hypotension. On ECG was documented sinus tachycardia with diffuse ST elevation....

ea0099ep726 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal vs pituitary hypercortisolism: population characteristics and metabolic complications

Nacu Miruna-Viorela , Sorina Martin Carmen , Simonescu Ana-Maria , Sirbu Anca , Barbu Carmen , Cima Luminita , Stoian Iulia , Fica Simona

Introduction: Cushing’s syndrome (CS) is associated with a plethora of metabolic consequences. Current literature regarding the impact of different aetiologies on metabolic complications is scarce, and results are inconsistent. More studies are needed to validate previous findings.Aim and methods: In order to compare the outcomes of pituitary and adrenal CS, we conducted an observational retrospective study, investigating the medical records of 72 p...

ea0099ep727 | Adrenal and Cardiovascular Endocrinology | ECE2024

Developing of a clinico-biological score to predict the diagnosis of cushing’s syndrome

Terzi Ameni , Ouesleti Ibtissem , Kammoun Elyes , Merhbene Yesmine , Mabrouk Meriem , Abid Arige , Yazidi Meriem , Chihaoui Melika

Introduction: Cushing’s syndrome (CS) has relevant morbidity and mortality and poses several diagnostic challenges underlining the need for a prompt diagnosis in order to initiate earlier treatment. The aim of the present study was to develop a new clinical and biological score to predict the diagnosis of CS.Methods: This was a monocentric retrospective study including patients who were admitted to the Department of Endocrinology of La Rabta Hospita...

ea0099ep728 | Adrenal and Cardiovascular Endocrinology | ECE2024

17 alpha hydroxylase deficiency, a case report

Sellami Youcef , Bessaid Khadidja , Mezoued Mouna , Azzouz Malha

Introduction: Congenital adrenal hyperplasia (CAH) due to 17-alpha-hydroxylase deficiency is a very rare form of CAH characterized by glucocorticoid deficiency, hypergonadotropic hypogonadism and hypertension with hypokalemia. It is an autosomal recessive disorder with an estimated incidence of one in 1,000,000 newborns. Over 100 mutations in the CYP17A1 gene have been identified with combined 17-hydroxylase/17,20-lyase deficiency, but in some authentic cases no mutation has b...

ea0099ep729 | Adrenal and Cardiovascular Endocrinology | ECE2024

The cost burden of hospitalisation for adrenal insufficiency patients in the NHS in england

Ruiz Leonardo , Ritz Beate , Murray Robert , Beckett Matthew , Wild Janet

Introduction: Adrenal Insufficiency (AI) is a heterogeneous condition comprising primary, secondary and tertiary disease. Individuals with AI suffer more frequent infections and take longer to recover. Adrenal Crises (ACs), most commonly precipitated by infections, are an acute life-threatening complication with a reported mortality of 6%. ACs are, at least in part, potentially preventable and outcomes are improved by early initiation of high-dose glucocorticoids. Currently, t...

ea0099ep730 | Adrenal and Cardiovascular Endocrinology | ECE2024

11-DOC secreting adrenal lesion as a cause of mineralocorticoid induced hypertension

Alomari Lina , Hughes David

Background: It is well recognised that the most frequent cause of mineralocorticoid induced hypertension is primary hyperaldosteronism. Excess 11-deoxycorticosterone (11-DOC), which is a precursor molecule for the production of aldosterone, may in rare cases be the cause of the mineralocorticoid induced hypertension in patients with normal or low aldosterone levels.Case: We describe a 70 year old female patient with a background of treated breast cancer ...

ea0099ep731 | Adrenal and Cardiovascular Endocrinology | ECE2024

Prevalence of metabolic syndrome in non functional adrenal incidentaloma: a case-control study

Ayari Sabrina , Khessairi Nadia , Abidi Sahar , Kamoun Elyes , Ibtissem Oueslati , Melika Chihaoui

Background: The diagnosis of adrenal incidentaloma (AI) is becoming more common with the rising use of radiological tests. Most of AI are nonfunctional adrenal incidentalomas (NFAI) that may produce small amounts of glucorcorticoids that, in consequence, may cause metabolic disorders. Metabolic syndrome being a significant health concern should be evaluated in patients with NFAI. The objective of the study was to assess metabolic syndrome (MS) prevalence and characteristics in...

ea0099ep732 | Adrenal and Cardiovascular Endocrinology | ECE2024

Hypothalamic-pituitary-adrenal axis, type 1b glycogen storage disease & pregnancy

Pouliasi Fotini , Ilias Ioannis , Papadopoulou Vasiliki , Barouti Konstantina , Koukkou Eftychia

Introduction: Individuals with glycogen storage disease type 1b (GSD1b) usually have low blood glucose and are at constant risk of hypoglycemia. We recently hospitalized a pregnant woman with GSD1b, where despite nutritional management, her glycemia values were almost unwaveringly towards the lower physiological limits. In a recent study (Rossi et al. Orphanet Journal of Rare Diseases 2020; 15: 99, https://doi.org/1...

ea0099ep733 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal Insufficiency Detection Challenges in Adult Beta-Thalassemia

Hanife Oguz Seda , Onur İşler Alperen , Unluturk Uğur

Background: Adult beta-thalassemia patients experience various endocrine complications associated with iron deposition. However, data regarding adrenal insufficiency (AI) are limited.Subjects and Methods: A total of 104 beta-thalassemia patients examined between 2015 and 2024 in our outpatient clinic had at least one measurement of morning serum ACTH and cortisol levels. At the time of presentation, two male patients had already been diagnosed with prima...

ea0099ep734 | Adrenal and Cardiovascular Endocrinology | ECE2024

Hydrocortisone vs prednisolone for treatment of adrenal insufficiency disease (HYPER-AID Study) – interim results from a single, tertiary care centre

Maria Leca Bianca , Thadani Puja , Dineesha Kumarathunga Dineesha , Wellala Vindya , Davasgaium Allan , George Rojet , Seehra Parminder , Mattu Rajan , Randeva Harpal S.

Introduction: Adrenal insufficiency (AI) requires lifelong steroid replacement therapy, traditionally with hydrocortisone (HC), which, taken in divided doses, mimics the normal daytime cortisol profile. Prednisolone, with its longer duration of action, presents a cost-effective, once-daily alternative, yet its comparative efficacy and safety profile in AI management still need to be explored. Therefore, the current study aims to assess the metabolic and cardiovascular outcomes...

ea0099ep735 | Adrenal and Cardiovascular Endocrinology | ECE2024

Heart failure and its reversibility in patients with cushing’s syndrome

Kosharnaia Raisa , Belaya Zhanna , Mamedova Elizaveta , Przhiyalkovskaya Elena , Zuraeva Zamira , Michurova Marina , Kalashnikov Victor

Myopathy is a common complication of Cushing’s syndrome (CS), which predicts the possibility of heart muscle damage and may be a cause of heart failure. Goal of this study is to evaluate the prevalence of heart failure in patients with active CS and the probability of recovery after achieving a remission.Materials and methods: We enrolled patients with CS hospitalized in our clinic from October 2018 to December 2022. To confirm the diagnosis of CS w...

ea0099ep736 | Adrenal and Cardiovascular Endocrinology | ECE2024

Polygenic risk score for autoimmune Addison’s disease combined with whole-genome sequencing identifies patients with undiagnosed monogenic primary adrenal insufficiency

Aranda-Guillen Maribel , Botusan Ileana R. , Fernando Venuja , Royrvik Ellen , Susanne Boe Wolff Anette , Johansson Stefan , Sverre Husebye Eystein , Bensing Sophie , Kampe Olle , Eriksson Daniel

Background: Primary adrenal insufficiency (PAI) is sometimes misdiagnosed as autoimmune Addison’s disease (AAD), affecting clinical management and genetic counselling. We tested a polygenic risk score (PRS) for AAD (PRS14AAD) as a tool to reevaluate disease etiology and identify patients misdiagnosed with AAD.Methods: We calculated the PRS14AAD in a cohort of patients diagnosed with AAD but lacking 21-hydroxylase autoantibodies...

ea0099ep737 | Adrenal and Cardiovascular Endocrinology | ECE2024

Measurement of cortisol in hair using a commercial ELISA

Rauchschwalbe Nico , Masz Lucia , Schmitter Elisabeth , Neisze Thomas , Meyer-Schlinkmann Kristin , Doelle Michael

Increased cortisol production (Cushing’s syndrome) is a rare disease that is sometimes very difficult to diagnose. Cyclical Cushing’s syndrome in particular is a major challenge. In this case of hypercortisolism, which is not always present, longitudinal diagnostic methods are advantageous. In the past, it has already been shown several times that the measurement of cortisol in the scalp hair shows significantly increased values in patients with Cushing’s syndro...

ea0099ep738 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal lesions prevalence and hormonal profiles in a tertiary endocrinology center from romania

Barbu Carmen , Zuga Luana , Florea Suzana , Bunghez Roxana , Martin Sorina , Sirbu Anca , Cima Luminita , Albu Alice , Stoian Iulia , Fica Simona

Backround: The increased frequency of performing imaging investigations in the period following the SARS-COV-2 pandemic has led to more frequent identification of adrenal lesions in patients who subsequently required further endocrine evaluation.Objective: To compare the functional profile of the newly diagnosed lesions vs those coming for follow up over 2023.Methods: Retrospective observational study aiming all of the patients adm...

ea0099ep739 | Adrenal and Cardiovascular Endocrinology | ECE2024

Surgical management of adrenal masses: experience of a tertiary center

Santos Sara , Saraiva Miguel , Marques Puga Francisca , Palma Isabel

Introduction: Adrenal masses (AM) are being increasingly diagnosed but only a small portion will need surgical treatment.Methods: We retrospectively reviewed patients referred to the Endocrinology Clinic that underwent adrenalectomy between 1996 and 2023.Results: We included 57 patients. Most AM were diagnosed incidentally (53%) and had a median size of 32 (25) mm. Forty (70%) patients had hormonal hypersecretion (HH): pheocromocyt...

ea0099ep740 | Adrenal and Cardiovascular Endocrinology | ECE2024

Significance of screening and confirmatory tests in identifying primary hyperaldosteronism among patients investigated for secondary endocrine hypertension

Bocai Raluca , Simona Andreea Găloiu , Raluca Alexandra Trifanescu , Alice Manda Dana , Poiana Catalina

Introduction: Delayed diagnosis of secondary hypertension, notably primary aldosteronism, challenges healthcare. Inconsistent guideline adherence hampers detection rates and diagnostic uniformity, emphasizing the imperative for improved diagnostic strategies in identifying primary hyperaldosteronism. Our study directly addresses this critical gap in clinical care, underscoring the need for enhanced diagnostics in patients undergoing investigation for secondary endocrine hypert...

ea0099ep741 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical and biochemical data for the diagnosis of endogenous hypercortisolism: the “Cushingomic” approach

Ceccato Filippo , Bavaresco Alessandro , Ragazzi Eugenio , Barbot Mattia , Boscaro Marco , Basso Daniela , Carla Scaroni , Antonelli Giorgia

Background: The recommended first-line screening tests for Cushing’s syndrome (CS) are serum cortisol after 1-mg dexamethasone suppression test (FDST), urinary free cortisol (UFC), and late-night salivary cortisol (LNSC). CS is often diagnosed late: the clinical presentation of endogenous hypercortisolism overlaps with common clinical conditions.Methods: We analyzed the diagnostic test accuracy of FDST, UFC, and LNSC in patient...

ea0099ep742 | Adrenal and Cardiovascular Endocrinology | ECE2024

Cushing’s syndrome in a patient with non-hodgkin’s lymphoma

Ilie Iuliana , Felicia Mihai Lidia , Lepadat Gabriel , Musat Madalina

Endogenous Cushing’s syndrome is a rare disease, with an incidence of 0.7–2.4 per million people per year. Adrenal origin is described in approximately 20 percent of all cases. Adrenal lymphoma presenting as adrenal incidentaloma with autonomous cortisol production has recently been described, though this is a rare condition. We report a rare case of adrenal Cushing’s syndrome in a patient diagnosed with a low-grade non-Hodgkin’s lymphoma. Female patient, a...

ea0099ep743 | Adrenal and Cardiovascular Endocrinology | ECE2024

Radiological characteristics of adrenal incidentalomas followed in the endocrinology department

Ismael Mbossa Lembopo Prince , Essabah Haraj Nassim , El Aziz Siham , Chadli Asma

Introduction: Adrenal incidentaloma refers to an adrenal mass discovered incidentally during imaging for another indication, most commonly through a CT scan. The discovery of an adrenal incidentaloma has become frequent with the use of imaging studies. CT scans play a crucial role in characterizing adrenal incidentalomas, allowing for better management. The aim of the study is to determine the contribution of CT scans in exploring adrenal incidentalomas in patients followed in...

ea0099ep744 | Adrenal and Cardiovascular Endocrinology | ECE2024

Unlocking the metabolic mysteries: exploring metabolic syndrome in primary aldosteronism

Soomauroo Siddiqa , Hadjkacem Faten , Missaoui Abdelmuhaymen , Maalej Souhir , Mnif Mouna , Abid Mohamed , Rekik Nabila

Introduction: Primary aldosteronism (PA) is associated with increased prevalence of metabolic disorders such as impaired glucose and lipid metabolism and insulin resistance. Individuals with PA have an increased risk of cardiovascular events. The aim of this study is to determine the characteristics of metabolic syndrome (MS) in patients with PA.Patients and methods: Retrospective study concerning 40 patients with PA over the period of 10 years from Janu...

ea0099ep745 | Adrenal and Cardiovascular Endocrinology | ECE2024

Association of cognitive-behavioral disorders with a 21-hydroxylase deficiency

Elfekih Hamza , Ben Hadj Slama Nassim , Yanes Amira , ACH Taieb , El Euch Koussay , Hasni Yosra , Chadli Chaieb Molka

Introduction: Congenital adrenal hyperplasia encompasses a spectrum of autosomal recessive disorders marked by enzymatic deficiencies in cortisol biosynthesis. The prevailing etiology predominantly involves a deficit in 21-hydroxylase. This pathophysiological state gives rise to a myriad of complications, with acute adrenal insufficiency standing out as the most critical. Nevertheless, it is noteworthy that less-explored are the intricacies of additional complications, particu...

ea0099ep746 | Adrenal and Cardiovascular Endocrinology | ECE2024

When two rare conditions come together

Leitao Francisca , Quitalo Ana , Carlos Cordeiro Maria , Raimundo Luisa

Introduction: Deficiency of 11-beta hydroxylase (11-HD) accounts for 5% of the causes of congenital adrenal hyperplasia (CAH), with an incidence of 1:100,000. The classic form phenotype consists in an excess of androgens and mineralocorticoids, which clinically translates into hypertension and hypokalaemia. In boys, there may be an increase in penis size, early adrenarche, increased growth velocity, and advancing bone age.Clinical case: We present a case...

ea0099ep755 | Adrenal and Cardiovascular Endocrinology | ECE2024

Allgrove syndrome: a case report

Mezghani Ines , Rim Marrakchi , Faten Hadjkacem , Mariem Boudaya , Kamel Jammoussi , Nabila Rekik , Mohamed Abid , Mouna Turki

Introduction: Allgrove syndrome or Triple A (3A) syndrome is a rare autosomal recessive disease characterized by alacrima, esophageal achalasia and adrenocorticotropic hormone-resistant adrenal insufficiency.Observation: A 3-year-old and 9 months patient, from a consanguineous marriage, consulted for melanoderma, with family history: sisters with an heterozygous mutation of the AAAS gene, two paternal cousins, 5 years and 22 years, followed for autism an...

ea0099ep759 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical profile of patients with adrenal tumors in a tertiary endocrine center in Kathmandu, Nepal

Joshi Ansumali , Karmacharya Srijana , Dahal Puspa , Rana Rama

Adrenal tumors are not uncommon in endocrine practice. We collected retrospective data from our clinical records of our patients with adrenal tumors from 2021 January to 2023 January. There were a total 20 patients; males 10 (50%) and females 10 (50%). Mean age was 47.4&pm;10.65 years and average BMI was 26.57&pm;4.94. Hypertension was seen in 13 patients (65%) and diabetes in 9 patients (45%). Nonfunctioning adrenal adenomas (NFAAs) were seen in 12 patients (60%) and function...

ea0099ep760 | Adrenal and Cardiovascular Endocrinology | ECE2024

Challenges of endocrine hypertension

Khurodze Tea , Javelidze Sopo , Pruidze Ana , Vashakidze Vitali

Background: Endocrine pathologies are a common cause of secondary hypertension. Most patients with primary aldosteronism and primary hyperparathyroidism suffer from hypertension. Although the coexistence of parathyroid adenoma and cones syndrome in the same patient is uncommon, the occurrence of these two adenomas at the same time can have significant implications for the patient’s clinical presentation, diagnostic evaluation, and treatment approach.<p class="abstext"...

ea0099ep768 | Adrenal and Cardiovascular Endocrinology | ECE2024

Metastatic giant pheochromocytoma and primary hyperparathyroidism: Association or coincidence: about a case report and literature review

Katia Benabdelatif , Lachkhem Aicha , Yahi Abdelkader , Longo Redhouane , Kablia Samia Ould , Meriem Bensalah

Introduction: Pheochromocytomas and paragangliomas (PPGLs) are chromaffin cell tumors that arise from neuroectodermal cells. These tumors are characterized by a very heterogeneous natural history and an unpredictable ability to metastasize. The rate of metastatic disease ranges from lessthan 1% to 79%, depending on tumor site and size, age at diagnosis and genotype.30% are considered to be hereditary. Primary hyperparathyroidism can be associated with PPLGs. We report a case o...

ea0099ep877 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical, biological and anatomopathological profile of pheochromocytomas

El Arem Marwa , Ben Amor Bilel , Hajji Ekram , Abid Sana , Bayar Ines , Marmouch Hela , Sayadi Hanene , Khochteli Ines

Introduction: Pheochromocytoma is a rare tumour of the adrenal medulla. The aim of our work is to describe the clinical, biological and anatomopathological profile of pheochromocytomas.Material and method: Retrospective descriptive study carried out in the endocrinology department of the Fattouma Bourguiba University Hospital, Monastir, Tunisia.Results: Analysis of a series of 13 cases found 9 women and 4 men with an average age of...

ea0099ep905 | Adrenal and Cardiovascular Endocrinology | ECE2024

Assessing the Metabolic profile of young healthcare professionals: a cross-sectional study

Rekaya Zeineb , Mekaouer Samir , Yazidi Meriem , Kamoun Elyes , Khessairi Nadia , Oueslati Ibtissem , Chaker Fatma , Chihaoui Melika

Introduction: The prevalence of metabolic syndrome (MS) is constantly increasing, particularly among young individuals with sedentary professions. Identifying individuals with MS is crucial for implementing personalized interventions to prevent cardiovascular events. Our study aimed to assess the metabolic profile of young and healthy healthcare professionals, considering the specific lifestyle linked with their professional roles.Methods: This cross-sec...

ea0099ep915 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal incidentaloma: A case of pheochromocytoma with sub-clinical Cushing’s syndrome

Rafi Sana , Alahyane Meryam , Mghari Ghizlane El , Ansari Nawal El

Background: An adrenal incidentaloma (AI) is defined as an adrenal lesion that is discovered when a radiological study is performed for indications other than suspected adrenal disease. All patients with an AI should be evaluated for endocrine adrenal functioning and malignancy potential features. A combination of pheochromocytoma and Cushing’s syndrome in same adrenal gland is extremely rare. We report a case of AI with the evidence of both pheochromocytoma and sub-clini...

ea0099ep916 | Adrenal and Cardiovascular Endocrinology | ECE2024

Value of low-dose short synacthen test (1μg) vs high-dose synacthen test (250 μg) for assessment of the adrenal axis

Patricia Stanescu-Smocot Anastasia , George Radulescu Vlad , Stancu Cristina , Manda Dana , Badiu Corin

Introduction: Assessment of adrenal insufficiency (AI) is done routinely through Synacthen test. However, the conventional high dose (250 μg) stimulation is supra-physiological, therefore 1 μg low dose test was developed.Aim: to investigate the utility of the Low-dose test vs the High-dose test, in patients with suspected central AI, in a tertiary centre of endocrinology, in the National Institute of Endocrinology, Bucharest, Romania.<p cla...

ea0099ep917 | Adrenal and Cardiovascular Endocrinology | ECE2024

Evaluation of late-night salivary cortisol diagnostic accuracy for Cushing’s syndrome in the clinical setting

Dadej Daniela , Szczepanek-Parulska Ewelina , Ruchała Marek

Introduction: The diagnosis of Cushing’s syndrome (CS) is often challenging and requires the use of several diagnostic methods. Late-night salivary cortisol (LNSC) offers an easy, non-invasive screening method for CS. However, its availability is still limited and the cut-off values vary widely between laboratories. The aim of this study was to assess the diagnostic value of LNSC for CS in comparison with late-night serum cortisol (LNSerC) and 24-hour urinary free cortiso...

ea0099ep918 | Adrenal and Cardiovascular Endocrinology | ECE2024

Identification of risk factors and indications for performing an ACTH-Test in cases of suspected adrenal insufficiency

Eggers Janine-Marie , Bullmann Catharina , Harbeck Birgit

Introduction: Adrenal insufficiency can result in a life-threatening situation if undetected. This pathology is diagnosed by performing an ACTH-Test. Most symptoms like fatigue, loss of weight or arthralgia are rather unspecific. Therefore it is difficult to assess which patients really need an ACTH-Test. Aim of this study was to identify risk factors and indications in order to specify which patients actually require it.Material and methods: 324 patient...

ea0099ep919 | Adrenal and Cardiovascular Endocrinology | ECE2024

Primary unilateral macronodular adrenal hyperplasia with concomitant glucocorticoid and androgen excess and KDM1A inactivation

Elhassan Yasir , Appenzeller Silke , Landwehr Laura-Sophie , Lippert Juliane , Popat Dillon , C. Gilligan Lorna , Abdi Lida , Goh Edwina , Diaz-Cano Salvador , Kircher Stefan , Gramlich Susanne , Sutcliffe Robert , Thangaratinam Shakila , Chan Li , Fassnacht Martin , Arlt Wiebke , L Ronchi Cristina

Background: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare cause of Cushing’s syndrome. Primary unilateral macronodular adrenal hyperplasia with concomitant glucocorticoid and androgen excess has never been studied before.Methods: We investigated a woman with a large, heterogeneous 7 cm adrenal mass (with a radiologically normal contralateral adrenal) and adrenocorticotropic hormone (ACTH)-independent glucocorticoid and androge...

ea0099ep920 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal lesions do matter in the course of primary aldosteronism: a comparative analysis of Conn’s adenoma vs bilateral adrenal hyperplasia

Soomauroo Siddiqa , Hadjkacem Faten , Ridwaan Auckburally Ahmad , Missaoui Abdelmuhaymen , Maalej Souhir , Feki Wiem , Mnif Zeinab , Mnif Mouna , Abid Mohamed , Rekik Nabila

Introduction: Primary aldosteronism (PA) is commonly identified as the main cause of secondary hypertension. It is becoming increasingly wide-spread, affecting between 1 and 30% of people suffering from hypertension. We aim to determine the different characteristics between aldosterone-producing adenoma (APA) and bilateral adrenal hyperplasia (BAH).Patients and methods: Retrospective descriptive and analytical study concerning 40 patients with PA, collec...

ea0099ep923 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenoleucodistrofia ligada al cromosoma X con genética atípica

Dominguez Rabadan Rocio , Manzanares Cordova Rossana , Florencio Ojeda Luna

Background: X-linked adrenoleukodystrophy (X-ALD) is a hereditary disease that occurs in boys in childhood and adolescence, with cases being rarer in adulthood. Primary adrenal insufficiency (PSI) is present in more than 50% of patients and in 10% it is the only manifestationCase report: 24-year-old male, diagnosed with primary adrenal insufficiency as a child. The pathological history included dyslipidemia, obesity, prediabetes and parietospastic gait a...

ea0099ep929 | Adrenal and Cardiovascular Endocrinology | ECE2024

Angiomyolipoma of right adrenal gland

Ahmed Mariyah , Shaikh Sheeba , Gulamhusein Aziz , Oliveira Pedro , Adam Safwaan

We describe the case of a 52-year-old female, with a body mass index of 32 kg/m2 and without significant co-morbid illness who initially presented acutely, with self-resolving abdominal pain. During that admission, an abdominal computed tomography (CT) scan demonstrated a right-sided heterogeneous and contrast enhancing adrenal mass (measuring 59×41 mm) with a 15 mm focus of cystic degeneration. Based on the scan appearances, the patient was suspected as having...

ea0099ep930 | Adrenal and Cardiovascular Endocrinology | ECE2024

Silent yet aggressive: a case of large adrenocortical carcinoma with asymptomatic hypercortisolism

Larisa Robu , Beatrice Blesneac Ilona , Tarcau Otilia , Matei Anca , Teodoriu Laura , Florescu Alexandru , Preda Cristina

Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy arising from the adrenal cortex often with unexpected biological behavior. It can occur at any age, with two peaks of incidence: in the first and between fifth and seventh decades of life. Although ACC are mostly hormonally active, precursors and metabolites may be also produced by dedifferentiated and immature malignant cells.Case report: We report a rare and challenging case of...

ea0099ep974 | Adrenal and Cardiovascular Endocrinology | ECE2024

The 1-mg overnight low-dose dexamethasone suppression test cut-off in establishing the diagnosis of Cushing’s syndrome

Terzi Amani , Oueslati Ibtissem , Merhbene Yasmine , Kamoun Elyes , Chehaider Cyrine , Yazidi Meriem , Chihaoui Melika

Introduction: The 1-mg overnight low-dose dexamethasone suppression test (DST) has been used to screen for mild autonomous cortisol secretion and Cushing’s syndrome (CS). The aim of the present study was to determine the DST discriminatory threshold confirming the diagnosis of CS.Methods: This was a monocentric retrospective study including patients who were admitted to the Department of Endocrinology of La Rabta Hospital, Tunis between 2014 and 202...

ea0099ep978 | Adrenal and Cardiovascular Endocrinology | ECE2024

A middle aged man presented with hypertension and adrenal incidentaloma diagnosed with pheochromocytoma

Salah Uddin Mohammad , Abourawi Fathi

Pheochromocytomas are rare tumors located in the adrenal medulla, that derive from the chromaffin cells and produce catecholamines. They are an uncommon cause of hypertension, and only 50% of the patients present symptoms compatible with this pathology. Here we describe the case of a 67-year-old man who was referred with h/o mild headache, hypertension and adrenal incidentaloma detected by CT abdomen and pelvis which showed 4.5 cm indeterminate nodule in the left adrenal gland...

ea0099ep979 | Adrenal and Cardiovascular Endocrinology | ECE2024

Pheochromocytoma with an atypical presentation

Gjermeni Ilir , Kecaj Irida , Hysa Ediola , Nelaj Ergita

Introduction: Pheochromocytoma is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure. The clinical manifestations of patients with pheochromocytoma are diverse, ranging from asymptomatic, paroxysmal hypertension, episodic anxiety to devastating acute heart failure and acute pulmonary edema, which all increase the difficulty of identifying and diagnosing it....

ea0099ep980 | Adrenal and Cardiovascular Endocrinology | ECE2024

Neurofibromatosis type 1: rare cause of pheochromocytoma - a report of 2 cases

Meryem Karimi , Azagouagh Hajar , Asfour Mustapha , Kaoutar Rifai , Hind Iraqi , Elhassan Gharbi Mohamed

<table Introduction: Neurofibromatosis type 1 is a multi-organ genetic disease, commonly occurring with variable severity. Pheochromocytoma is a rare manifestation in NF1, affecting 1-15% of NF1 patients according to studies.Case Report: We present 2 cases: - Patient 1: 28 years old, with personal history of café au lait spots, cutaneous and subcutaneous neurofibromas, axillary lentigines. Referred for endocrinology consultation due to an adrenal m...

ea0099ep1014 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal cavernous hemangioma: a diagnostic challenge

Garcia Piorno Alberto , Losada Gata Isabel , Gomez-Gordo Hernanz Monica , Collado Gonzalez Gloria , Perez Noguero Marta , Jimenez Hernando Ignacio , Rivas Alejandra , Perez Lopez Gilberto , Gonzalez Fernandez Laura

Introduction: Cavernous hemangiomas (CH) are benign vascular tumors that frequently involve the skin, central nervous system or liver. Rarely, they can also affect adrenal glands. Adrenal cavernous hemangiomas are mostly unilateral lesions, typically discovered incidentally on radiological imaging. They generally present in the sixth to seventh decade of life and tend to be asymptomatic and non-functioning tumors. Preoperative differential diagnosis from malignant neoplasms ow...

ea0099ep1019 | Adrenal and Cardiovascular Endocrinology | ECE2024

[131I]6ß-iodomethyl-19-norcholesterol SPECT/CT in the localization of cortisol-producing adrenal adenoma

Erdei Annamaria , Koroskenyi Laura , Daniel Eszter , Andrasi Monika , Barna Sandor , Nagy Endre

Introduction: Adrenal scintigraphy using [131I]6ß-iodomethyl-19-norcholesterol has been available since 1975, primarily for the diagnosis of hyperaldosteronism helping to distinguish between unilateral adenoma and bilateral hyperplasia. First line treatment of ACTH-independent form of Cushing syndrome is surgery after localization of the cortisol-producing adrenal tumour.Case report: A 31-year-old woman has been referred to the endocrine ...

ea0099ep1056 | Adrenal and Cardiovascular Endocrinology | ECE2024

Administration of high dose vitamin E in female rabbits with hypercholesterolemia increases acutely androgen levels: an animal model study

Vlachos Ioannis , Chatzi Sofia , Kontzoglou Konstantinos , Boutzios Georgios

Introduction: Only few studies were observed, supporting the hypothesis that the administration of high doses of vitamin E in people with elevated serum total cholesterol levels leads to increased adrenocortical hormone secretion. There are only limited data concerning androgen or estrogen levels. The aim of this study is to investigate the possible effect of Vitamin E on adrenal and sex hormones in rabbits with hypercholesterolemia, as an animal model for the research.<p ...

ea0099ep1057 | Adrenal and Cardiovascular Endocrinology | ECE2024

Malignant mesenteric paraganglioma: a case report

Samir Merad Mohamed , Mohammedi Fatiha

Introduction: Paragangliomas are neuroendocrine tumors that develop from the paraganglia of the sympathetic and parasympathetic nervous systems. They are benign in approximately 80% of cases and are usually localized. However, in rare situations, they can be malignant, which is defined by the presence of tumor cells in nearby tissues or at a distance (metastases). Most parasymphathetic paragangliomas are located in the skull base and along the vagus and glossopharyngeal nerves...

ea0099ep1058 | Adrenal and Cardiovascular Endocrinology | ECE2024

Norepinephrine-only secreting pheocromocytoma: case report

Dragan Elena

Introduction: Pheocromocytomas are catecholamine-secreting tumors that arise from cromaffin cells of the adrenal medulla, probably occurring in less than 0.2% of pacients with hypertension. The objective of this report is to describe a case of norepinephrine-only secreting pheocromocitoma.Case description: A 43-year-old female pacient presented with hypertension, recent onset diabetes and right adrenal mass measuring 3.5×2.7 cm on a CT scan. Hormona...

ea0099ep1059 | Adrenal and Cardiovascular Endocrinology | ECE2024

A case of silent giant pheochromocytoma

Lider-Burciulescu Sofia-Maria , Stancu Cristina , Anghel Maria , Radulescu Vlad , Badiu Corin

Introduction: Pheochromocytoma is a rare tumor, representing a cause of secondary endocrine hypertension. Traditionally, prior to the widespread availability of imaging investigations, pheochromocytoma was diagnosed based on the triad: headache, palpitations and sweating. Diagnosis is crucial, as 40-50% of pheochromocytoma patients exhibit genetic mutations associated with multiple syndromes, such as MEN2 syndrome, succinate dehydrogenase enzyme mutations, neurofibromatosis ty...

ea0099ep1091 | Adrenal and Cardiovascular Endocrinology | ECE2024

Caae report of rare hormonally active adrenocortical oncocytoma: two-year follow-up

Chakvetadze Khatuna , Shervashidze Tamar

Introduction: Adrenocortical oncocytomas, made up of specific epithelial-origin cells, are rare neoplasms, generally without hormonal activity. Most of them are considered to be benign tumors, with the size of generally 4-8 cm and lack of pathognomonic radiological features.Case Report: This is a 2 year follow up of a 43-year-old woman, who first referred to the endocrinologist in 2021 due to weight gain, resistant arterial hypertension and menstrual irr...

ea0099ep1092 | Adrenal and Cardiovascular Endocrinology | ECE2024

A rare association of salt-wasting congenital adrenal hyperplasia and type 1 diabetes mellitus

Soyer Ahmet , Aksu Hatice , Ayrancİ Esma , Dibeklioglu Bilge , Polat Sefika , Topaloglu Oya , Ersoy Reyhan , Cakir Bekir

The co-occurrence of congenital adrenal hyperplasia and type 1 diabetes mellitus (T1DM) is a rare phenomenon in existing literature. The primary cause of congenital adrenal hyperplasia (CAH) is often 21-hydroxylase deficiency (21OHD), a condition associated with the CYP21A2 gene located on chromosome 6p21.3 within the major human leukocyte antigen (HLA) histocompatibility locus. Various gene polymorphisms, particularly in HLA-DQalpha, DQbeta, and DR genes on chromosome 6p21.32...

ea0099ep1093 | Adrenal and Cardiovascular Endocrinology | ECE2024

Metyrapone treatment for mild autonomous cortisol secretion (MACS) - a case report

Manuel Ruiz-Canovas Jose , Pascual-Corrales Eider , Aracely Achote-Rea Estefania , Madrid-Egusquiza Imanol , Noelia Sanchez-Ramirez Maria , Anabel Idrobo-Zambrano Cindy , Garcia-Regal Carlos , Maria Jimenez-Cassinello Jose , Vega-Beyhart Arturo , Araujo-Castro Marta

A 68-year-old man with history of non-muscle-infiltrating bladder tumor and atrial fibrillation was referred to the Endocrinology Department in November 2020 for a functional study of a left adrenal incidentaloma. Furthermore, the patient had a history of arterial hypertension diagnosed at the age of 45 years, on treatment with 3 drugs (enalapril 20 mg B.I.D., amlodipine 5 mg B.I.D., hydrochlorothiazide 12.5 mg/day), achieving usual blood pressure (BP) levels of 150/90 mmHg. A...

ea0099ep1094 | Adrenal and Cardiovascular Endocrinology | ECE2024

Subclinical hypercortisolism revealed by a resistant hypertension

Essafir Nouhaila , Ait Kassi Nada , Guerboub Anas

Introduction: Hypercortisolism is considered to be a rare condition with an estimated incidence between 0.4 and 2.4 cases per million per year, typically manifests as the clinically and biochemically evident Cushing’s syndrome. However, a more subtle form, known as subclinical hypercortisolism (SH) or autonomous cortisol secretion (ACS), poses diagnostic challenges. It is defined as excessive cortisol secretion without the classic manifestations of clinically overt Cushin...

ea0099ep1095 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal insufficiency revealing multifocal tuberculosis

Alahyane Meryam , Rafi Sana , Bari Manar , El Mghari Ghizlane , El Ansari Nawal

Background: Multifocal tuberculosis is defined as the involvement of at least two extra-pulmonary sites, with or without pulmonary involvement. The most commonly involved endocrine organ is the adrenal gland. We report a case of adrenal insufficiency revealing multifocal tuberculosis.Case report: A 65 year old female patient with no context of immunosuppression, presented to emergency department with Consciousness disturbance associated with severe hypon...

ea0099ep1097 | Adrenal and Cardiovascular Endocrinology | ECE2024

The complex intersection of congenital adrenal hyperplasia, antiphospholipid syndrome, and infertility: a successful pregnancy journey

Cemerkaite Aiste , Lizdeniene Vita

Congenital Adrenal Hyperplasia (CAH), a genetic adrenal gland disorder, can disrupt hormonal balance, leading to fertility issues in females. Timely interventions, like hormone therapy, are essential for managing fertility concerns and ensuring a safe pregnancy for individuals with CAH. A 28-year-old patient consulted an endocrinologist for a detailed examination due to infertility issues persisting for 2 years. Prior to this, the patient had given birth to a 22-week-old newbo...

ea0099ep1098 | Adrenal and Cardiovascular Endocrinology | ECE2024

Testosterone producing adrenal cortical carcinoma in a post-menopausal woman

Moazzami Mitra , Lyden Melanie , Bancos Irina

Introduction: In post-menopausal women, the differential diagnosis of hirsutism caused by testosterone excess includes ovarian and adrenal sources. Bilateral ovarian hyperthecosis is a common cause of testosterone excess in post-menopausal women and the diagnosis is confirmed by histopathological examination of the ovaries. Adrenal tumors causing testosterone excess is exceedingly rare. In fact, most causes of hirsutism secondary to adrenal tumors is due to dehydroepiandroster...

ea0099ep1099 | Adrenal and Cardiovascular Endocrinology | ECE2024

Gonadal impact of congenital adrenal hyperplasia in adulthood: a follow-up study

Frikha Hamdi , Abdelkafi Yassmine , Dhieb Nesrine , Elleuch Mouna , Kamoun Mahdi , Kamoun Thouraya , Hachicha Mongia , Mnif Mouna , Sfar Habib , Abid Mohamed , Rekik Majdoub Nabila

Introduction: Advances in diagnosis and treatment over the years have improved the life expectancy and quality of life for individuals with congenital adrenal hyperplasia (CAH). The inevitable alteration of the hypercortisolism-hyperandrogenism balance with current CAH therapy could be responsible for several anomalies in the gonadotropic axis and compromise fertility. This study aims to investigate this aspect in an aging Tunisian population of patients with CAH.<p class=...

ea0099ep1100 | Adrenal and Cardiovascular Endocrinology | ECE2024

Cardiovascular and cerebrovascular burden associated with primary aldosteronism: a monocentric study

Soomauroo Siddiqa , Hadjkacem Faten , Missaoui Abdelmuhaymen , Ridwaan Auckburally Ahmad , Maalej Souhir , Feki Wiem , Mnif Zeinab , Mnif Mouna , Abid Mohamed , Rekik Nabila

Introduction: Primary aldosteronism (PA) is commonly identified as the main cause of secondary hypertension. It is becoming increasingly wide-spread, affecting between 1 and 30% of people suffering from hypertension. A prolonged exposure to high aldosterone concentrations has a deleterious effect on cardiovascular tissues and is associated with target organ damage, independently of blood pressure, so a higher risk of cardiovascular events has been reported in patients with pri...

ea0099ep1101 | Adrenal and Cardiovascular Endocrinology | ECE2024

Giant adrenal masses during congenital adrenal hyperplasia: a case report

Frikha Hamdi , Trimeche Oumeyma , Gherissi Wiem , Ben Salah Dhoha , Boujelben Khouloud , Mnif Fatma , Mnif Mouna , Abid Mohamed , Rekik Majdoub Nabila

Introduction: Congenital adrenal hyperplasia (CAH) in its classical form is an early-onset and challenging-to-treat condition with long-term evolution associated with significant morbidity, typically involving metabolism, bone, and gonadal aspects. Through this specific case study, we illustrate one of the rare complications of CAH in adulthood.Case Report: A 24-year-old patient, born of consanguineous parents, has been monitored since birth for classica...

ea0099ep1102 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical features and complication profile of arterial hypertension in patients with primary aldosteronism

Soomauroo Siddiqa , Hadjkacem Faten , Missaoui Abdelmuhaymen , Ridwaan Auckburally Ahmad , Maalej Souhir , Feki Wiem , Mnif Zeinab , Mnif Mouna , Abid Mohamed , Rekik Nabila

Introduction: Primary aldosteronism (PA) is frequently recognized as the main cause of secondary hypertension. Its prevalence is on the rise, impacting a range of 1 to 30% among individuals with hypertension.Patients and methods: Retrospective and descriptive study concerning 40 patients with PA, collected in the endocrinology department of the Hedi Chaker University Hospital of Sfax, over the period of 10 years from January 2010 to December 2022.<p ...

ea0099ep1103 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical and biological study of adrenal incidentaloma

Farid Hayfa , ACH Taieb , Ben Abdelkarim Asma , Elfekih Hamza , Hasni Yosra , Maaroufi Amel , Chedli Chaieb Molka

Introduction: The adrenal incidentaloma is an asymptomatic tumor measuring at least one cm, discovered incidentally during a medical imaging examination. The adrenal incidentaloma continues to grow with technological advances and improved radiological examinations. Any adrenal incidentaloma involves the search for a secretion or malignant character. The objective of our study is to study the clinical, biological and etiological aspects of adrenal incidentalomas.<p class="a...

ea0099ep1105 | Adrenal and Cardiovascular Endocrinology | ECE2024

Clinical case: manifestation of primary adrenal insufficiency in Addison’s crisis

Bieliauskienė Justina

Introduction: An Addison’s crisis is a life-threatening situation that usually results hypotension/hypovolemic shock, nausea or vomiting, fever, loss of consciousness, hyponatremia (Na ≤132 mmol/l), hyperkalemia and hypoglycemia.Case description: 33 years old patient was found at home after firefighters broke down the door, with a lot of stomach contents around. The last contact with relatives was a day ago, when the patient complained of feve...

ea0099ep1164 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal fusion during renal transplantation: A challenging situation

Dassoufi Rania , Nyogushima Eleazar , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Adrenal-renal fusion is a rare entity wherein the capsule of the adrenal gland is fused to the kidney. Generally asymptomatic, it is only in pathological situations or in cases of adrenal or renal resection that this situation can cause problems. Adrenal transplantation has long been studied in rats solely to treat adrenal insufficiency, but no cases of accidental transplantation have been reported. Here, we report a case of adrenal-renal fusion making intraopera...

ea0099ep1165 | Adrenal and Cardiovascular Endocrinology | ECE2024

Modified classification of autoimmune adrenal insufficiency

Nuralieva Nurana , Yukina Marina , Troshina Ekaterina

Objectives: to modify the classification of autoimmune adrenal insufficiency (AAI).Methods: n=8 patients with early stages (potential and latent) of AAI were included (table 1).Results: Based on the analysis of clinical and laboratory data of patients, a modified classification of AAI has been developed (table 2).Table 1. Characteristics of patient...

ea0099ep1166 | Adrenal and Cardiovascular Endocrinology | ECE2024

Simultaneous papillary and medullary thyroid carcinoma, primary hyperparathyroidism and ACTH-independent Cushing syndrome- an intriguing puzzle of endocrine disorders

Badita Ana-Iolanda , Jercalau Simona , Goldstein Andrei , Marcu Andreea , Stanciulea Oana , Dumitrascu Anda , Buduluca Larisa , Badiu Corin

Case presentation: A 67-year old diabetic and hypertensive female, with no significant family history, first underwent total thyroidectomy, with a histological and immunohistochemical result of both papillary thyroid carcinoma (PTC) T3Nx stage III and medullary thyroid carcinoma (MTC), with additional radioiodine treatment for PTC, showing excellent response to therapy at follow-ups (stimulated thyroglobulin <0.2 ng/ml, normal CEA and calcitonin). Almost 10 years later, th...

ea0099ep1167 | Adrenal and Cardiovascular Endocrinology | ECE2024

Demographic, clinical, and paraclinical features of patients with adrenal incidentaloma

Mabrouk Mariam , Abid Arige , Ibtissem Oueslati , Kamoun Elyes , Cherchir Faten , Yazidi Meriem , Melika Chihaoui

Introduction: Adrenal incidentalomas (AI) are adrenal masses detected on imaging performed for reasons other than suspected adrenal disease. It is important to categorize whether the mass is a functioning or non-functioning incidentalomas to determine the appropriate management and follow-up. The aim of this study was to assess demographic, clinical, and paraclinical features of patients with AI.Methods: This was a monocentric retrospective study includi...

ea0099ep1168 | Adrenal and Cardiovascular Endocrinology | ECE2024

Testicular adrenal rests in a patient with congenital adrenal hyperplasia: a case report and literature review

Ouakrim Hind , Ettalibi Fatiha , Rafi Sana , El Mghari Ghizlane , El Mghari Nawal

Introduction: Congenital adrenal hyperplasia (CAH) is a group of rare inherited autosomal recessive disorders, CAH is caused by a mutation in the CYP21A2 gene that leads to a deficiency of 21-hydroxylase (CYP21), due to CYP21A2 gene mutations. Testicular adrenal rest tumors (T-ARTs) is a rare kind of benign tumor in the testis, which occurs mainly secondary to congenital adrenal hyperplasia (CAH). We report a rare case of bilateral TART in a patient with CAH whose diagnosis wa...

ea0099ep1169 | Adrenal and Cardiovascular Endocrinology | ECE2024

Congenital adrenal hyperplasia: Cardiometabolic and bone outcomes

Frikha Hamdi , Dhieb Nesrine , Charfi Hana , Ben Salah Dhoha , Kamoun Mahdi , Kamoun Thouraya , Hachicha Mongia , Mnif Mouna , Sfar Habib , Elleuch Mouna , Abid Mohamed , Rekik Majdoub Nabila

Introduction: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder affecting adrenal steroid synthesis. Its treatment aims to achieve a balance between optimal glucocorticoid replacement and normal androgen levels. The long-term outcomes of this condition are poorly studied. The objective of this study is to evaluate the impact of CAH due to 21-hydroxylase deficiency on final height (FH), bone metabolism, and cardiometabolic risk in a Tunisian cohort.<p ...

ea0099ep1192 | Adrenal and Cardiovascular Endocrinology | ECE2024

Case of amenorrhea in identical twin sisters. late-onset congenital adrenal hyperplasia (?)

Lataria Naia

Overview: Congenital adrenal hyperplasia is a group of autosomal recessive disorders. In the presented case we will evaluate milder form of the disease, also referred as, non-Classical’’. Prevalence of CAH is 1-9/100000. In 90-95% of cases, CAH is caused by a mutation in the CYP21A2 gene located on chromosome 6p21.3Presented case: 16-year-old girl came to our clinic with amenorrhea, she had her last menstrual cycle 1 year ago. No signs...

ea0099ep1199 | Adrenal and Cardiovascular Endocrinology | ECE2024

Precocious puberty: a case report

Hammami Omaima , Mezghani Ines , Marrakchi Rim , Maalej Souhir , Hajkacem Faten , Boudaya Mariem , Jammoussi Kamel , Rekik Nabila , Abid Mohamed , Turki Mouna

Introduction: Precocious puberty is characterized by the onset of signs of puberty before the usual age and can be caused by various etiologies. Congenital adrenal hyperplasia represents a rare cause of precocious puberty. Our aim was to report a case of a child with precocious puberty.Observation: A 4-year-old and 11 months patient, from a consanguineous marriage, hospitalized in the endocrinology department for precocious puberty. The clinical examinat...

ea0099ep1214 | Adrenal and Cardiovascular Endocrinology | ECE2024

Adrenal insufficiency in allgrove syndrome:a case report

Azagouagh Hajar , Meryem Karimi , Moussaid Nawal , Kaoutar Rifai , Hind Iraqi , Elhassan Gharbi Mohamed

Introduction: Allgrove syndrome or triple A syndrome is a rare genetic disorder of autosomal recessive inheritance combining in its complete form: esophageal achalasia, alacrymia and adrenal insufficiency.Observation: Patient aged 16, 3rd of 4 siblings from a consanguineous marriage, followed for allograve Sd with megaesophagus operated on in 2016, alacrymia with artificial tears and neurological impairment. As part of the follow-up of his pathology, an ...

ea0099ep1215 | Adrenal and Cardiovascular Endocrinology | ECE2024

Addison’s disease presented as a persistent hyperkaliemia in a patient with diabetic ketosis and autoimmune polyendocrine syndrome type 2 (APS-2). a case report and review of literature

Kermaj Marjeta , Ylli Dorina , Hoxha Violeta , Poshi Klodiana , Ylli Agron

Introduction: APS-2 is the most common autoimmune polyendocrine syndrome. It is characterized by the presence of various endocrine-related diseases, such as autoimmune thyroid disease, type 1 diabetes mellitus, Addison’s disease, primary hypogonadism, and, in rarer cases, hypoparathyroidism or hypopituitarism.Case report: Our patient is a 38-year-old female with a medical history of type 1 diabetes mellitus (DMT1) for 13 years, Hashimoto’s thyr...

ea0099ep1223 | Adrenal and Cardiovascular Endocrinology | ECE2024

Primary aldosteronism: clinical presentation and management about 2 cases

Boukhalfa Ahmed , Rafi Sana , El Mghari Ghizlane , El Ansari Nawal

Introduction: Primary aldosteronism (PA) is widely recognized as the most common form of secondary hypertension (1). PA, also known as Conn syndrome, is a group of pathological conditions associated with an aldosterone secretion inappropriate for sodium intake, that is relatively autonomous from renin–angiotensin system activity and potassium levels.Clinical Case 1: Thirty two year-old patient, diagnosed since 11 months with arterial hypertension wi...