Endocrine Abstracts

Background: Although surgery is considered the first-line treatment for patients with endogenous Cushing’s syndrome (CS), medical therapy is often required to control severe hypercortisolism. Metyrapone and osilodrostat are inhibitors of 11β-hydroxylase that have not been directly compared yet.Methods: Retrospective analysis of patients with adrenocorticotropin (ACTH)-dependent and ACTH-independent CS treated with metyrapone or osilodrostat (as...

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

BackgroundAgouti related peptide (AgRP) is a neuropeptide, produced by the hypothalamus and by the adrenal glands. AgRP is an antagonist of proopiomelanocortin (POMC) and its principal role is to stimulate appetite. Although current evidences suggest that AgRP levels are influenced by glucocorticoids, it is still not clear, whether they depend on adrenocorticotropic hormone (ACTH) or cortisol. One of the aims of this study was to address this issue. Furt...

Background: Mitotane is regularly used in patients with adrenocortical carcinoma (ACC) adjuvantly, in patients with high risk of recurrence, and in advanced disease. Multiple effects of mitotane result in adrenal insufficiency in virtually all patients. However, it is unclear how frequently the hypothalamic-pituitary-adrenal (HPA) axis is recovering after treatment discontinuation. Here, we aim to investigate the HPA axis after treatment with mitotane.Me...

Objective: Glucocorticoid excess impairs immune function, thereby predisposing patients with endogenous Cushing’s syndrome (CS) to infections. However, it is still not clear whether there is a CS-subtype specific pattern in white blood cell (WBC) and WBC differential (WBCD) count.Methods: Retrospective monocentric cohort study in patients with either overt endogenous CS or adrenal adenomas with autonomous cortisol secretion (ACS), with WBC and WBCD ...

Background: Standard treatment for advanced adrenocortical carcinoma (ACC) is mitotane in monotherapy or combined with etoposide, doxorubicin and cisplatin (EDP), yet biomarkers predictive of treatment response are lacking. Inflammation-based scores were proposed as predictors for gemcitabine+capecitabine efficacy, used as second-line in progressive ACC. We investigated the role of inflammation-based scores in predicting response to first-line treatment in advanced ACC.<p ...

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

Context: Endogenous Cushing syndrome (CS) is associated with hematological abnormalities. Nevertheless, conflicting data have been reported on erythropoiesis. Some studies reported an association between CS and anemia in men, whereas others described erythrocytosis in affected patients. Furthermore, it is unclear whether there are CS subtype-specific changes in red blood cells (RBC) parameters.Objective: To investigate sex and subtype-specific changes in...

Introduction: The aim of the present study was to explore pain prevalence, pain locations and its impact on everyday activities and health-related quality of life (QoL) in a large cohort of patients with acromegaly.Methods: We conducted a survey at three major centers specialized on the treatment of pituitary diseases. 124 patients with acromegaly (mean age 56.6y ± 13.5) filled in a self-constructed questionnaire on acromegaly symptoms, pain includi...

ContextThe occurrence of different subtypes of endogenous Cushing’s syndrome (CS) in single individuals is extremely rare. We here present the case of a female patient who was successfully cured from adrenal CS 4 years before being diagnosed with Cushing’s disease (CD).Case DescriptionA 50-year-old female was diagnosed with ACTH-independent CS and a left-sided adrenal adenoma in January 2015. After ...