Endocrine Abstracts

Primary adrenal insufficiency (AI) is often a consequence of autoimmune destruction of the adrenal cortex, but a number of other causes have been reported, including genetic diseases, haemorrhage, infections, infiltration by tumour or metastasis, and medication. AI is rare with reported prevalence at 10–20 per 100 000 inhabitants. Before replacement therapy with corticosteroids became available, AD was invariably fatal. Accessibility to hydrocortisone and fludrocortisone ...

Autoimmune Addison’s disease (AAD) is an endocrine disease resulting from the immune system’s destruction of hormone producing cells in the adrenal cortex. Diagnosis is frequently first established after a life-threatening adrenal crisis, often resulting in untimely fatalities. The disease is rare, more common in women than in men, and also affects children. AAD very frequently occurs with other autoimmune diseases, such as type 1 diabetes mellitus, autoimmune thyroi...

Primary adrenal insufficiency is often a consequence of autoimmune destruction of the adrenal cortex. Mortality is increased primarily due to acute adrenal crises, especially among patients diagnosed at young age. In the long-term more than 50% of the patients will develop other autoimmune diseases or manifestations, particularly autoimmune thyroid disease. Despite seemingly adequate treatment, accumulating evidence document reduced subjective health status, particularly gener...

Primary adrenal insufficiency (PAI) is relatively straightforward to diagnose. However, the challenge lies in considering it as a differential diagnosis due to its rarity, the gradual onset of symptoms, and the nonspecific and common nature of these symptoms. Even with optimal corticosteroid replacement therapy, patients with adrenal insufficiency often report a diminished quality of life (QoL), and studies indicate increased mortality and morbidity. Identifying the underlying...

Context: Premature ovarian insufficiency (POI) affects approximately 1-3% of women. Clinical presentations are heterogeneous and the underlying etiologies remain unknown in the majority of cases.Objective/aim: To characterize presentations of POI and to evaluate the distribution of underlying etiologies in women with newly diagnosed POI of unknown cause.Design: Prospective study of 100 women with newly diagnosed POI. Autoimmunity w...

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

Background: Hormones oscillate in circadian and ultradian rhythms. Consequently, single time point measurements are very difficult to interpret. To address this, we developed an automated system of 24-hour ambulatory microdialysis. This allows measurement of free hormone concentrations in subcutaneous interstitial fluid collected while participants continue normal daily activities. To validate the technique for adrenal steroid hormones, we simultaneously sampled interstitial f...

Background: Primary aldosteronism (PA) patients have increased left ventricular mass (LVM) and increased cardiovascular morbidity compared with those with essential hypertension. Echocardiographic studies have demonstrated that adrenalectomy or spironolactone decreases LVM. The aim of the present study was to use MRI to assess both LVM and cardiac function before and during stress testing, at baseline and after treatment with adrenalectomy or spironolactone, compared with heal...

Background: The Synachten test is used to diagnose for adrenal insufficiency (AI) and non-classical congenital adrenal hyperplasia (CAH). The cut-off levels for s-cortisol and s-17-hydroxyprogesterone are derived from immunoassays that were not well standardized and are no longer in use. Introduction of liquid chromatography tandem mass spectrometry (LCMSMS) could resolve the lack of standardization of steroid hormone assays and enable increased diagnostic accuracy.<p clas...

Objective: Immunoassays of steroids are still used in the diagnosis and biochemical monitoring of patients with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (21 OHD). However, high levels of steroid intermediates can promote cross-reactivity between steroids giving rise to falsely elevated levels.Design: Fifty-nine patients with classic 21OHD (38 women) were studied. Blood samples were collected in the morning after overnight medicatio...