Endocrine Abstracts

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...

Context: Fludrocortisone (FC) is the mineralocorticoid (MC) replacement treatment for patients with primary adrenal insufficiency (PAI). Objective: To explore the dose of FC treatment and its relationship with glucocorticoid therapy, sodium, potassium, renin and clinical parameters. Design: Longitudinal study.Setting: Monocentric cohort.Patients: Data of 193 patients with PAI (130 autoi...

Introduction: Transsphenoidal surgery (TSS) is the first-choice treatment in Cushing’s disease (CD) with an immediate success rate of 70-80%. Unfortunately, due to the high rate of post-operative recurrences, CD patients require life-long surveillance. However, there is no consensus on how to follow these patients after TSS to early diagnose relapses. The aim of the study was to find reliable predictors of recurrence after neurosurgery in CD.Materia...

Context: Cushing’s disease (CD) is rare condition burdened by several systemic complications that in turn increase mortality. The main goal of CD treatment is to promptly reduce cortisol excess, but whether remission can revert cortisol-related complications and guarantee a normal life expectancy remains debated. Aim: To assess the prevalence of cortisol-related complications and mortality in a large monocentric cohort of CD patients followed at our...

Background and aim: Aldosterone-to-Renin Ratio (ARR) is recommended as initial test to screen for Primary Aldosteronism (PA), especially in high-risk hypertensive population. Endocrine Society (ES) Guidelines recommend that patients with an increased ARR should undergo one or more confirmatory tests in order to confirm or exclude PA diagnosis. Captopril Challenge Test (CCT) and Saline Infusion Test (SIT) are commonly used in routine clinical practice. The aim of our study was ...

Introduction: Since DI was reported to be associated to increase mortality, the aim of this study is to evaluate the presence of autonomic dysfunction (AD) in patients with DI.Methods: We enrolled 12 patients (six females) with central idiopathic DI and 12 controls, matched for age, sex and common cardiovascular risk factors, who were evaluated using the tilt, lying-to-standing, hand grip, deep breath, Valsalva maneuver and Stroop tests.<p class="abs...

Introduction: The diagnosis of Cushing’s syndrome (CS) might be challenging especially in ACTH-dependent CS when it comes to detect the origin of ACTH secretion.Materials and methods: We retrospectively recorded data about 170 patients with ACTH-dependent CS (149 CD, 21 EAS) referring to two Endocrinology Units. We focused especially on the performance of 3 dynamic tests: the dexamethasone 8 mg overnight challenging (HDDST), the CRH and the desmopre...

Background: Classic congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is characterized by impaired cortisol synthesis, requiring life-long glucocorticoid (GC) replacement therapy. Given the detrimental systemic effects of GCs in the long term, the aim of our study was to assess whether CAH patients have increased metabolic and cardiovascular alterations compared with age-matched controls.Materials and methods: For this cross-sectional...

Introduction: Transsphenoidal surgery (TSS) is the first-choice treatment in Cushing’s disease (CD). When performed by experienced neurosurgeon, post-operative remission can be achieved in 70–80% of cases; however, recurrences during follow-up are quite frequent, involving around 20–30% of patients initially in remission. Early detection of relapses is crucial to avoid cortisol-related comorbidities. The aim of the study was to find reliable predictors of rec...

Introduction and aim: A prompt diagnosis of Cushing’s Syndrome (CS) in high-risk populations is mandatory: 1-mg dexamethasone suppression test (1-mg DST); late night salivary cortisol (LNSC) and urinary free cortisol (UFC) are recommend, despite thresholds calculated in retrospective studies. Our aim was to study the diagnostic accuracy of LNSC measured with chemiluminescence assay in a prospective study, confirming discrepancies with mass spectrometry (MS).<p class="...