Endocrine Abstracts

Introduction: Hyponatremia is the most common electrolyte disorder and it affects approximately 5% of adults and 35% of hospitalized patients. Diagnostic and/or therapeutic challenge is given. It is defined by a serum sodium concentration of less than 136 mmol/l. Symptoms of hyponatremia range from mild and nonspecific to severe and life-threatening. Hyponatremia is classified as mild, moderate and severe and may be acute or chronic. Mortality and morbidity are significantly i...

Background: Hypophosphatemia is of relevant clinical importance, especially in its severe form. Hypophosphatemia occurs when serum phosphate levels are below 0.84 mmol/l. It can be divided into a mild form (serum phosphate between 0.5 and 0.83 mmol/l), a moderate form (serum phosphate between 0.3 and 0.5 mmol/l) and a severe form (serum phosphate <0.3 mmol/l). Approximately 2.2 to 3.1% of hospitalized patients not requiring intensive care are affected (Brunelli et al., 200...

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...

Introduction: Adrenal carcinomas are rare aggressive endocrine tumours with an incidence of 1–1.7 per 1 000 000. Sixty percent of patients present with symptoms of excess hormone secretion, most commonly as hypercortisolism, with or without virilisation due to accompanying androgen secretion. Tumours without clinical hormonal excess most often present with symptoms such as abdominal discomfort or back pain due to tumour growth.Case report: A 72-year...

Context: Hypocortisolism has been associated with increased cardiovascular risk (CVR) and mortality. Higher levels of certain inflammatory markers such as Interleukin-6 (IL6) in patients with adrenal insufficiency (AI) may partly explain the increase in CVR. Recent studies demonstrate an increased prevalence of cardiovascular disease (CVD) in patients with elevated IL-6 levels. Hypocortisolism is generally treated with glucocorticoid replacement therapy (GRT). Current GRT regi...

Introduction: Patients with primary, secondary or tertial adrenal insufficiency are usually treated with a glucocorticoid substitution therapy adjusting dosages to align with the circadian rhythm. Despite those attempts, finding the correct dosage individually seems challenging, influenced not only by the complexity of circadian rhythms but also by various other factors. Approximately 6-8% of adrenal insufficiency patients still experience adrenal crises every year, which is a...

Introduction: Patients with adrenal insufficiency (AI) are known to have a higher cardiovascular risk (CVR) than the normal population. In particular arteriosclerosis, coronary heart disease, arterial hypertension, hyperlipoproteinemia as well as metabolic disturbances contribute to the increased morbidity and mortality. Aim of this study was to evaluate known cardiovascular risk factors as well as the quality of care by the treating physicians.Material ...

Introduction: A well known side effect of glucocorticoid treatment is abdominally centred weight gain due to increased sensation of hunger but the underlying mechanism is still only incompletely clarified. To elucidate whether the brain reward system is involved in this regulation we studied here the effects of an acute prednisolone infusion on brain centres responding to food stimulation by fMRI in healthy males and correlated these findings to the 24 h food intake of the sub...

Background: Current glucocorticoid replacement regimens for patients with primary adrenal insufficiency (PAI) mean patients wake with either low or undetectable cortisol levels1, associated with fatigue and a reduced quality of life (QoL)2. Plenadren® (Takeda, UK) is a once-daily modified-release formulation of hydrocortisone that replaces daytime cortisol levels whereas Chronocort® (modified-release hydrocortisone hard capsules, Diurnal, UK) wh...

Background: Primary adrenal insufficiency (PAI) is rare: prevalence ~100–140/million and incidence 4:1 000 000/year in Western societies 1. The diagnosis of PAI is suggested by an early-morning cortisol <140 nmol/l (5 μg/dl) 1. The commonest cause in adults is autoimmunity (~90% in Western countries) and it is generally considered progressive once the diagnosis is made, although it has been reported that residual cortis...