Endocrine Abstracts

Hyponatraemia is associated with adverse outcomes including increased mortality and risk of falls. It is not previously known whether hyponatraemia, on discharge from hospital, is associated with an increased risk of readmission.We conducted a retrospective cohort study identifying all patients admitted to a UK teaching hospital as emergency general medical admissions over a 2-month period. We identified all readmissions within 28 days of discharge and c...

Background: Metyrapone is commonly used in medical management of Cushing’s syndrome. It inhibits 11-β hydroxylase, which catalyses the conversion of 11-deoxycortisol to cortisol. The adequacy of metyrapone blockade can be assessed either clinically or biochemically using a target mean serum cortisol 150–300 nmol/l. Cortisol is normally measured by immunoassay.Case report: A 21-year-old female presented with clinical and biochemical feature...

Background: Metyrapone inhibits 11-β hydroxylase and causes a subsequent rise in the cortisol precursor, 11-deoxycortisol. Cortisol measurements by immunoassays are susceptible to interference and reagent antibody cross-reactivity with cortisol precursors when used in patients receiving metyrapone treatment. Clinicians rely on clinical and biochemical features of cortisol excess for dose titration of this medical blockade. The extent of this interference remains unclear. ...

Introduction: Pituitary and adrenal Cushing’s may be managed by pharmacological-inhibition of adrenal steroidogenesis, using metyrapone and/or ketoconazole. Assessment of biochemical control is challenging owing to cross-reactivity in immunoassays (e.g. cortisol and 11-deoxycortisol) leading to over/under-treatment. Off-target effects can also result, e.g. hyperandrogenism/mineralocorticoid hypertension (increased 11-deoxycorticosterone/DOC). LC-MS/MS analysis is free fro...