Endocrine Abstracts

Purpose: Sepsis is hallmarked by high circulating glucocorticoids in face of low plasma adrenocorticotropic hormone (ACTH) (1). At the hypothalamic-pituitary level, ongoing stress-induced corticotropin-releasing hormone- (CRH) and arginine vasopressin- (AVP) driven expression of the ACTH-precursor POMC coincides with impaired proprotein convertase 1 (PC1/3)-mediated processing into ACTH, with ultimately leaching of unprocessed POMC into the circulation (2). Despite uncertainty...

Aim: For several decades, transient hypothyroxinemia of prematurity is topic of debate. The pathophysiology is incompletely understood and consensus on the therapeutic approach is lacking. This study aimed to obtain more insight in the pathogenesis by studying trends in thyroid hormone levels during the first week of life.Methods: This single-center prospective observational study studied plasma levels of total and free T4, total T3, TSH and TBG in cord ...

Introduction: Patients in need of an intensive care unit (ICU) treatment due to severe diseases often develop the non-thyroidal illness syndrome (NTI). These critically ill patients present with low thyroxine (T4), low 3,3’,5-triiodothyronine (T3) and elevated reverse T3 (rT3) serum concentrations while TSH and 3,3’-diiodothyronine (3,3’-T2) concentrations remain unaffected. To further elucidate the underlying changes ...

Aim of the work: The time courses of ACTH, (free) cortisol and cortisol metabolites beyond the first week of critical illness and upon recovery have not been documented. We studied adrenocortical function over time in relation to critical illness duration and presence of sepsis/septic shock, to initiation of glucocorticoid treatment, and to recovery/death.Methods: Patients still in ICU on day 7 (N=392) and 20 matched healthy subjects were includ...

Background: Sepsis is hallmarked by an immediate and sustained decrease in total-, HDL-, and LDL- cholesterol, associated with poor outcome and suggested to be a potential contributor to adrenal failure and muscle weakness in the critically ill. Although the underlying mechanisms are unclear, this sepsis-induced hypocholesterolemia has been postulated to be due to an increased conversion of cholesterol to cortisol. We hypothesized that hydrocortisone (HC) trea...