Endocrine Abstracts

Introduction: Acromegaly is usually not a difficult condition to diagnose if the possibility of this diagnosis has been raised. However, there are a few conditions presenting with some aspects of acromegaly or gigantism but without growth hormone excess. Such cases are described as ‘pseudoacromegaly’ (acromegaloidism).Methods: A female patient was first investigated for GH excess at 10 y for tall stature since infancy (over 97th perc...

Background: Carpal tunnel syndrome (CTS) is common in patients with acromegaly, with a reported prevalence of 19–64%. We have studied CTS in a large national cohort of patients with acromegaly, and the temporal relationship between the diagnosis of the two diseases.Methods: Retrospective nationwide cohort study including patients diagnosed with acromegaly in Sweden between 2005 and 2017. Patients with acromegaly were identified in the Swedish Natio...

Introduction: Compared with healthy controls, women with Cushing’s syndrome (CS) in long-term remission have reduced functional brain responses during episodic and working memory testing and decreased overall levels of DNA methylation in blood cells. Here, we sought to test the hypothesis that functional brain responses in the prefrontal cortex and hippocampus are related to epigenetic changes in subjects with CS in long-term remission.Methods: In t...

Context: Late-night salivary cortisol is a recommended screening method for Cushing’s syndrome. Liquorice intake may lead to falsely elevated salivary cortisol as glycyrrhizic acid inhibits the 11β-hydroxysteroid dehydrogenase type 2 induced conversion of cortisol to cortisone in the salivary glands. Furthermore, sample contamination by blood from the oral mucosa may also cause falsely elevated salivary cortisol levels. Salivary cortisone has been suggested to more ...

Purpose: We aimed to validate the diagnosis and estimated national incidence of acromegaly reported in the Swedish National Patient Register (NPR), based on clinically reported International Classification of Diseases (ICD-codes), in comparison with the Swedish Pituitary Register (SPR).Methods: All patients in NPR or SPR between 1991-2018 with the ICD-9 or ICD-10 diagnosis of acromegaly and age >18 years at diagnosis were included. The diagnosis was ...

Introduction: Glucocorticoid replacement for adrenal insufficiency (AI) remains inadequate, resulting in high morbidity, premature mortality and quality-of-life (QoL) impairment. This study investigated the long-term safety of dual-release hydrocortisone (DR-HC) in patients with primary AI.Methods: AI patients who completed a randomized, 3-month crossover study of once-daily DR-HC versus thrice-daily conventional immediate-release hydrocortisone plus a 6...

Background: Neuropsychiatric symptoms and cognitive dysfunction are common in Cushing´s disease (CD), and seem only partly reversible after biochemical remission has been achieved.Aim: To investigate prescription of drugs associated with neuropsychiatric morbidity in a large national cohort of CD patients.Methods: Patients in the Swedish Pituitary Registry, diagnosed with CD between July 2006 and January 2018 were included, <e...

Introduction: Cushing’s syndrome is rare, but assessment of patients with clinical suspicion of Cushing’s and/or adrenal incidentaloma is frequently required. Thus, there is a need for biochemical screening methods that with high sensitivity and specificity identifies or rule out hypercortisolism. Analysis of late night salivary cortisol allows an easy sampling procedure performed at home and is independent of variations in plasma CBG levels. Analysis by liquid chrom...

Background & Objective: Late night salivary cortisol (LNSC) and 1 mg overnight dexamethasone suppression test (DST) are two of the three recommended screening tests for Cushing’s syndrome (CS). The classical DST uses serum cortisol, but analysis of salivary cortisol and cortisone has shown high diagnostic accuracy at DST (1). Salivary cortisol can be analysed with immunoassays, which suffer from variable degree of cross reactivity with other steroids, or with LC-MS/MS...

Background: Subtle symptoms such as fatigue, weight gain and depression are commonly present for years in patients with pituitary adenoma (PA) before the diagnosis is made. A delayed diagnosis with risk of increased morbidity and mortality may be due to differences between patient-reported symptoms and symptoms reported in the patient’s medical record.Aim: To estimate diagnostic delay and investigate the concordance between patient-reported symptoms...