Endocrine Abstracts

Background: Although surgery is considered the first-line treatment for patients with endogenous Cushing’s syndrome (CS), medical therapy is often required to control severe hypercortisolism. Metyrapone and osilodrostat are inhibitors of 11β-hydroxylase that have not been directly compared yet.Methods: Retrospective analysis of patients with adrenocorticotropin (ACTH)-dependent and ACTH-independent CS treated with metyrapone or osilodrostat (as...

Introduction: Measurements of plasma metanephrines (META) and normetanephrines (NOR) have been advocated as first-line tests for the diagnosis of pheochromocytoma. This study assessed the impact of several potential confounders, which may influence the correct diagnosis.Methods: Eight healthy males (age 26.8±1.7; BMI 23.1±0.8) were tested on 6 separate days. Tests were performed in supine rest with blood sampling via i.v. canullas at 0900 h fol...

Introduction: Optimizing glucocorticoid (GC) therapy in patients with congenital adrenal hyperplasia (CAH) remains a challenge. While overdosing may result in Cushing’s syndrome, underdosing is associated with female virilization and adrenal insufficiency. This study evaluated day-profiling of salivary 17-hydroxyprogesterone (17OHP) for the biochemical control of adolescents with CAH due to 21-hydroxylase deficiency.Methods: Twelve patients (4 males...

Background: Adult GH deficiency (GHD) is diagnosed by provocative testing of GH secretion. To improve diagnostic accuracy of GHRH plus arginine (GARG) testing, we evaluated the influence of age, BMI, and sex. Furthermore, we aimed to established normative data for an automatic immunoassay specifically measuring 22kD human GH.Methods: Eighty-seven patients with hypothalamic-pituitary disease and 200 healthy controls were enrolled. Controls were prospectiv...

Introduction: Measurement of urinary cortisol is often used to assess disease activity in patients with suspected or proven hypercortisolism. However, specific reference ranges are lacking for some of the newer assays. This study analyzed upper limits of normal (ULN, mean+2S.D.) for two analytical procedures (GC–MS, ECLIA) in relation to various independent variables. Besides, the influence of different storage conditions was investigated (by ECLIA).<p ...

Introduction: Treatment of poorly differentiated neuroendocrine tumors (NET) usually includes chemotherapeutic intervention. However, both the rarity and the heterogeneity of the disease have led to relatively few clinical trials. This study evaluated the outcome of two chemotherapy regimens in patients suffering from undifferentiated and histologically confirmed NET.Methods: Eighteen patients (11 males; age 56.7±2.5) with proven progressive disease...

Objective: Glucocorticoid excess impairs immune function, thereby predisposing patients with endogenous Cushing’s syndrome (CS) to infections. However, it is still not clear whether there is a CS-subtype specific pattern in white blood cell (WBC) and WBC differential (WBCD) count.Methods: Retrospective monocentric cohort study in patients with either overt endogenous CS or adrenal adenomas with autonomous cortisol secretion (ACS), with WBC and WBCD ...

Introduction and Objective: Adult craniopharyngioma as a rare neoplasm of the central nervous system is still very poorly understood. The clinical implications for affected patients are numerous, ranging from endocrine dysfunction to visual loss and neurological impairment. Although the progress of this tumor entity is slow by nature, affected patients often suffer from multiple symptoms even after successful treatment with a strong impact on their individual quality of life. ...

Objective: The saline infusion test (SIT) is a standard confirmatory test for primary aldosteronism (PA) and based on impaired aldosterone suppression in PA compared to essential hypertension (EH). In the past, aldosterone was quantified using immunoassays (IA). Due to the more widespread use of liquid chromatography tandem mass spectrometry (LC-MS/MS) in clinical routine, we aimed at a method-specific aldosterone threshold for the diagnosis of PA during SIT and explored the d...

Background: The diagnosis of hyperaldosteronism is hindered by the absence of a well-defined gold-standard. CYP11B2 (aldosterone synthase) belongs to the steroid-metabolizing enzymes catalyzing the last step of the aldosterone synthesis. To establish a molecular marker for aldosterone-producing adenomas, we compared the expression in various adrenal tumors.Methods: Tissue from 20 aldosterone-producing adenomas (APA), 12 hyperplasias associated with hyper...