Endocrine Abstracts

BackgroundCushing’s syndrome (CS) occurs due to cortisol overproduction. Endogenous hypercortisolemia can be secondary to Adrenocorticotropic hormone (ACTH) dependent as well as independent causes (1). Early identification and prompt definitive management is crucial to minimize mortality. Successful management of CS becomes extremely challenging due to multiple associated complications, especially the thrombotic events which are even more prominent ...

Retinoic acid, a major modulator of adrenal development and differentiation, has also been shown to inhibit ACTH secretion by tumoral corticotropes. Recent clinical trials in patients with Cushing’s disease revealed that retinoic acid exerts beneficial effects in these patients (1, 2). Of note, the decrease in cortisol secretion during retinoic acid administration was more pronounced than the change in ACTH levels (1) suggesting a direct action at adrenal level. Aim of th...

IntroductionAdequate supply of zinc, selenium, and vitamin D is essential for resistance to other viral infections, immune function, and reduced inflammation. Low levels of micronutrients are associated with adverse clinical outcomes during viral infections. Vitamin D improves the physical barrier against the virus and stimulates the production of antimicrobial peptides. It can prevent cytokine storms by reducing the production of inflammatory cytokines....

A 28-year-old woman presents with a one-year history of marked weight gain of 18 kg, increasing hirsutism and night sweats. Clinically, hyperandrogenism and Cushing’s syndrome were suspected. A diagnosis of Polycystic ovarian syndrome was made based on Rotterdam criteria and Metformin was initiated. Initial testing for Cushing’s syndrome demonstrated a high 24 h urinary free cortisol (306 nmol/l) with incomplete cortisol suppression on an overnight dexamethaso...

The impact of novel coronavirus (COVID-19) infection in adult patients with endocrine diseases is well established, with the evidence showing a link between endocrine pathology and disease severity (A. Badawi, S.G. Ryoo, 2016, J. Yang et al, 2020, S. Cianfarani, A. Brancatella, 2020). The thyroid gland and the virus infection with its associated inflammatory-immune responses are known to be engaged in complex interplay (L. Scappaticcio, et al, 2...

Introduction: The syndrome of apparent mineralocorticoid excess (AME), a genetic disorder, resembles findings similar to those in primary aldosteronism, but aldosterone levels are low. AME is due to deficiency in the 11-beta-hydroxysteroid-dehydrogenase-enzyme-type-2 isoform (11-beta-HSD2), which normally converts cortisol to cortisone to prevent its mineralocorticoid activity at the aldosterone-sensitive sites. The deficiency in 11-beta-HSD2 leads to marked elevation in net m...

BackgroundSuspicion of Cushing´s syndrome (CS) is usually suggested by non-specific clinical data. Chronic hypercortisolism associates changes in white blood cell count (WBC), essentially a higher count with relative lymphopenia. Our purpose is to investigate the prevalence of these findings among a local series of patients with Cushing’s syndrome before and after the hypercortisolism revertion to assess the diagnostic value of these parameters...

IntroductionHashimoto’s thyroiditis (HT) has been linked to papillary carcinoma of the thyroid, Hurthle cell cancer or even lymphoma. In contrast, there are only a few reports of co-existence of HT with medullary thyroid carcinoma. The link between them is unknown. An overall prevalence of medullary carcinoma of only 0.35% has been reported in HT patients. This prevalence is higher in female rather than male. We present the case of a female patient ...

This case shows the potential unreliability of a single ACTH assay in the context of Cushing’s syndrome and need for better ways of measuring ACTH and precursors. A 35 year-old lady presented with severe abdominal pain and cushingoid features. CT scan showed a 2.9 cm right adrenal nodule. Investigations: 24-hour UFC 446 nmol/l, post-dexamethasone cortisol level of 572 nmol/l. The referring hospital found a suppressed ACTH < 0.1ng/l consistent with ACTH-independent Cus...

A 33-year-old woman with type 1 diabetes and autoimmune Addison’s disease conceived in September 2021 following careful preconception counselling. The patient had a history of recurrent, severe hypoglycaemia requiring intensive care admission and had previously received two allogenic islet cell transplants (January 2020 and November 2020). The patient had no severe hypoglycaemia following transplantation, although she continued to experience overnight hypoglycaemia, while...