Endocrine Abstracts

Autonomous cortisol secretion (ACS), a term that refers to biochemical evidence of excess cortisol, but without the overt Cushing’s syndrome in people with adrenal adenomas. Prevalence of adrenal tumours is 5-10%. Up to 50% of benign adenomas present with some degree of cortisol excess. There is little guidance for investigating and managing these patients leading to different standards of care. Cortisol secretion here is in wide range although post dexamethasone suppress...

Background: Management of adrenal insufficiency (AI) with glucocorticoid replacement is associated with increased mortality and morbidity. There is growing evidence that this is because of excess, non-physiological steroid exposure. Low dose prednisolone (2-4 mg) is a once-daily alternative to standard hydrocortisone regimens that more closely mimics the circadian rhythm and may translate to better outcomes. There is however a paucity of studies comparing the two treatments.</...

Background /Methods: Adrenal incidentalomas pose a significant burden to endocrinology services in assessing the clinical significance of these lesions. Following vetting of the incidentaloma referrals, the patients at our centre are initially seen in a nurse-led clinic for biochemical investigations and to ensure completion of radiology assessment using a structured proforma. This step facilitates efficient patient flow and quicker decision making. The clinical outcomes of th...

Aim: This is a retrospective study of imaging with adrenal incidentalomas at our DGH to assess clinical practice. Their management was followed and compared with the European Society of Endocrinology (ESE) Clinical Practice Guidelines 2016 for management of adrenal incidentalomas. The aim was to improve clinical service by developing a local management pathway.Materials and Methods: Data was collected for two years from 2018 to 2019 which included all im...

Primary adrenal lymphoma is an extremely rare type of lymphoma. There have been only about 200 cases described in the literature so far. About a half of patients can present with adrenal insufficiency. We report a case of a 70- year-old previously fit and well patient referred to Endocrinology services after a CT scan of her adrenal showed bilateral adrenal masses right measuring 6 cm and left measuring 9 cm. CT was performed as she complained of 9 kilograms weight loss in las...

Functioning adrenal masses are often a diagnostic challenge and can present with unusual symptoms. We describe a case of a 37-year-old male with a background of ulcerative colitis, who presented with gynecomastia in the breast clinic. His serumbiochemistry showed persistently elevated Oestradiol and prolactin, with low testosterone and FSH. On physical examination, he had marked breast tenderness, bilateral gynecomastia and no signs of steroid excess. He reported a decline in ...

Familial glucocorticoid deficiency (FGD) is characterised by isolated glucocorticoid deficiency with retention of normal mineralocorticoid production. FGD causing mutations in the MC2R accessory protein, MRAP, often occur at the canonical donor splice-site of intron 3, presumed to result in skipping of the first coding exon with unknown consequences at the protein level. DNA from three patients (0 - 6 months) with high ACTH and/or low cortisol levels underwent whole e...

Background: SARS-CoV-2 targets membrane-bound angiotensin-converting enzyme 2 (ACE2) to achieve cellular entry. Resultant loss of ACE2 function may lead to unregulated activation of the renin-angiotensin-aldosterone system (RAAS), contributing to the pathogenesis of hypertension and triggering a proinflammatory cascade. However, evidence to support this is conflicting, with either no change or an increase in the concentration of circulating aldosterone reported in patients wit...

In neonates, cardiomyocytes exit the cell cycle thus establishing cardiomyocyte number for life. Further growth is through hypertrophy. Factors that advance the timing of the switch from hyperplastic to hypertrophic growth may increase risk of cardiac disease in adulthood. Early life administration of glucocorticoids is known to increase risk of cardiovascular disease. We hypothesized that dexamethasone, a synthetic glucocorticoid, causes precocious cell cycle exit of neonatal...

Background: The gonads are the major source of classic androgens during reproductive years. Additionally, the adrenal gland produces precursors for both classic and 11-oxygenated androgen biosynthesis, with androgen activation predominantly occurring in peripheral target tissues of androgen action. We used liquid chromatography-tandem mass spectrometry to profile classic and 11-oxygenated androgens in serum and saliva across the adult age range and assessed diurnal as well as ...