Endocrine Abstracts

Introduction: Androgens are known to play an important role in renal tubular epithelial cell growth, hypertrophy and erythropoetin production, however the exact mechanisms are not clear yet. 5α-dihydrotestosterone is synthesized primarily in gonads and skin, and is the most used androgen in studies. However, little is known about testosterone effects in non-gonadal tissues.Methods: Male Wistar rats aged 8–10 weeks were orchiectomized and put on...

Objective: Patients from FRG and West-Berlin with primary (1AI) or secondary (2AI) adrenal insufficiency were treated with hydrocortisone (HC) while in contrast patients from the former GDR received prednisolone (PR). Investigation of our study is to detect any differences in quality of life (QoL) in patients on HC or PR medication.Methods: 350 patients of our outpatient clinic were contacted by mail. Up to now 131 patients took part in the survey. 2 sta...

Background: Mitotane is regularly used in patients with adrenocortical carcinoma (ACC) adjuvantly, in patients with high risk of recurrence, and in advanced disease. Multiple effects of mitotane result in adrenal insufficiency in virtually all patients. However, it is unclear how frequently the hypothalamic-pituitary-adrenal (HPA) axis is recovering after treatment discontinuation. Here, we aim to investigate the HPA axis after treatment with mitotane.Me...

Background: Potentially fatal adrenal crises (AC) still occur in educated patients with adrenal insufficiency (AI). Identifying predisposing factors is necessary for prevention in this patient population.Objectives: Investigating clinical and biochemical fingerprints of increased susceptibility to AC.Material and methods: Our study population included 260 patients with chronic AI, classified as high and low risk according to the fr...

Introduction: The daily maintenance dose of conventional hydrocortisone currently recommended by international guidelines for the management of primary adrenal insufficiency (PAI) or secondary adrenal insufficiency (SAI) is 15−25 mg/day, in 2−3 divided doses. The aim of this analysis was to investigate inter-country differences in glucocorticoid replacement doses in patients with PAI and SAI.Design: EU-AIR (ClinicalTrials.gov identifier: NCT0...

Introduction: If untreated, adrenal insufficiency (AI) leads to premature death. Hospital record data suggest mortality associated with primary (PAI) and secondary AI (SAI) to be 2–3-fold higher than in the general population. Major causes of death include cardiovascular disease, Addisonian crises, brain tumours and infections; however, there is little further characterization of patients who died.Design: We analysed real-world data from the Europea...

Introduction: Adrenal crises (ACs) are life-threatening events in patients with primary (PAI) or secondary (SAI) adrenal insufficiency, occurring ~4–10 times per 100 patient-years. Major causes of ACs are infections, especially gastroenteritis and tonsillitis/laryngitis. Risk factors for ACs remain ill defined, but could include concomitant endocrine diseases (diabetes mellitus, premature ovarian failure) in PAI, diabetes insipidus in SAI, and concomitant non-endocrine di...

Volume 82, Issue 1, January 2015, Pages 2–11. DOI: 10.1111/cen.12603...

Introduction: Prednisolone is the standard treatment for most inflammatory conditions. However, it is also used in hormone replacement therapy in adrenal insufficiency (AI) for historical reasons or due to its longer half-life and once-daily application. Recent data indicate that daily prednisolone could be associated with lower bone mineral density than daily hydrocortisone in patients with AI. However, data on risk factors for cardiovascular disease in patients with AI treat...

Introduction: Prednisolone is the standard treatment for most inflammatory conditions. However, it is also used in hormone replacement therapy in adrenal insufficiency (AI) due to historical reasons or due to its longer half-life and once daily application. Recent data showed that 5 mg daily prednisolone promotes loss in bone mineral density compared to 20 mg of hydrocortisone in patients with AI questioning the 4:1 conversion rate. Data is scarce on prednisolone treated AI pa...