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...

Background and Aim: Bilateral Macronodular Adrenal Hyperplasia (BMAH) is a rare form of adrenal Cushing’s syndrome (CS). The treatment of choice in patients with BMAH and overt CS is bilateral adrenalectomy (B-Adx), which however implies lifelong glucocorticoid and mineralocorticoid replacement therapy. Unilateral adrenalectomy (U-Adx) has been proposed as an alternative to B-Adx, especially in case of clearly asymmetric adrenal size. Our aim was to determine predictive f...

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...

Objectives: The insulin tolerance test (ITT) is considered the gold standard to evaluate corticotropic function in patients with suspected pituitary disease, but is limited by several contraindications. As an alternative, we evaluated the diagnostic value of basal cortisol in serum and saliva.Methods: volunteers (V) and 61 patients with suspected pituitary disease (P) were enrolled into this study. Basal serum and saliva samples were collected simultaneo...

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 ...

Context: Endogenous Cushing syndrome (CS) is associated with hematological abnormalities. Nevertheless, conflicting data have been reported on erythropoiesis. Some studies reported an association between CS and anemia in men, whereas others described erythrocytosis in affected patients. Furthermore, it is unclear whether there are CS subtype-specific changes in red blood cells (RBC) parameters.Objective: To investigate sex and subtype-specific changes in...