Endocrine Abstracts

Introduction: Aggressive ACTH-independent Cushing’s syndrome is rare and frequently related to malignant adrenocortical tumor. However, in exceptional situations, ectopic steroids secretion has been described.Case report: We report the case of an 87 years-old woman referred to our clinic in September 2020 after a low trauma sacral fracture. Her recent medical history revealed the onset, in the previous months, of severe hypokalemia, uncontrolled typ...

Introduction Primary bilateral macronodular adrenal hyperplasia (PBMAH) is potentially responsible for variable degree of cortisol excess. In patients with PBMAH the complete remission of cortisol hypersecretion can be achieved only by performing bilateral adrenalectomy, leading to a persistent hypocortisolism and to a consequent need of a lifelong glucocorticoid replacement therapy. Therefore, bilateral adrenalectomy is worth doing only in patients with severe hypercortisolis...

Introduction: Primary aldosteronism (PA) has been described in association with endocrine and non-endocrine neoplasms. Aldosterone-producing adenomas mainly associate with hyperparathyroidism, prolactinomas and pancreatic endocrine tumors, particularly in the context of multiple endocrine neoplasia type 1 MEN1 syndrome. Next-generation sequencing (NGS) studies have shown frequent somatic mutations underlying PA and, rarely, germline mutations of CYP11B1/CYP11B2</e...

Background: The Endocrine Society Guidelines recommend screening for hypercortisolism especially in patients with specific features that best discriminate Cushing’s Syndrome (CS): easy bruising, facial plethora, proximal myopathy and striae. Clinical experience suggests that these features, though suggestive of hypercortisolism, are not enough sensitive. Indeed, patients with hypercortisolism frequently manifest primarily less discriminatory cortisol-related features, suc...

Primary pigmented nodular adrenocortical disease (PPNAD) is a rare form of ACTH-independent Cushing’s syndrome (CS). Approximately 30% of patients with PPNAD are sporadic cases and the other are familial. We describe a case of a patient affected by PPNAD presenting with isolated arterial hypertension. A 19-year-old black female patient was referred to the Endocrinology Unit in september-2021 due to severe arterial hypertension and fatigue. Previous clinical history was un...

The nuclear Farnesoid X receptor (FXR) and the G protein-coupled bile acid receptor 1 (TGR5) are bile acids receptors that play a key role in energy metabolism. In an animal model of non-genomic metabolic syndrome (MetS), obtained with a high fat diet (HFD), treatment with the dual FXR/TGR5 agonist INT767 reduced visceral adipose tissue (VAT) accumulation, insulin resistance, hypercholesterolemia and nonalcoholic steatohepatitis (NASH). In liver, INT767 reduced the high macrop...

Introduction: The classical replacement therapy for hypoadrenalism may expose patients to non-physiologic glucocorticoids levels with negative metabolic consequences. Up to now, one study demonstrated that, as compared to the classical treatment, a modified-release hydrocortisone (MRH), improves weight, blood pressure, glycaemic control and QoL in a 3-month follow-up period. Few data are available on the long-term persistence of these benefits.Design/met...

Introduction: In subjects with erectile dysfunction (ED) responding poorly to sildenafil, metformin was reported to improve erections.Aims: To investigate metformin’s mechanism of action on erectile function, particularly focusing on adenosine (ADO), and NO signalling in an animal model of high fat diet (HFD)-induced metabolic syndrome (MetS).Methods: In vitro contractility studies of penile strips. Penile expression ...

Introduction: For defining SH in AI patients at least 2 altered criteria among serum cortisol after 1 mg dexamethasone test (1 mgDST), ACTH levels, 24 h urinary free cortisol (UFC) and midnight serum cortisol levels are generally required. Midnight salivary cortisol (MSC), a sensitive and easy-to-perform marker of overt hypercortisolism, appears to be of limited utility in these patients. Data on the role of salivary cortisol using LC-MS/MS, the gold standard procedure for ste...

Introduction: Subclinical hypercortisolism (SH), affecting about 30% of patients with unilateral adrenal incidentaloma (UAI), has been associated to hypertension (HT), type 2 diabetes mellitus (T2DM), dyslipidemia (DL), osteoporosis and vertebral fractures (FX). The prevalence of SH in patients with bilateral adrenal incidentaloma (BAI) seems to be even higher. Data on metabolic and bone complications in these patients are lacking.Methods/design: We enro...