Endocrine Abstracts

Patients with adrenal insufficiency require increased hydrocortisone (HC) replacement doses during surgery, trauma and infection to avoid life-threatening adrenal crisis. However, currently administered HC doses are chosen empirically rather than on rational grounds, with huge variability in administration modes, total dose and dosing intervals. To conclusively determine serum cortisol levels observed under stress conditions, we firstly collected blood samples from healthy con...

Objective: Somatic mutations in the GNAS1 gene, which encodes the alpha-subunit of G stimulatory proteins (gsp), are frequently detected in somatotroph pituitary tumors and have been associated to specific clinical-smaller and less invasive tumors occurring in older patients- and histopathological-densely granulated adenomas- characteristics. However, the question whether the presence of a somatic gsp mutation affects the response to somatostatin analogue treatment remains unr...

Patients with adrenal insufficiency (AI) require adjustment of hydrocortisone (HC) dose to avoid life-threatening adrenal crisis during illness, surgery and trauma. However, current dose recommendations are based on empirical grounds only and choice of dose and administration modes vary considerably. We designed the PACS study to compare cortisol levels achieved by currently recommended HC stress doses to those in i) healthy controls (n=85, 21–70 years), ii) mili...

Introduction: The hypothalamo-pituitary adrenal axis has been extensively investigated in sepsis. Most studies concentrated in the acute phase and in most the high-dose ACTH stimulation test has been applied. Studies extending in the post-acute phase by using the more physiological low-dose ACTH stimulation are scarce.We aimed to investigate the time course of cortisol levels before and after stimulation with 1μg Synacthen in mechanically ventilated...

Glucocorticoid treatment in congenital adrenal hyperplasia (CAH) is a continuous challenge, with even the experienced clinician struggling to strike the right balance between glucocorticoid over- and undertreatment. There is no consensus on monitoring of glucocorticoid therapy in adults with CAH. Some recommend a serum 17-hydroxyprogesterone (17OHP) target range of 12–36 nmol/l prior to glucocorticoid morning dose. Here we investigated the value of serum and urinary stero...

Polycystic ovary syndrome (PCOS) affects 5–10% of the female population. It is characterised by androgen excess and anovulatory infertility; several studies have reported an increased incidence of the metabolic syndrome and enhanced 5α-reductase activity in PCOS. However, the contribution of obesity to these findings has yet to be clarified. Here we have analysed metabolic status and urinary steroid metabolite excretion in 114 patients with PCOS (median age 30 (range...

Background: An increasing number of mutations are associated with pheochromocytomas. Genetic screening is advocated in all cases and immunohistochemistry as well as phenotype profile recognition may permit a more targeted screening for specific genes.Case Presentation: A 54-year-old male presented with symptoms compatible with pheochromocytoma and increased levels of plasma normetanephrines, metanephrines and 3-methoxytyramine. On Computed Tomography, th...

Background: In patients with adrenal nodules increased 17-OH Progesterone (17-OHP) does not necessarily indicate congenital adrenal hyperplasia (CAH) since adrenocortical tumors may harbor defects in steroidogenesis resulting in high steroid precursors, either basally or, usually, after Synacthen stimulation. Secretion of precursors has been associated with malignancy but it can also be present in benign adenomas.Case Presentation: A 62-year-old lady wit...

Background: ACTH-dependent Cushing’s syndrome (CS) is mostly associated with corticotroph adenomas or, infrequently, ectopic ACTH secretion(EAS). Adrenals may show diffuse bilateral enlargement or even macronodules. Adrenal metastases may occur in various cancers. They are often bilateral, irregular, with attenuation values >20 Hounsfield units(HU) on unenhanced CT scan and elevated SUVmax on FDG-PET scan. They may cause adrenal insufficiency due to the destruction of...

Adrenal hormones possess both circadian and ultradian rhythms, making interpretation of single time point measurements difficult, particularly in the context of suspected endocrine disease. Attempting to capture either normal or pathological rhythms in detail by traditional measurement of blood is impractical and generally unfeasible. However, minimally invasive microdialysis sampling of free tissue hormones coupled with a portable fraction collector (U-RHYTHM), and a targeted...