Endocrine Abstracts

Background: Nonclassic congenital adrenal hyperplasia (NCAH) is a condition associated with adrenal masses and suggested by current European guidelines to be considered in case of bilateral adrenal lesions. NCAH is caused by different mutations in the CYP21A2 gene coding for the 21-hydoxylase enzyme in the glucocorticoid synthesis leading to mild cortisol deficiency and elevated androgen and steroid precursor levels. 17-hydroxyprogesterone (17OHP) is the most importan...

Background: Resource-saving and medically safe investigations of adrenal incidentaloma (AI) is one of the challenges in modern endocrinology. The absolutely majority of AIs are benign and hormonally inactive. Mild hypercortisolemia is the most common finding in hormonally active AI and is often referred to as subclinical Cushing syndrome (SCS). SCS is associated with increased risk of type 2 diabetes, poorly regulated hypertension, osteoporosis and cardiovascular disease. Ther...

Background: Adrenal incidentalomas (AI) are common and reported at frequencies of 2-10% at CT-scans of the abdomen. It is established that the number of diagnosed and investigated cases of AI have increased over the last decades. This increase is closely related to the development of modern radiology. General access of CT scanners with higher performance have led to an improved capacity and consequently more performed investigations. Other contributing factors are improved ima...

Objective: Mortality in autoimmune Addison’s disease (AAD) is increased twofold compared to matched populations. Cardiovascular disease (CVD) is the most common cause of death, but little is known of cardiovascular morbidity. Inadequate glucocorticoid replacement has been implicated in the increased risk of CVD, but evidence is lacking. The objective of this study was to examine cardiovascular morbidity and mortality in AAD, and to investigate the effects of glucocorticoi...

A systematic survey of low S-cortisol levels at the department of clinical chemistry: indications for testing and frequency of undiagnosed adrenal insufficiency.Background: S-cortisol is frequently analyzed at clinical chemistry departments. Low levels of S-cortisol needs to be promptly acted on if the cause is undiagnosed adrenal insufficiency (AI). The causes of S-cortisol testing are however multiple and low levels are necessarily not alarming if foun...

Objective: Several autoimmune disorders are known to be associated with an increased risk of psychiatric morbidity. Yet, the effect of autoimmune Addison’s disease (AAD) on mental health is not well known. The aim of this study was to examine the use of psychotropic drugs around diagnosis in Swedish individuals with AAD.Design and methods: In this population-based cohort study, The Swedish national patient register, and the Swedish Addison register ...

Background: Both cortisol and other adrenal hormones are well known to affect brain structure and function throughout development. Due to destruction of the adrenal cortex, patients with Autoimmune Addison’s disease (AAD) lack production of adrenal hormones and therefore receive lifelong replacement of cortisol and aldosterone, and, for some female patients dehydroepiandrosterone (DHEA). However, replicating the natural rhythm of secretion is difficult, and patients are o...

Introduction: Generously supported by IPSEN)-->Pituitary infarction is rare in the paediatric age. In adolescents and adults it is often secondary to haemorrhage into an underlying lesion such as pituitary adenoma or cyst. Lymphocytic hypophysitis is rare in children and usually peri-tumoral due to germinoma, craniopharyngioma or Rathke’s cyst and often associated with hypopituitarism and diabetes insipidus.<p class="abstext...

Background: Immune responses to self-peptides should not generally occur. However, four of 12 autoimmune Addison’s disease (AAD) patients developed adverse reactions immediately after synacthen injections, following repeated subcutaneous synacthen injections during a clinical trial (RoSA study). We wondered if these adverse effects were due to the production of anti-synacthen (ACTH1–24) antibodies.Methods: We evaluated the presence o...

Objective: The origin of idiopathic isolated secondary adrenal insufficiency (IISAI) is uncertain, however autoimmunity seems to be the most probable cause. Within last eight years the initial number of about 100 such cases, increased in our registry by 250%. We searched for features of autoimmune diseases in our group of patients to prove autoimmune etiology in a majority of these patients.Materials and methods: The material consisted of 260 patients wi...