Endocrine Abstracts

Background and aim: Aldosterone-to-Renin Ratio (ARR) is recommended as initial test to screen for Primary Aldosteronism (PA), especially in high-risk hypertensive population. Endocrine Society (ES) Guidelines recommend that patients with an increased ARR should undergo one or more confirmatory tests in order to confirm or exclude PA diagnosis. Captopril Challenge Test (CCT) and Saline Infusion Test (SIT) are commonly used in routine clinical practice. The aim of our study was ...

Introduction: Since DI was reported to be associated to increase mortality, the aim of this study is to evaluate the presence of autonomic dysfunction (AD) in patients with DI.Methods: We enrolled 12 patients (six females) with central idiopathic DI and 12 controls, matched for age, sex and common cardiovascular risk factors, who were evaluated using the tilt, lying-to-standing, hand grip, deep breath, Valsalva maneuver and Stroop tests.<p class="abs...

Introduction: Urinary free cortisol (UFC) determination has suboptimal sensitivity (SE) and specificity (SP) especially in mild Cushing’s syndrome (CS).Aim: To determine the performance of UFC and its metabolite cortisone (UFE) measured using accurate assays such as HPLC and LC–MS/MS in diagnosing patients with CS.Patients and methods: Sixty-seven patients with CS were compared to 49 sex- and age-matched non-CS. UFF and U...

Introduction: The diagnosis of Cushing’s syndrome (CS) might be challenging especially in ACTH-dependent CS when it comes to detect the origin of ACTH secretion.Materials and methods: We retrospectively recorded data about 170 patients with ACTH-dependent CS (149 CD, 21 EAS) referring to two Endocrinology Units. We focused especially on the performance of 3 dynamic tests: the dexamethasone 8 mg overnight challenging (HDDST), the CRH and the desmopre...

Introduction: Pasireotide is a multireceptor-targeted somatostatin analogue effective in the treatment of patients with Cushing’s disease (CD) but associated with an increased risk of hyperglycaemia. We prospectively investigate the role of an acute pasireotide suppression test (PST) in predicting long-term response in CD.Methods: Eleven patients with CD (seven females, four males; mean age 45±17.3 years) received at 0900 h a single s.c. inject...

Context: Late-night salivary cortisol (LNSC) measurement has been promoted as an ideal screening test for the diagnosis of Cushing’s syndrome (CS). However, its performance using commercially available assays has not been widely evaluated and limited data are available on its use in population with chronic medical conditions.Aim: To compare the diagnostic performance of LNSC (routine use) in patients with CS and in a patients’s group with diffe...

Introduction: Pasireotide is a promising treatment option for patients with Cushing’s disease (CD). The measurement of salivary cortisol is useful for diagnosing hypercortisolism and monitoring patients with CD following pituitary surgery. It may also be a better index of cortisol secretion than serum cortisol or urinary free cortisol (UFC). We investigated the value of salivary cortisol in monitoring short-term efficacy of pasireotide in patients with CD.<p class="ab...

The management of Cushing’s disease (CD) can be problematic, particularly when the disease persists following pituitary surgery. Here we report the case of a 55-year old woman with CD that persisted after repeat transsphenoidal surgery. The patient had an overt phenotype with facial rubeosis, central obesity with supraclavicular fat accumulation, cervical fat pad and proximal muscle weakness. She had received anti-hypertensive drugs and insulin for diabetes mellitus. Horm...

Context: The desmopressin (DDAVP) test has been proposed to discriminate Cushing’s disease (CD) from Pseudo-Cushing states (PC); however, current information on its value is scarce and contradictory.Objective: To assess the ability of the DDAVP test in distinguishing between these conditions, with emphasis on subjects with mild hypercortisolism.Design: Retrospective/prospective study.Setting: Division of...

Introduction: Pasireotide reduced UFC levels in 22 of 29 patients with Cushing’s disease after 15 days’ treatment (Boscaro et al. JCEM 2009). Of these 22 patients, 5 achieved normalized UFC (UFC-responders) and 17 had reduced but not normalized UFC (UFC-reducers). Results of an extension phase to this study are presented.Methods: Patients with de novo or persistent/recurrent Cushing’s disease received pasireotide 600 μg ...