Article
Endocrinology & Metabolism
Lucyna Papierska, Michal Rabijewski, Bartosz Migda, Dorota Leszczynska, Karolina Nowak, Agnieszka Lebek-Szatanska, Piotr Glinicki, Wojciech Zgliczynski
Summary: The study aimed to determine whether a single measurement of ACTH is sufficient to confirm or rule out secondary adrenal insufficiency in the short Metyrapone test. The results showed that the readily available plasma ACTH assay cannot replace the measurement of 11-deoxycortisol concentrations for evaluating the results of the Metyrapone test.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Hasan Husni, Mohammed S. Abusamaan, Roshan Dinparastisaleh, Lori Sokoll, Roberto Salvatori, Amir H. Hamrahian
Summary: This study aimed to evaluate the appropriate cortisol values during the standard dose CST in patients with normal HPA axis when using the Roche Elecsys (R) Cortisol II assay. The results showed that the lowest cortisol levels at 30 and 60 minutes after cosyntropin administration were lower than the previously recommended cutoff values, suggesting the importance of considering the timing of cortisol draw after cosyntropin administration.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Clinical Neurology
Lucinda M. Gruber, Sanjeev Nanda, Todd Nippoldt, Alice Chang, Irina Bancos
Summary: This retrospective study aimed to investigate if a subset of patients with fibromyalgia have secondary adrenal insufficiency (SAI) and growth hormone deficiency (GH). The results showed that some patients with fibromyalgia may have concurrent SAI and GH deficiency, and appropriate hormone replacement therapy may improve symptoms in some patients.
JOURNAL OF PAIN RESEARCH
(2021)
Article
Endocrinology & Metabolism
Li Zha, Jieli Li, Subhashree Mallika Krishnan, Michael R. Brennan, Yan Victoria Zhang, Patrick Povse, Rae Kerlin, Kevin Shively, Felicia Oleksik, JoAnna Williams, Elizabeth Sykes, Qian Sun
Summary: This study established the specific cutoffs for the level of cortisol in the Abbott Architect immunoassay by comparing it with other immunoassays. The results showed that the cortisol concentrations measured using the Abbott assay were similar to those measured using liquid chromatography-tandem mass spectrometry and the Roche Elecsys II assay but significantly lower than those measured using the Siemens assay. The recommended threshold for cortisol using the Abbott assay is 14.6 μg/dL at 60 minutes after ACTH stimulation.
ENDOCRINE PRACTICE
(2022)
Review
Biochemistry & Molecular Biology
Maria Francesca Birtolo, Simone Antonini, Andrea Saladino, Benedetta Zampetti, Elisabetta Lavezzi, Iacopo Chiodini, Gherardo Mazziotti, Andrea G. A. Lania, Renato Cozzi
Summary: Secondary Adrenal Insufficiency (SAI) is a condition characterized by low ACTH secretion due to hypothalamus or pituitary disease or injury. The evaluation of SAI is challenging due to non-specific symptoms, rarity, and pitfalls associated with laboratory tests. The gold standard test for assessing the HPA axis is the insulin tolerance test, but the ACTH stimulation test is safer and well-tolerated, although its diagnostic accuracy varies.
Article
Endocrinology & Metabolism
Subhasis Neogi, Pradip Mukhopadhyay, Niladri Sarkar, Pradip Kumar Datta, Madhurima Basu, Sujoy Ghosh
Summary: The study indicates a high prevalence of overt and subclinical adrenal dysfunction in patients with pulmonary tuberculosis, which is correlated with disease severity and duration, suggesting that an algorithm-based approach may have important clinical implications for diagnosis and management.
ENDOCRINE PRACTICE
(2021)
Article
Endocrinology & Metabolism
Zuleyha Karaca, Ashley Grossman, Fahrettin Kelestimur
Summary: The HPA axis is essential for maintaining normal physiological events and survival, with cortisol playing a key role. While a correct diagnosis of AI can often be made with basal cortisol levels, more complicated tests may be necessary for SAI cases. Numerous studies have been published on assessing the HPA axis, with detailed discussions and recommendations for diagnosing secondary AI or investigating suspected HPA axis insufficiency.
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS
(2021)
Article
Geriatrics & Gerontology
Nina P. Le, Ravi Varadhan, Linda P. Fried, Anne R. Cappola
Summary: Old-old women demonstrated a robust cortisol response to ACTH challenge testing, but inadequate negative feedback, resulting in prolonged exposure to cortisol. While DHEA levels did not differ significantly by frailty status, dose-response curves showed divergence after stimulation.
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
(2021)
Article
Endocrinology & Metabolism
Valentina Gasco, Chiara Bima, Alice Geranzani, Jacopo Giannelli, Lorenzo Marinelli, Chiara Bona, Valeria Cambria, Alessandro Maria Berton, Nunzia Prencipe, Ezio Ghigo, Mauro Maccario, Silvia Grottoli
Summary: This study identified a morning serum cortisol cutoff that best predicts the response to ITT in order to simplify the diagnostic process in patients with suspected CAI. A new diagnostic flow-chart for CAI is proposed based on the results.
NEUROENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Shamaila Zaman, Raya Almazrouei, Amir H. Sam, Aimee N. DiMarco, Jeannie F. Todd, Fausto F. Palazzo, Tricia Tan, Waljit S. Dhillo, Karim Meeran, Florian Wernig
Summary: A study showed that conducting synacthen stimulation testing following unilateral adrenalectomy may falsely diagnose some patients as adrenally insufficient, leading to unnecessary steroid prescriptions.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Ekkehard Werner Zollner, Carl J. Lombard, Annalise E. Zemlin
Summary: This study compared the performance of glucose stimulation test (GST) and overnight metyrapone test (ONMTPT) in diagnosing central adrenal insufficiency (CAI) in children. The results suggest that GST cannot replace ONMTPT as a diagnostic test for CAI.
JOURNAL OF PEDIATRIC ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Guy Yalovitsky, David Shaki, Eli Hershkovitz, Michael Friger, Alon Haim
Summary: This study evaluated the diagnostic capability of the glucagon stimulation test (GST) for detecting secondary adrenal insufficiency (AI) caused by pituitary hormone deficiency in children. The results showed that while GST is highly accurate and acceptable for diagnosing growth hormone (GH) deficiency, it is not an optimal tool for determining secondary AI. Clinicians should interpret the results of this test with caution.
CLINICAL ENDOCRINOLOGY
(2023)
Article
Medicine, General & Internal
Clio Musurakis, Solab Chitrakar, Ekta Shrestha, Randa Sharag Eldin, Mariam Charkviani, Gauri Pethe, Faisal Qureshi
Summary: This case report highlights the challenges in diagnosing adrenal insufficiency, emphasizing the importance of careful consideration in choosing the right diagnostic modalities.
AMERICAN JOURNAL OF CASE REPORTS
(2021)
Review
Endocrinology & Metabolism
Birgit Harbeck, Peter Kropp, Ilonka Kreitschmann-Andermahr
Summary: Patients with adrenal insufficiency (AI) receive glucocorticoid (GC) replacement therapy (GRT). However, temporary phases of hypo- and hypercortisolism are common, and prolonged phases of these can impair cognitive functioning. Little is known about the effects of dosage and duration of GC replacement therapy on cognitive functioning in AI patients. This Mini-Review provides an overview of current studies on GRT for AI and discusses their implications for clinical practice.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Keith B. Quencer, Abhilasha Singh, Anu Sharma
Summary: Primary hyperaldosteronism (PA) is the most common secondary form of hypertension in middle-aged adults. Treatment options depend on the extent of aldosterone secretion, with unilateral cases treated surgically and bilateral cases treated medically. Adrenal vein sampling (AVS) is crucial in determining the appropriate treatment approach, but there is variability in AVS techniques and guidelines regarding its use in young patients with unilateral adrenal findings on imaging.
AMERICAN JOURNAL OF ROENTGENOLOGY
(2023)
Article
Peripheral Vascular Disease
Mirko Parasiliti-Caprino, Barbara Lucatello, Chiara Lopez, Jacopo Burrello, Francesca Maletta, Marinella Mistrangelo, Enrica Migliore, Francesco Tassone, Antonio La Grotta, Anna Pia, Giuseppe Reimondo, Roberta Giordano, Giuseppe Giraudo, Alessandro Piovesan, Giovannino Ciccone, Desiree Deandreis, Paolo Limone, Fabio Orlandi, Giorgio Borretta, Marco Volante, Paolo Mulatero, Mauro Papotti, Gianluca Aimaretti, Massimo Terzolo, Mario Morino, Barbara Pasini, Franco Veglio, Ezio Ghigo, Emanuela Arvat, Mauro Maccario
HYPERTENSION RESEARCH
(2020)
Article
Oncology
Barbara Altieri, Silviu Sbiera, Sabine Herterich, Silvia De Francia, Silvia Della Casa, Anna Calabrese, Alfredo Pontecorvi, Marcus Quinkler, Tina Kienitz, Massimo Mannelli, Letizia Canu, Anna Angelousi, Vasileios Chortis, Matthias Kroiss, Massimo Terzolo, Martin Fassnacht, Cristina L. Ronchi
Article
Oncology
Marta Lagana, Salvatore Grisanti, Deborah Cosentini, Vittorio Domenico Ferrari, Barbara Lazzari, Roberta Ambrosini, Chiara Sardini, Alberto Dalla Volta, Carlotta Palumbo, Pietro Luigi Poliani, Massimo Terzolo, Sandra Sigala, Guido Alberto Massimo Tiberio, Alfredo Berruti
Article
Health Care Sciences & Services
Vittoria Basile, Soraya Puglisi, Barbara Altieri, Letizia Canu, Rossella Libe, Filippo Ceccato, Felix Beuschlein, Marcus Quinkler, Anna Calabrese, Paola Perotti, Paola Berchialla, Ulrich Dischinger, Felix Megerle, Eric Baudin, Isabelle Bourdeau, Andre Lacroix, Paola Loli, Alfredo Berruti, Darko Kastelan, Harm R. Haak, Martin Fassnacht, Massimo Terzolo
Summary: The study found that extending adjuvant mitotane treatment over two years did not show significant survival advantage in patients with ACC, and the relationship between treatment duration and the frequency of ACC recurrence was not linear.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Health Care Sciences & Services
Marco Volante, Ida Rapa, Jasna Metovic, Francesca Napoli, Cristian Tampieri, Eleonora Duregon, Massimo Terzolo, Mauro Papotti
Summary: This study identified dysregulation of 14 genes in adrenocortical carcinomas, with most being downregulated. However, three exceptions showed increased expression levels, including HAS-1, laminin alpha 3, and osteopontin genes, which could serve as potential diagnostic and prognostic biomarkers in adrenal cortical tumors.
JOURNAL OF PERSONALIZED MEDICINE
(2021)
Article
Biology
Sarah Allegra, Soraya Puglisi, Irene Brescia, Francesco Chiara, Vittoria Basile, Anna Calabrese, Giuseppe Reimondo, Silvia De Francia
Summary: Gender is an important factor in pharmacological management and treatment outcomes. Research on adrenocortical carcinoma patients shows that gender can predict mitotane concentrations and affect the achievement of therapeutic targets, with female sex potentially being a risk factor for treatment failure.
Article
Medicine, General & Internal
Alessandro Prete, Anuradhaa Subramanian, Irina Bancos, Vasileios Chortis, Stylianos Tsagarakis, Katharina Lang, Magdalena Macech, Danae A. Delivanis, Ivana D. Pupovac, Giuseppe Reimondo, Ljiljana Marina, Timo Deutschbein, Maria Balomenaki, Michael W. O'Reilly, Lorna C. Gilligan, Carl Jenkinson, Tomasz Bednarczuk, Catherine D. Zhang, Tina Dusek, Aristidis Diamantopoulos, Miriam Asia, Agnieszka Kondracka, Dingfeng Li, Jimmy R. Masjkur, Marcus Quinkler, Grethe A. Ueland, M. Conall Dennedy, Felix Beuschlein, Antoine Tabarin, Martin Fassnacht, Miomira Ivovic, Massimo Terzolo, Darko Kastelan, William F. Young, Konstantinos N. Manolopoulos, Urszula Ambroziak, Dimitra A. Vassiliadi, Angela E. Taylor, Alice J. Sitch, Krishnarajah Nirantharakumar, Wiebke Arlt
Summary: Patients with mild autonomous cortisol secretion (MACS), especially MACS-2 and CS, have a higher prevalence and severity of hypertension and type 2 diabetes. MACS predominantly affects women and regular assessment for cardiometabolic diseases is warranted.
ANNALS OF INTERNAL MEDICINE
(2022)
Article
Oncology
Letizia Canu, Soraya Puglisi, Paola Berchialla, Giuseppina De Filpo, Francesca Brignardello, Francesca Schiavi, Alfonso Massimiliano Ferrara, Stefania Zovato, Michaela Luconi, Anna Pia, Marialuisa Appetecchia, Emanuela Arvat, Claudio Letizia, Mauro Maccario, Mirko Parasiliti-Caprino, Barbara Altieri, Antongiulio Faggiano, Roberta Modica, Valentina Morelli, Maura Arosio, Uberta Verga, Micaela Pellegrino, Luigi Petramala, Antonio Concistre, Paola Razzore, Tonino Ercolino, Elena Rapizzi, Mario Maggi, Antonio Stigliano, Jacopo Burrello, Massimo Terzolo, Giuseppe Opocher, Massimo Mannelli, Giuseppe Reimondo
Summary: This study was the first to assess the risk of developing a second malignant tumor in PPGL patients, showing that they have a higher incidence of additional malignant tumors compared to the general population who had a first malignancy. The main tumors associated with second malignancies differed by gender, with an impact on surveillance strategy.
Review
Oncology
Marco Lo Iacono, Soraya Puglisi, Paola Perotti, Laura Saba, Jessica Petiti, Claudia Giachino, Giuseppe Reimondo, Massimo Terzolo
Summary: Mitotane is the only approved drug for the treatment of advanced adrenocortical carcinoma and is increasingly used for postoperative adjuvant therapy. It destroys the adrenal cortex, impairs steroidogenesis, and leads to cell death by deregulating cytochromes P450 enzymes, depolarizing mitochondrial membranes, and accumulating free cholesterol. The exact mechanism of mitotane's action is still unclear, and the variability in in vitro experimental conditions could impact the significance of identified molecular mechanisms.
Article
Biochemistry & Molecular Biology
Mirko Parasiliti-Caprino, Fabio Bioletto, Chiara Lopez, Martina Bollati, Francesca Maletta, Marina Caputo, Valentina Gasco, Antonio La Grotta, Paolo Limone, Giorgio Borretta, Marco Volante, Mauro Papotti, Anna Pia, Massimo Terzolo, Mario Morino, Barbara Pasini, Franco Veglio, Ezio Ghigo, Emanuela Arvat, Mauro Maccario
Summary: This study aimed to develop a simplified scoring system to help assess the recurrence risk of pheochromocytoma patients after surgery. Analysis of previous data revealed tumor size, genetic testing result, age, and PASS value as independent variables associated with recurrence.
Article
Biochemistry & Molecular Biology
Sarah Allegra, Soraya Puglisi, Chiara Borin, Francesco Chiara, Vittoria Basile, Anna Calabrese, Giuseppe Reimondo, Silvia De Francia
Summary: This study aimed to evaluate the effects of gender on lipoprotein and lipid levels during mitotane adjuvant treatment. The results suggest that gender and personalized approaches may be useful in preventing and managing alterations in the lipid profile.
Review
Endocrinology & Metabolism
Massimo Terzolo, Martin Fassnacht
Summary: Surgery remains the most important therapeutic option for non-metastatic ACC, with the surgeon's expertise being more important than surgical technique. For patients at low risk of recurrence, active surveillance can spare them from unnecessary adjuvant mitotane treatment, while those at moderate-to-high risk should ideally enroll in the ongoing ADIUVO2 trial. Prospective multicenter trials are needed for long-term improvement of patient care.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Martin Fassnacht, Stylianos Tsagarakis, Massimo Terzolo, Antoine Tabarin, Anju Sahdev, John Newell-Price, Iris Pelsma, Ljiljana Marina, Kerstin Lorenz, Irina Bancos, Wiebke Arlt, Olaf M. Dekkers
Summary: Adrenal incidentalomas are adrenal masses detected on imaging for non-suspected adrenal disease. A revision of the first international guidelines on incidentalomas has been provided, focusing on assessing risk of malignancy, managing mild autonomous cortisol secretion, deciding surgical treatment, and determining follow-up for nonoperated patients. Key recommendations include dedicated adrenal imaging for each adrenal mass, thorough clinical and endocrine work-up to exclude hormone excess, consideration of surgical treatment for patients with mild autonomous cortisol secretion and relevant comorbidities, and appropriate surgical intervention guided by risk of malignancy and hormone excess.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Aurora Schiavon, Laura Saba, Gianluca Catucci, Jessica Petiti, Soraya Puglisi, Chiara Borin, Giuseppe Reimondo, Gianfranco Gilardi, Claudia Giachino, Massimo Terzolo, Marco Lo Iacono
Summary: This study found that albumin can bind to mitotane and block its biological activity, leading to altered drug effects. This discovery may contribute to the individualized treatment of rare tumors with mitotane.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)