Angelica Sharma
Angelica Sharma
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Katharine Lazarus
Katharine Lazarus
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Deborah Papadopoulou
Deborah Papadopoulou
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Hemanth Prabhudev
Hemanth Prabhudev
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Tricia Tan
Tricia Tan
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Karim Meeran
Karim Meeran
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
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Sirazum Choudhury
Sirazum Choudhury
Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK
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mortality ( 2 ). Replacement with glucocorticoid therapy is the mainstay of treatment, with an objective to mimic the circadian cortisol profile ( 3 ). Current guidelines recommend the use of hydrocortisone in divided doses or low-dose (3–5 mg
Sandra R Dahl
Sandra R Dahl
Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
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Ingrid Nermoen
Ingrid Nermoen
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Division of Medicine, Akershus University Hospital, Lørenskog, Norway
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Division of Medicine, Akershus University Hospital, Lørenskog, Norway
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Ingeborg Brønstad
Ingeborg Brønstad
National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Eystein S Husebye
Eystein S Husebye
Department of Clinical Science, University of Bergen, Bergen, Norway
K.G. Jebsen-Center for Autoimmune Diseases, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway
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K.G. Jebsen-Center for Autoimmune Diseases, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Kristian Løvås
Kristian Løvås
Department of Clinical Science, University of Bergen, Bergen, Norway
K.G. Jebsen-Center for Autoimmune Diseases, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway
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K.G. Jebsen-Center for Autoimmune Diseases, University of Bergen, Bergen, Norway
Department of Medicine, Haukeland University Hospital, Bergen, Norway
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Per M Thorsby
Per M Thorsby
Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
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Introduction Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders with impaired biosynthesis of adrenal glucocorticosteroids and defects in cortisol biosynthesis. More than 95% of cases are caused by mutations in
Ali Abbara
Ali Abbara
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Sophie Clarke
Sophie Clarke
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
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Pei Chia Eng
Pei Chia Eng
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
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James Milburn
James Milburn
Imperial College Healthcare NHS Trust, London, UK
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Devavrata Joshi
Devavrata Joshi
Imperial College Healthcare NHS Trust, London, UK
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Alexander N Comninos
Alexander N Comninos
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
Imperial College Healthcare NHS Trust, London, UK
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Imperial College Healthcare NHS Trust, London, UK
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Rozana Ramli
Rozana Ramli
Imperial College Healthcare NHS Trust, London, UK
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Amrish Mehta
Amrish Mehta
Imperial College Healthcare NHS Trust, London, UK
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Brynmor Jones
Brynmor Jones
Imperial College Healthcare NHS Trust, London, UK
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Florian Wernig
Florian Wernig
Imperial College Healthcare NHS Trust, London, UK
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Ramesh Nair
Ramesh Nair
Imperial College Healthcare NHS Trust, London, UK
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Nigel Mendoza
Nigel Mendoza
Imperial College Healthcare NHS Trust, London, UK
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Amir H Sam
Amir H Sam
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
Imperial College Healthcare NHS Trust, London, UK
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Imperial College Healthcare NHS Trust, London, UK
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Emma Hatfield
Emma Hatfield
Imperial College Healthcare NHS Trust, London, UK
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Karim Meeran
Karim Meeran
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
Imperial College Healthcare NHS Trust, London, UK
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Imperial College Healthcare NHS Trust, London, UK
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Waljit S Dhillo
Waljit S Dhillo
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
Imperial College Healthcare NHS Trust, London, UK
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Imperial College Healthcare NHS Trust, London, UK
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Niamh M Martin
Niamh M Martin
Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
Imperial College Healthcare NHS Trust, London, UK
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Imperial College Healthcare NHS Trust, London, UK
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(persistent hiccup). One patient was hypotensive (systolic BP <90 mmHg; serum cortisol of 118 nmol/L and serum sodium of 115 nmol/L on admission). However, 11/30 were hypertensive at presentation (systolic BP >140 mmHg) ( Table 2 ). Symptoms consistent with
Peter Ergang
Peter Ergang
Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
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Anna Mikulecká
Anna Mikulecká
Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
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Martin Vodicˇka
Martin Vodicˇka
Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
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Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
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Karla Vagnerová
Karla Vagnerová
Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
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Ivan Mikšík
Ivan Mikšík
Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
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Jirˇí Pácha
Jirˇí Pácha
Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic
Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
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Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
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-hydroxysteroid dehydrogenase type 1 (11HSD1) and type 2 (11HSD2). 11HSD2 is an enzyme that catalyzes the oxidations of cortisol and corticosterone to the inactive cortisone and 11-dehydrocorticosterone, reducing the local glucocorticoid signals. In contrast, 11HSD1 converts
Paal Methlie
Paal Methlie
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Steinar Hustad
Steinar Hustad
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Ralf Kellman
Ralf Kellman
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Bjørg Almås
Bjørg Almås
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Martina M Erichsen
Martina M Erichsen
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Eystein S Husebye
Eystein S Husebye
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Kristian Løvås
Kristian Løvås
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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Department of Clinical Science, Department of Medicine, University of Bergen, N-5021 Bergen, Norway
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monitoring of prednisone and prednisolone has the potential to optimize treatment (11, 12) . Because of the widespread use of these glucocorticoids and impact on endogenous cortisol levels, information on serum levels may also be valuable in the setting of a
Gavin P Vinson
Gavin P Vinson
School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK
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Caroline H Brennan
Caroline H Brennan
School of Biological and Chemical Sciences, Queen Mary University of London, London E1 4NS, UK
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actually represent a drive to lower cortisol, with its sequelae? Or is the heightened secretion of corticosteroids in drug withdrawal simply a response to stress? We here argue that the adrenal cortex has a critical role in the acquisition of addiction and
Solène Castellnou
Solène Castellnou
Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France
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Université Lyon 1, Villeurbanne, France
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Alexandre Vasiljevic
Alexandre Vasiljevic
Université Lyon 1, Villeurbanne, France
Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Véronique Lapras
Véronique Lapras
Service de Radiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
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Véronique Raverot
Véronique Raverot
Laboratoire d’Hormonologie, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
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Eudeline Alix
Eudeline Alix
Département de Cytogénétique, Centre de Biologie et Pathologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
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Françoise Borson-Chazot
Françoise Borson-Chazot
Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France
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Université Lyon 1, Villeurbanne, France
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Emmanuel Jouanneau
Emmanuel Jouanneau
Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
Service de Neurochirurgie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
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INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
Service de Neurochirurgie, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
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Gérald Raverot
Gérald Raverot
Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Hélène Lasolle
Hélène Lasolle
Service d’Endocrinologie, Centre de Référence des Maladies Rares de l’Hypophyse HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Bron, France
Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Université Lyon 1, Villeurbanne, France
INSERM U1052, CNRS, UMR5286, Centre de Recherche en Cancérologie de Lyon, Lyon, France
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Introduction Cushing’s disease is a rare disorder defined as chronic hypercortisolism due to a corticotropin-secreting pituitary tumor (corticotroph tumor) ( 1 ). Chronic cortisol excess is responsible for multisystem morbidity, contributing
Lia Ferreira
Lia Ferreira
Department of Endocrinology, Centro Hospitalar do Porto, Porto, Portugal
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João Silva
João Silva
Department of Endocrinology, Hospital das Forças Armadas, Lisboa, Portugal
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Susana Garrido
Susana Garrido
Department of Endocrinology, Centro Hospitalar Tâmega e Sousa, Porto, Portugal
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Carlos Bello
Carlos Bello
Department of Endocrinology, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
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Diana Oliveira
Diana Oliveira
Department of Endocrinology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Hélder Simões
Hélder Simões
Department of Endocrinology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal
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Isabel Paiva
Isabel Paiva
Department of Endocrinology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Joana Guimarães
Joana Guimarães
Department of Endocrinology, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
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Marta Ferreira
Marta Ferreira
Department of Endocrinology, Centro Hospitalar de Leiria, Leiria, Portugal
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Teresa Pereira
Teresa Pereira
Department of Endocrinology, Centro Hospitalar de Leiria, Leiria, Portugal
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Rita Bettencourt-Silva
Rita Bettencourt-Silva
Department of Endocrinology, Centro Hospitalar de São João, Porto, Portugal
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Ana Filipa Martins
Ana Filipa Martins
Department of Endocrinology, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
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Tiago Silva
Tiago Silva
Department of Endocrinology, Hospital Garcia da Orta, Lisboa, Portugal
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Vera Fernandes
Vera Fernandes
Department of Endocrinology, Hospital de Braga, Braga, Portugal
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Maria Lopes Pereira
Maria Lopes Pereira
Department of Endocrinology, Hospital de Braga, Braga, Portugal
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Adrenal Tumors Study Group of the Portuguese Society of Endocrinology
Adrenal Tumors Study Group of the Portuguese Society of Endocrinology
Department of Endocrinology, Centro Hospitalar do Porto, Porto, Portugal
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endocrinology residents from the 12 Portuguese centres. AD was diagnosed based on one of the following criteria: (1) a plasma adrenocorticotropic hormone (ACTH) concentration exceeding 66 pmol/L in combination with a low serum cortisol (<5 µg/dL); (2) an
Nikolaj Rittig
Nikolaj Rittig
Department of Internal Medicine and Endocrinology (MEA) and Medical Research Laboratory, Aarhus University Hospital, Aarhus C, Denmark
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Mads Svart
Mads Svart
Department of Internal Medicine and Endocrinology (MEA) and Medical Research Laboratory, Aarhus University Hospital, Aarhus C, Denmark
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Niels Jessen
Niels Jessen
Research Laboratory for Biochemical Pathology, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus C, Denmark
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Niels Møller
Niels Møller
Department of Internal Medicine and Endocrinology (MEA) and Medical Research Laboratory, Aarhus University Hospital, Aarhus C, Denmark
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Holger J Møller
Holger J Møller
Department of Clinical Biochemistry Aarhus University Hospital, Aarhus C, Denmark
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Henning Grønbæk
Henning Grønbæk
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark
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analysis Blood samples were stored at −20°C and analysed in the same assay after all participants had completed all trials. Serum concentrations of cortisol (ELISA, DRG Cortisol Enzyme Immunoassay Kit, Germany), glucagon (EMD Millipore’s Glucagon
Thabiso R P Mofokeng
Thabiso R P Mofokeng
Department of Medicine, University of the Free State, Bloemfontein, South Africa
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Salem A Beshyah
Salem A Beshyah
Department of Medicine, Dubai Medical College, Duabi, United Arab Emirates
Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
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Department of Endocrinology, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
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Fazleh Mahomed
Fazleh Mahomed
Department of Medicine, University of the Free State, Bloemfontein, South Africa
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Kwazi C Z Ndlovu
Kwazi C Z Ndlovu
Department of Medicine, University of the Free State, Bloemfontein, South Africa
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Ian L Ross
Ian L Ross
Division of Endocrinology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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in addition to serum sodium and serum potassium only, clinical features and serum sodium and/or serum potassium in addition to relevant antibodies, or clinical features in addition to low serum cortisol with synthetic ACTH (tetracosactide) stimulation
