Carla Scaroni
Carla Scaroni
Dipartimento di Medicina, U.O.C. Endocrinologia, Università di Padova, Padova, Italy
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Nora M Albiger
Nora M Albiger
Dipartimento di Medicina, U.O.C. Endocrinologia, Università di Padova, Padova, Italy
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Serena Palmieri
Serena Palmieri
Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Davide Iacuaniello
Davide Iacuaniello
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
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Chiara Graziadio
Chiara Graziadio
Department of Experimental Medicine, University La Sapienza, Rome, Italy
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Luca Damiani
Luca Damiani
Department of Medical Sciences, Endocrinology and Internal Medicine Section, University of Ferrara, Ferrara, Italy
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Marialuisa Zilio
Marialuisa Zilio
Dipartimento di Medicina, U.O.C. Endocrinologia, Università di Padova, Padova, Italy
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Antonio Stigliano
Antonio Stigliano
Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, University La Sapienza, Rome, Italy
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Annamaria Colao
Annamaria Colao
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
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Rosario Pivonello
Rosario Pivonello
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Napoli, Italy
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the Altogether to Beat Cushing’s Syndrome (ABC) study group
the Altogether to Beat Cushing’s Syndrome (ABC) study group
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ACS, adrenal Cushing’s syndrome; CD, Cushing’s disease; CS, Cushing’s syndrome; CS-E, Cushing’s syndrome excluded; CT, controls; Dexa, dexamethasone; Dexa-CRH test, dexamethasone-suppressed corticotropin-releasing hormone test; EAS, ectopic ACTH
Jingya Zhou
Jingya Zhou
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Meng Zhang
Meng Zhang
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Lin Lu
Lin Lu
Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Key Laboratory of Endocrinology of National Health Commission of People’s Republic of China, Beijing, China
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Key Laboratory of Endocrinology of National Health Commission of People’s Republic of China, Beijing, China
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Xiaopeng Guo
Xiaopeng Guo
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Lu Gao
Lu Gao
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Weigang Yan
Weigang Yan
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Haiyu Pang
Haiyu Pang
Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yi Wang
Yi Wang
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Collaborating Center for the WHO Family of International Classifications in China, Beijing, China
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Bing Xing
Bing Xing
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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China Pituitary Disease Registry Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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(ACTH)-dependent and ACTH-independent etiologies. The former includes Cushing’s disease (CD) and ectopic ACTH syndrome (EAS), and the latter includes adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), primary bilateral macronodular adrenal
Adrian F Daly
Adrian F Daly
Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
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David A Cano
David A Cano
Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Eva Venegas-Moreno
Eva Venegas-Moreno
Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Patrick Petrossians
Patrick Petrossians
Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
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Elena Dios
Elena Dios
Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Emilie Castermans
Emilie Castermans
Department of Human Genetics, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
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Alvaro Flores-Martínez
Alvaro Flores-Martínez
Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Vincent Bours
Vincent Bours
Department of Human Genetics, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
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Albert Beckers
Albert Beckers
Department of Endocrinology, Centre Hospitalier Universitaire de Liège, Liège Université, Liège, Belgium
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Alfonso Soto-Moreno
Alfonso Soto-Moreno
Unidad de Gestión de Endocrinología y Nutrición, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Introduction Clinically apparent pituitary adenomas are present in about 1:1000 of the general population in Europe; the most frequent sub-types are prolactinomas, non-secreting adenomas and somatotropinomas, while Cushing’s disease and
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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summarised in Table 2 . Table 2 Causes of secondary adrenal insufficiency. Cause of secondary adrenal insufficiency Patient population ( n = 48) Pathology requiring trans-sphenoidal pituitary surgery Cushing’s disease
Patricia Arroyo Tardio
Patricia Arroyo Tardio
University Hospital Basel, Basel, Switzerland
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Gabriela Baldini
Gabriela Baldini
University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
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Eleonora Seelig
Eleonora Seelig
University Hospital Basel, Basel, Switzerland
University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
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University Clinic of Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
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cortisol response to food is essential as amplified or recurrent cortisol surges could lead to hypercortisolism and contribute to obesity. The consequences of hypercortisolism on weight are evident in patients with Cushing’s disease who have excessive
Eva Olga Melin
Eva Olga Melin
Diabetes Research Laboratory, Lund University, Lund, Sweden
Department of Research and Development, Region Kronoberg, Växjö, Sweden
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Department of Research and Development, Region Kronoberg, Växjö, Sweden
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Magnus Hillman
Magnus Hillman
Diabetes Research Laboratory, Lund University, Lund, Sweden
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Mona Landin-Olsson
Mona Landin-Olsson
Diabetes Research Laboratory, Lund University, Lund, Sweden
Department of Endocrinology, Skane University Hospital, Lund, Sweden
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Department of Endocrinology, Skane University Hospital, Lund, Sweden
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their normal environment ( 31 ). Third, the cut-off level we chose to indicate high MSC has clinical implications. In previous research this cut-off level for high MSC was highly predictive of Cushing’s disease in patients with clinical features of
Adrian F Daly
Adrian F Daly
Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
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Liliya Rostomyan
Liliya Rostomyan
Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
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Daniela Betea
Daniela Betea
Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
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Jean-François Bonneville
Jean-François Bonneville
Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
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Chiara Villa
Chiara Villa
Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
Department of Pathological Cytology and Anatomy, Foch Hospital, Paris, France
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Department of Pathological Cytology and Anatomy, Foch Hospital, Paris, France
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Natalia S Pellegata
Natalia S Pellegata
Institute for Diabetes and Cancer, Helmholtz Zentrum München, Neuherberg, Germany
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Beatrice Waser
Beatrice Waser
Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Bern, Bern, Switzerland
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Jean-Claude Reubi
Jean-Claude Reubi
Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Bern, Bern, Switzerland
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Catherine Waeber Stephan
Catherine Waeber Stephan
Clinique Générale Ste-Anne, Fribourg, Switzerland
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Emanuel Christ
Emanuel Christ
Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, University of Basel, Basel, Switzerland
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Albert Beckers
Albert Beckers
Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
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preferentially to SST5 and SST2 ( 20 ). In the clinical setting, pasireotide is used in either short-acting or long-acting depot formulations for the treatment of Cushing’s disease and acromegaly ( 21 , 22 ). In acromegaly, pasireotide LAR is indicated for
Filippo Ceccato
Filippo Ceccato
Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
Department of Neuroscience DNS, University of Padova, Padova, Italy
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Department of Neuroscience DNS, University of Padova, Padova, Italy
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Diego Cecchin
Diego Cecchin
Department of Neuroscience DNS, University of Padova, Padova, Italy
Nuclear Medicine Unit, Department of Medicine – DIMED, University-Hospital of Padova, Padova, Italy
Padova Neuroscience Center PNC, University of Padova, Padova, Italy
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Nuclear Medicine Unit, Department of Medicine – DIMED, University-Hospital of Padova, Padova, Italy
Padova Neuroscience Center PNC, University of Padova, Padova, Italy
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Michele Gregianin
Michele Gregianin
Nuclear Medicine Unit, Castelfranco Veneto, Italy
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Giacomo Ricci
Giacomo Ricci
Department of Neuroscience DNS, University of Padova, Padova, Italy
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Cristina Campi
Cristina Campi
Padova Neuroscience Center PNC, University of Padova, Padova, Italy
Department of Mathematics ‘Tullio Levi-Civita’ DM, University of Padova, Padova, Italy
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Department of Mathematics ‘Tullio Levi-Civita’ DM, University of Padova, Padova, Italy
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Filippo Crimì
Filippo Crimì
Radiology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
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Marta Bergamo
Marta Bergamo
Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
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Annibale Versari
Annibale Versari
Nuclear Medicine Unit, Reggio Emilia, Italy
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Carmelo Lacognata
Carmelo Lacognata
Radiology Department, University-Hospital of Padova, Padova, Italy
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Federico Rea
Federico Rea
Thoracic Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padova, Padova, Italy
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Mattia Barbot
Mattia Barbot
Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
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Carla Scaroni
Carla Scaroni
Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padova, Padova, Italy
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Introduction Cushing’s syndrome (CS), characterized by excessive endogenous cortisol secretion, is in most cases ACTH-dependent. Corticotropin (ACTH) secretion arises from a pituitary adenoma (Cushing’s disease) or, less frequently, from a non
M Cherenko
M Cherenko
Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
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N M Appelman-Dijkstra
N M Appelman-Dijkstra
Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
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A L Priego Zurita
A L Priego Zurita
Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
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N R Biermasz
N R Biermasz
Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
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O M Dekkers
O M Dekkers
Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
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F A Klok
F A Klok
Department of Medicine, Division of Thrombosis and Haemostasis, Leiden University Medical Centre, Leiden, Netherlands
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N Reisch
N Reisch
Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
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A Aulinas
A Aulinas
Department of Endocrinology, Fundacio de Gestio Sanitaria Hospital de la Santa Creu i Sant Pau, IR-SantPau and CIBERER Unit 747 (ISCIII), Barcelona, Spain
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B Biagetti
B Biagetti
Department of Endocrinology, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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S Cannavo
S Cannavo
Endocrine Unit, University Hospital AOU Policlinico G. Martino, Messina, Italy
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L Canu
L Canu
University Hospital Florence Careggi, Florence, Italy
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M Detomas
M Detomas
Department of Internal Medicine, University Hospital Würzburg, Wuerzburg, Germany
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F Devuyst
F Devuyst
Department of Endocrinology, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Brussels, Belgium
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H Falhammar
H Falhammar
Department of Endocrinology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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R A Feelders
R A Feelders
Department of Internal Medicine, Division of Endocrinology, Erasmus MC, Rotterdam, Netherlands
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F Ferrau
F Ferrau
Endocrine Unit, University Hospital AOU Policlinico G. Martino, Messina, Italy
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F Gatto
F Gatto
IRCCS Ospedale Policlinico San Martino, Genova, Genoa, Italy
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C Grasselli
C Grasselli
Cardiovascular Medicine Unit, AUSL-IRCCS, Reggio Emilia, Italy
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P van Houten
P van Houten
Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, Netherlands
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C Hoybye
C Hoybye
Department of Endocrinology, Karolinska University Hospital and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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A M Isidori
A M Isidori
Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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A Kyrilli
A Kyrilli
Department of Endocrinology, Hôpital Universitaire de Bruxelles, Hôpital Erasme, Brussels, Belgium
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P Loli
P Loli
Division of Endocrinology, San Raffaele Vita-Salute University, IRCCS San Raffaele Hospital Milan, Italy
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D Maiter
D Maiter
Department of Endocrinology, Cliniques universitaires Saint-Luc – UCLouvain, Brussels, Belgium
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E Nowak
E Nowak
Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
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R Pivonello
R Pivonello
Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Università “Federico II” di Napoli, Naples, Italy
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O Ragnarsson
O Ragnarsson
Sahlgrenska Academy, Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine (O.R.), University of Gothenburg, Sweden
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R V Steenaard
R V Steenaard
Department of Internal Medicine, Máxima MC, Veldhoven, Netherlands
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N Unger
N Unger
University Hospital Essen, Department of Endocrinology, Diabetes and Metabolism, Essen, Germany
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A van de Ven
A van de Ven
Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, Netherlands
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S M Webb
S M Webb
Department of Endocrinology, Fundacio de Gestio Sanitaria Hospital de la Santa Creu i Sant Pau, IR-SantPau and CIBERER Unit 747 (ISCIII), Barcelona, Spain
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D Yeste
D Yeste
Pediatric Endocrinology Service, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain. CIBER Enfermedades Raras, Instituto Carlos III, Madrid, Spain
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S F Ahmed
S F Ahmed
Department of Medicine, Division of Endocrinology, Leiden University Medical Centre, Leiden, Netherlands
University of Glasgow, Office for Rare Conditions, Glasgow, UK
University of Glasgow, Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, UK
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University of Glasgow, Office for Rare Conditions, Glasgow, UK
University of Glasgow, Developmental Endocrinology Research Group, Royal Hospital for Children, Glasgow, UK
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A M Pereira
A M Pereira
Department of Endocrinology & Metabolism, Amsterdam University Medical Centre, Amsterdam, Noord-Holland, Netherlands
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%) 41 (59.4%) 10 (83.3%) 154 (69.3%) Surgery: n (%) 133 (94.3%) 64 (92.8%) 7 (58.3%) 204 (91.9%) CSI, Cushing severity index; VTE, venous thromboembolism. One hundred forty-one patients had Cushing’s disease (64
Peter Wolf
Peter Wolf
Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Yvonne Winhofer
Yvonne Winhofer
Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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Martin Krššák
Martin Krššák
Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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High Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
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Michael Krebs
Michael Krebs
Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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metabolic comorbidities in Cushing’s disease including dyslipidemia and the high prevalence of T2DM, it is tempting to speculate about glucolipotoxic effects on the heart, although no data on ectopic lipid accumulation in the heart in endogenous
