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Elena V Varlamov Department of Medicine (Endocrinology, Diabetes and Clinical Nutrition), Oregon Health & Science University, Portland, Oregon, USA
Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
Pituitary Center, Oregon Health & Science University, Portland, Oregon, USA

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Dan Alexandru Niculescu Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA

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Swechya Banskota Department of Medicine (Endocrinology, Diabetes and Clinical Nutrition), Oregon Health & Science University, Portland, Oregon, USA
Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
Pituitary Center, Oregon Health & Science University, Portland, Oregon, USA

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Simona Andreea Galoiu Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA

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Catalina Poiana Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA

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Maria Fleseriu Department of Medicine (Endocrinology, Diabetes and Clinical Nutrition), Oregon Health & Science University, Portland, Oregon, USA
Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon, USA
Pituitary Center, Oregon Health & Science University, Portland, Oregon, USA

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Introduction Acromegaly is a rare disease that is caused by excessive growth hormone (GH) secretion by a pituitary adenoma ( 1 , 2 , 3 ). The clinical picture of active acromegaly is characterized by a combination of symptoms, signs, and

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Henrik Falhammar Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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Magnus Kjellman Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Department of Breast and Endocrine Surgery, Karolinska University Hospital, Stockholm, Sweden

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Jan Calissendorff Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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is a serious condition which can be fatal if not diagnosed and/or managed appropriately ( 1 , 5 ). It has been estimated that at least 25% of all affected by pheochromocytomas were never diagnosed during life ( 6 ). The presenting symptoms of

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Salman Razvi Translational and Clinical Research Institute, University of Newcastle, Newcastle-upon-Tyne, UK

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Sanaa Mrabeti Medical Affairs EMEA, Merck Serono Middle East FZ-LLC, Dubai, United Arab Emirates

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Markus Luster Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany

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, respectively) ( 8 ). For most patients, administration of levothyroxine is sufficient to resolve symptoms of hypothyroidism and maintain quality of life ( 1 , 2 , 3 ). However, a minority of people with hypothyroidism continue to report symptoms reminiscent

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Yen Kheng Tan Duke-NUS Medical School, SingHealth, Singapore, Singapore

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Yu Heng Kwan Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore

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David Choon Liang Teo Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore

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Marieke Velema Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Jaap Deinum Division of Vascular Medicine, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Pei Ting Tan Department of Clinical Trials Research Unit, Changi General Hospital, Singapore, Singapore

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Meifen Zhang Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Joan Joo Ching Khoo Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Wann Jia Loh Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Linsey Gani Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Thomas F J King Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Eberta Jun Hui Tan Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Shui Boon Soh Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Vanessa Shu Chuan Au Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Tunn Lin Tay Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Lily Mae Quevedo Dacay Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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Keng Sin Ng Department of Diagnostic Radiology, Changi General Hospital, Singapore, Singapore

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Kang Min Wong Department of Diagnostic Radiology, Changi General Hospital, Singapore, Singapore

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Andrew Siang Yih Wong Department of Surgery, Changi General Hospital, Singapore, Singapore

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Foo Cheong Ng Department of Urology, Changi General Hospital, Singapore, Singapore

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Tar Choon Aw Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore

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Yvonne Hui Bin Chan Duke-NUS Medical School, SingHealth, Singapore, Singapore

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Khim Leng Tong Department of Cardiology, Changi General Hospital, Singapore, Singapore

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Sheldon Shao Guang Lee Department of Cardiology, Changi General Hospital, Singapore, Singapore

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Siang Chew Chai Department of Cardiology, Changi General Hospital, Singapore, Singapore

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Troy Hai Kiat Puar Department of Endocrinology, Changi General Hospital, Singapore, Singapore

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psychological symptoms, which may improve after treatment ( 5 ). Hence, in this prospective observational study, we aimed to assess for both HRQoL and depressive symptoms in a cohort of patients with PA after appropriate treatment with either surgical or

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Jens P Goetze
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Linda M Hilsted
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Jens F Rehfeld
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Urban Alehagen Department of Clinical Biochemistry, Division of Cardiovascular Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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hampered the general use of CgA as a biomarker, because CgA processing is extensive, variable, and harbors a plethora of fragments. In the present study, we examined a cohort of elderly patients with symptoms suggestive of heart failure, i.e. tiredness

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Greta B Raglan Department of Psychology, American University, Washington, District of Columbia, USA

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Louis A Schmidt Department of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada

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Jay Schulkin Department of Research, American College of Obstetricians and Gynecologists, Washington, District of Columbia, USA
Department of Neuroscience, Georgetown University, Washington, District of Columbia, USA

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generalized anxiety and depressive disorders, posttraumatic stress disorder (PTSD) and social anxiety. Each of these areas of research has implicated glucocorticoid levels, either high or low, in the presentation of variable symptoms of anxiety ( 3 ). Despite

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Małgorzata Kałużna Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Pola Kompf Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Katarzyna Wachowiak-Ochmańska Heliodor Święcicki Clinical Hospital, Poznan, Poland

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Jerzy Moczko Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland

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Aleksandra Królczyk Chair and Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Adam Janicki Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Karol Szapel Department of Physiotherapy, Poznan University of Medical Sciences, Poznan, Poland

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Marian Grzymisławski Chair and Department of Gastroenterology, Dietetics and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Marek Ruchała Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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Katarzyna Ziemnicka Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

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, associated with a change in the form of stool and/or its frequency, with such symptoms starting 6 months before diagnosis and being present for the previous 3 months ( 11 ). Clinical diagnosis necessitates the exclusion of underlying organic disease, history

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Natalie Rogowski-Lehmann Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany

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Aikaterini Geroula Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany

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Aleksander Prejbisz Department of Hypertension, Institute of Cardiology, Warsaw, Poland

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Henri J L M Timmers Section of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Felix Megerle Medizinische Klinik und Poliklinik I des Universitätsklinikums Würzburg, Würzburg, Germany

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Mercedes Robledo Hereditary Endocrine Cancer Group, Human Cancer Genetics Programme, Spanish National Cancer Research Centre, Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Madrid, Spain

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Martin Fassnacht Medizinische Klinik und Poliklinik I des Universitätsklinikums Würzburg, Würzburg, Germany

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Stephanie M J Fliedner First Department of Medicine, University Medical Center Schleswig-Holstein, Lübeck, Germany

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Martin Reincke Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany

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Anthony Stell Department of Computing and Information, University of Melbourne, Melbourne Australia

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Andrzej Januszewicz Department of Hypertension, Institute of Cardiology, Warsaw, Poland

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Jacques W M Lenders Section of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
Medizinische Klinik III, Universitätsklinikum Carl Gustav Carus an der Technische Universität Dresden, Dresden, Germany

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Graeme Eisenhofer Institut für Klinische Chemie und Laboratoriumsmedizin, Universitätsklinikum Carl Gustav Carus an der TU Dresden, Dresden, Germany
Medizinische Klinik III, Universitätsklinikum Carl Gustav Carus an der Technische Universität Dresden, Dresden, Germany

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Felix Beuschlein Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland

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analyses indicate that life-threating events with cardiovascular complications including hypertensive crisis and catecholamine-induced cardiomyopathy are not uncommon even as first presentation of disease ( 3 , 4 ). The symptoms that occur in patients with

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Michelle Hadjiconstantinou University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK

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Hamidreza Mani University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Naina Patel University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK

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Miles Levy Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Melanie Davies University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
Department of Diabetes and Endocrinology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, Leicester, UK

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Kamlesh Khunti University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK

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Margaret Stone University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK

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‘freak’ ( 12 ). Lack of information given to women diagnosed with PCOS may also create confusion about why they are experiencing symptoms, leading to feelings of guilt and lack of control ( 4 , 12 , 13 ). It is clear that a diagnosis of PCOS has

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Navid Tabriz University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany

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Kilian Gloy University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany

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Astrid Schantzen University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany

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Dennis Fried University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany

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Dirk Weyhe University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany

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Verena Uslar University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Carl von Ossietzky University, Oldenburg, Germany

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patient sample was performed, for the results see Table 1 . Of these 98 patients, 91 participated in and completed the retest questionnaire. Out of these 91 patients, only those with self-reported stable disease symptoms and no change in medication were

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