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thereafter, while free cortisol is only elevated upon PICU admission and normal thereafter ( 4 ). Plasma POMC has not been quantified in critically ill children. In addition, the dynamics of plasma ACTH and free cortisol before PICU admission are unknown. In
Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Department of Endocrinology, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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showed normalisation of her serum electrolytes with a persistently elevated renin (372.8 mIU/L) during fludrocortisone treatment. Following COCP withdrawal, she had a basal cortisol of 344 nmol/L, rising to 452 nmol/L 60 min post-injection of 250 µg
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–pituitary–adrenal (HPA) axis, with insufficient adrenocorticotrophic hormone (ACTH) stimulation of the adrenal cortex ( 2 ) leading to deficiency in cortisol and adrenal androgens. This is mostly commonly caused by pituitary tumours and the resultant treatment including
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, the adrenocorticotrophic hormone (ACTH) stimulation test (AST) is the most commonly used ( 3 ). During the AST, 250 µg of synthetic ACTH was administered intravenously or intramuscularly, and serum cortisol is drawn at baseline, 30 min, and 60 min
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Introduction Timely diagnosis of endogenous Cushing's syndrome (CS) is important to reduce morbidity and mortality ( 1 , 2 , 3 ). Late-night salivary cortisol (LNSC) is an important screening instrument for CS with high sensitivity and
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®, Diurnal Ltd, UK). Plenadren is a tablet with an immediate-release outer layer and a sustained-release core, which provides once-daily hydrocortisone replacement but does not replace the physiological overnight rise in cortisol, as cortisol only rises after
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK
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for CS including late-night salivary cortisol (LNSC), overnight dexamethasone suppression test (ODST), low-dose dexamethasone suppression test (LDDST) and 24-h urinary free cortisol (UFC) ( 1 , 2 , 3 ). A hallmark of CS is the disruption of the
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Clinical Research Centre, Medical University of Bialystok, Bialystok, Poland
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, pheochromocytoma, aldosteronism, or overt cortisol excess due to hyperfunction may be observed in patients with adrenal incidentaloma. It has been shown that cortical adenoma is the most frequent tumour type among adrenal incidentalomas ( 5 ), whereas adrenal
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Department and Graduate Institute of Forensic Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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studies (computed tomography (CT) or magnetic resonance imaging (MRI)). Adrenalectomy has consequently been established as the treatment of choice for unilateral disease. Recently, there has been a growing focus on a special group with cortisol co
University of Alcalá, Madrid, Spain
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associated with increased cardiovascular morbidity and mortality compared to patients with essential hypertension (EHT) ( 2 ). On the other hand, autonomous cortisol secretion (ACS) is a well-known condition linked to a detrimental cardiometabolic profile