ISSN 1662-4009 (online)

ey0017.8-7 | Important for Clinical Practice | ESPEYB17

8.7. Alternative pathway androgen biosynthesis and human fetal female virilization

N Reisch , AE Taylor , EF Nogueira , DJ Asby , V Dhir , A Berry , N Krone , RJ Auchus , CHL Shackleton , NA Hanley , W Arlt

To read the full abstract: Proc Natl Acad Sci U S A. 2019; 116(44): 22294-22299. PMID: 31611378.Androgen biosynthesis in the human fetus proceeds through the adrenal sex steroid precursor dehydroepiandrosterone (DHEA), which is converted to testosterone in the gonads, followed by further activation to 5α-dihydrotestosterone (DHT) in genital skin, thereby facilitating male external genit...

ey0016.8-5 | Important for Clinical Practice | ESPEYB16

8.5. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an endocrine society clinical practice guideline

PW Speiser , W Arlt , RJ Auchus , LS Baskin , GS Conway , DP Merke , HFL Meyer-Bahlburg , WL Miller , MH Murad , SE Oberfield , PC White

To read the full abstract: J Clin Endocrinol Metab. 2018; 103(11): 4043–4088.Since the publication of the 2010 Endocrine Society clinical practice guideline for Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency, there have been several advances in the diagnosis and management of the condition. Neonatal diagnosis methods have been refined to use gestational age in...

ey0015.8-16 | New Concerns | ESPEYB15

8.16 Quantitative brain MRI in congenital adrenal hyperplasia: in vivo assessment of the cognitive and structural impact of steroid hormones

EA Webb , L Elliott , D Carlin , M Wilson , K Hall , J Netherton , J Reed , TG Barrett , V Salwani , JD Clayden , W Arlt , N Krone , AC Peet , AG Wood

To read the full abstract: J Clin Endocrinol Metab. 2018;103(4):1330-1341Glucocorticoids exert an inverted U-shaped influence on human cognition, particularly on acquiring and consolidating memory (25), whereas androgens have an overall beneficial effect on cognitive control, verbal memory, and spatial cognition in humans (26). Although previous studies in patients with CAH have con...

ey0015.15-5 | New treatments | ESPEYB15

15.5 Modified-Release and Conventional Glucocorticoids and Diurnal Androgen Excretion in Congenital Adrenal Hyperplasia

CM Jones , A Mallappa , N Reisch , N Nikolaou , N Krone , BA Hughes , DM O'Neil , MJ Whitaker , JW Tomlinson , KH Storbeck , DP Merke , RJ Ross , W Arlt

To read the full abstract: J Clin Endocrinol Metab 2017;102:1797-1806We know that conventional glucocorticoid therapies fail to mimic the normal diurnal profile of cortisol secretion, which should show an early morning surge in circulating levels, followed by a gradual daytime reduction, and night-time suppression. The early morning surge in ACTH also drives adrenal androgen production, which is e...

ey0020.12-6 | Steroids | ESPEYB20

12.6. Classic and 11-oxygenated androgens in serum and saliva across adulthood: a cross-sectional study analyzing the impact of age, body mass index, and diurnal and menstrual cycle variation

L Schiffer , P Kempegowda , AJ Sitch , JE Adaway , F Shaheen , A Ebbehoj , S Singh , MP McTaggart , MW O'Reilly , A Prete , JM Hawley , BG Keevil , I Bancos , AE Taylor , W Arlt

Brief summary: In this cross-sectional study, 11-oxygenated androgens were measured in morning serum samples from 290 healthy adults (125 men, age 22–95 years; 165 women, age 21–91 years) by LC–MSMS (liquid chromatography, tandem mass spectrometry) to generate normative values across the lifespan. In a subset of volunteers (n=83), additional measurements were performed in saliva to assess diurnal and menstrual cycle-dependent variation. In general, it w...

ey0018.8-3 | Important for Clinical Practice | ESPEYB18

8.3. Modified-release hydrocortisone in congenital adrenal hyperplasia

DP Merke , A Mallappa , W Arlt , A Brac de la Perriere , A Linden Hirschberg , A Juul , J Newell-Price , CG Perry , A Prete , DA Rees , N Reisch , N Stikkelbroeck , P Touraine , K Maltby , FP Treasure , J Porter , RJ Ross

J Clin Endocrinol Metab 2021; 106(5): e2063–e2077.https://pubmed.ncbi.nlm.nih.gov/33527139/The authors report the findings of a 6-month, randomized, phase 3 trial, with a single arm extension, to investigate the efficacy, safety and tolerability of modified release hydrocortisone (MC-HC) replacement therapy versus standard glucocorticoid replacement therapy in 122 adult patients with c...

ey0015.8-10 | Important for Clinical Practice | ESPEYB15

8.10 Guidelines for the Diagnosis and Management of Critical Illness-Related Corticosteroid Insufficiency (CIRCI) in Critically Ill Patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017

D Annane , SM Pastores , B Rochwerg , W Arlt , RA Balk , A Beishuizen , J Briegel , J Carcillo , M Christ-Crain , MS Cooper , PE Marik , G Umberto Meduri , KM Olsen , SC Rodgers , JA Russell , G Van den Berghe

To read the full abstract: Crit Care Med. 2017; 45(12): 2078-2088This guideline replaces/updates the 2008 recommendations regarding the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. In CIRCI, inadequate glucocorticoid-mediated anti-inflammatory activity is observed in relation to the severity of the critical illne...

ey0017.8-17 | Food for Thought | ESPEYB17

8.17. Plasma renin measurements are unrelated to mineralocorticoid replacement dose in patients with primary adrenal insufficiency

R Pofi , A Prete , V Thornton-Jones , J Bryce , SR Ali , Ahmed S Faisal , A Balsamo , F Baronio , A Cannuccia , A Guven , T Guran , F Darendeliler , C Higham , W Bonfig , L de Vries , TASS Bachega , MC Miranda , BB Mendonca , V Iotova , M Korbonits , NP Krone , R Krone , A Lenzi , W Arlt , RJ Ross , AM Isidori , JW Tomlinson

To read the full abstract: J Clin Endocrinol Metab. 2020; 105(1): dgz055. PMID: 31613957.Mineralocorticoid (MC) replacement therapy along with glucocorticoid (GC) replacement is crucial to avoid life-threating adrenal crises in Addison´s disease (AD) and in classical CAH (1–3). MC is administered with the aim of achieving plasma renin concentration (PRC) within the upper limit of ...

ey0020.6-7 | Clinical Trials – New Treatments | ESPEYB20

6.7. [11C]metomidate PET-CT versus adrenal vein sampling for diagnosing surgically curable primary aldosteronism: A prospective, within-patient trial

X Wu , R Senanayake , E Goodchild , WA Bashari , J Salsbury , CP Cabrera , G Argentesi , SM O'Toole , M Matson , B Koo , L Parvanta , N Hilliard , V Kosmoliaptsis , A Marker , DM Berney , W Tan , R Foo , CA Mein , E Wozniak , E Savage , A Sahdev , N Bird , K Laycock , I Boros , S Hader , V Warnes , D Gillett , A Dawnay , E Adeyeye , A Prete , AE Taylor , W Arlt , AN Bhuva , F Aigbirhio , C Manisty , A McIntosh , A McConnachie , JK Cruickshank , H Cheow , M Gurnell , WM Drake , MJ Brown

Brief summary: This study validates dexamethasone-suppressed [11C]metomidate positron emission tomography computed tomography (MTO) scanning as a CYP11B2-selective investigation for lateralizing PA.Primary aldosteronism (PA) is the most common single cause of hypertension, accounting for 5–14% of all cases and 20–25% of treatment-resistant hypertension (1, 2). Traditionally, patients with PA are divided equally into ...