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Endocrinology

Adrenal Disorders   

Questions discussed in this category

Do patients with central adrenal insufficiency on maintenance hydrocortisone therapy require doubling of their corticosteroid during chemotherapy cycles?
1 Answer available
Should we be using a cut off of 20 rather than the traditional 10 Hounsfield units to distinguish between benign and malignant adrenocortical tumors on imaging?
Viëtor et al., PMID 34503194
2 Answers available
What clinical sign or symptom do you consider to be the most specific for Cushing syndrome?
1 Answer available
What strategies do you use to prevent overcorrection of serum sodium in patients with severe hyponatremia and adrenal insufficiency when initiating glucocorticoid therapy?
1 Answer available
Is it necessary to prescribe a steroid taper after two weeks of high-dose prednisone (60 mg daily)?
4 Answers available
What factors guide you in adjusting the dose of fludrocortisone in a patient with primary adrenal insufficiency?
1 Answer available
In your practice, when do you opt to treat unilateral primary hyperaldosteronism medically rather than surgically?
1 Answer available
Is adequate BP control sufficient enough when titrating spironolactone therapy for primary hyperaldosteronism treatment?
2 Answers available
Do progesterone only oral contraceptive pills affect cortisol binding globulin?
1 Answer available
What 60 minute cortisol threshold value do you use for diagnosis of adrenal insufficiency after ACTH stimulation?
Zha et al., PMID 35487459
5 Answers available
How does contralateral suppression of more than 50% with cosyntropin during adrenal venous sampling influence your decision to recommend adrenalectomy in patients with primary aldosteronism?
Okubo et al., PMID 38442744
1 Answer available
What evaluation do you do in patients with hypertension and persistently elevated aldosterone/renin ratio (over 20) but without an elevated aldosterone level (under 10 ng/dL)?
1 Answer available
When performing adrenal vein sampling, is calculating selectivity index using androstenedione superior to using cortisol alone for determining successful catheterization?
1 Answer available
Under what circumstances would you test for hypercortisolism in a patient with insulin resistance?
1 Answer available
In what clinical scenarios should we use the 2-day 2mg DST instead of the 1mg overnight DST for screening of Cushing syndrome?
1 Answer available
In patients with hypertension and suspected primary aldosteronism who have undergone negative confirmatory testing, what follow-up and monitoring strategies would you recommend to ensure early detection of potential aldosteronism?
1 Answer available
Under what circumstances would you refer a patient with mild autonomous cortisol secretion without features of Cushing syndrome for adrenalectomy?
1 Answer available
Should oral combined contraceptives be held prior to overnight dexamethasone suppression test to rule out Cushings?
If so, how long should OCPs be held to reliably trust the dex suppression test results?
2 Answers available
Is it possible to have undetectable cortisol levels in secondary adrenal insufficiency?
Young, previously healthy male with normal growth presenting with two syncopal episodes. Currently, only symptom is mild fatigue. Labs showed: Cortiso...
2 Answers available
What further work-up (if any) should be considered in patients with pituitary microadenoma and stigmata of Cushing's disease but low ACTH and repeatedly normal plasma, urinary, and salivary cortisol levels?
1 Answer available
Is there an indication for adrenalectomy in patients with subclinical Cushing syndrome and adrenal nodule?
1 Answer available
What is the best treatment of isolated elevated DHEA-S in a woman with clinical androgen excess (without PCOS, neoplasm, etc)?
1 Answer available
In adult women with NCCAH, is there a benefit in using supratherapeutic doses of prednisone in addition to clomiphene to improve fertility rates?
1 Answer available
Should a short trial of androgen therapy be used in patients with primary adrenal insufficiency suffering from persistent fatigue and hypoactive sexual desire despite sufficient glucocorticoid and mineralocorticoid replacement?
1 Answer available
What is the next best anti-hypertensive medication to start after mineralocorticoid receptor antagonists in patients with primary aldosteronism?
1 Answer available
What is your preferred method for confirming the diagnosis of primary aldosteronism in a patient with an elevated plasma aldosterone to renin ratio?
1 Answer available
Is there any indication for obtaining adrenal imaging in patients with MEN2 who have normal plasma or urinary metanephrines?
1 Answer available
Is a significant rise in cortisol post cosyntropin stimulation sufficient to rule out adrenal insufficiency in patients with low albumin?
1 Answer available
Can osilodrostat be used indefinitely in poor surgical candidates with cushing syndrome from adrenal adenoma?
1 Answer available


Papers discussed in this category

The Journal of clinical endocrinology and metabolism, 2016-05
The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.
The New England journal of medicine, 2020 Sep 24
Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.
The Journal of clinical endocrinology and metabolism, 2010 Jan 15
Fertility in women with nonclassical congenital adrenal hyperplasia due to 21-hydroxylase deficiency.
The Journal of clinical endocrinology and metabolism, 2005-04
Biochemical and clinical manifestations of dopamine-producing paragangliomas: utility of plasma methoxytyramine.
European journal of cancer (Oxford, England : 1990), 2012-07
Plasma methoxytyramine: a novel biomarker of metastatic pheochromocytoma and paraganglioma in relation to established risk factors of tumour size, location and SDHB mutation status.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2019-02
THE EVALUATION OF INCIDENTALLY DISCOVERED ADRENAL MASSES.
European journal of endocrinology, 2023 Jul 20
European Society of Endocrinology clinical practice guidelines on the management of adrenal incidentalomas, in collaboration with the European Network for the Study of Adrenal Tumors.
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 2020 Sep
Adrenal Vein Sampling Without Discontinuation of Mineralocorticoid Receptor Antagonist Therapy.
European journal of endocrinology, 2022 Nov 22
Cardiovascular outcomes and all-cause mortality in primary aldosteronism after adrenalectomy or mineralocorticoid receptor antagonist treatment: a meta-analysis.
Journal of cardiovascular development and disease, 2022 Sep 08
Stroke Risks in Primary Aldosteronism with Different Treatments: A Systematic Review and Meta-Analysis.
Clinical endocrinology, 2018-01
Diagnostic performance of unenhanced computed tomography and 18 F-fluorodeoxyglucose positron emission tomography in indeterminate adrenal tumours.
Journal of the Endocrine Society, 2022 Dec 02
Perioperative Evaluation and Management of Patients on Glucocorticoids.
Diagnostics (Basel, Switzerland), 2021 Apr 20
Glucocorticoid Withdrawal-An Overview on When and How to Diagnose Adrenal Insufficiency in Clinical Practice.
Frontiers in endocrinology, 2022 Aug 18
Cortisol values during the standard-dose cosyntropin stimulation test: Personal experience with Elecsys cortisol II assay.

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