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Exp Clin Endocrinol Diabetes 2019; 127(02/03): 81-83
DOI: 10.1055/a-0752-4176
Editorial
© Georg Thieme Verlag KG Stuttgart · New York

The Adrenal Gland: Central Relay in Health and Disease

Martin Reincke
1   Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Germany
,
Felix Beuschlein
1   Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Germany
2   Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitäts-Spital Zürich, Zürich, Switzerland
,
Stefan Bornstein
3   Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
,
Graeme Eisenhofer
3   Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
4   Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany
,
Martin Fassnacht
5   Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
,
Nicole Reisch
1   Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Germany
,
Tracy Ann Williams
1   Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Germany
6   Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
› Author Affiliations
Further Information

Publication History

received 25 September 2018
revised 25 September 2018

accepted 28 September 2018

Publication Date:
27 February 2019 (online)

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Diseases of the adrenal gland are as important for the general practitioner as for the endocrine specialist. The high prevalence of some adrenal endocrinopathies, such as adrenal incidentalomas (1–2% of the population) and primary aldosteronism (6% of hypertensives), which affect millions of patients, makes adrenal diseases a relevant health issue. The high morbidity and mortality of some of the rarer adrenal diseases, i. e., Addison’s disease and Cushing’s syndrome ([Table 1]), make early detection and appropriate treatment such a challenge for the health care system.

Key words

Addison disease - congenital adrenal hyperplasia - Cushing’s syndrome - hypercortisolism - primary aldosteronism - adrenocortical carcinoma - pheochromocytoma - paraganglioma
 

  • References

  • 1 Prada ETA, Burrello J, Reincke M. et al. Old and New Concepts in the Molecular Pathogenesis of Primary Aldosteronism. Hypertension. 2017; 70: 875-881. doi:10.1161/HYPERTENSIONAHA.117.10111.
    CrossrefPubMedGoogle Scholar
  • 2 Albani A, Theodoropoulou M, Reincke M. Genetics of Cushing's disease. Clin Endocrinol (Oxf) 2018; 88: 3-12. doi:10.1111/cen.13457.
    CrossrefPubMedGoogle Scholar
  • 3 Fassnacht M, Arlt W, Bancos I. et al. Management of adrenal incidentalomas: European society of endocrinology clinical practice guideline in collaboration with the European network for the study of adrenal tumors. Eur J Endocrinol 2016; 175: G1-G34. doi:10.1530/EJE-16-0467.
    CrossrefPubMedGoogle Scholar
  • 4 Crona J, Taïeb D, Pacak K. New Perspectives on Pheochromocytoma and Paraganglioma: Toward a molecular classification. Endocr Rev 2017; 38: 489-515 doi:10.1210/er.2017-00062.
    CrossrefPubMedGoogle Scholar
  • 5 Schilbach K, Junnila R, Bidlingmaier M.. The aldosterone to renin ratio as screening tool in primary aldosteronism. Exp Clin Endocrinol Diabetes 2019; 127: 84-92
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Pérez-Rivas LG, Williams T, Reincke M.. Inherited forms of primary hyperaldosteronism: new genes, new phenotypes and proposition of a new classification. Exp Clin Endocrinol Diabetes 2018; 12: 93-99
    PubMedGoogle Scholar
  • 6 Mulatero P, Tizzani D, Viola A. et al. Prevalence and characteristics of familial hyperaldosteronism: The PATOGEN study (Primary Aldosteronism in TOrino-GENetic forms). Hypertension 2011; 58: 797-803 doi:10.1161/HYPERTENSIONAHA.111.175083.
    CrossrefPubMedGoogle Scholar
  • 8 Yang Y, Reincke M, Williams T.. Treatment of unilateral PA by adrenalectomy: Potential reasons for incomplete biochemical cure. Exp Clin Endocrinol Diabetes 2019; 127: 100-108
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Williams TA, Lenders JWM, Mulatero P. et al. Outcomes after adrenalectomy for unilateral primary aldosteronism: An international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol 2017; 5: 689-699 doi:10.1016/S2213-8587(17)30135-3.
    CrossrefPubMedGoogle Scholar
  • 10 Fassnacht M, Terzolo M, Allolio B. et al. Combination chemotherapy in advanced adrenocortical carcinoma. N Engl J Med 2012; 366: 2189-2197. doi:10.1056/NEJMoa1200966.
    CrossrefPubMedGoogle Scholar
  • 11 Kroiss M, Deutschbein T, Schlötelburg W. et al. Treatment of Refractory Adrenocortical Carcinoma with Thalidomide: Analysis of 27 Patients from the European Network for the Study of Adrenal Tumours Registry.. Exp Clin Endocrinol Diabetes 2018; DOI: 10.1055/a-0747-5571.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Megerle F, Kroiss M, Hahner S, Fassnacht M. Advanced Adrenocortical Carcinoma - What to do when First-Line Therapy Fails?. Exp Clin Endocrinol Diabetes 2019; 127: 109-116
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Nölting S, Grossman AB, Pacak K.. Metastatic Phaeochromocytoma: Spinning towards more promising treatment options. Exp Clin Endocrinol Diabetes 2019; 127: 117-128
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Erlic Z, Beuschlein F. Metabolic alterations in patients with pheochromocytoma. Exp Clin Endocrinol Diabetes 2019; 127: 129-136
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Schreiner F, Anand G, Beuschlein F.. Perioperative management of endocrine active adrenal tumors. Exp Clin Endocrinol Diabetes 2019; 127: 137-146
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Petersenn S, Beckers A, Ferone D. et al. Therapy of endocrine disease: outcomes in patients with Cushing's disease undergoing transsphenoidal surgery: Systematic review assessing criteria used to define remission and recurrence. Eur J Endocrinol. 2015; 172: R227-R239. doi:10.1530/EJE-14-0883.
    CrossrefPubMedGoogle Scholar
  • 17 Stalla GK, Ciato D, Dimopoulou C. Cushing's disease. Exp Clin Endocrinol Diabetes 2019; 127: 147-155
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Kamilaris CDC, Faucz FR, Voutetakis A. Stratakis CA. et al. Carney complex. Exp Clin Endocrinol Diabetes 2019; 127: 156-164
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Barthel A, Benker G, Berens K. et al. An update on Addison's disease. Exp Clin Endocrinol Diabetes 2019; 127: 165-170
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Reisch N. Review of health problems in adult patients with congenital adrenal hyperplasia. Exp Clin Endocrinol Diabetes 2019; 127: 171-177
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Di Dalmazi G.. Adrenal incidentaloma: picking out the high-risk patients. Exp Clin Endocrinol Diabetes 2019; 127: 178-184
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 http://www.dfg.de/gefoerderte_projekte/programme_und_projekte/listen/projektdetails/index.jsp?id=314061271
    PubMed