{"title":"Role of thyroid function in non-basal ganglia intracerebral hemorrhage prognosis.","authors":"Yiting Xu, Zirui Xu, Yang Chen, Junjie Yang, Kezheng Li, Yinuo Chen, Jiali Xie, Chunyang Pang, Lingfei Gao, Mengwan Song, Huan Yu, Binbin Deng, Huanjie Huang","doi":"10.1007/s40618-025-02603-7","DOIUrl":"https://doi.org/10.1007/s40618-025-02603-7","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid function disorders serve as unfavorable prognosis predictors for numerous diseases. However, their role in predicting intracerebral hemorrhage outcome is unclear. This study investigated the prognostic potential of thyroid function parameters for intracerebral hemorrhage.</p><p><strong>Methods: </strong>Admissions for intracerebral hemorrhage caused by hypertension were retrospectively enrolled to determine thyroid function levels. Patients were subjected to three month- and three year-follow up to assess short- and long-term prognosis, respectively.</p><p><strong>Results: </strong>Elevated levels of thyroxine and decreased levels of free triiodothyronine (fT3) are associated with unfavorable short-term prognosis in non-basal ganglia intracerebral hemorrhage patients. The levels of thyroid stimulating hormone and free tetraiodothyronine did not exhibit any significant change. This alteration in thyroid function was not observed in basal-ganglia intracerebral hemorrhage patients. Furthermore, the inclusion of thyroxine and fT3 enhanced the prognostic power of the traditional model (NIHSS only) in predicting short-term outcomes. Among patients 55 years or older, subgroup analyses results are consistent with previous findings. Additionally, our clinical model is also applicable towards predicting the long-term prognosis of non-basal ganglia intracerebral hemorrhage.</p><p><strong>Conclusion: </strong>Thyroid function concentrations, especially the levels of thyroxine and fT3, could serve as key prognostic predictors for non-basal ganglia cerebral hemorrhage, especially among the middle-aged and elderly groups.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valentino Marino Picciola, Giovanni Paolo Ivaldi, Paolo Zamboni
{"title":"The Fieschi conservatory of Genoa: art, medicine, and the representation of endemic goiter in 18 th-Century sculpture.","authors":"Valentino Marino Picciola, Giovanni Paolo Ivaldi, Paolo Zamboni","doi":"10.1007/s40618-025-02604-6","DOIUrl":"https://doi.org/10.1007/s40618-025-02604-6","url":null,"abstract":"","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lomibuvir sensitizes radioiodine-resistant thyroid cancer cell lines to radioiodine treatment by targeting hTERT RNA-dependent polymerase activity.","authors":"Xian Cheng, Shichen Xu, Jing Wu, Wenjing Gao, Jiandong Bao, Huixin Yu, Li Zhang","doi":"10.1007/s40618-025-02598-1","DOIUrl":"https://doi.org/10.1007/s40618-025-02598-1","url":null,"abstract":"<p><p>Radioactive iodine (RAI) is selectively used in the treatment of residual or recurrent differentiated thyroid cancer for over fifty years. However, radioiodine-refractory differentiated thyroid cancer (RAIR-DTC) is difficult to treat with radioactive iodine because of the decreased sodium iodide symporter (NIS) activity. Patients with RAIR-DTC derive limited benefit from RAI therapy, necessitating the exploration of new treatment options. In the current study, we aimed to explore the mechanism underlying thyroid cancer dedifferentiation and to provide new targets for RAIR therapy. We established a RAIR thyroid cancer cell line which was verified by the colony formation ability under radioiodine-131 treatment at doses up to 100 µCi. As expected, higher expressions of cancer stem cell genes, SOX2, CD133, and OCT4 A were found in RAIR cells compared to non-RAIR cells. Correspondingly, the expression of iodine-handling genes such as NIS, TPO, and Pendrin were downregulated. Interestingly, we discovered that the RNA-dependent RNA polymerase (RdRP) activity of TERT was also upregulated in RAIR cells, evidenced by the upregulation of phosphorylated telomerase reverse transcriptase (TERT), BRG1 and CDK1. Moreover, miR-146b-5p, transcribed by TERT gene, was likewise upregulated. RdRP inhibitor lomibuvir treatment downregulated miR-146b-5p level in RAIR cells, resulting in the upregulation of NIS gene expression. Lomibuvir not only restored the expressions of TPO and NIS but also downregulated the elevated ALDH1A1 and CD133 in RAIR cells. Consequently, the uptake of radioiodine-131 was significantly enhanced in these RAIR cells. Taken together, our research identifies novel therapeutic targets and provides new insights into the management of RAIR-DTC.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sam Kafai Yahyavi, Ida Enggaard Kaae, Anders Juul, Ebbe Eldrup, Martin Blomberg Jensen
{"title":"Longitudinal changes in minerals are influenced by immunosuppressive treatment in men with granuloma disease.","authors":"Sam Kafai Yahyavi, Ida Enggaard Kaae, Anders Juul, Ebbe Eldrup, Martin Blomberg Jensen","doi":"10.1007/s40618-025-02607-3","DOIUrl":"https://doi.org/10.1007/s40618-025-02607-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether granuloma formation following self-administered cosmetic oil injections affects mineral homeostasis, specifically calcium, magnesium, phosphate, iron, sodium, and potassium, and to assess the potential impact of prednisolone treatment on these mineral levels.</p><p><strong>Methods: </strong>In this retrospective study, we reviewed blood samples from baseline through a follow-up period of 48 months in patients referred to a tertiary center at Herlev Hospital, Denmark. Changes in serum minerals over time were assessed by a linear mixed model for repeated measures.</p><p><strong>Results: </strong>A total of 111 patients were included. Men who injected > 2,000 mL paraffin oil had higher total and ionized calcium (p = 0.029 and p < 0.001), lower PTH (p < 0.001), but also lower magnesium (p < 0.001) and higher sodium (p = 0.048) compared to those who had injected < 500 mL. Men with manifest hypercalcemia at baseline (n = 32) compared to men with normocalcemia (n = 79) experienced an increase in serum PTH and phosphate concentrations over time (p = 0.042 at 48 months), and also a transient increase in iron concentration, although this reached baseline levels again after 24 months. Prednisolone lowered calcium in hypercalcemic men but also decreased serum magnesium (p = 0.027 after 36 months), phosphate, and increased serum iron concentration.</p><p><strong>Conclusion: </strong>Men who had injected large volumes of paraffin oil were more likely to have hypercalcemia, lower magnesium, and higher sodium concentrations. Minor aberration in serum minerals was more frequent in patients with more pronounced disease and this may likely be a poor prognostic sign although the mechanism behind this observation remains unclear.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara S Hammerstad, Hanna J Lee, Yaron Tomer, Mihaela Stefan-Lifshitz
{"title":"Immune checkpoint inhibitors associated thyroiditis: mechanisms and clinical outcomes.","authors":"Sara S Hammerstad, Hanna J Lee, Yaron Tomer, Mihaela Stefan-Lifshitz","doi":"10.1007/s40618-025-02608-2","DOIUrl":"https://doi.org/10.1007/s40618-025-02608-2","url":null,"abstract":"<p><p>Background Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment improving prognosis in many cancers. However, ICI often trigger immune-related adverse events (irAEs) that can affect various organ systems, leading to significant clinical challenges. The most frequent irAEs are those affecting the endocrine glands, reported in approximately 10% of treated patients. Thyroid dysfunction is the most common endocrine irAEs, mainly associated with PD-1/PD-L1 blockade therapies. Transient asymptomatic thyrotoxicosis is the most common form of clinical presentation, often followed by hypothyroidism. Interestingly, several studies have demonstrated that irAEs correlate with the response to cancer therapy and with improved overall survival (OS). The mechanisms underlying thyroid irAEs are not fully elucidated but complex interactions between genetic predisposition to thyroid autoimmunity, distinct immune mechanisms and thyroid cell intrinsic mechanisms are thought to drive thyroiditis associated with ICI therapy. Purpose In this review we discuss the latest data on clinical features of thyroid irAEs, proposed mechanisms and their association with improved survival.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alberto Maran, Federico Boscari, Carlo Fagarazzi, Maria Cristina Crepaldi, Monica Vedovato, Benedetta Maria Bonora, Daniela Bruttomesso, Mario Luca Morieri, Gian Paolo Fadini
{"title":"Long-term effects of adding an SGLT-2 inhibitor to insulin therapy in patients with type 1 diabetes. An observational study and systematic review of real-world evidence.","authors":"Alberto Maran, Federico Boscari, Carlo Fagarazzi, Maria Cristina Crepaldi, Monica Vedovato, Benedetta Maria Bonora, Daniela Bruttomesso, Mario Luca Morieri, Gian Paolo Fadini","doi":"10.1007/s40618-025-02602-8","DOIUrl":"https://doi.org/10.1007/s40618-025-02602-8","url":null,"abstract":"<p><strong>Purpose: </strong>The addition of SGLT2i to insulin therapy in type 1 diabetes (T1D) is an emerging treatment strategy. This study evaluates the real-world effects of SGLT2i on glycaemic control and other outcomes in individuals with T1D.</p><p><strong>Methods: </strong>In this single-center retrospective study, we included 78 adults with T1D who initiated SGLT2i and were observed for up to 24 months. Data included demographics, laboratory values, diabetic complications, and ongoing therapy. The primary outcome was the change in HbA1c over time. Persistence on therapy and adverse events were also recorded.</p><p><strong>Results: </strong>The mean age was 47.2 years, diabetes duration 24.6 years, baseline HbA1c 8.3%, and BMI 29.8 kg/m<sup>2</sup>. The median persistence on therapy was 14.8 months. HbA1c reduction was significantly associated with persistence (p = 0.01), with a maximum decrease of 0.61% at 6 months (p < 0.001). Time in range improved by 13.7% at 3 months (p < 0.001). Persistent users experienced a maximum weight loss of 2.5 kg at 9 months (p < 0.001). Insulin doses declined significantly (max 15% at 21 months). UACR declined significantly at 15 months (p = 0.025). Treatment discontinuation due to adverse events (mainly genitourinary tract infections) occurred in 25.6% of patients, and 1 episode of diabetic ketoacidosis was recorded. A review of the literature suggests that the observed effects are within the range of benefits reported previously from different countries.</p><p><strong>Conclusion: </strong>SGLT2i addition to insulin therapy in T1D patients resulted in sustained HbA1c reductions and weight loss. Therapy persistence significantly influenced outcomes, underscoring the importance of patient selection and monitoring for adverse effects.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli
{"title":"The mystery of Mont'e Prama: sculptures, acromegaly, and nuragic society.","authors":"Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli","doi":"10.1007/s40618-025-02605-5","DOIUrl":"https://doi.org/10.1007/s40618-025-02605-5","url":null,"abstract":"","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaetano Paride Arcidiacono, Valentina Camozzi, Giovanni Tripepi, Cristina Eller-Vainicher, Giuseppe Vezzoli, Maria Luisa Brandi, Gemma Marcucci, Giuseppe Girasole, Antonio Aversa, Corrado Vitale, Gaetana Cerbone, Maria Michela D'Alessandro, Martina Zaninotto, Maria Fusaro, Marco Onofrio Torres, Michele Cannito, Alberta Cecchinato, Martin Diogo, Mor Peleg Falb, Francesca Guidolin, Marta Zampogna, Mario Plebani, Elena Campello, Paolo Simioni, Stefania Sella, Sandro Giannini
{"title":"Predictors of response to burosumab in adults with X-linked hypophosphatemia: real-world data from an Italian cohort.","authors":"Gaetano Paride Arcidiacono, Valentina Camozzi, Giovanni Tripepi, Cristina Eller-Vainicher, Giuseppe Vezzoli, Maria Luisa Brandi, Gemma Marcucci, Giuseppe Girasole, Antonio Aversa, Corrado Vitale, Gaetana Cerbone, Maria Michela D'Alessandro, Martina Zaninotto, Maria Fusaro, Marco Onofrio Torres, Michele Cannito, Alberta Cecchinato, Martin Diogo, Mor Peleg Falb, Francesca Guidolin, Marta Zampogna, Mario Plebani, Elena Campello, Paolo Simioni, Stefania Sella, Sandro Giannini","doi":"10.1007/s40618-025-02596-3","DOIUrl":"https://doi.org/10.1007/s40618-025-02596-3","url":null,"abstract":"<p><strong>Purpose: </strong>X-linked hypophosphatemia (XLH) is a genetic disorder characterized by elevated FGF23 levels, leading to phosphate wasting and hypophosphatemia, causing skeletal and extraskeletal abnormalities. Burosumab, an antibody targeting FGF23, improves hypophosphatemia and clinical outcomes. This study evaluated the real-world efficacy of burosumab and identify predictors of treatment response.</p><p><strong>Methods: </strong>Twenty-seven adult XLH patients (mean age 42 years; 48% female) from an Italian multicenter cohort were treated with burosumab for up to 24 weeks. Laboratory tests were evaluated at midpoints and endpoints (14 and 28 days) of the dosing interval. In a subset of patients (N = 11) followed for 48 weeks, laboratory tests and patient-reported outcomes were also assessed.</p><p><strong>Results: </strong>After initiating burosumab, median serum phosphate levels increased from 1.5 mg/dL (IQR 1.3-1.8) to 2.0 mg/dL (IQR 1.7-2.4) (p < 0.05), remaining higher than baseline at the midpoints of the dosing interval for up to 24 weeks. Higher baseline phosphate predicted higher midpoint levels (p < 0.05), whereas higher baseline PTH (p < 0.05) and FGF23 (p < 0.001) were associated with lower phosphate levels at midpoints. In patients (N = 11) followed for 48 weeks, significant improvements in patient-reported outcomes in all patients were observed. Both WOMAC Pain (r = 0.94, p = 0.02) and BPI Worst Pain (r = 0.98, p < 0.001) were positively correlated with increased phosphate at week 48.</p><p><strong>Conclusion: </strong>Burosumab effectively increased serum phosphate levels and improved clinical outcomes in a real-world setting, particularly in patients with more substantial increases in serum phosphate levels. Baseline serum phosphate, PTH, and FGF23 levels predicted response, helping tailor treatment strategies and improve long-term patient management.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaoyuan Guo, Jiaqi Qiang, Zhibo Zhou, Yuxin Sun, Yutong Wang, Yuelun Zhang, Hongbo Yang, Huijuan Zhu, Mei Zhang, Bo Ban, Shi Chen, Hui Pan
{"title":"Insulin sensitivity index independently predicts serum IGF-1 decreases in adolescents with long-term exercise.","authors":"Xiaoyuan Guo, Jiaqi Qiang, Zhibo Zhou, Yuxin Sun, Yutong Wang, Yuelun Zhang, Hongbo Yang, Huijuan Zhu, Mei Zhang, Bo Ban, Shi Chen, Hui Pan","doi":"10.1007/s40618-025-02562-z","DOIUrl":"https://doi.org/10.1007/s40618-025-02562-z","url":null,"abstract":"<p><strong>Background: </strong>The study aims to investigate associations between insulin sensitivity and insulin-like growth factor-1 (IGF-1) in adolescents engaged in long-term exercise training, and to assess the impact on growth.</p><p><strong>Methods: </strong>We conducted a prospective cohort study and followed for 1 year from a general high school (non-exercise group, age 13.3 ± 0.5 years, n = 149) and an exercise training school (exercise group, age 13.5 ± 1.3 years, n = 100). Growth indices, insulin sensitivity assessed using the Quantitative Insulin Sensitivity Check Index (QUICKI), and IGF-1 levels were obtained.</p><p><strong>Results: </strong>Participants in the exercise group exhibited higher QUICKI and lower IGF-1 levels. In the exercise group, IGF-1 was independently associated with QUICKI cross-sectionally at baseline and follow-up. Longitudinal analysis revealed that QUICKI at baseline was independently associated with IGF-1 levels at follow-up in the exercise group (β = -532.926, P = 0.032). Such associations were not found in non-exercise group. Additionally, no impairments in growth indices were observed in the exercise group.</p><p><strong>Conclusions: </strong>Our findings suggest that QUICKI is an independent predictor of IGF-1 levels in adolescents with a long-term exercise regimen.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvia Monticone, Jessica Goi, Jacopo Burrello, Guido Di Dalmazi, Arrigo F G Cicero, Costantino Mancusi, Elena Coletti Moia, Guido Iaccarino, Franco Veglio, Claudio Borghi, Maria L Muiesan, Claudio Ferri, Paolo Mulatero
{"title":"Screening of primary aldosteronism and pheochromocytoma among patients with hypertension: an Italian nationwide survey.","authors":"Silvia Monticone, Jessica Goi, Jacopo Burrello, Guido Di Dalmazi, Arrigo F G Cicero, Costantino Mancusi, Elena Coletti Moia, Guido Iaccarino, Franco Veglio, Claudio Borghi, Maria L Muiesan, Claudio Ferri, Paolo Mulatero","doi":"10.1007/s40618-025-02532-5","DOIUrl":"10.1007/s40618-025-02532-5","url":null,"abstract":"<p><strong>Purpose: </strong>The delayed or missed diagnosis of secondary hypertension contributes to the poor blood pressure control worldwide. This study aimed to assess the diagnostic approach to primary aldosteronism (PA) and pheochromocytoma (PHEO) among Italian centers associated to European and Italian Societies of Hypertension.</p><p><strong>Methods: </strong>Between July and December 2023, a 10-items questionnaire was administered to experts from 82 centers of 14 Italian regions and to cardiologists from the ARCA (Associazioni Regionali Cardiologi Ambulatoriali) Piemonte. Results were stratified for geographical area, specialty, and center category (excellence vs. non-excellence centers).</p><p><strong>Results: </strong>Each center diagnosed an average of 2 cases of PA and 0.2 cases of PHEO annually, with higher figures in excellence centers. PA screening is performed mainly in patients with resistant hypertension (73.2%) or hypertension and spontaneous hypokalemia (84.1%), while only 17.1% and 35.4% of centers screen patients with grade 2-3 hypertension. Screening rate is lower for cardiologists compared to other specialists. The main barriers to wider testing were challenges in interpreting the aldosterone/renin ratio under interfering medications and switching to non-interfering drugs. Clinical scores to predict the likelihood of PA and the definition of Standard Operating Procedures were identified as potential tools to boost screening rates. Testing for PHEO was mostly conducted in patients with typical symptoms (75.6%) and/or hypertensive crisis (74.4%). Only 37.8% of centers screened all patients with adrenal incidentaloma.</p><p><strong>Conclusion: </strong>This study highlights significant gaps in the screening and diagnosis of PA and PHEO across Italian centers and underscores the need for widespread and standardized diagnostic protocols.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":" ","pages":"1197-1205"},"PeriodicalIF":5.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}