hrp0097p1-435 | Diabetes and Insulin | ESPE2023

Management of severe diabetic ketoacidosis with extremely high doses of insulin in a girl with severe insulin resistance syndrome due to compound heterozygous mutations in the insulin receptor gene

Kamrath Clemens , Genthner Nora , Rakicioglu Hande , Wudy Stefan

We report a girl born small for gestational age with a birth weight of 1970g. At the age of 2 years she developed marked dystrophy, height was -4.39 SDS and BMI was -3.1 SDS. Later she developed severe insulin restistance and hyperglycaemia due to compound heterozygous mutations in the insulin receptor gene: exon 16: c.2986A>G (paternal) and intron 9: c.2029+1G>T (maternal). Clinical findings included severe acanthosis nigricans, mild hypertrophic cardiomyopathy, abnorma...

hrp0092p1-12 | Adrenals and HPA Axis | ESPE2019

Trientine Treatment Mimicking Severe Hyperandrogenism

Binder Gerhard , Weber Karin , Wudy Stefan A. , Holterhus Paul-Martin , Hartleif Stefan

Drugs can interfere with immunoassays causing false measurements. Trientine (triethylene tetramine dihydrochloride) is a chelator of copper and is used in the treatment of patients with Wilson's disease as alternative for penicillamine. Trientine mainly increases urinary copper excretion leading to a negative copper balance. Serum concentrations of trientine reached under treatment are not known. This is the first report of an interference of trientine with two chemilumine...

hrp0089p1-p050 | Diabetes & Insulin P1 | ESPE2018

NBAS Gene Mutation Causes Insulin-Dependent Diabetes Mellitus in a Patient with a Multisystem Disorder Consisting Immunodeficiency and Extremely Short Stature

Giatropoulou Sofia , Konig Rainer , Wudy Stefan A. , Speckmann Carsten , Kury Patrick , Fischer-Zirnsak Bjorn , Clemens Kamrath

We report the case of a 19 years old male patient suffering from a multisystem disease involving of the skeleton, connective tissue, immune system, brain and endocrine system due to compound-heterozygote mutations in the NBAS (Neuroblastoma amplified sequence) gene (c.5741G>A [p.(Arg1914His)]; c.6565_6566insT [p.(Glu2189Valfs*7)]), detected using whole-exome-sequencing. He has an immunodeficiency including decreased CD4+T-cells, B-cells and NK-cells with expanded ...

hrp0086rfc4.5 | Pathophysiology of Obesity | ESPE2016

Steroid Metabolomic Signature of Liver Disease in Childhood Obesity

Gawlik Aneta , Shmoish Michael , Hartmann Michaela F. , Malecka-Tendera Ewa , Wudy Stefan A. , Hochberg Ze'ev

Background: Analysis of steroids by gas chromatography-mass spectrometry (GC-MS) defines a subject’s steroidal fingerprint. Here, we compare the steroidal fingerprints of obese children with or without liver disease to identify the ‘steroid metabolomic signature’ of childhood non-alcoholic fatty liver disease.Methods: Urinary samples of 85 children (43 girls) age 8.5–18.0 with obesity (BMI >97%) were quantified for 31 steroid meta...

hrp0086p2-p56 | Adrenal P2 | ESPE2016

The Effect of Anti-TNF on the Metabolism of Adrenal Hormones; A Steroid Metabolomic Approach

Keinan Ariel , Hartmann Michaela F. , Butbul Yonatan , Wudy Stefan A. , Tiosano Dov

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease seen in children. The systemic features of JIA are mediated by cytokine products of an activated immune system. Recent studies showed that the median level of urine cortisol in active JIA patients is significantly lower than remission period and control groups.Objective and hypotheses: One of the najor drugs in JIA is TNFα blocker (Enbrel). The aim of the study was ...

hrp0086p1-p887 | Thyroid P1 | ESPE2016

EEG Alterations are Common in Hashimoto’s Thyroiditis

Boettcher Claudia , Brosig Burkhard , Windhaus Henriette , Kamrath Clemens , Wudy Stefan A. , Hahn Andreas

Background: Steroid responsive encephalopathy with autoimmune thyroiditis (SREAT) is a clinically and electrographically heterogeneous steroid-responsive encephalopathy associated with thyroid autoantibodies.Objective and hypotheses: To investigate, whether children and adolescents with Hashimoto’s Thyroiditis (HT) lacking acute clinical manifestation of SREAT show electroencephalogram (EEG) alterations, and to compare EEGs of HT patients with those...

hrp0084fc12.3 | Obesity - Clinical | ESPE2015

Re-Classification of Childhood Obesity by Steroid Metabolomic Disease Signature

Gawlik Aneta , Shmoish Michael , Hartmann Michaela , Malecka-Tendera Ewa , Wudy Stefan , Hochberg Ze'ev

Context: Analysis of steroids by gas chromatography – mass spectrometry (GC-MS) defines a subject’s ‘steroidal fingerprint’. Here, we clustered steroidal fingerprints to classify childhood obesity by ’steroid metabolomic signatures’.Methods: Urinary samples of 87 children (44 F) age 8.5–18.0 with obesity (BMI >97%) underwent solid phase extraction, enzymatic hydrolysis and derivatization. 31 steroids metabolites wer...

hrp0084p1-147 | Miscelleaneous | ESPE2015

A New LC-MS/MS Assay for the Analysis of Sulfated Steroids in Human Serum: Quantification of Cholesterol Sulfate, Pregnenolone Sulfate, 17-Hydroxypregnenolone Sulfate and Androgen Sulfates

Sanchez-Guijo Alberto , Oji Vinzenz , Hartmann Michaela F , Traupe Heiko , Wudy Stefan A

Background: Steroids are found in human blood predominantly as sulfated steroids. Conjugation of steroids increases their solubility in blood, facilitating their physiological regulation and excretion. Chromatographic separation and quantification of an extensive number of sulfated steroids is challenging. For instance, androgen sulfates are structurally related and their signals are very similar in mass spectrometry.Objective and hypotheses: Some of the...

hrp0094p1-107 | Adrenal B | ESPE2021

Cortoic Acids: Renaissance of a Forgotten Class of Steroids

Schauermann Marcel , Wachter Ulrich A. , Homoki Janos , Hartmann Michaela F. , Hua Yifan , Remer Thomas , Wudy Stefan A. ,

Initially discovered in the 1970s, the C21 steroidal acids α-cortolic acid, β-cortolic acid, α-cortolonic acid and β-cortolonic acid present the terminal oxidative products of cortisol metabolism. Undergoing renal elimination, these cortoic acids have been assumed to represent up to 25% of total urinary cortisol metabolites. However, their analysis has been difficult, only few data has been published in adults, and this class of steroids has beco...

hrp0092fc9.4 | Fetal, Neonatal Endocrinology and Metabolism (to include Hypoglycaemia) | ESPE2019

Prenatal Environment and Genetic Background Influence Urinary Steroid Excretion in Monozygotic Twins with Intra-Twin Birth-Weight Differences

Schulte Sandra , Woelfle Joachim , Schreiner Felix , Kasner Charlotte , Gruenewald Mathias , Hartmann Michaela F. , Wudy Stefan A. , Bartmann Peter , Gohlke Bettina

Background: Low birth-weight and unfavourable intrauterine conditions are associated with a subsequent impact on the endocrine system. Many studies reported hyperandrogenaemia and precocious adrenarche in children born small for gestational age (SGA). However, little information is available on steroid profiles in these subjects.Objective and Hypotheses: We followed genetically identical twins with intra-twin birth-weigh...