DHEAS and Differential Blood Counts as Indirect Signs of
                    Glucocorticoid Excess in Adrenal Non-Producing Adenomas

Eliza P. Winzinger; Hana Jandikova; Matthias Haase; Andreas Knauerhase; Tudor Winzinger; Matthias Schott; Holger S. Willenberg

doi:10.1055/a-1539-6442

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2021; 53(08): 512-519
DOI: 10.1055/a-1539-6442

Endocrine Care

DHEAS and Differential Blood Counts as Indirect Signs of Glucocorticoid Excess in Adrenal Non-Producing Adenomas

Authors

Eliza P. Winzinger

¹Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany
Hana Jandikova

²Third Department of Medicine – Clinic of Endocrinology and Metabolism, Charles University First Faculty of Medicine, Prague, Czech Republic

³Division for Specific Endocrinology, University Hospital Dusseldorf, Medical Faculty HHU Dusseldorf, Dusseldorf, Germany
Matthias Haase

³Division for Specific Endocrinology, University Hospital Dusseldorf, Medical Faculty HHU Dusseldorf, Dusseldorf, Germany
Andreas Knauerhase

¹Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany
Tudor Winzinger

¹Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany
Matthias Schott

³Division for Specific Endocrinology, University Hospital Dusseldorf, Medical Faculty HHU Dusseldorf, Dusseldorf, Germany
Holger S. Willenberg

¹Division of Endocrinology and Metabolism, Rostock University Medical Center, Rostock, Germany

Abstract

The majority of incidentally discovered adrenal tumors are later characterized as non-producing adrenocortical adenomas (NPA). We asked whether laboratory abnormalities in parameters that reflect glucocorticoid action can be found in patients with NPA despite their nature of being clinically unapparent. Since glucocorticoids are potent immunosuppressants we studied blood counts and differential blood counts along with corticotropin and dehydroepiandrostenedione sulfate (DHEAS) blood concentrations, as well as cortisol values before and after an overnight 1 mg dexamethasone suppression test. We compared the results of normal individuals, of patients with adrenal adenomas and normal hormone profiles and with subclinical autonomous glucocorticoid hypersecretion, as well as overt cortisol excess. We found that almost all indices of the blood counts were significantly different between the patients groups. In particular, patients with adrenal non-producing adenomas already showed signs of glucocorticoid excess, including relative lymphocytopenia, lowered DHEAS, and ACTH concentrations than control individuals. We also found that the extent of lymphocytopenia correlated with the concentrations of DHEAS and ACTH, and DHEAS correlated well with ACTH. We conclude that the basal ACTH and DHEAS values along with the differential blood counts give good information on the extent of glucocorticoid excess and that silent adrenal adenomas seem to oversecrete glucocorticoids at concentrations that already alter these parameters.

Key words

adrenal - DHEAS - incidentaloma - cortisol - blood count

Full Text

References

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