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Objective: Adrenal haemorrhage (AH) is an uncommon, usually incidental imaging finding in acutely unwell patients. AH has been reported during coronavirus disease 2019 (COVID‐19) infection and following ChAdOx1 nCoV‐19 (Oxford‐AstraZeneca) vaccination. The Society for Endocrinology (SfE) established a task force to describe the UK experience of COVID‐19‐related AH. Design: A systematic literature review was undertaken. A survey was conducted through the SfE clinical membership to identify patients with COVID‐19‐related AH using a standardized data collection tool. Results: The literature search yielded 25 cases of COVID‐19‐related AH (19 bilateral; 13 infection‐related, and 12 vaccine‐related). Eight UK centres responded to the survey with at least one case. A total of 18 cases were included in the descriptive study, including 11 from the survey and 7 UK‐based patients from the systematic review. Seven patients (4 males; median age 53 (range 26–70) years), had infection‐related AH (four bilateral). Median time from positive COVID‐19 test to AH detection was 8 (range 1–30) days. Eleven cases of vaccine‐related AH (eight bilateral) were captured (3 males; median age 47 (range 23–78) years). Median time between vaccination (nine Oxford‐AstraZeneca and two Pfizer‐BioNTech) and AH was 9 (range 2–27) days; 9/11 AH occurred after the first vaccine dose. Acute abdominal pain was the commonest presentation (72%) in AH of any cause. All 12 patients with bilateral AH and one patient with unilateral AH required glucocorticoid replacement. Conclusion: Adrenal haemorrhage with consequential adrenal insufficiency can be a complication of COVID‐19 infection and vaccination. Adrenal function assessment is mandatory to avoid the potentially fatal consequences of unrecognized adrenal insufficiency. [ABSTRACT FROM AUTHOR]

This article is an editorial for a special issue on congenital adrenal hyperplasia (CAH) in the journal Clinical Endocrinology. The issue includes contributions from international experts in the field, covering various aspects of clinical care for patients with CAH. Topics discussed include optimal biochemical monitoring, oral glucocorticoid chronotherapy, long-term health consequences, transition from pediatric to adult care, mineralocorticoid replacement therapy, prenatal and pregnancy care, rare genetic subtypes of CAH, and the i-CAH international registry. The editorial emphasizes the importance of tailored individual approaches and future biomarker discovery in the management of CAH. [Extracted from the article]

Objective To compare ethnic differences in total, free and bioavailable testosterone amongst young healthy South Asian and Caucasian men. Design and subjects Cross-sectional study of 134 healthy men (age 20-40 years) of South Asian ( n = 67) or Caucasian ( n = 67) origin, recruited from hospital staff and students working in Newport, UK. Subjects were excluded if they had a fasting plasma glucose >5·9 mmol/l, central obesity [waist circumference ≥94 cm (Caucasian) or ≥90 cm (South Asian)] or significant other disease. Measurements Fasting plasma glucose, total testosterone (determined by immunoassay and mass spectrometry), albumin, sex hormone-binding globulin (SHBG) and insulin were measured. Free and bioavailable testosterone were calculated using Vermeulen's formula, and insulin resistance was estimated by HOMA-IR. Results The South Asians were slightly older ( P = 0·04), shorter ( P < 0·001), lighter ( P < 0·001), more insulin resistant ( P = 0·006), and had a lower body mass index BMI ( P = 0·012), waist circumference ( P = 0·043) and SHBG ( P = 0·001) than the Caucasians. Total testosterone was significantly lower in South Asians (mass spectrometry: geometric mean 16·3 nmol/l; 95% reference interval 9·3-28·6 nmol/l) compared with Caucasians (mass spectrometry: geometric mean 18·4 nmol/l; 95% reference interval 10·6-31·9 nmol/l; P = 0·015), but calculated free and bioavailable testosterone were not different between groups. Adjusting for HOMA-IR, but not BMI or waist circumference, partly attenuated the differences in total testosterone. Conclusions Total, but not free, testosterone concentrations are lower in healthy South Asian men than in Caucasians. These differences are apparent at a young age and may be partly attributable to alterations in insulin sensitivity. [ABSTRACT FROM AUTHOR]