Endocrine Abstracts

Acromegaly is associated with skeletal fragility and an increased prevalence of vertebral fractures (VF). In recent years several authors have tried to investigate the markers that can predict the risk of bone fragility in this endocrine disorder. Two different isoforms of the GH receptor (GHR) have been described so far, which differ in the presence or absence of a transcript of exon 3 of the GHR gene. Both isoforms produce a functional receptor, but the exon 3-deleted isofor...

Medullary thyroid carcinoma (MTC) accounts for 1%–2% of thyroid cancers and has a variable clinical course. MTCs present with locoregional metastasis in 50% of patients and distant metastasis in 10% to 15% at the time of initial diagnosis. The lungs, liver, and bone are common metastatic sites, and distant metastasis is known to be a poor prognostic factor for long-term oncologic outcomes. We present the long course case, under somatostatin analogues (SSA) therapy, of a 7...

Purpose: Osteopathy is an emerging complication of acromegaly characterized by increased bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures (VFs). In somatostatin analog (SSA)-resistant patients (pts), Pegvisomant (PegV) and Pasireotide LAR (Pasi) are used for acromegaly treatment, but their effect on skeletal health is still not defined.Methods: In a longitudinal international multicenter study, we evaluated inci...

Introduction: Bilateral sampling of the inferior petrosal sinuses (IPSS) is considerate actually the best diagnostic test for Cushing.Patients and methods: We retrospectively reviewed our series of patients undergone IPSS for Cushing disease and we compared the difference between central and peripheral ACTH gradient in basal condition and after CRH stimulation in cases of localization of the tip of the catheters inside the inferior petrosal sinus or at t...

Aim: To evaluate calcium and bone metabolism in a monocentric series of acromegaly patients (pts), treated with pegvisomant (PEG) alone or in association to long acting somatostatine analogs.Patients and methods: All pts with at least 24 consecutive months PEG treatment (alone or in combination with SSA) were enrolled. All pts had been tested at least twice/year for biochemical acromegaly-disease evaluation and annually for calcium metabolism and for bon...

Background and objective: Atypical pituitary adenomas (APA), in 2004, were defined according to WHO classification, as those with Ki-67>3%, excessive p53 expression and increased mitotic activity and invasive behaviour. The real usefulness of this classification is still controversial, so we reviewed compared clinical and prognostic features in our typical and atypical pituitary adenomas.Patients and methods: We retrospectively reviewed 343 consecuti...

The IGF1 response to recombinant human growth hormone (rhGH) showed some individual variability and the responsible factors for this behavior remain unknown. Some studies have emphasized the possible role of isoforms of the GH receptor (GHR), showing conflicting results.Therefore, we investigated the possible influence of the isoforms of the GHR to the diagnosis of GHD and in determining adult hormone replacement therapy responsiveness.<p class="abst...

Introduction: The main goal in the treatment of acromegaly is achieving biochemical and tumor mass control. Therapeutic options include surgery, medical treatment and, in selected cases, radiotherapy. A GH receptor (GHR) variant that differs for the genomic retention or exclusion (d3GHR) of exon 3 is present in about 50% of general population and its presence is related to a greater sensitivity to GH.Materials and methods: We describe a series of 118 pat...

GH deficiency (GHD) and excess of glucocorticoids are associated with increased risk of fragility fractures. Most adult GHD patients have other pituitary deficiencies, but it is unclear whether these deficiencies or their overreplacement therapies may influence the bone disease occurring in GHD. The aim of this study was to evaluate whether the prevalence of vertebral fractures may be influenced by glucocorticoid replacement therapy in hypopituitary males with GHD. We studied ...

Introduction: A significant number of GH-secreting pituitary adenomas show an aggressive behavior, therefore, when uncontrolled acromegaly persists, a pharmaceutical combination may improve biochemical control, with reduction of disease morbidity and mortality. We aimed to describe the clinical features of four patients successfully treated with a pharmacological combination of pasireotide LAR, pegvisomant and cabergoline.Case reports: Acromegaly was dia...