Endocrine Abstracts

TSH-secreting pituitary adenomas (TSHomas) are rare. Previously, the reported prevalence was one case per million populations although this is probably an underestimate. A recently published study reported a prevalence of TSHomas in Sweden of 2.8/million inhabitants.Methods/design: Observational study conducted in four tertiary referral centres in Ireland. We retrospectively collected data on the prevalence, demographics, hormonal profile, tumour charact...

Introduction: Hypoaldosteronism is characterized by the development of hyperkalemia, but can also induce hypovolemic hyponatremia. Trimethroprim can cause hypoaldosteronism through mineralocorticoid resistance. That hypoaldosteronism can induce hyponatremia in absence of Addison’s disease has been questioned. We studied the electrolyte disturbances found following initiation of trimetroprim therapy.Material and methods: Retrospective, analytical. La...

Introduction: Primary hyperparathyroidism (PHP) has been postulated to be a cause of primary hyperaldosteronism (PHA). In fact, PTH receptors have been detected in aldosteronoma tissue. Hyperaldosteronism can also induce elevation of PTH levels, as increased circulating volume increases calciuria, with secondary elevation of PTH levels as serum calcium levels rise. We studied the prevalence of PHP in a group of patients diagnosed with PHA either following or simultaneously wit...

Inroduction: Polydipsia -excessive oral intake of liquids, with/without thirst- can induce euvolemic hyponatremia. Adequate inhibition of AVP secretion induced by low plasma osmolality (POsm) is reflected in a urinary osmolality (UOsm) ≤100 mOsm/kg. However, increased fluid intake can also reveal underlying non-osmotic AVP secretion, induced by pain, nausea, and/or SIADH, with UOsm >100. Iatrogenic polydipsia is characterized by increased liquid intake without thirst...

Introduction: Primary hyperaldosteronism (PH) is characterized by autonomous adrenal aldosterone (A) hypersecretion. Unilateral adrenalectomy is the treatment of choice, when adrenal vein sampling (AVS) indicates lateralization of A secretion. To assure that each adrenal vein (AV) has been correctly sampled, cortisol levels in each adrenal vein must be higher than in the inferior vena cava. The adrenal gland cortisol/vena cava cortisol ratio is referred to as the selectivity i...

Introduction: Hereditary phaeochromocytoma (PCC) and paraganglioma (PGL) account for 30–35% of cases and have some clinically relevant peculiarities.Material and methods: Retrospective, unicentric cohort study that included all genotyped patients (n=36, 27 with PCC and 9 with PGL) diagnosed at Hospital Clínico San Carlos (Madrid) between 1984 and 2013; 33% were germline mutation carriers (25% pseudohypoxic [PH] phenotype, 75% MAP-kinas...

Introduction: Hereditary Medullary Thyroid Cancer (MTC) accounts for 20–30% of cases and has some clinically relevant peculiarities.Material and methods: Retrospective, unicentric cohort study that included all genotyped patients with MTC (n=48) diagnosed at Hospital Clínico San Carlos (Madrid) between 1984–2013; 42% were germline mutation carriers (45% moderate risk (category MOD), 45% high risk (category H), 10% highest risk (ca...

Context: Fluid restriction (FR) is recommended as first line therapy for SIAD by both the European1 and the American guidelines2 for management of SIAD. Not all patients respond to FR however, and the American guidelines have identified clinical predictors of failure to respond to FR. These include 1.Urine osmolality (UOsm) >500 mOsm/Kg 2. Furst formula (ratio UNa+UK/pNa) > 1, and 3. 24 hour-urine volume<1500 mlObjective...

Introduction: Some authors consider aldosteronism to be a spectrum, ranging from aldosterone-associated (or low-renin) hypertension (AAH) to primary hyperaldosteronism (PHA) due to bilateral adrenal hyperplasia. Thus, blood pressure (BP) response to mineralocorticoid-receptor blockade (MRB) could be similar.Methods: Retrospective analysis of 60 patients. Screening per Endocrine Society guidelines, positive screening: aldosterone (pg/ml) to direct-renin (...

Introduction: Furosemide can be used in the treatment of SIADH. However, to be effective, renal medulla osmolality (OsmRM) as reflected in urinary osmolality (UOSM) must be high. Sodium is the most important contributor to OsmRM, which increases following the administration of oral salt. We analyze the use of an oral salt load followed by furosemide for the acute/short-term treatment of euvolemic SIADH hyponatremia.Method...