Pituitary Clinical | 0029 | ICEECE2012 | 15th International & 14th European Congress of Endocrinology

ea0029p1361 | Pituitary Clinical | ICEECE2012

Case series of diabetic ketoacidosis as the first presentation of 860 patients with acromegaly

Yoshida N. , Suzuki H. , Nagasawa K. , Okubo M. , Takeshita A. , Miyakawa M. , Mori Y. , Fukui T. , Fukuhara N. , Nishioka H. , Yamada S. , Takeuchi Y.

Background and aims: Excess GH causes insulin resistance resulting in impaired glucose metabolism. Although diabetes mellitus (DM) is common in patients with acromegaly, diabetic ketoacidosis (DKA) is rarely associated with acromegaly. Actually only 11 DKA patients have been anecdotally reported as the first presentation of acromegaly so far. Here we present nine cases of DKA as the first presentation of 860 consecutive patients with acromegaly and their clinical characteristi...

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ea0029p1362 | Pituitary Clinical | ICEECE2012

Markers of recurrence and long-term morbidity in craniopharyngioma

Gautier A. , Godbout A. , Grosheny C. , Tejedor I. , Coudert M. , Courtillot C. , Jublanc C. , De Kerdanet M. , Poirier J. , Riffaud L. , Sainte-Rose C. , VanEffenterre R. , Brassier G. , Bonnet F. , Touraine P.

Context: Craniopharyngiomas are often associated with an unfavorable prognosis but data on their long-term consequences are sparse.Objective: To identify markers of recurrence and factors associated with compromised social rehabilitation and altered quality of life (QoL) in a large cohort of patients with either childhood onset (CO) or adult onset (AO) craniopharyngioma.Methods: Retrospective analysis was performed for 171 patients...

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ea0029p1363 | Pituitary Clinical | ICEECE2012

Familial isolated pituitary adenoma: review of four families

Belo S. , Mesquita J. , Nogueira C. , Magalhaes A. , Basto M. , Pereira J. , Carvalho D.

Introduction: Pituitary adenomas are frequent brain tumors, with prevalence of about 1:1000. Most occur sporadically. The familial forms represent 5% of cases. These can be found associated with other endocrine neoplasia (MEN 1, Carney complex, MEN 4) or as a clinical isolated entity FIPA. This is characterized by the presence of pituitary tumors in two or more family members, in the absence of features of other endocrine syndromes. AIP gene mutation, which may or may n...

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ea0029p1364 | Pituitary Clinical | ICEECE2012

A prospective study of cardiac valvular status in patients treated with cabergoline for endocrine disease

Vroonen L. , Lancellotti P. , Tome M. , Magne J. , Auriemma R. , Daly A. , Pierard L. , Beckers A.

Introduction: Since the 1990s cabergoline has become the treatment of choice in prolactinomas, allowing rapid and efficient hormonal and tumoral control in most cases. Evidence of cardiac valculopathy was demonstrated in patients treated by dopamine agonists for Parkinson disease, which led to curtailment of their use in this disease. Retrospective studies in hyperprolactinemia patients treated with cabergoline did not show such an effect, probably due to much lower dose...

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ea0029p1365 | Pituitary Clinical | ICEECE2012

IGF1 as a risk factor for insulin resisitance and glucose intolerance in acromegaly

Niculescu D. , Purice M. , Lichiardopol R. , Coculescu M.

Introduction: In normal subjects GH is a hyperglycemic hormone as opposed to insulin-like growth factor 1 (IGF1). Active acromegaly is associated with insulin resistance (IR) and glucose intolerance although both GH and IGF1 are elevated. Our objective was to assess whether GH, IGF1 or both are risk factors for IR and glucose intolerance in acromegaly.Methods: Basal serum IGF1 and GH, glucose and insulin during an oral glucose tolerance test were measure...

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ea0029p1366 | Pituitary Clinical | ICEECE2012

An insight into the mechanisms underlying the sympathoinhibition of acromegaly

Carzaniga C. , Seravalle G. , Attanasio R. , Grassi G. , Lonati L. , Facchini C. , Cozzi R. , Fatti L. , Montini M. , Vitale G. , Sciortino G. , Damanti S. , Brambilla G. , Cavagnini F. , Mancia G. , Scacchi M. , Persani L.

By direct measurement of muscle sympathetic nerve activity (MSNA) we previously demonstrated a markedly decreased adrenergic tone in newly diagnosed acromegalic patients. The present study was aimed at confirming this finding in a larger group of patients and establishing the pathophysiological role of insulin resistance, GH and IGF1 levels, circulating leptin and extracellular water (ECW) in this abnormality.Study design: Fifteen de novo patients...

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ea0029p1367 | Pituitary Clinical | ICEECE2012

Aneurysmal subarachnoid haemorrhage is a rare cause of acute glucocorticoid deficiency and long term hypopituitarism

Hannon M. , Behan L. , O'Brien M. , Rogers B. , Sherlock M. , Smith D. , Agha A. , Thompson C.

Subarachnoid haemorrhage (SAH) is a well reported cause of hypopituitarism but the precise incidence is controversial. We aimed to prospectively determine the incidence of acute and long term hypopituitarism in SAH.We prospectively recruited 100 patients (61% female, median age 53 (range 1682)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium, urea, osmolality, glucose, and 0900 h cortisol (PC) measured on days 1, 2, 3, 4, 6, 8, 10...

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ea0029p1368 | Pituitary Clinical | ICEECE2012

Hyponatraemia in aneurysmal subarachnoid haemorrhage is due to the syndrome of inappropriate antidiuresis and acute glucocorticoid deficiency

Hannon M. , Behan L. , Rogers B. , Sherlock M. , Smith D. , Agha A. , Ball S. , Thompson C.

Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH). Retrospective data suggests that the Syndrome of Inappropriate Antidiuresis (SIAD) is the most common cause, although glucocorticoid deficiency and rarely cerebral salt wasting may also cause hyponatraemia.We prospectively studied 100 patients (61% female, median age 53 (range 1682)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (p...

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ea0029p1369 | Pituitary Clinical | ICEECE2012

Pregnancy outcomes following cabergoline treatment in hyperprolactinemic patients: an observational survey study

Auriemma R. , Grasso L. , Di Sarno A. , Perone Y. , Pivonello R. , Colao A.

Cabergoline (CAB) and other dopamine agonists are usually discontinued shortly after hyperprolactinemic patients become pregnant. Data on maternal and foetal exposure to CAB and on recurrence of hyperprolactinemia after pregnancy are still limited. The current survey study aimed at elucidating the safety of exposure to CAB during early pregnancy and the recurrence rate of hyperprolactinemia after pregnancy. Thus, 68 pregnancies in a cohort of 59 patients with hyperprolactinemi...

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ea0029p1370 | Pituitary Clinical | ICEECE2012

Sleep apnea in acromegaly: pathogenetic factors and long-term follow up

Castellani C. , Francia G. , Ferrari M. , Viva E. , Davi M.

Background: Sleep apnea syndrome (SAS) is a common disease in acromegaly and it can persist during remission in up to 58% of the patients. Data regarding long term outcome of SAS in acromegalic patients are lacking. Moreover it is still unknown which component, either craniofacial deformation or soft tissue hypertrophy of the palate and upper airways, may play the major role in the pathogenesis of this complication.Aim: To assess the presence of SAS in a...

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ea0029p1371 | Pituitary Clinical | ICEECE2012

Japan National Survey of metastatic pituitary tumor: preliminary report on 164 cases

Habu M. , YUnoue S. , Fujio S. , Shimatsu A. , Teramoto A. , Arita K.

Background and objective: The number of reports of metastatic (secondary) pituitary tumors has been increasing with progression of diagnostic and treatment skills for cancer patients. However, there were no nation-wide epidemiologic surveys or epidemiologic reviews about this topic. We have started a multi-institutional joint research in Japan to understand clinical features of metastatic pituitary tumors.Subjects and methods: We distributed 1069 closely...

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ea0029p1372 | Pituitary Clinical | ICEECE2012

Effects of previous GH excess and current medical treatment for acromegaly on cognition

Brummelman P. , Koerts J. , Dullaart R. , van den Berg G. , Tucha O. , Wolffenbuttel B. , van Beek A.

Context: In untreated acromegalic patients, decreased cognitive functioning is reported to be associated with the degree of GH and IGF1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear.Objective: To compare cognitive functioning in patients who are treated for acromegaly and non-functioning pituitary adenomas (NFA). In addition, we assessed the influence of prolonged medical tre...

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ea0029p1373 | Pituitary Clinical | ICEECE2012

See OC10.2...

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ea0029p1374 | Pituitary Clinical | ICEECE2012

Circulating total and high molecular weight adiponectin levels are lower in adult GH deficient subjects

Caputo M. , Prodam F. , Garbaccio V. , Sama M. , Zavattaro M. , Pagano L. , Marzullo P. , Aimaretti G.

Introduction: Regulation of adiponectin in GH deficiency (GHD), which presents visceral obesity, is still a matter of debate. No studies have evaluated circulating adiponectin isoforms in adult GHD subjects. Aim of this study was to evaluate total adiponectin (TA) and its isoforms (high molecular weight: HMW, medium molecular weight: MMW, low molecular weight: LMW) in hypopituitary adult subjects with and without GHD, in relation to weight, IGF1 and GH levels.<p class="abs...

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ea0029p1375 | Pituitary Clinical | ICEECE2012

Quality of life and mood disturbances in patients with acromegaly followed-up in a single center

Anagnostis P. , Efstathiadou Z. , Vounaki A. , Maria C. , Selalmatzidou D. , Gotoufa G. , Kita M.

Introduction: Acromegaly is a chronic disease associated with impairment of quality of life (QoL) and psychological status. The aim of the present study was to assess QoL and mood disturbance in patients with acromegaly.Description of methods/design: It was a comparative, cross-sectional study conducted in the department of Endocrinology at a tertiary medical centre of northern Greece in 2011. AcroQoL questionnaire was used to assess QoL in acromegalics ...

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ea0029p1376 | Pituitary Clinical | ICEECE2012

Low total cortisol correlates closely with low free cortisol in traumatic brain injury and predicts mortality and long term hypopituitarism

Hannon M. , Crowley R. , Behan L. , O'Sullivan E. , Rogers B. , O'Brien M. , Rawluk D. , O'Dwyer R. , Agha A. , Thompson C.

Published data has demonstrated that low 0900 h plasma total cortisol (PTC) immediately following traumatic brain injury (TBI) predicts mortality. However, potential discrepancies exist between PTC and plasma free cortisol (PFC). We hypothesised that low PTC would correlate closely with PFC and predict mortality and long-term hypopituitarism.One hundred patients (84 men, median age 33, range 1875) with TBI (mean GCS±S.D.=8.59&#1...

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ea0029p1377 | Pituitary Clinical | ICEECE2012

Array-comparative genomic hybridization in congenital morphological alteration of the pituitary gland

Ribichini D. , Romagnoli M. , Baccini M. , Pasquali R. , Pagotto U. , Seri M.

Congenital morphological alteration of pituitary gland is a rare disease often associated with isolated or multiple hormonal deficiency. So far only few genes have been shown to be implicated in a small number of these cases.Aim of this study was to evaluate putative genetic alteration by an array-based comparative genomic hybridization (array-CGH) in 19 adulthood patients, 16 males and 3 females, affected by congenital morphological alteration of the pi...

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ea0029p1378 | Pituitary Clinical | ICEECE2012

Low IGF1 levels are associated with a lower prevalence and incidence of anxiety disorders in primary care patients (DETECT cohort) and the general population (SHIP cohort)

Sievers C. , Auer M. , Klotsche J. , Pieper L. , Athanasoulia A. , Schneider H. , Marz W. , Nauck M. , Volzke H. , John U. , Freyberger H. , Friedrich N. , Biffar R. , Wittchen H. , Stalla G. , Wallaschofski H. , Grabe H.

Objective: In vitro and in vivo models revealed that the somatotropic system exerts central effects on the central nervous system. The objective of this study was to investigate for the first time whether varying endogenous IGF1 levels are associated with mental health outcomes, namely affective disorders, in humans.Design and methods: We included 6773 subjects from the DETECT study, a representative study on primary care patients in German...

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ea0029p1379 | Pituitary Clinical | ICEECE2012

Epidemiology, histophatological characteristics and clinical manifestations of aggressive pituitary tumors, evaluated on the basis of KI-67 immunostaining: a single center experiense

Grasso L. , De Angelis M. , Di Somma C. , Savanelli C. , Galdiero M. , Cozzolino A. , Cavallo L. , Cappabianca P. , Del Basso De Caro M. , Pivonello R. , Colao A.

Aggressive pituitary tumors are classically defined as pituitary tumors with large size, rapid growth and massive invasion of surrounding anatomical structures. This is a group of pituitary tumors with biological behavior between pituitary adenomas and carcinomas and includes a new group of pituitary tumor, defined atypical adenoma, characterized by the presence of invasive growth and combination of increased mitotic activity and a Ki-67 labeling index >3%. The aim of this...

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ea0029p1380 | Pituitary Clinical | ICEECE2012

Congenital hypopituitarism with ectopic posterior pituitary and pulmonic stenosis: hormonal and radiologic followup into adulthood

Vaz C. , Dhindsa S.

We describe the course of a now 24y/o M with congenital hypopituitarism, severe micropenis, cryptorchidism, hypoplastic testes, hypospadiasis and pulmonic stenosis. He presented with neonatal hypoglycemia. MRI showed small anterior pituitary and ectopic posterior pituitary near tuberous cinereum. Pulmonic stenosis detected after auscultation of a murmur, was mild grade on echo. Free T4 1 ng/dl (12.5) TSH 6.7 μU/ml (0.26) glucagon stimulation for GH ...

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ea0029p1381 | Pituitary Clinical | ICEECE2012

Childhood onset craniopharyngiomas have normal selfrating quality of life but impaired neurocognitive function in adult life

Fjalldal S. , Holmer H. , Erfurth E.

Introduction: Hypothalamic damage in craniopharyngiomas (CP) is associated with poor functional outcome. Data on quality of life (QoL) in CP on complete hormone replacement, including GH, is missing. The aim of this study was to assess QoL and neurocognitive function in childhood onset (CO) CP on complete hormone substitution.Methods and design: Forty-two (20 women) patients, aged ≥17 years were recruited from the South Medical Region of Sweden (po...

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ea0029p1382 | Pituitary Clinical | ICEECE2012

Orexin A concentration is reduced in acromegaly, regardless activity of the disease

Jawiarczyk A. , Bolanowski M.

It has been reported that orexins play an important role in the regulation of GH secretion. It is suggested that the defect in orexins synthesis could be responsible for the disturbances in GH synthesis and consequently aggravate metabolic disturbances. The aim of the study was to assess plasma orexin A levels in patients with acromegaly in relation to the activity of disease and hormonal and metabolic profiles. Fifty-five patients with acromegaly divided into three groups acc...

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ea0029p1383 | Pituitary Clinical | ICEECE2012

No evidence for detrimental effect of cabergoline therapy on cardiac valves in patients with acromegaly

Maione L. , Garcia C. , Kallel N. , Bouchachi A. , Maison P. , Kamenicky P. , Salenave S. , Young J. , Assayag P. , Chanson P.

Context: The effects of cabergoline on cardiac valves have been extensively studied in Parkinsons disease and hyperprolactinemia but not in acromegaly, a condition at risk of cardiac valve abnormalities.Objective: We examined the prevalence of heart valve disease and regurgitation in a series of patients with acromegaly treated with cabergoline, by comparison with matched patients who had never received this drug.Design and s...

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ea0029p1384 | Pituitary Clinical | ICEECE2012

Prevalence and incidence of pituitary adenomas; a population based study in Malta

Gruppetta M. , Mercieca C. , Vassallo J.

Context: Epidemiological data is important to correctly quantify the extent of disease and needed health care resources. There are no reports on both incidence and prevalence rates for pituitary adenomas (PAs) together in the same population.Objective: The objective of the study was to establish the prevalence and incidence of pituitary adenomas with in-depth analysis of their various subtypes in a well defined population.Design: T...

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ea0029p1385 | Pituitary Clinical | ICEECE2012

Markers of disease activity correlate with cephalometric parameters in acromegalic patients

Carvalho A. , Pinho T. , Pinto J. , Santos A. , Carvalho D.

Introduction: Acromegaly, a rare disorder resulting of tumor GH excess, is frequently associated with prognathism and facial dysmorphia. Characteristics and mechanisms responsible for the malocclusion and the craniofacial changes in acromegalic patients (ACR) are not clarified.Aims: To evaluate the craniofacial changes in an acromegalic group.Methods: We observed 59 individuals, 33 with ACR and 26 controls with nonfunctioning pitui...

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ea0029p1386 | Pituitary Clinical | ICEECE2012

Management of giant cystic invasive prolactinoma-the role of medical therapy revisited

Bukowczan J. , Kane P. , Nag S.

Introduction: Giant prolactinomas are uncommon tumours and typically exceed 40 mm. These tumours are locally invasive but still respond to dopamine agonist therapy. The medical management of cystic giant prolactinomas with dopamine agonists is controversial as the non-solid components of these aggressive tumours are believed to respond poorly to drug therapy. We present a case of a giant cystic invasive prolactinoma masquerading as a multilobular schwannoma that was successful...

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ea0029p1387 | Pituitary Clinical | ICEECE2012

Surveillance study on the prevalence of manifestations, complications and illness associated to acromegaly

Guaraldi F. , Maccario M. , Prencipe N. , Di Giacomo S. , Gasco V. , Berton A. , Mainolfi A. , Ghigo E. , Grottoli S.

Introduction: Acromegaly is a rare disease caused by chronic exposure to excessive levels of GH, usually related to the presence of a pituitary adenoma, and associated to somatic and visceral hypertrophy, metabolic alterations, respiratory and cardiovascular complications, and increased risk of neoplasias.Materials and methods: The prevalence of manifestations, complications and associated illness was evaluated in 137 acromegalic subjects (52 M, 85 F; ag...

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ea0029p1388 | Pituitary Clinical | ICEECE2012

Diabetes insipidus could be the initial sign of primary hypophysitis

Suh S. , Park S. , Joung J. , Cho Y. , Jin S. , Kim S. , Kim H. , Bae J. , Kim J. , Kim S. , Chung J. , Min Y. , Lee M. , Lee M. , Kim K.

Introduction: The natural history of primary hypophysitis is incompletely understood and best treatment remains controversial.Methods: We performed a retrospective study of 19 patients (mean age of 47 years, fifteen women and four men) who were diagnosed with primary hypophysitis in Samsung Medical Center in Seoul, Korea, from January 2001 to October 2011.Results: Two patients had recent pregnancy and underlying autoimmunity. Most ...

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ea0029p1389 | Pituitary Clinical | ICEECE2012

Evaluation of metabolic parameters in patients with craniopharyngiomas using visceral adiposity index

Savanelli M. , Brunelli V. , Scarano E. , Esposito R. , Rubino M. , Contaldi P. , Savastano S. , Colao A. , Di Somma C.

Background: Craniopharyngiomas are benign tumors of the parasellar and sellar region. Patients with craniopharyngioma, treated with surgery, have comorbidities such as obesity and multiple pituitary deficiencies.Aim: To evaluate the metabolic parameters of patients with craniopharyngioma treated with surgery.Methods: We recruited 20 patients with craniopharyngioma (M=11, 46.6±12.6) and 20 patients (M=10, 53.5&#17...

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ea0029p1390 | Pituitary Clinical | ICEECE2012

Oxidative stress and reduced anti-oxidative status, along with endothelial dysfunction in acromegaly

Anagnostis P. , Efstathiadou Z. , Gougoura S. , Polyzos S. , Karathanasi E. , Dritsa P. , Kita M. , Koukoulis G.

Introduction: Acromegaly is characterized by high cardiovascular morbidity and mortality. Oxidative stress and endothelial dysfunction are underlying mechanisms of atherosclerosis. The aim of this study was to evaluate the blood redox status and endothelial function by means of nitric oxide (NO) levels in patients with acromegaly.Description of methods/design: Total antioxidant capacity (TAC), catalase activity and glutathione concentration (GSH), as mea...

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ea0029p1391 | Pituitary Clinical | ICEECE2012

Evaluation of clinical presentation, treatment approach and outcome of a cohort of patients with acromegaly: a single centre experience

Gouveia S. , Paiva I. , Ribeiro C. , Vieira A. , Alves M. , Saraiva J. , Moreno C. , Carvalheiro M.

Introduction: Acromegaly is a rare disease with a high morbidity and mortality rate.Our aim was to characterise the population with acromegaly that is currently under supervision at our Department.Materials and methods: We included 104 patients with acromegaly (mean age at the diagnosis 44.0±13.0; with 71.2% females).The referred population was analysed on what concerns diseases duration, clinical ...

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ea0029p1392 | Pituitary Clinical | ICEECE2012

Permanent panhypopituitarism is a rare complication of acute bacterial sinusitis

Lavan A. , Hannon M. , O'Brien M. , Thompson C.

Permanent pan-anterior hypopituitarism is a rare complication of bacterial sinusitis, with only six cases reported worldwide. However, all were reported before the advent of MR imaging and most did not have what is now regarded as gold standard evaluation of pituitary function. Also, all previous cases noted an interval of months between resolution of sinusitis and development of hypopituitarism. We report two cases of previously healthy Caucasian adults who developed pan-ante...

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ea0029p1393 | Pituitary Clinical | ICEECE2012

Carboplatin is a novel cause of the syndrome of inappropriate antidiuresis

O'Brien M. , Hannon M. , Lavan A. , Thompson C.

The syndrome of inappropriate antidiuresis (SIAD) is characterised by plasma hyponatraemia and plasma hypoosmolality with a high urinary sodium in a clinically euvolaemic patient. We describe only the second reported case of SIAD due to carboplatin administration, with consequent acute severe hyponatraemia.A 61-year-old lady with no background history of note received neoadjuvant carboplatin and paclitaxel for stage III ovarian carcinoma. Five days after...

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ea0029p1394 | Pituitary Clinical | ICEECE2012

Evaluation of ejaculatory function in acromegalic men: preliminary study

Galdiero M. , Vitale P. , Grasso L. , Lo Calzo F. , Cariati F. , Lotti F. , Maggi M. , Colao A. , Pivonello R.

Introduction: Acromegaly is a systemic disease frequently characterized by hypogonadotropic hypogonadism, endothelial dysfunction and diseases classically associated with an increased incidence of erectile dysfunction (ED) (hypertension, dyslipidemia, impaired glucose metabolism) and premature ejaculation (prostatic disease). Furthermore, the high prevalence of ED may negatively affect ejaculatory function. The purpose of this study was to evaluate the ejaculatory function of ...

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ea0029p1395 | Pituitary Clinical | ICEECE2012

Evaluation of male sexual function in active acromegalic patients and after disease remission: preliminary study

Galdiero M. , Vitale P. , Grasso L. , Lo Calzo F. , Cariati F. , Lotti F. , Maggi M. , Colao A. , Pivonello R.

Introduction: Acromegaly is frequently characterized by hypogonadotropic hypogonadism, endothelial dysfunction, hypertension and impaired glucose and lipid metabolism, classically associated with impaired sexual function (SF). There are no literature data on the SF in acromegaly. The purpose of this study was to evaluate the SF of patients with acromegaly.Patients and methods: Twenty-two patients (47.8±8.6 years) were enrolled into the study. Among ...

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ea0029p1396 | Pituitary Clinical | ICEECE2012

The clinical outcome of pituitary adenomas in the cavernous sinus

Marathe C. , Irish G. , Torpy D.

Introduction: Pituitary adenomas with cavernous sinus involvement (CSI) are associated with serious clinical sequelae but are often incompletely excised during surgery. Contradictory viewpoints exist regarding management of residual tumors in the cavernous sinus with some authors suggesting use of adjuvant radiotherapy post-operatively for long term tumor control. But radiotherapy has been associated with hypopituitarism and increased mortality due to cerebrovascular causes. W...

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ea0029p1397 | Pituitary Clinical | ICEECE2012

Outcome of transsphenoidal surgery for Cushing’s disease dependent on tumor size: a single center experience

Dimopoulou C. , Stalla G.

Introduction: Transsphenoidal surgery (TSS) currently presents treatment of choice for Cushings disease (CD). Dependent on tumor size, remission rates after initial TSS range from 66 to 94%. In ACTH-secreting pituitary macroadenomas, remission rates are reported to be lower. Visible adenomas on preoperative MRI or intraoperatively and neurosurgical expertise might contribute to successful TSS.Design: A retrospective, single center analysis in 51 CD...

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ea0029p1398 | Pituitary Clinical | ICEECE2012

Effects of medical therapy of acromegaly on glucose metabolism

Urbani C. , Calevro A. , Scattina I. , Lombardi M. , Sardella C. , Nuzzo A. , Marchello A. , Martino E. , Bogazzi F.

Introduction: Acromegaly is associated with alterations of glucose metabolism. The effect of somatostatin analogues (SMS) and pegvisomant (PEG) on glucose metabolism is still argument of debate.Study design: The purpose of this historical-prospective study was to compare, in a cohort of 47 patients with active acromegaly, the effects of SMS and PEG alone or in combination on glucose metabolism. All subjects were evaluated at baseline and at least 6 month...

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ea0029p1399 | Pituitary Clinical | ICEECE2012

Insulin resistance and the effect of treatment on insulin resistance in patients with prolactinoma

Soytac Inancli S. , Usluogullari A. , Ustu Y. , Caner S. , Tam A. , Ersoy R. , Cakir B.

Aim: The relationship between hyperprolactinoma and insulin resistance has been shown in many studies. It is also known that hyperprolactinoma causes changes in carbohydrate and lipid metabolism. The aim of our study is to evaluate insulin resistance in patients with prolactinoma and see the effect of treatment on insulin resistance and karotis intima media thickness (CIMT).Material and methods: Twenty-two female patients diagnosed biochemically and radi...

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ea0029p1400 | Pituitary Clinical | ICEECE2012

Effects on GH/IGF1 hypersecretion and tumor size of long-acting somatostatin analogue (Sandostatin LAR) in patients with untreated acromegaly and in previously treated with surgery and/or radiotherapy

Hasan T , Pemovska G , Jovanovska B , Subeska S

Objectives: To comperate the efficacy of sandostatin LAR therapy in patients with untreated acromegaly and in previously treated with surgery and/or radiotherapy.Material and methods: We studied 16 consecutive patients (seven women and nine men, aged 2971 year). Fourteen patients harboured a macroadenoma and two microadenoma. The study was retrospective examination of untreated and previously treated patients with surgery and/or radiotherapy based ...

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ea0029p1401 | Pituitary Clinical | ICEECE2012

Management of hyponatremia in the hospital: interim results from a prospective, observational, multi-center, global registry

Haymann J , Verbalis J , Makin A , Chase S

Background: Hyponatremia (HN) is the most common electrolyte disorder of hospitalized patients. It occurs in up to 28% of in-patients, is more common in the elderly and patients with multiple co-morbidities, increases the in-hospital risk of death by 1.47-fold, and is associated with significantly higher mortality risk following discharge. The HN Registry is the first large-scale, international effort to document the clinical characteristics, choice of therapies, and impact of...

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ea0029p1402 | Pituitary Clinical | ICEECE2012

Cardiac magnetic resonance imaging detects myocardial fibrosis in patients with active acromegaly

Feldkamp J , Reinhardt J , Gottschalk S , Rommel T , Gehl H , Buschsieweke D , Stellbrink C

Background: Acromegaly affects almost all organs, including the cardiovascular system. Long-term exposure to high levels of IGH and insulin-like-growth-factor 1 (IGF1) may lead to cardiomyopathy.Study design: Aim of our investigation was to study cardiac function in patients with active acromegaly using magnetic resonance imaging of the heart (cardiac-MRI) and echocardiography. Eleven patients with active acromegaly could be evaluated within a period of ...

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ea0029p1403 | Pituitary Clinical | ICEECE2012

Pregnancies in a large cohort of patients on growth hormone replacement therapy

Vila G , Akerblad A. , Biller B. , Koltowska-Haggstrom M. , Lundgren F. , Riedl M. , Luger A.

Introduction: Growth hormone replacement (GHRT) during conception and pregnancy is an off-label treatment. Reports on pregnancy outcomes in women with growth hormone deficiency (GHD) are derived from single center studies with small sample sizes and show conflicting results.Methods/design: We evaluate pregnancies reported in the KIMS (Pfizer International Metabolic Database) patients on GHRT. KIMS includes 4651 women aged 1550 years (followed for 1...

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ea0029p1404 | Pituitary Clinical | ICEECE2012

Pasireotide LAR vs octreotide LAR in patients with acromegaly: double-blind, crossover, extension period to a randomized, double-blind, multicenter, phase III study

Fleseriu M , Sheppard M , Bronstein M , Freda P , Gu F , Shen C , Gadelha M , Hermosillo Resendiz K , Ruffin M , Chen Y , Colao A

Introduction: In a large, randomized, double-blind, phase III trial in patients with acromegaly, pasireotide LAR was significantly more effective than octreotide LAR at inducing GH<2.5 μg/l and normal IGF1 after 12 months of therapy (core study). The crossover phase of this trial allowed patients without full biochemical control at month 12 to switch treatments. This abstract reports the results of patients who switched therapy.Methods: Medicall...

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ea0029p1405 | Pituitary Clinical | ICEECE2012

Long-term use of pasireotide in Cushing’s disease: 24-month safety results from a randomized phase III study

Bertherat J , Ludlam W , Pivonello R , Maldonado M , Trovato A , Hughes G , Gu F , Schopohl J , Salgado L

Introduction: Rapid and sustained decreases in UFC and significant improvements in signs and symptoms were seen in a large, randomized, 12-month phase III study of pasireotide in Cushings disease. The safety profile of pasireotide was found to be similar to that of other somatostatin analogues, with the exception of hyperglycemia-related AEs (reported in 72.8% of patients). This abstract reports safety data from a 12-month extension to this phase III trial.<p class="...

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ea0029p1406 | Pituitary Clinical | ICEECE2012

Pasireotide treatment is associated with improvements in hypertension: 12-month results from a large phase III study in Cushing’s disease

Pivonello R , Petersenn S , Newell-Price J , Gu F , Maldonado M , Trovato A , Hughes G , Salgado L , Lacroix A , Schopohl J , Biller B

Introduction: Patients with Cushings disease (CD) have an increased risk of hypertension (HTN). phase III data have shown that pasireotide leads to rapid reductions in UFC levels and significant improvements in CD symptoms. We now present further analyses of these data, evaluating the effects of pasireotide on HTN in patients with CD.Methods: Patients with persistent/recurrent or de novo (if not surgical candidates) CD and UFC≥1.5 time...

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ea0029p1407 | Pituitary Clinical | ICEECE2012

GH Secretion response to triple secretagogue stimulus (ghrh, ghrelin and arginine) is gender and BMI dependent in healthy postmenopausal women and older men

Norman C , Erickson D , Miles J , Bowers C , Veldhuis J

Objective: Identify predictors of pulsatile GH secretion following a triple secretagogue stimulus (TSS, Ghrelin and GHRH preceded by an infusion of Arginine) in a cohort of healthy postmenopausal women and healthy older men.Hypothesis: Even in older subjects, total GH secretory capacity is gender dependent.Design: 23 men and 19 women participated in 6 separate, overnight 16-h infusion sessions at Clinical Research Center. At the en...

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ea0029p1408 | Pituitary Clinical | ICEECE2012

Pasireotide treatment is associated with clinically meaningful improvements in health-related quality of life in Cushing’s disease: results from a large, randomized, double-blind phase III trial

Webb S , Badia X , Zgliczynski W , Portocarrero-Ortiz L , Maldonado M , Trovato A , Forsythe A , Nelson L , McLeod L , De Block C , Gadelha M

Introduction: Patients with Cushings disease have significantly impaired health-related quality of life (HRQoL). Effective treatment is needed to treat Cushings disease and improve HRQoL; however, there are currently no approved medical treatments for Cushings disease. The effect of pasireotide on HRQoL in patients with Cushings disease was evaluated as part of a randomized, phase III study.Methods: Patients with persistent/recurr...

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ea0029p1409 | Pituitary Clinical | ICEECE2012

Increased risk of hypothalamic pituitary dysfunction amongst nasopharyngeal cancer survivors with the use of concurrent chemo-irradiation

Ratnasingam J , Karim N , Paramasivam S , Tan Tong Boon A , Vethakkan S , Choong K , Pendek R , Chan S

Background: Radiotherapy is the mainstay of NPC (nasopharyngeal carcinoma) treatment and recently there is increased use of concurrent chemo-irradiation (CCRT) to improve survival. The irradiation field for NPC includes the base of skull, risking radiation damage to the hypothalamicpituitary (HP) axis.Aims: To evaluate the prevalence of HP dysfunction in NPC survivors post-irradiation and to compare the risk of developing HP dysfunction amongst pat...

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ea0029p1410 | Pituitary Clinical | ICEECE2012

Long-term pasireotide use leads to improvements in the biochemical parameters of Cushing’s disease: 24-month results from a randomized phase III study

Schopohl J , Bertherat J , Ludlam W , Maldonado M , Trovato A , Hughes G , Gu F , Salgado L , Pivonello R

Introduction: The large, randomized, phase III study of pasireotide in Cushings disease found that pasireotide treatment resulted in rapid and sustained decreases in UFC levels and in significant improvements in signs and symptoms over 12 months of treatment. A 12-month extension of this trial has recently completed, and the results are reported here.Methods: Patients with persistent/recurrent or de novo (if not surgical candidates) Cushing&...

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ea0029p1411 | Pituitary Clinical | ICEECE2012

Hyperprolactinemic patients are prone to increased protein oxidation: a risk for low grade inflammation?

Cakir I , Baskol G , Elbuken G , Karaca Z , Mert M , Simsek Y , Bayram F

Objective: Hyperprolactinemia is reported to be associated with impaired glucose metabolism, and low-grade inflammation. There is some data regarding increased oxidative stress- particularly protein oxidation in the conditions like metabolic syndrome or diabetes, but not in hyperprolactinemic subjects in the literature. We aimed to investigate advanced oxidation protein product (AOPP) levels-an established marker of protein oxidation and antioxidant thiol levels in hyperprolac...

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ea0029p1412 | Pituitary Clinical | ICEECE2012

Fifteen years of GH replacement improves body composition and metabolic parameters

Elbornsson M , Gotherstrom G , Bosaeus I , Bengtsson B , Johannsson G , Svensson J

Objective: Few studies have determined the effects of more than 5-10 years of GH replacement in adults on body composition and metabolic parameters.Design/Patients: In this prospective, single-center, open-label study, the effects of 15 years of GH replacement on body composition and metabolic parameters were determined in 156 hypopituitary adults (93 men) with adult onset GH deficiency (GHD). Mean age was 50.5 (range 2274) years at study start. Bo...

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ea0029p1413 | Pituitary Clinical | ICEECE2012

Incidence of hypogonadism and evaluation of its impact on cardiovascular risk factors and quality of life in acromegalic patients

Rebora A , Nazzari E. , Malpassi D , Moretti S , Goglia U , Boschetti M , Minuto F , Ferone D

Acromegaly and hypogonadism represent independent cardiovascular risk factors, worsening either different metabolic parameters or quality of life (QoL).In our cohort of 41 acromegalic males (2082 years), 35 resulted affected by hypogonadotropic hypogonadism, while only six were eugonadal. Twenty-nine out 35 had low testosterone levels at diagnosis and six developed a post-surgical hypogonadism (testosterone cut-off: 350 ng/dl). Among hypogonadal su...

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ea0029p1414 | Pituitary Clinical | ICEECE2012

GH secretory function is well preserved in surgically cured acromegalics

Arita K , Fujio S , Tokimura H , Hanaya R , Yunoue S , Kinoshita Y , Tominaga A

Objective: To know the GH secretory function in surgically cured acromegaly and its impact on quality of life of the patients.Subjects and methods: Sixty-seven acromegalics were judged to be surgically cured according to the Cortina consensus criteria and underwent postoperative insulin tolerance test (ITT) provoking hypoglycemia with nadir blood sugar under 50 mg/dl. All the patients underwent surgery under combined microscopic and endoscopic observatio...

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ea0029p1415 | Pituitary Clinical | ICEECE2012

The effect of GH replacement therapy on exercise capacity, fat mass, ectopic lipids intramyocellular and intrahepatocellular lipids and insulin resistance in hypopituitary patients with GH deficiency

Egger A , Allemann S , Stettler C , Diem P , Buehler T , Boesch C , Christ E

Introduction: Increased levels of ectopic lipids (IMCL and IHCL) have been related to insulin resistance. Aerobic exercise affects IMCL. GHRT is known to increase exercise capacity, insulin resistance and decrease fat mass. The effect of GHRT on ectopic lipids is not known.Methods: Ten patients with GHD and ten sedentary control subjects (CS; matched for gender, age, BMI and waist) were recruited. VO2max was assessed using an exercise test on ...

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ea0029p1416 | Pituitary Clinical | ICEECE2012

Prevalence of central adrenal insufficiency during lifespan in Prader–Willi syndrome

Grugni G , Beccaria L , Crino A , Andrulli S , Cappa M , De Medici C , Di Candia S , Gargantini L , Iughetti L , Mariani B , Mussa A , Ragusa L , Sartorio A , Salvatoni A , Spera S , Chiumello G , Corrias A

Introduction: The etiology of the increased mortality seen in PraderWilli syndrome (PWS) is not completely known. In this context, it has been suggested that central adrenal insufficiency (CAI) due to hypothalamic dysfunction may be responsible for unexplained deaths. However, data on hypothalamic-pituitaryadrenal (HPA) axis in PWS are still conflicting. Because adrenal insufficiency is a life-threatening disease, its diagnosis should be precise, urgent and reliabl...

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ea0029p1417 | Pituitary Clinical | ICEECE2012

Limited effects of temozolomide monotherapy on aggressive pituitary tumors. -Based on our own experiences of three cases-

Habu M , Yunoue S , Fujio S , Tominaga A , Kinoshita Y , Arita K

Back ground: Encouraging responses of pituitary adenomas and pituitary carcinomas to temozolomide treatment have been well described and loss of immunopositivity of O6-methyl-guanine-DNA methyltransferase (MGMT) reportedly serves a predictor of good response. Recently some nonresponsive cases, however, also appeared. We describe here our own experiences of temozolomide treatment on three aggressive pituitary tumors.Subjects and methods: Three pitu...

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ea0029p1418 | Pituitary Clinical | ICEECE2012

The impact of long-acting somatostatin analogs treatment on glucose tolerance and insulin resistance in acromegaly.

Stelmachowska-Banas M , Zdunowski P , Zgliczynski W

Introduction: Impaired glucose tolerance and insulin resistance are frequently associated with acromegaly. The aim of this study was to assess the impact of long-acting somatostatin analog treatment on glucose homeostasis in acromegalic patients.Patients and methods: In this prospective study 16 naïve acromegalic patients (eight females, eight males; aged 51.5±10.9 years) were studied before and after 3-month therapy with long-acting somatostat...

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ea0029p1419 | Pituitary Clinical | ICEECE2012

Immunohistochemical detection of sstr2 and 5 ligand binding domains in 110 pituitary tumors

Rossi V. , Ilardi G. , Massimo M. , Bellastella G. , Visconti D. , Staibano S. , Del Basso De Caro M. , Abbondanza C. , Cavallo L. , De Bellis A. , Cappabianca P. , Colao A. , De Rosa G. , Bellastella A. , Sinisi A.

Classical somatostatin analogues (SST-A), such as octreotide and lanreotide, bind mainly SSTR2 whilst the multiligand pasireotide binds with the highest affinity SSTR5. The selective immunodetection of ligand binding domain (LBD) of SSTR subtypes with specific monoclonal antibodies may be useful to explain the potential efficacy of different SSTA on pituitary tumours growth and/or secretory activity.Patients and Methods: We applied new monoclonal antibod...

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ea0029p1420 | Pituitary Clinical | ICEECE2012

Symptomatic hypotonic hyponatraemia after endoscopic transsphenoidal surgery: results from two large series

Faustini-Fustini M. , Zoli M. , Mazzatenta D. , Frank G. , Kunicki J. , Sherry I. , Garni B. , Laws E.

Introduction: The incidence of hyponatremia as a delayed complication of transsphenoidal surgery varies widely from study to study and much of the debate has focused on the symptomatic hypotonic hyponatremia (SHH) occurring usually after discharge.Aim/Design: We studied the incidence, risk factors, course and management of postoperative SHH in two large series of endoscopic transsphenoidal surgery (ETS) for pituitary tumors.Results...

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ea0029p1421 | Pituitary Clinical | ICEECE2012

Audit of pituitary dysfunction after traumatic brain injury: caution in interpretation of glucagon stimulation test in diagnosis of GH and ACTH deficiency.

Tenorio Jimenez C. , Niemi M. , Malik A. , Papadopoulou D. , Ham T. , Baxter D. , Sharp D. , Goldstone A.

Introduction: Traumatic brain injury (TBI) is the leading cause of death and disability in young adults. It is important to recognise pituitary dysfunction following TBI as it can cause significant morbidity.Methods: 179 TBI patients (137 males) age 41.0±15.7 years (17.688.1 years) attended Charing Cross Hospital clinic (July 2009August 2011). Median time since TBI was 0.27years (0.0546.5 years, 26% >1 years). 34% had an intrac...

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ea0029p1422 | Pituitary Clinical | ICEECE2012

Body composition has a higher impact on peak GH during the pyridostigmine–GHRH test than the insulin tolerance test in healthy individuals

Eriksen T. , Klose M. , Feldt-Rasmussen U.

Objective: To evaluate the association between body-composition and peak GH, during two standard GH stimulation tests; the pyridostigmine-GHRH (PDGHRH) test and an insulin tolerance test (ITT).Method: 83 healthy subjects (56 men), aged 1865 years with a median BMI of 24 kg/m2 (range 1735) underwent a PDGHRH test and an ITT in random order 1 week to 1 month apart. Women had both tests performed in the same phase of their menstrual c...

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ea0029p1423 | Pituitary Clinical | ICEECE2012

Progression of acromegalic arthropathy despite long-term biochemical control: a prospective, radiological study

Claessen K. , Ramautar S. , Pereira A. , Smit J. , Roelfsema F. , Romijn H. , Kroon H. , Kloppenburg M. , Biermasz N.

Background: Leiden University Medical Center, Leiden, The Netherlands; 2Leiden University Medical Center, Leiden, The Netherlands; 3Leiden University Medical Center, Leiden, The NetherlandsBackground: Arthropathy is an invalidating complication of acromegaly, despite persisting biochemical disease control, which has a high impact on the quality of life (QoL). The prognosis and determinants are currently unknown.<p class="abstext...

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ea0029p1424 | Pituitary Clinical | ICEECE2012

Cavernous Sinus Sampling (CSS) - a specific method for localization of minute ACTH secreting adenomas in Cushing Disease (CD)

Ludecke D. , van Leyen P. , Flitsch J.

Introduction: Diagnosis and exact localization of minute adenomas in Cushing disease (CD) can be problematic, leading to unsuccessful trans-sphenoidal pituitary explorations (TSS). In addition to the well established inferior petrosal sinus sampling (IPS) first described in 1989, direct intraoperative cavernous sinus sampling (CSS) and in 1993, preoperative CSS with very small catheters, have been published (1,2). The experience in relatively small series had been promising, b...

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ea0029p1425 | Pituitary Clinical | ICEECE2012

Effects of medical treatment on proliferation parameters MIB-1 and topoisomerase-IIα in GH secreting pituitary adenomas

Schlaffer S. , Lin F. , Saeger W. , Buchfelder M.

Introduction: In this present study, we assessed the effects of the last preoperative medical treatment (dopamine-agonists, somatostatin-analogous and GH receptor antagonists) on the proliferation parameters Ki-67 and Topoisomerase-IIα in pituitary adenomas of patients with acromegaly.Material and methods:: We retrospectively studied the clinical characteristics, neuroimaging, histology and immuno-histochemistry (Ki-67 and topoisomerase-IIα lab...

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ea0029p1426 | Pituitary Clinical | ICEECE2012

Comprasion of cycline D1 gene (Ccnd1) polymorphism in invasive and non-invasive prolactinomas

Cander S. , Erturk E. , Karkucak M. , Oz Gul O. , Yakut T. , Unal O. , Ersoy C. , Tuncel E. , Imamoglu S.

Cycline D1 gene that plays a crucial role in a cell cycle, have been shown to be expressed more in nonfunctioning pituitary adenomas and functioning invasive pituitary adenomas compared to normal hypophisis tissue and noninvasive pituitary adenomas. A/G polymorphism in CyD1 gene exon 4/intron 4 regions have been demonstrated to affect clinical outcomes and survey in some tumors. Objective of this study was to investigate the effect of polymorphism of cycline D1 gene on the tum...

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ea0029p1427 | Pituitary Clinical | ICEECE2012

Control of GH and IGF1 in acromegaly in the UK: responses to medical treatment

Howlett T. , Willis D. , Walker G. , Wass J. , Trainer P. , UK National Acromegaly Register Investigators

UK National Acromegaly Register collects data on real-life clinical practice in 34 centres. We analysed all GH and IGF1 data to assess adequacy of control on medical treatment (Rx) with somatostatin analogs (SMS) and dopamine agonists (DA).Methods: All GH records (basal, profile or GTT) in database were correlated with IGF1, Rx, surgery (TSS) and radiotherapy (RT), then processed to derive summary data for each patient and each course of Rx. GH considere...

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ea0029p1428 | Pituitary Clinical | ICEECE2012

Low tumoral mRNA IGF2 might balance the mechanism of tumorigenesis in GH-secreting adenomas

Diaz A. , Barlier A. , Kral M. , Garcia F. , Paes de Lima A. , Manavela M. , Enjalbert A. , Bruno O.

Pituitary adenomas may show alterations of PI3K/Akt pathway. IGF2, binding the IGF1-R, is able to active it. LOI of IGF2 has been implicated in the pathogenesis of many tumours. Activation of PI3K produces phosphorylation of p27 and its cytoplasmic mislocalization. Loss of nuclear p27 was associated with worse prognosis. In this study we correlated IGF2 imprinting with activation of PI3K/Akt pathway in a series of 29 somatotropinomas. After surgery, tumors were embedded in RNA...

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ea0029p1429 | Pituitary Clinical | ICEECE2012

Synergistic effects of combined stimulation with CRH+ghrelin on ACTH and cortisol responses in patients with Cushing’s disease: a pilot study

Miljic D. , Doknic M. , Pekic S. , Stojanovic M. , Damjanovic S. , Popovic V.

Background: Several stimulatory tests for differential diagnosis of ACTH dependent Cushings syndrome are avilable, CRH being the most valuable test in patients with Cushings disease (CD). Exaggerated responses to ghrelin have also been shown in patients with CD mainly due to overexpression of GHS receptors on corticotrope tumor cells. However, the effects of combined stimulation with CRH+ghrelin on ACTH and cortisol secretion have not been tested before in these pa...

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ea0029p1430 | Pituitary Clinical | ICEECE2012

Bone turnover in patients with active acromegaly in relation to glucose metabolism

Pekic Djurdjevic S. , Miljic D. , Stojanovic M. , Doknic M. , Jeremic V. , Jovanovic M. , Popovic V.

Objective: There is a complex cross-talk between bone and glucose metabolism. The surrogate markers of bone metabolism are osteocalcin (for bone formation) and CTx (for bone resorption). The osteoblast-derived protein osteocalcin has recently been shown to affect glucose homeostasis.Aim of the study: To investigate the relationship between markers of bone metabolism and parameters reflecting bone composition, glucose homeostasis and insulin resistance in...

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ea0029p1431 | Pituitary Clinical | ICEECE2012

Relationship between gsp mutations and clinico-pathological features in GH producing pituitary adenomas

Arita K. , Bakhtiar Y. , Yunoue S. , Habu M. , Tominaga A. , Hirano H. , Yasufuku-Takano J. , Takano K.

Purpose: To know the relationship between gsp mutations and clinico-pathological features in GH producing pituitary adenomas.Subjects and methods: Somatotropinomas resected from 43 acromegalic patients, 18 males and 25 females, were examined for gsp mutation analysis. The mutation was detected in 25 of 43 (58.1%) tumours with alternations of Arg to Cys in codon 201 (68%), Arg to Ser in codon 201 (8%), Gln to Leu in codon 227 (20%) and Gln to Arg in codon...

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ea0029p1432 | Pituitary Clinical | ICEECE2012

Decreased IGF1 levels and GH-resistant hepatic state to estrogens during the first trimester of pregnancy in non-acromegalic women

Persechini M. , Gennero I. , Grunenwald S. , Vezzosi D. , Bennet A. , Caron P.

Introduction: In women with GH-secreting pituitary adenoma, a decrease of IGF1 levels has been reported during the first trimester of pregnancy, before placental GH (pGH) secretion inducing a progressive increase in IGF1 levels throughout gestation. This decrease has been related to hepatic GH-resistant state, via JAK2/STAT pathway, due to increased estrogen (E2) levels.Objectives: Evaluate IGF1 change in non-acromegalic women during the first...

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ea0029p1433 | Pituitary Clinical | ICEECE2012

Coexistence of macroprolactinaemia and hyperprolactinaemia in women with oligo-/amenorrhoea is associated with high risk of pituitary adenomas

Gasior-Perczak D. , Lewandowski K. , Kowalska A. , Lewinski A.

Background: The so called big-big prolactin, also known as macroprolactin is formed by prolactin-immunoglobulin complexes, is considered to be biologically inactive, but may cause elevation of serum prolactin (Prl) concentrations measured by standard assays. In women presenting with oligo- and/or amenorrhoea the cause of menstrual irregularity needs to be explained even in the setting of concomitant macroprolactinaemia. We have therefore attempted to assess the pre...

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ea0029p1434 | Pituitary Clinical | ICEECE2012

Mortality rates in childhood and adult onset GH deficient patients enrolled in the Global Hypopituitary Control and Complications Study (HypoCCS)

Jung H. , Zimmermann A. , Mo D. , Robison L. , Erfurth E. , Melmed S. , Lamberts S. , Attanasio A.

Preliminary data suggested an increased mortality in a French cohort after childhood somatropin treatment compared to the French reference population1. This cohort included patients (pts) with idiopathic-isolated GH-deficiency (GHD), and a similar cohort is also under follow-up for adult GH-replacement in HypoCCS.We therefore assessed all-cause mortality rates (n/1000 person-years (PY), (95% CI), standardized to the age/gender structure...

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ea0029p1435 | Pituitary Clinical | ICEECE2012

Experience in the use of tolvaptan in patients with syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Zamuner M. Mijares , Sanchez-Pacheco M. , Tardon , Gotarredona J. Serrano , Perez O. Moreno , Avella G. Negueruela , Vidal R. Cerezo , Ortiga R. Sanchez , Alfonso A. Pico

Introduction: Hyponatremia is the most common electrolyte disorder in hospitalized patients. SIADH is characterized by euvolemic hyponatremia with sodium and urine osmolality inappropriately high. The selective antagonist of the vasopressin V2 receptor (tolvaptan) helps to eliminate water free of solute (aquaresis), being effective in treating this condition.Objetive: Evaluate the efficacy and safety of tolvaptan in the treatment of SIADH.<p class="a...

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ea0029p1436 | Pituitary Clinical | ICEECE2012

Blast concussion is associated with high frequency of pituitary dysfunction

Wilkinson C. , Pagulayan K. , Colasurdo E. , Shofer J. , Peskind E.

Introduction: Studies of traumatic brain injury from all causes have found evidence of chronic hypopituitarism, defined by deficient production of one or more pituitary hormones at least 1 year after injury, in 2550% of cases. Most studies found the occurrence of posttraumatic hypopituitarism (PTHP) to be unrelated to injury severity. Growth hormone deficiency (GHD) and hypogonadism were reported most frequently. Hypopituitarism, and in particular adult GHD, is associate...

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ea0029p1437 | Pituitary Clinical | ICEECE2012

Efficacy of transsphenoidal surgery for Cushing’s disease: the role of combined dexamethasone desmopressin test

Witek P. , Glinicki P. , Szamotulska K. , Zielinski G.

Introduction: The treatment of choice in Cushings disease (CD) is transsphenoidal surgery (TSS). The success of surgical procedure is of particular importance in terms of patient`s prognosis. The aim of this study was the prospective evaluation of compatibility of coupled 1 mg dexamethasone suppression test and 10 μg desmopressin stimulation test (CDDT) with standard criteria of remission in CD.Methods: The study population consisted of 36 pat...

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ea0029p1438 | Pituitary Clinical | ICEECE2012

Improved renal function after five years of GH therapy in GH deficient (GHD) adult survivors of childhood leukaemia

Follin C. , Wiebe T. , Moell C. , Erfurth E.

Introduction: Acute lymphoblastic leukaemia (ALL) is the most common childhood malignancy. The survival rate is now 85% which emphasis the importance of long-term treatment complications. GH-deficiency (GHD) is common among these survivors treated with cranial radiotherapy (CRT) and chemotherapy. Renal impairment has been reported in childhood (CO) cancer survivors and glomerular filtration rate (GFR) is decreased in hypopituitarism. GH therapy to CO GHD patients has been show...

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ea0029p1439 | Pituitary Clinical | ICEECE2012

Thyrotropin-secreting pituitary adenomas: experience of a single centre

Malchiodi E. , Mantovani G. , Ferrante E. , Sala E. , Verrua E. , Giavoli C. , Profka E. , Bergamaschi S. , Filopanti M. , Lania A. , Spada A. , Beck-Peccoz P.

Thyrotropin-secreting pituitary adenomas (TSH-omas) account for less than 1% of all pituitary adenomas. Here we report retrospective data of 17 patients (seven M and 10 F) with TSH-oma followed at our centre from 1990 to present. Median follow-up time was 9.7 years. The mean age at diagnosis was 43±12 years. Radiological evaluation revealed macroadenomas in 11 of 17 patients (71.6%). Macroadenomas were extrasellar in 58.4% of cases, while only one microadenoma had extrase...

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ea0029p1440 | Pituitary Clinical | ICEECE2012

Detection of somatostatin receptors in aggressive non-functioning pituitary adenomas and effects of somatostatin analogs therapy in these tumors

Kunert-Radek J. , Pawlikowski M. , Pisarek H. , Gorska-Chrzastek M. , Zawada N. , Radek M.

Clinically non-functioning pituitary adenomas (CNFPA) represent a heterogenous group of tumors. Most of CNFPA are aggressive, usually diagnosed relatively late and surgery often fails to achieve the complete excision of tumor and the recurrence rate is high. About 80% of CNFPA are characterized by intense expression of somatostatin receptors (SSTR) inspiring use of somatostatin analogs (SSTa) in the medical cure of CNFPA. Scintigraphy with visualization of SSTR2 expression and...

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ea0029p1441 | Pituitary Clinical | ICEECE2012

Effect of a modulation of somatostatin release on TSH secretion in healthy volunteers

Bouali N. , Corvilain B. , Devuyst F.

Objectives: In normal subjects, inhibitory effect of a glucose load (OGTT) on GH secretion is probably mediated by an increase in hypothalamic release of somatostatin whereas the stimulatory effect of arginine on GH secretion is probably mediated by a decrease in somatostatin release. In humans and animals, somatostatin infusion inhibits basal and TRH-stimulated TSH secretion but little is known on the role of endogenous somatostatin in the regulation of TSH secretion. The aim...

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ea0029p1442 | Pituitary Clinical | ICEECE2012

Are “in silico” predictions reliable regarding splice-site mutations? – Studies in the aryl hydrocarbon receptor-interacting protein (AIP)

Martucci F. , Trivellin G. , Khoo B. , Owusu-Antwi S. , Stals K. , Kumar A. , Ellard S. , Grossman A. , Bouloux P. , Korbonits M.

Background: It is often difficult to define the clinical relevance of a novel gene variant. In silico analyses of variants located close to exonintron-junctions are utilised to predict the result of these basepair changes. We have previously identified two splice-site variants in AIP and confirmed the predicted changes for c.249G>T, p.G83AfsX15 and c.807C>T. We identified the c.469-2A>G heterozygous variant located at the end of intron-3 in a childhood...

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ea0029p1443 | Pituitary Clinical | ICEECE2012

Effectiveness of cyberknife in the management of pituitary adenomas and craniopharyngiomas

Marini F. , Conti A. , Pontoriero A. , Granata F. , Cannavo S.

Introduction: CyberKnife (CK), an innovative LINAC-based robotic device for frameless stereotactic surgery, is an emerging approach in the management of tumours of the sellar region.Patients and methods: In total, 14 patients (six men, mean age 52.7 years) with sellar tumours (three craniopharyngiomas and 11 pituitary adenomas) were evaluated. Pituitary adenomas (PA) were non-functioning (7), GH-secreting (2), one GH/TSH-secreting (1) or PRL-secreting (1...

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ea0029p1444 | Pituitary Clinical | ICEECE2012

Evaluation of cardiovascular risk factors and metabolic profile in hyperprolactinemic subjects

Sayki Arslan M. , Sahin M. , Esra T. , Cakir Ozkaya E. , Bozkurt Colak N. , Karbek B. , Ozturk Unsal I. , Ucan B. , Gungunes A. , Cakal E. , Ozbek M. , Topaloglu O. , Demirci T. , Karakose M. , Caliskan M. , Ginis Z. , Delibasi T.

Objective: Hyperprolactinemia has been reported to be associated with abnormalities of glucose metabolism and cardiovascular inflammatory markers. However, the metabolic effects of high prolactin levels are not adequately clarified. The aims of this study were to evaluate the effects of hyperprolactinemia on endothelial function, insulin sensitivity and inflammatory markers in prolactinoma diagnosed subjects.Methods: In total, 58 hyperprolactinemic subje...

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ea0029p1445 | Pituitary Clinical | ICEECE2012

Pituitary tumor apoplexy: overview of 14 cases diagnosed during the last 12 years at a central hospital

Caldas A. , Ferreira M. , Moreira S. , Ribeiro I. , Cardoso H. , Palma I. , Borges F.

Introduction: Pituitary apoplexy is a potentially life-threatening syndrome due to acute infarction and/or hemorrhage of the pituitary gland. In many cases it is the first form of presentation of a pituitary adenoma. The purpose of the study is to analyze the clinical presentation, diagnosis and treatment of this syndrome.Patients and methods: A retrospective analysis of the patients diagnosed with pituitary tumor apoplexy at Santo Antonios Hospita...

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ea0029p1446 | Pituitary Clinical | ICEECE2012

Copeptin is not associated with menstrual cycle hormones

Blum C. , Mirza U. , Christ-Crain M. , Mueller B. , Puder J.

Background: Copeptin (CP), a derivate from the antidiuretic hormone (ADH) precursor pre-pro-vasopressin, stochiometrically mirrors ADH secretion. CP is increasingly evaluated as a diagnostic and prognostic biomarker in different diseases. It is therefore important to recognize possible confounding factors when interpreting CP levels. In healthy regularly menstruating women, there is a small but measurable physiological variability of hormones involved in fluid regulation. ADH ...

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ea0029p1447 | Pituitary Clinical | ICEECE2012

Acylated ghrelin as provocative test for the diagnosis of gh deficiency in adults

Gasco V. , Beccuti G. , Baldini C. , Prencipe N. , Guaraldi F. , Di Giacomo S. , Berton A. , Maccario M. , Ghigo E. , Grottoli S.

ITT is the test of reference for the diagnosis of adult GH deficiency (GHD), but also GHRH in combination with arginine (ARG) or GH secretagogues (GHS) are considered equally reliable tests. Testing with GHS alone is, anyway, a potent stimulus exploring the integrity of hypothalamic pathways controlling somatotropic function.We therefore aimed to clarify the diagnostic reliability of testing with ghrelin, the natural GHS.We studied...

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ea0029p1448 | Pituitary Clinical | ICEECE2012

National incidence and prevalence of TSH-secreting pituitary adenomas in Sweden

Onnestam L. , Berinder K. , Bramnert M. , Burman P. , Dahlqvist P. , Eden-Engstrom B. , Wahlberg Topp J. , Filipsson Nystrom H.

Introduction: TSH-secreting pituitary adenomas (TSHoma) are rare. Epidemiological data are scant and there are no reports on national incidence. The aim of this study was to estimate the national incidence and prevalence of TSHomas in Sweden.Methods: This is an observational study from all tertial referral centers where the Swedish Pituitary Registry and WHO ICD coding were used to identify patients diagnosed with TSHomas in Sweden 19902010. Medica...

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ea0029p1449 | Pituitary Clinical | ICEECE2012

High mean platelet volume and lipid abnormalities in prolactinoma patients without insulin resistance

Aycicek Dogan B. , Tuna M. , Arduc A. , Tutuncu Y. , Yilmaz M. , Berker D. , Guler S.

Introduction: Hyperprolactinemia has been associated with dyslipidaemia, hypercoagulability, impaired endothelial function and decreased insulin sensitivity. Recent data show that prolactin hormone (PRL) could contribute to atherogenesis. The aim of our study was to investigate the relationship between MPV and PRL, androgen hormones, lipid profiles in premenopausal prolactinoma patients, who did not have insulin resistance (IR).Methods: Thirty-nine newly...

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ea0029p1450 | Pituitary Clinical | ICEECE2012

Asymptomatic nonfunctioning pituitary macroadenomas take advantage of surgery

Dubourg J. , Messerer M. , Daniel R. , Bervini D. , Berhouma M. , Perrin G. , Iype G. , Chacko A. , Trouillas J. , Raverot G. , Jouanneau E.

Introduction: Pituitary incidentalomas (PIs) defined as pituitary tumors discovered by systematic neuroimaging constitute an increasingly clinical problem. Most of PIs are nonfunctioning tumors (NFPIs) with systematic investigation revealing visual and/or endocrinological impairment in some patients while others remained asymptomatic. If the therapeutic management is well codified for functioning PIs and symptomatic NFPIs, a debate still remain for asymptomatic NFPIs between s...

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ea0029p1451 | Pituitary Clinical | ICEECE2012

Mortality and survival in a large series of adult patients with hypopituitarism followed for 10 years

Fernandez-Rodriguez E. , Lopez-Raton M. , Cadarso C. , Casanueva F. , Bernabeu I.

Hypopituitarism is associated with increased morbidity and mortality compared to healthy population. However, the factors influencing prognosis are still not well known.Objectives: To determine the causes of mortality in adult patients with hypopituitarism and compare the mortality rate with general populationTo identify the factors associated with mortality and survival.Patients: Two hundred and nine adult p...

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ea0029p1452 | Pituitary Clinical | ICEECE2012

Gastric and colonic pathology at patients with active acromegaly

Dreval A. , Tereschenko S. , Titaeva A. , Gurevich L. , Ilovayskaya I.

We examined gastroenterocolonic tract condition at 92 patients with active acromegaly (male 30, female 66, age 2678 y.o., most of the patients 4559 y.o.). Gastroduodenoscopy (n=92) and colonoscopy (n=74) were performed. Median GH levels were 22.7 (12.5; 51) mMe/l, median IGF1 levels 640 (507; 800) ng/ml.Esophagitis was diagnosed at 22 (23.9%) patients, incompetence of cardia 33 (35.8%) patients. There was one case ...

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ea0029p1453 | Pituitary Clinical | ICEECE2012

Pituitary dysfunction in adult patients after cranial radiotherapy for non-pituitary tumors: a long-term follow-up study

Appelman-Dijkstra N. , Kokshoorn N. , Malgo F. , Neelis K. , Biermasz N. , Smit J. , Pereira A.

Background: Hypopituitarism after cranial radiotherapy for non-pituitary tumors is well recognized. However structured endocrine assessments are not incorporated into routine clinical practiceAim of the study: To evaluate pituitary function in adult patients irradiated for non-pituitary tumors at our centerPatients and Methods: Cross-sectional evaluation of pituitary function of all available patients treated with irradiation at ou...

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ea0029p1454 | Pituitary Clinical | ICEECE2012

The treatment of results of endoscopic transsphenoidal surgery for GH-secreting pituitary adenomas

Tahara S. , Ishii Y. , Sanno N. , Teramoto A.

Objective: With the progress of neuroendoscopic surgery in recent years, the application of endoscopy to transnasal surgery for pituitary tumors is increasing. At our institution, endonasal surgery using an endoscope alone (eTSS) has been performed in 825 patients with pituitary adenomas since November 2001. Among them, 156 patients (18.9%) had GH-secreting pituitary adenoma (GHoma), so the outcome and complications of eTSS-treated GHomas were investigated in the present study...

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ea0029p1455 | Pituitary Clinical | ICEECE2012

Glucose metabolism in children with GH deficiency before and after GH therapy

De Martino L. , Capalbo D. , Di Mase R. , Esposito A. , Rezzuto M. , Barbieri F. , Salerno M.

Background: Adults with untreated GH deficiency (GHD) may have a cluster of cardiovascular risk factors. The effects of GH replacement therapy on insulin homeostasis in GHD subjects are still debated. Only a few studies investigated the effects of GHD and GH therapy on glucose metabolism in children.Objective: To evaluate the effects of GHD and GH treatment on glucose metabolism in a large cohort of GHD children before and after GH replacement therapy.</...

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ea0029p1456 | Pituitary Clinical | ICEECE2012

Endocrine disturbances and quality of life in adult patients after multimodal treatment for brain tumors or leukemia

Siegel S. , Rosenkranz E. , Thissen A. , Piroth M. , Mertens R. , Streetz-van-der-Werf C. , Brabant G. , Kreitschmann-Andermahr I.

Objective: Brain tumour treatment with radio- and chemotherapy may lead to endocrine and other medical sequelae. Still, many countries lack tailored surveillance programs for such patients so that potential health problems may remain unrecognized. The present study was performed to investigate endocrine and psychosocial impairment in a single centre university setting in Germany in patients treated with cranial radiotherapy as a part of brain tumour or leukaemia treatment....

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ea0029p1457 | Pituitary Clinical | ICEECE2012

Anterior pituitary autoantibodies in patients with diabetes mellitus

Pisanu C. , Cossu E. , Baroni M. , Frau G. , Pigliaru F. , Cocco C. , Ferri G. , Mariotti S.

Objective: The presence of APA has been reported in patients with autoimmune polyendocrinopathies, but their prevalence in type 1 diabetes mellitus (T1D) is still unknown. The aim of this study was to assess APA prevalence in T1D patients as compared to patients with type 2 diabetes mellitus (T2D) and healthy subjects.Research design and methods: The presence of APA was assessed by indirect immunofluorescence (IF) technique, with bovine adrenal gland and...

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ea0029p1458 | Pituitary Clinical | ICEECE2012

Pitfalls in Cushing’s disease: report of an ectopic ACTH-producing pituitary adenoma in the sphenoid sinus

Ritter M. , Burkhardt T. , Schmid S. , Bernreuther C. , Winterberg B. , Lehnert H. , Flitsch J.

Cushings disease is caused by ACTH-secreting pituitary adenomas. Gold standard therapy is the resection of the adenoma by transsphenoidal surgery with high cure rates even in cases of negative MR imaging. Surgical failure despite clear endocrinological test results is possible and mostly explained by hidden minute adenomas within the gland.We report on a 50-year-old woman suffering from ACTH-dependent Cushings syndrome. Endocrinological work-...

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ea0029p1459 | Pituitary Clinical | ICEECE2012

The effect of Ki67 index on tumor behavior in proloctanimas

Cander S. , Erturk E. , Oz Gul O. , Saraydaroglu O. , Unal O. , Ersoy C. , Tuncel E. , Imamoglu S.

Majority of prolactinomas consists of the small microadenomas that can be treated with dopamine agonists, but they can present different biological behavior features and not infrequently seen as macroadenomas or in giant adenoma size. There are different results on finding of studies which investigate the relationship between high levels of cell proliferation indicators with tumor behavior in pituitary adenomas. In this study, Ki 67 index to investigate the relationship betwee...

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ea0029p1460 | Pituitary Clinical | ICEECE2012

Cyclin D1 gene exon 4/intron 4 region A / G polymorphism and allele ratios in patients with prolactinoma

Karkucak M. , Cander S. , Gul O Oz , Yakut T. , Erturk E.

Excessive expression of CyD1 in CCND1 gene increase G1-S phase transition and cellular proliferation. In various tumor types and of the few studies of pituitary adenomas, over expression of CyD1 or amplification in the locus of CCND1 gene, have been demonstrated. In this study, we aimed to investigate the effect of cyclin D1 gene polymorphism on tumor formation in prolactinoma patients.A hundred and thirteen patients and 108 age and gender matched contro...

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ea0029p1461 | Pituitary Clinical | ICEECE2012

Cancer detection in long-term follow-up of patients with acromegaly

Vallette S. , Beauregard C. , Aris-Jilwan N. , Beauregard H. , Serri O.

Objective: To evaluate the prevalence of cancer in patients with acromegaly followed in our institution.Design and Patients: Retrospective analysis of clinical data from our Quebec pituitary tumor registry. A total of 107 patients with acromegaly (49% females) followed at the Centre de lUniversité de Montréal (CHUM) from 1980 to 2011 for a median of 7 years (Q1Q3: 312).Results: Thirteen cancers were dete...

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ea0029p1462 | Pituitary Clinical | ICEECE2012

Study on IGF(CA)19 gene polymorphism in adults with GH deficiency

Giavoli C , Profka E , Olgiati L , Filopanti M , Bergamaschi S , Ferrante E , Arosio M , Ambrosi B , Spada A , Beck-Peccoz P

A highly polymorphic microsatellite in the IGF1 gene promoter, composed of variable cytosine-adenine (CA) repeats (n=1024) has been linked to IGF1 serum concentrations in normal, acromegalic and GHD subjects with conflicting results. Aim of this study was to investigate whether this polymorphism may influence the clinical and biochemical characteristics of adult patients with GHD (n=97). Moreover, the response to 12-month rhGH replacement in terms of IGF1 l...

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ea0029p1463 | Pituitary Clinical | ICEECE2012

META-analysis on the effects of octreotide on tumor mass in acromegaly

Mazziotti G , Torri V , Spinello M , Floriani I , Melmed S , Giustina A

The long-acting somatostatin analogue octreotide is used either as an adjuvant or primary therapy to lower GH levels in patients with acromegaly and may also induce pituitary tumor shrinkage. However, inconclusive evidences in this respect have been produced by either single-center research paper or pooled analyses. Therefore, we performed a meta-analysis to thoroughly assess the current literature on the effect of octreotide on pituitary tumor shrinkage. A computerized Medlin...

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ea0029p1464 | Pituitary Clinical | ICEECE2012

Parasellar masses: experience in 47 patients

Saraiva J , Gomes L , Paiva I , Vieira A , Alves M , Gouveia S , Moreno C , Carvalheiro M

Introduction: The differential diagnosis of nonpituitary sellar masses is broad. Clinical presentation may be similar to that of pituitary adenomas. Sometimes certain findings are particular to some lesions and may help in their differentiation. Correct preoperative diagnosis is important to better guide therapeutic management. The aim of this work was to analyze patients with parasellar lesions (craniopharyngiomas excluded), attended in the Department of Endocrinology of our ...

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ea0029p1465 | Pituitary Clinical | ICEECE2012

Colonic neoplasms in acromegaly: are there serum risk factors?

Lombardi M , Scattina I , Urbani C , Sardella C , Marchello A , Nuzzo A , Dell'Unto E , Martino E , Bogazzi F

Hyperinsulinemia has been associated to an increased risk of colorectal cancer and adenomas, while higher serum 25-hydroxy vitamin D3 and folate seem to reduce the development of colonic lesions in general population. Acromegalic patients have an increased risk of colonic tumors and an association between higher fasting insulin levels and risk of colonic adenomas has been previously demonstrated. No data are available about the influence of vitamin D and folate-homocysteine le...

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ea0029p1466 | Pituitary Clinical | ICEECE2012

No long-term weight reduction after gastric banding in obese patients with craniopharyngioma involving hypothalamic structures: experiences from KRANIOPHARYNGEOM 2000

Muller H , Gebhardt U , Maroske J , Hanisch E

Background: Craniopharyngiomas are embryogenic malformations which lead to eating disorders and morbid obesity due to hypothalamic involvement. The experience with laparoscopic adjustable gastric banding (LAGB) in obese craniopharyngioma patients is limited especially in regard to long-term effects and tolerability.Patients and methods: We are reporting on four patients with childhood craniopharyngioma diagnosed at age 2, 13, 12, and 20 years.<p clas...

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ea0029p1467 | Pituitary Clinical | ICEECE2012

Predictors of the acromegaly-associated mortality in the last decade

Galoiu S , Ioacara S , Baciu I , Coculescu M

Introduction: Acromegaly is associated with an increased mortality in untreated patients. Recent papers suggest an improvement of survival in the last years.Aims: To assess mortality ratio and to identify prognostic factors associated with mortality in acromegaly in the last decade.Methods: 297 patients (186 F/111 M, mean age 49.8±0.7 years) with acromegaly admitted in a single Neuroendocrinology Department between Jan 2001 an...

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ea0029p1468 | Pituitary Clinical | ICEECE2012

Endoscopic transsphenoidal surgery as the therapy of choice for acromegaly: a 13-year experience in a single centre

Faustini-Fustini M , Zoli M , Mazzatenta D , Sciarretta V , Pasquini E , Frank G

Aim of the study: To assess the efficacy of endoscopic transsphenoidal surgery (ETS) in acromegalic patients.Methods: Over the past 13 years, 207 consecutive patients (117 females; median age, 46 years, range 1478) affected with GH-secreting adenoma (79 microadenomas, 38%) were operated on in our centre by the same surgical team. Age, gender, tumor size, extension, invasiveness of surrounding structures, and histopathologic features (ki67, mitoses,...

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ea0029p1469 | Pituitary Clinical | ICEECE2012

MALE macroprolactinomas: response to medical treatement

Chentli F , Azzoug S , Ould Driss N , Belkhamsa D , Kessaci F , Mansouri B

Introduction: Male macroprolactinomas are very rare and more invasive compared to female ones. So, they are few reports concerning their response to medical treatment. We aimed to appreciate their response to Bromocriptine: the only product available in our country.Subjects and methods: 55 men (mean age: 36.3 years) with mean height pituitary tumor =38.3 mm (12118) and mean PRL: 2942 ng/ml (13228 000) were analyzed. Bromocriptine was given tw...

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ea0029p1470 | Pituitary Clinical | ICEECE2012

Evaluation of pituitary gland with magnetic resonance imaging in hypogonadic patients

Arpaci D , Cuhaci N , Ozdemir D , Kaya G , Gumus M , Ersoy R , Cakir B

Aim: Hypogonadism is a result of testicular failure and/or insufficient pituitary stimulation. Various hypothalamo-pituitary abnormalities or lesions can contribute to hypogonadism. Benign or malign tumoural lesions of cellar or paracellar region, may lead to hypogonadism. Therefore, pituitary magnetic resonance imaging (MRI), is needed in hypogonadic patients. In our study, we aimed to investigate our hypogonadic patients hypothalamo-pituitary MRI findings.<p class=...

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ea0029p1471 | Pituitary Clinical | ICEECE2012

Is acromegaly associated with irritable bowel syndrome?

Caglar E , Hatipoglu E , Niyazoglu M , Celik O , Tuncer M , Kadioglu P

Introduction: Gastrointestinal system is under the influence of excessive GH and IGF1 in acromegaly. Increased bowel length and delayed transit time may cause functional disturbence of the bowel in acromegaly. The objective of the current study is to evaluate the frequency of irritable bowel syndrome (IBS) in cases with acromegaly.Methods: Twenty-five active cases with acromegaly who were newly diagnosed between 20102011 and 16 inactive acromegaly ...

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ea0029p1472 | Pituitary Clinical | ICEECE2012

Acromegaly, does tumor size matters?

Serra F , Duarte S , Ferreira R , Moniz C , Simoes H , Marques C , Azinheira J , Saraiva C , Saraiva M

Introduction: Acromegaly is a rare disease which results from a GH producing adenoma. Around 7080% are macroadenomas. The therapeutic options currently available are surgery, radiotherapy (RT) and medical treatment (MT). According to literature microadenomas have a higher remission rate, around 80%.Methods: A retrospective chart review of the patients with acromegaly treated in our centre from 1976 to 2011 was performed. In terms of disease control...

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ea0029p1473 | Pituitary Clinical | ICEECE2012

Clinical and histological characteristics of giant GH producing pituitary adenomas

Fukui T , Fukuhara N , Nishioka H , Kobayashi N , Inoshita N , Yoshida N , Suzuki H , Takeshita A , Takeuchi Y , Yamada S

Introduction: Surgical treatment of giant GH cell adenomas (>4 cm in maximum diameter; GHomas) has been considered difficult. However, clinical and histological characteristics of these adenomas are still enigmatic. We retrospectively analyzed data of 17 giant GHomas experienced at Toranomon hospital to clarify their characteristics.Methods: These 17 patients, accounting for 3.1% of 549 acromegalic patients undergoing surgery between 2006 and 2011, w...

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ea0029p1474 | Pituitary Clinical | ICEECE2012

Long-term outcomes after sterotactic radiosurgery for non-functioning pituitary adenomas

Suleiman Y , Vilchez R , Roman A , Soto A , Venegas E , Soto A , Atutxa A , Martin J , Torres E

Introduction: Sterotactic radiosurgery (SR) has been used to treat recurrent adenomas and also as a primary treatment. The objective is to evaluate long-term tumor control, development of hypopituitarism and other side effects in the follow-up.Patients and method: Retrospective analysis of 21 patients with non-functioning pituitary adenomas (NFA) treated with modified linear accelerator (LINAC) between 1998 and 2009 in three tertiary Spanish hospitals. C...

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ea0029p1475 | Pituitary Clinical | ICEECE2012

Long-term outcomes after sterotactic radiosurgery for functioning pituitary adenomas

Suleiman Y , Vilchez R , Roman A , Soto A , Venegas E , Leal A , Atutxa A , Martin J , Torres E

Introduction: Sterotactic radiosurgery (SR) has been used to treat recurrent adenomas after failure of medical and surgical procedures and also as a primary treatment. The aim of this paper is to evaluate long-term control of functioning pituitary adenomas (FPA).Patients and method: Thirty-eight patients with FPA treated with modified linear accelerator (LINAC) between 1998 and 2009 in three tertiary Spanish hospitals. Hormonal control was defined as hor...

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ea0029p1476 | Pituitary Clinical | ICEECE2012

Comparison of immunoassay and mass spectrometry measurement of cortisol during ACTH_1--24 stimulation tests

Burt M , Mangelsdorf B , Whiting M , Rogers A , Ho J , Inder W , Doogue M

Measurement of plasma cortisol by immunoassay after ACTH124 stimulation is used to assess the hypothalamicpituitaryadrenal (HPA) axis. Liquid chromatographytandem mass spectrometry (LCMS/MS) has greater specificity and equilibrium dialysis allows measurement of free plasma cortisol. We investigated whether measuring cortisol by LCMS/MS improves the sensitivity of ACTH124 stimulation testing in pituitary patients. ...

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ea0029p1477 | Pituitary Clinical | ICEECE2012

Cushing’s disease: prospective assessment of factors influencing the efficacy of transsphenoidal surgery

Witek P , Zielinski G , Szamotulska K , Zgliczynski W

Introduction: Assessment of the efficacy of surgical treatment for Cushings disease (CD) is one of the biggest challenges in contemporary endocrinology. The aim of this study was prospective evaluation of factors influencing the result of transsphenoidal surgery for CD.Methods: The study population consisted of 36 consecutive patients with CD hospitalized in the Department of Endocrinology from 2005 to 2009 and operated on using the same surgical p...

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ea0029p1478 | Pituitary Clinical | ICEECE2012

The results of surgical treatment on prolactinomas in females of child bearing ages

Fujio S , Habu M , Yunoue S , Hirano H , Arita K

Introduction: Medical therapy with dopaminergic drugs is the preferred initial treatment for symptomatic prolactinoma. However, some drawbacks of medical therapy are still of concern. Surgery is indicated in cases of resistance or intolerance to drugs or where patients prefer definitive cure to lifelong drug treatment. In addition, young women with small and enclosed type tumor may be good candidates for surgical treatment because of high curability and safety. We evaluated th...

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ea0029p1479 | Pituitary Clinical | ICEECE2012

Treatment outcomes in prolactinomas with and without cavernous sinus invasion

Oz Gul O , Cander S , Erturk E , Unal O , Ersoy C , Tuncel E , Imamoglu S

In prolactinomas, today first choice of treatment is medical treatment with dopamine agonists. Cavernous sinus invasion is not uncommon in prolactinomas and stands out as a blocking factor for surgical removal of the tumor fully. In our study, the presence of cavernous sinus invasion was to investigate the effect on the results of surgical and medical treatment in prolactinomas.Eighty-seven patients followed up with a diagnosis of prolactinoma were inclu...

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ea0029p1480 | Pituitary Clinical | ICEECE2012

Change in somatostatinergic tone of acromegalic patients according to the size of GH-producing pituitary tumors

Chin S , Oh S , Kim S

Objective: Change in somatostatinergic tone (SST) is one of the key features of acromegaly, but the effect of tumor size on SST is not clear.Design: The aim of this study was to determine how SST changes depending upon the size of GH-producing pituitary tumors.Method: GH levels of 29 patients with newly diagnosed acromegaly were measured using a 75 g oral glucose tolerance test (OGTT), an insulin tolerance test (ITT) and an octreot...

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ea0029p1481 | Pituitary Clinical | ICEECE2012

Two cases of sever congenital central hypothyroidism with TSH and prolactin deficiency-possible new syndrome

Matsuura N , Koike A , Ohtsu S , Takubo N , Kikuda K , Shibayama K , Narumi S , Hasegawa T

Instruction: Most of cases reported before who were detected by FT4 or T4 newborn screening are, TSH and GH deficiency or CNS anomalies, and their hypothyroidism is mild. We report two cases of sever congenital hypothyroidism with TSH and Prolactin (PRL) deficiency, detected by TSH and FT4 screening.Case report: Case 1. K.W. boy, was born at 38 gestations, weighted 3.17 kg. Thyroid function at 5 days of age was TSH 5.6 mU...

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ea0029p1482 | Pituitary Clinical | ICEECE2012

Treatment response and comorbilities in acromegalic patients

Maraver Selfa S , Garcia-Quiros Munoz J , Roca Rodriguez M , Tinahones Madueno F

To evaluate the prevalence of comorbilities related to acromegaly and the grade of response to the different therapeutic alternatives.Material-methods: A retrospective study of 25 acromegalic patients diagnosed between 19902010 was made. It included a descriptive analysis on sex, age, hypertension, impaired glucose metabolism when diagnosed acromegaly, screening for dygestive and cardiac pathology, tumoral size, and percentage of disease control an...

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ea0029p1483 | Pituitary Clinical | ICEECE2012

Reproductive function in acromegalic women: a one-center experience

Attanasio R , Albizzi M , Cortesi L , Pagani M , Montini M , Pagani G

Background: It is well-known that gonadal function is impaired in acromegalic females, due to several mechanisms.Aim and design: Retrospective survey of our series.Patients: Our electronic database encompassing data of 180 acromegalic patients collected over 30 years was searched, extracting first data of women (n=91) and then of females aged less than 50 years at diagnosis of acromegaly (n=34)....

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ea0029p1484 | Pituitary Clinical | ICEECE2012

Evaluation of bone mass and fracture in patients with prolactinoma

Guerra E , Rubino M , Di Sarno A , Vuolo L , Contaldi P , Scarano E , Brunelli V , Grasso L , Lombardi G , Colao A , Di Somma C

Patients with hyperprolactinemia have impaired bone metabolism and bone mineral density (BMD) partially represents bones health.To evaluate vitamin D levels, PTH, Ca and P, BMD and bone morphometry in patients with prolactin-secreting pituitary adenomas.Forty-four patients (30 W, 40±11 years, BMI 27.6±5 kg/m2) underwent to lumbar and femoral DEXA, to vertebral morphometry by X-ray and was calculated the S...

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ea0029p1485 | Pituitary Clinical | ICEECE2012

Prolactin levels are correlated with tumor size and invasiveness in prolactinomas

Cander S , Erturk E , Oz Gul O , Unal O , Ersoy C , Tuncel E , Imamoglu S

Prolactinomas are more common tumors by 60% among the hypophysis adenomas. These are often benign, but may present differences in terms of tumor size and treatment responses. Aim of this study was investigate the relationship of serum prolactin levels with tumor size and invasiveness in the prolactinomas.113 patients with the diagnosis of prolactinoma were included to study. Pretreatment plasma levels of prolactin in the time of diagnosis and sella MR im...

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ea0029p1486 | Pituitary Clinical | ICEECE2012

Is every joint symptom related to acromegaly?

Oruk G , Tarhan F , Argin M , Ozmen M

Introduction: Acromegaly is a chronic endocrinopathy characterized by hypersecretion of GH and insulin-like growth factor 1 (IGF1). Musculoskeletal pain is a frequent problem encountered in acromegaly and is associated with a reduction in quality of life. In this study we investigated the presence of inflammatory, rheumatologic and degenerative disease retrospectively.Methods: Fourty acromegaly patients who were in remission as laboratory findings but wh...

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ea0029p1487 | Pituitary Clinical | ICEECE2012

Acromegaly and pregnancy: case reports

Abreu A , Rueda A

Acromegaly is a rare clinical disorder characterized by progressive somatic disfigurement and a wide range of systemic complications which include gonadotrophic dysfunction, menstrual abnormalities and infertility. Thus, pregnancy in patients with acromegaly is a rare and challenging medical situation. Furthermore, the evidence about the use of somatostatin analogs (SSAs) during pregnancy in patients with acromegaly and its outcomes is still limited. Here we describe the clini...

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ea0029p1488 | Pituitary Clinical | ICEECE2012

Pegvisomant and cabergoline combination therapy in acromegaly

Bernabeu I , Alvarez-Escola C , Paniagua A , Lucas T , Pavon I , Cabezas Agricola J , Casanueva F , Marazuela M

Objective: Combination with cabergoline may offer additional benefits to acromegalic patients on pegvisomant monotherapy. We evaluated the safety and efficacy profile of this combination and investigated the determinants of response.Design: An observational, retrospective, cross-sectional, registry-based study.Patients and methods: Fourteen acromegalic patients (9 females), who were partially resistant to somatostatin analogs and o...

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ea0029p1489 | Pituitary Clinical | ICEECE2012

Influence of the family environment during the early years in life in the vulnerability to the development of pituitary adenomas

Afonso A , Carvalho D

Introduction: Prolactinomas are the most common pituitary adenomas. Several authors hypothesized that there is an association between the development of pituitary adenomas and psychologically significant experiences, especially traumatic ones. This is particularly well-established for Cushings disease. When it comes to prolactinomas, it was suggested that prolactin acts as an alternative to cortisol in the response to stress, especially in patients who present with passi...

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ea0029p1490 | Pituitary Clinical | ICEECE2012

Hyperprolactinemia in polycystic ovary syndrome- diagnostic and therapeutic approach

Amzar D , Balas M , Golu I , Vlad M , Zosin I

Background: Prolactin (PRL) hypersecretion is the most common endocrine abnormality due to hypothalamic-pytuitary disorders. Hyperprolactinemia occurs in 2030% of cases with polycystic ovary syndrome (POS). It is considered that hyperprolactinemia is not involved in POS etiopathogeny, but other factors are implied.The aim of the study: was to retrospectively evaluate the diagnostic tools (Rotterdam criteria) and therapeuthic approach applied in 78 ...

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ea0029p1491 | Pituitary Clinical | ICEECE2012

Hypothalamo-pituitary dysfunction in patients with chronic subdural hematoma

Kosak M , Masopust V , Netuka D , Lacinova Z , Krsek M , Marek J , Pecen L , Hana V

Introduction: Hypothalamo-pituitary dysfunction has been reported in patients after traumatic brain injury or subarachnoid hemorrhage with relatively high frequency according to published studies. Assessment of hypothalamo pituitary functions in patients with chronic subdural hematomas has not been published yet, although dysfunction of hypothalamo- pituitary unit could be expected (head trauma, compression and oedema of the brain, shifting of the midline structures).</p...

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ea0029p1492 | Pituitary Clinical | ICEECE2012

Mood Disorders and Quality of Life in Patients with Acromegaly after Pituitary Adenomas

Lasaite L , Knispelis R , Lasiene J , Purtokaite-Labutiniene I

Objective: To evaluate frequencies of mood disorders in males and females with acromegaly and to compare their quality of life with that of control males and females of the same age.Patients and methods: males (age 48.8±10.3 yers) and 16 females (age 52.9±13.7 years) with acromegaly after pituitary adenomas; 13 control males (age 46.3±18.6 years) and 43 control females (age 54.8±9.8 years).Mood disorders diagnos...

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ea0029p1493 | Pituitary Clinical | ICEECE2012

Although dentists are frequently visited by acromegaly patients they do not diagnose the disease

Siegel S , Streetz-van-der-Werf C , Schott J , Nolte K , Karges W , Kreitschmann-Andermahr I

Objective: The aim of this study conducted in a German University Hospital was to systematically assess health care utilisation and delivery in patients with acromegaly and to thus identify possible starting points for the improvement of patient care.Design/Methods: By means of a standardized anamnestic interview, 41 patients with biochemically proven acromegaly were questioned on the course of their disease. To investigate patient care the interview inc...

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ea0029p1494 | Pituitary Clinical | ICEECE2012

The long term recurrence rates of cushing’s disease in turkish patients after transsphenodal surgery: a single-center experience

Altuntas Yuksel , Zuhur Sayid Shafi , Ilhan Aysegu , Velet Selvinaz , Yener Ozturk Feyza

Introduction: The treatment of choice in Cushings disease (CD) is transsphenoidal adenomectomy. However, the long term recurrence rate of the CD after transsphenoidal surgery in Turkish patients has not been determined so far.Purpose: We aimed to determine the long term recurrence rates of CD in Turkish patients after transsphenoidal surgery.Methods: The computer records of the 23 patients, operated for CD in our center durin...

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ea0029p1495 | Pituitary Clinical | ICEECE2012

Xanthoma disseminatum with cutaneous and pituitary stalk involvement

Slattery D , Hussain T , O'Cathail M , Fitzgibbon J , Plant B , Murphy M , O'Halloran D

Introduction: Xanthoma disseminatum (XD) is a rare, non - familial disease characterised by lipid deposition in skin and internal organs due to histiocytic cell proliferation, classified as a non-Langerhans cell histiocytosis. The disease is characterised by symmetrically distributed, coalescing cutaneous papules, initially redbrown then yellow involving the face, trunk, flexural and intertriginous areas. Involvement of mucous membranes has been reported. The upper and l...

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ea0029p1496 | Pituitary Clinical | ICEECE2012

Acromegaly and charles bonnet syndrome

Belhimer F , Bekkaye L , Chentli F

Introduction: Charles Bonnet syndrome is almost unknown by the endocrinologists. It is composed by visual hallucinations that do not react with the patient contrary to psychiatric hallucinations. The abnormal visions (generally hidden by patients) appear in subjects with an impaired vision of one of both eyes as in the following case:Case report: A man aged 27, was referred for acromegaly secondary to a huge invasive somatolactotrope pituitary adenomas d...

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ea0029p1497 | Pituitary Clinical | ICEECE2012

Planning for the future: preparing the endocrine specialist nurse of tomorrow

Carson M

We have come a long way in the UK over the past ten years towards our goal of meeting the educational needs of nurses specialising in adult endocrinology. Endocrine nurses are now able to access annual training updates and attend specific nurse-led sessions at scientific meetings thanks to the ongoing work undertaken by the Society for Endocrinologys nurse committee.It is therefore time to turn our attention to how we can encourage nurses to want t...

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ea0029p1498 | Pituitary Clinical | ICEECE2012

Changes in body composition in patients with acromegaly

Fujio S , Habu M , Yunoue S , Hirano H , Arimura H , Arita K

Introduction: With the advancement of surgical techniques and equipments, many patients with acromegaly have achieved complete remission after surgery. Normalization of growth hormone (GH) brings about improvement of vital prognosis, but recovery from high GH hematologic disease induces various abnormalities. We focused on the body weight and body composition of the patients with acromegaly and examined the post-surgical changes.Materials and Methods: 19...

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ea0029p1499 | Pituitary Clinical | ICEECE2012

Complications of pure endoscopic transsphenoidal surgery for pituitary adenoma

Zielinski G , Podgorski J , Koziarski A , Kaminski G

Object: The aim of the study was to evaluate the safety and efficacy of the pure endoscopic removal of the pituitary adenomas with special references to the complications.Material and methods: The authors analyzed retrospectively a database of 52 consecutive patients (16 males and 36 females) with pituitary adenomas who underwent endoscopic transsphenoidal surgery. Preoperative examination was based on radiological visualization of the tumor and endocrin...

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ea0029p1500 | Pituitary Clinical | ICEECE2012

A case of nephrotic syndrome hidden by cushing’s disease

Paoletta A , Billeci D , Fallo F

We report a case of Cushings disease associated to nephrotic syndrome. A 21-year old female was admitted to Cittadella-Hospital due to recent occurrence of weight gain, acne, hirsutism, amenorrhea and mild hypertension. Physical examination revealed truncal obesity, moon face, buffalo hump and a bilateral ankle edema. Suspected hypercortisolism was confirmed by elevated 24 h urinary cortisol (385 μg/24 h, normal range 32250 μg/24 h) and failure to suppres...

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ea0029p1501 | Pituitary Clinical | ICEECE2012

Preliminary report of hypoglycemic response in obese metabolic syndrome males treated with metformin after weight loss intervention

Radman M , Tesanovic S

We conducted this study to determine the degree of obesity influence on the hypoglycemic response of growth hormone and cortisol after weight loss of 5%. A total of 45 non-diabetic, male subjects followed in the outpatient endocrinological department were divided into three groups comprising 15 subjects in each group, based upon body mass index (BMI) to healthy, overweight and obese group. Metformin was administered in the dose of 500 mg daily to the overweight and obese parti...

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ea0029p1502 | Pituitary Clinical | ICEECE2012

A difficult case of hyponatraemia in a neurosurgical patient

Wernig F , Kaura A , Wynne K , Nair R , Meeran K

A 40-year-old female presented with a 6 week history of right-sided headaches and nausea. She was found to have an Arnold-Chiari malformation and an unusual C3 syrinx on MRI brain scanning. She underwent a foramen magnum decompression and C1 laminectomy. Three weeks later, she was admitted with headaches, nausea and vomiting, and blurring of her vision on left lateral gaze. Whilst in the emergency unit, the patient had a tonic-clonic seizure.Following th...

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ea0029p1503 | Pituitary Clinical | ICEECE2012

Invasive and giant pituitary adenomas in the elderly

Azzoug S , Hamrras S , Chentli F

Clinical presentation of pituitary adenomas is influenced by age of patients and stage of the tumour at diagnosis. In this study we intended to analyse the features of pituitary adenomas in old patients.Subjects and methods: It is a retro- and prospective study concerning 37 patients (19F/18M) aged 60 years and over harbouring a pituitary adenoma, these patients were divided into two groups:Group 1 (G1): Patients with invasive and/or giant tum...

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ea0029p1504 | Pituitary Clinical | ICEECE2012

Hyperprolactinemia: prolactinoma or pregnancy?

Belo S , Magalhaes A , Carvalho D

Introduction: High prolactin levels may have several etiologies including the presence of a prolactin producing pituitary adenoma or the treatment with drugs of different classes. Certain physiological states, from which pregnancy stands out, are also characterized by elevated levels of prolactin.Case: Woman, 28 years old, with no relevant medical history or chronic medication apart from oral contraceptives, begins with amenorrhea in May 2010, without ga...

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ea0029p1505 | Pituitary Clinical | ICEECE2012

DHEAS: a new marker in Cushing’s disease? Preliminary results of 32 patients

Burkhardt T , Aberle J , Mengel M , Jorg F

Introduction/objective: The objective was to determine if peri-operative levels of DHEAS correlate with levels of ACTH and cortisol and therefore are useful as a new marker for the definition of cure in patients suffering from Cushings disease. DHEAS is an ACTH-dependent precursor of androgens and estrogens secreted from the adrenals. Numerous clinical trials have shown that DHEAS in humans and other mammals is a multi-functional steroid implicated in a broad range of bi...

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ea0029p1506 | Pituitary Clinical | ICEECE2012

Clinical experience with acromegalic patients who have macroadenomas and long term follow-up results

Oruk G , Bahceci M , Oygen A , Olmezoglu A , Bezircioglu H

The increased morbidity and mortality of acromegaly makes early diagnosis and therapy critical. Long term follow-up and investigating comorbidities of this disease is also important. We present here retrospective results of 70 patients. There were 41 female, 29 male patient included in the study. Follow-up period was longer than 5 years. Fifty-nine of the patients were macroadenoma, 4 of them were empty sella, 7 of them were microadenoma. Seven patients refused surgical treatm...

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ea0029p1507 | Pituitary Clinical | ICEECE2012

Glucose metabolism and lipid disturbances in acromegalic patients before and during treatment with long-acting somatostatin analogues

Kazmierczyk-Puchalska A , Andrysiak-Mamos E , Sowinska-Przepiera E , Syrenicz A

Introduction: Acromegaly causes hyperlipidemia and glucose metabolism disturbances what finally results in increased mortality. Correctin of those lipid and glucose disturbances during treatment with long-acting somatostatin analogues was examinated in this study.Material and methods: Eleven patients (9 women and 2 men) with active acromegaly and macroadenoma diagnosed at our Department in the years 20082011 underwent monitoring of lipids and gluco...

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ea0029p1508 | Pituitary Clinical | ICEECE2012

The therapy with cabergoline evaluation of men with macroprolactinoma

Andrysiak-Mamos E. , Kazmierczyk-Puchalska A. , Sowinska-Przepiera E. , Sagan L. , Kojder I. , Syrenicz A.

Introduction: Pituitary gland adenomas producing prolactin are one of the most common hormonally active tumours. A pharmacological treatment with the usage of dopamine receptors agonists is a therapy of choice in case of prolactinoma.The aim of the study was evaluation of the therapy with cabergoline of men with macroprolactinoma basing on the clinical, hormonal and radiological examinations.Material and methods: Ten men aged 18 to...

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ea0029p1509 | Pituitary Clinical | ICEECE2012

Efficacy of testerone 2% gel replacement therapy on erectile function, muscle strenght and general wellbeing in men affected by normo-hypogonadotropic hypogonadism

Lo Calzo F. , Galdiero M. , Vitale P. , Cariati F. , Cozzolino A. , Grasso L. , Colao A. , Pivonello R.

Background: Hypogonadism is a clinical entity characterized by low serum testosterone (T) levels associated with several clinical signs and symptoms which can negatively affect the quality of life. T replacement therapy (TRT), restoring serum T concentrations, improves signs and symptoms related to hypogonadism. Many T formulations are presently available. The aim of the study was to assess effects of 2% gel TRT on serum T concentrations, erectile function, muscle strength and...

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ea0029p1510 | Pituitary Clinical | ICEECE2012

Follow up of pituitary incidentaloma: a study in 140 patients

Poiana C. , Carsote M. , Trifanescu R. , Danciulescu-Miulescu R. , Musat M. , Hortopan D. , Dumitrascu A.

Introduction: Pituitary incidentaloma is a relatively frequent imagistic finding. Since no therapy is necessary, the follow up protocol is the most important in patients approach.Aim: We present a study in patients diagnosed with pituitary incidentaloma, admitted in I.Parhon, Bucharest, between 1999 and 2011.Patients and method: This is a retrospective study in 140 patients, diagnosed with pituitary incidentaloma based on CT ...

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ea0029p1511 | Pituitary Clinical | ICEECE2012

Macroprolactin levels in healthy blood donors

Horvath D. , Locsei Z. , Catomio C. , Jager R. , Hadarits F. , Kovacs G. , Toldy E.

The incidence of macroprolactinemia decreased notably because of wide use of prolactin (PRL) assays measuring macroprolactin at a lower rate. However, in case of high PRL levels, measurement of monomeric PRL (mPRL) levels after polyethylene glycol (PEG) treatment is still required. Our aim was to determine by the use of a second generation PRL assay how total PRL (tPRL) levels in native sera of healthy blood donors change after PEG treatment. In women, the use of...

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ea0029p1512 | Pituitary Clinical | ICEECE2012

Sleep apnoea syndrome in acromegaly

Khemiri H. , Turki Z. , Yazidi M. , Kammoun I. , Turki M. , Ben Salem L. , Ben Slama C.

Sleep apnoea syndrome (SAS) is common in acromegaly and both diseases are independently associated with hypertension and insulin resistance contributing to increased morbidity and mortality.The aim of this study was to assess the prevalence and risk factors of SAS in acromegaly, to study clinical and polysomnographic particularities of SAS in acromegaly and to analyze the effects of acromegaly treatment on SAS.Its a retrospec...

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ea0029p1513 | Pituitary Clinical | ICEECE2012

Therapeutic trends, long-term outcome and efficacy of different treatment modalities in acromegaly: a single center registry covering a 40 year period

Tzanela M. , Karapanou O. , Assimakopoulou A. , Papastathopoulou L. , Christophoraki M. , Tsagarakis S.

The aim of the study was to examine the therapeutic trends and the long-term outcome of available therapeutic modalities for acromegaly in a single center over a 40 year period.We retrospectively studied 300 acromegalic patients (131 men, 169 women, 153 macroadenomas and 147 microadenomas) from 1970 until 2010; 154 patients were diagnosed before 1990 (group A) and 146 after 1990 (group B). Outcome was evaluated by IGF1 and GH (random plus post OGTT) meas...

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ea0029p1514 | Pituitary Clinical | ICEECE2012

Prevalence of the metabolic syndrome in patients with adult growth hormone deficiency before GH treatment

Romero-Munoz M. , Tenorio-Jimenez C. , Varsavsky M. , Luna-Del-Castillo J. , Munoz-Torres M. , Torres-Vela E.

Introduction: A increased prevalence of metabolic syndrome (MetS) has recently been described in patients with adult growth hormone deficiency (GHD). This fact could influence the increased risk of cardiovascular morbidity and mortality observed in these patients. Our objective was to investigate the characteristics and prevalence of MetS in adult GHD.Design and methods: Forty-nine adult patients (30 women, 19 men; 14 childhood-onset), mean age of 36.2&#...

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ea0029p1515 | Pituitary Clinical | ICEECE2012

Familial central diabetes insipidus with extremely high water intake

Pigarova E. , Rozhinskaya L. , Dzeranova L. , Zenkova T. , Tiulpakov A.

Water intake in central diabetes insipidus (CDI) usually falls in range of 320 l a day. Intake of more than 20 l is regarded as physiologically unnecessarily even in the absence of antidiuretic hormone. We describe a family with 8 members suffering from autosomal recessive form of CDI due to mutation C105Y (codon numeration is given for preprovasopressin) in AVP gene. In all family members disease had presented in neonatal period or early childhood. It is remarkable that...

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ea0029p1516 | Pituitary Clinical | ICEECE2012

Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients

Ciresi A. , Amato M. , Guarnotta V. , Galluzzo A. , Giordano C.

Background: The Visceral Adiposity Index (VAI) has been suggested as a new gender-specific marker of visceral adipose dysfunction, strongly associated with insulin sensitivity in patients with cardio-metabolic risk.Aim: To test VAI in active acromegaly for the assessment of disease-associated metabolic risk evaluating its association with hormonal data, adipocytokine levels, insulin sensitivity and secretion parameters in a cohort of 27 subjects (15 M, 1...

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ea0029p1517 | Pituitary Clinical | ICEECE2012

Isolated diabetes insipidus happened during premenopause solution ten years after

Ory J.

Pathologies of pituitary gland are often revealed by diabetes insipidus. Etiologies are, in first, tumors, inflammatory and granulomatosis diseases after, but stay idiopathic in 24% of French study, 52% of Italian study and 33% of Tunisian study.Case report: Mrs A., 53 years old, consults in 1998 because polyuriapolydipsia, without diabetes mellitus. She is hospitalized during 2 days and hydric restriction test shows the organic reality. The others...

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ea0029p1518 | Pituitary Clinical | ICEECE2012

Metaplastic Rathke’s cyst leading to hypopituitarism

Muniyappa S. , Sinha S. , Newell-price J.

A 22 years old woman, with secondary infertility, was found to have secondary hypothyroidism and referred to endocrinology. On review her symptoms consisted of headache for 6 months, amenorrhoea, weight gain and progressive loss of vision in the left eye for 69 months, which had been investigated by opticians and opthalmologists. Other history includes Von Willebrand disease type2. Clinical examination confirmed total loss of vision of the left eye and complete temporal ...

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ea0029p1519 | Pituitary Clinical | ICEECE2012

Pituitary macroadenomas: benefit from early GH substitution after surgery

Sauer N. , Dannheim V. , Flitsch J. , Aberle J.

Introduction: of non-functioning pituitary macroadenomas are associated with hyposecretion of the pituitary gland. In addition surgical therapy can lead to a partial or complete hypopituitarism. Data suggest that substitution of growth hormone can improve quality of life and reduce associated symptoms. However in many cases substitution is not started within the first 612 months after surgery. Therefore we intended to investigate if patients benefit from an early growth ...

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ea0029p1520 | Pituitary Clinical | ICEECE2012

Pituitary insufficiency in the acute phase of traumatic brain injury or subarachnoid hemorrhage, prevalence and predictive factors: a prospective, population based study

Sigurjonsson P. , Jonasdottir , Olafsson I. , Karason S. , Sigthorsson G. , Sigurjonsdottir H.

Background: Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) can cause long-term morbidity and death. Studies indicate that this may partially be due to transient or chronic hypopituitarism (HP). Guidelines recommend screening for HP in moderate and severe TBI patients (TBIp), Glasgow coma score (GCS) 912 and <9 respectively. The aim of this study was to evaluate markers of severity and physiologic changes as predictive factors for HP following TBI and ...

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ea0029p1521 | Pituitary Clinical | ICEECE2012

Difference of response to TRH (thyrotropin releasing hormone) stimulation according to octreotide response and the size of GH-producing pituitary adenomas

Oh S. , Chin S. , Kim S.

Objective: TRH induces GH secretion presumably by expression of TRH receptor dedifferentiated in pitutiary tumors, but it is not clear how the TRH elegantly stimulates GH secretion in tumoral states.Design: The aim of this study was to investigate how GH-producing pituitary adenomas respond to TRH with respect to GH secretion and how it differs according to octreotide responses and their sizes of tumor.Method: GH levels of 45 patie...

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ea0029p1522 | Pituitary Clinical | ICEECE2012

Ovarian hyperstimulation syndrome due to a functioning gonadotroph adenoma

Mohandas C. , Mustafa O. , Prague J. , Whitelaw B. , Thomas N. , King A. , Aylwin S B.

Background: Gonadotroph adenomas usually present as non-functioning pituitary adenomas.We describe a patient with a functioning gonadotroph adenoma presenting with ovarian hyperstimulation syndrome: an exceptionally rare presentation of pituitary disease.Case history: A 26-year-old female presented with a 10-year history of worsening lower abdominal pain, bloating, dysmenorrhea and irregular periods in 2006. She was found by ultrasound to have multiple o...

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ea0029p1523 | Pituitary Clinical | ICEECE2012

GH deficiency after treatment of medulloblastoma and thyroid cancer: is this the case for GH therapy?

Valkusz Z. , Magony S. , Sepp K. , Csajbok E. , Julesz J. , Pavics L.

The hypothalamicpituitary unit is a particularly radiosensitive region in the central nervous system. As a consequence, hypopituitarism commonly develops after radiation treatments for sellar and parasellar neoplasms, extrasellar brain tumours. Increasing tumour-related survival rates provide an expanding population at risk of developing hypopituitarism. The severity of hypopituitarism is related to the radiation doses given while whole body irradiation regimens to a dos...

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ea0029p1524 | Pituitary Clinical | ICEECE2012

Thyrotropinoma. A rare case report of hyperthyroidism

Tamez-Perez H. , Quintanilla-Flores D. , Hernandez-Coria M. , Cisneros-Franco J. , Tamez-Pena A. , Proskauer-Pena S.

Case presentation: A 84 year-old male without family history of thyroid disease was referred to our clinic by his cardiologist, diagnosed as having primary hypothyroidism, characterized by persistent elevated TSH without response to L-thyroxine over the course of a year. Co-morbidities included arterial hypertension, auricular fibrillation (AF) and glucose intolerance, treated with propafenone, clopidogrel, enalapril, and digoxine. On physical examination, he pr...

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ea0029p1525 | Pituitary Clinical | ICEECE2012

The dermatologic evaluation of acromegaly patients

Saler T.

Aim: To evaluate dermatologic findings in diabetic and nondiabetic acromegalic patients and compare with nonacromegalic diabetic patients. Also to investigate any possible correlation between skin lesions and colonic and thyroid neoplasms.Materials and methods: Data from dermatologic examination of 32 acromegalic and diabetic nonacromegalic patients were compared. Colonoscopic, ultrasonographic and biochemical findings of acromegalic patients were evalua...

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ea0029p1526 | Pituitary Clinical | ICEECE2012

Growth hormone effects on lipid profile in patients with acromegaly

Mykytuyk M. , Khyzhnyak O. , Sulima T. , Karachentsev Y.

Introduction: Active acromegaly is associated with increased mortality, which has been attributed largely to cardiovascular disease.Aims: To evaluate the effects of chronic excess of GH and IGF1 on lipid metabolism in patients with active acromegaly.Subjects and methods: Ninety-seven patients (37 men and 60 women; aged 1876 years) with macroadenoma of hypophysis (67 somatotropinoma, 30 somatomammotropinoma) were...

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ea0029p1527 | Pituitary Clinical | ICEECE2012

Pituitary lesions: Pituitary adenomas and what else?

Vourliotaki I. , Boumpaki A. , Alexaki S. , Stamataki K.

Introduction: Pituitary lesions are quite often in the general population and can be symptomatic or not. Most are attributed to pituitary adenomas. Differential diagnosis also includes other causes, such as granulomatous diseases (sarcoidosis, histiocyttosis). Neurosarcoidosis is rare. Sarcoidosis pituitary infiltration is even more rare and usually reported in multifocal forms of the disease.Case report: We describe a 34-year old female with headache an...

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ea0029p1528 | Pituitary Clinical | ICEECE2012

Progressive combined pituitary hormone deficiency produced by Prop1 gene mutation

Ghervan C. , Stroe M. , Young J.

Introduction: The appearance and normal development of the anterior pituitary gland requires several signalling molecules and specific transcription factors, such as PROP1, POUF1, HESX1/RPX, LHX3, LHX4, PITX2, T-PIT, SOX2 and SOX 3. Gene mutations of these pituitary transcription factors may lead to different degrees of combined pituitary hormone deficiency (CPHD) associated or not with morphological changes of the hypothalamicpituitary region.Mate...

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ea0029p1529 | Pituitary Clinical | ICEECE2012

Neurohypohysis tumors: about two cases

Belhimer F. , Belahcene S. , Souachi S. , Baba Ahmed R. , Chentli F.

Introduction: Neurohypophysis tumors also called pituicytomas are very rare low grade gliomas of the brain that developed in the posterior part of the pituitary gland. Our aim is to report two cases whose diagnosis was made by MRI in the first case and by histology in the second case.Cases reports: Observation No. 1: a woman aged 33 consulted for polyuria and polydypsia due to central diabetes insipidus without pituitary insufficiency. The MRI discovered...

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ea0029p1530 | Pituitary Clinical | ICEECE2012

Hypersomatotropism and glucose metabolism disorders

Belhimer F. , Namani S. , Lyazidi A. , Chentli F.

Introduction: Glucose metabolism disorder (GMD) is a classic complication of acromegaly, but its frequency varies from study to study.Aim: We aimed to analyze GMD frequency in our population, and predictive factors such as: family history of diabetes mellitus (DM), age, gender, and growth hormone (GH) rates.Subjects and methods: It is a prospective study where 75 hypersomatotropic subjects were analyzed. They all had fasting and po...

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ea0029p1531 | Pituitary Clinical | ICEECE2012

Hyperprolactinemia: etiology, diagnosis and therapeutic aspects

Crista C. , Vlazan A. , Scheau M. , Racolta A.

The complex etiology of hyperprolactinemia was represented, in our study group (426 cases hospitalized during the period 2000 2010; F/M ratio=372/54; age (years)=40.29±15.57), by the following entities: prolactin-secreting pituitary tumors (11.50%), growth hormone and prolactin-secreting pituitary tumors (1.64%), pituitary stalk compression (7.98%), primary myxedema (41.08%), polycystic ovary syndrome PCOS (24.65%), iatrogenesis (8.69%) and chronic renal ins...

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ea0029p1532 | Pituitary Clinical | ICEECE2012

Clinical, biological and radiological confrontation in Cushing disease

Haouat E. , Riahi T. , Ben Salem L. , Kandara H. , Turki Z. , Ben Slama C.

Introduction: Cushing disease (CD) is a condition due to an ACTH-secreting pituitary adenoma that is usually a microadenoma. Seldom, the lesion may be atypical by his size or his radiological aspect.The aim of this study is to analyze the clinical and biological data of CD with atypical radiological aspect (macroadenoma or other), to compare them to those of CD with a typical radiological aspect (microadenoma) and to determine the clinical or biological ...

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ea0029p1533 | Pituitary Clinical | ICEECE2012

Characteristics of giant and huge male prolactinomas

Chentli F. , Belkhamsa D. , Ould Driss N. , Azzoug S.

Introduction: Prolactinomas are more invasive in males. Giant (≥4 cm) and huge (≥6 cm) ones are relatively rare in literature, but in our population they are nearly common.Aim: We have taken our 20 last cases to analyze their radiological aspects, and their endocrine, neurological and ophthalmological complications.Methods: All of them had clinical exam, hormonal, ophthalmological, and radiological exploration based on ...

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ea0029p1534 | Pituitary Clinical | ICEECE2012

A case of acromegaly in the presence of coincidental liver cirrhosis

Topsakal S. , Akin F. , Yerlikaya E. , Korkmaz T.

Acromegaly is a rare and serious syndrome and commonly associated with pituitary neoplasm. Classic cause of acromegaly in adults is the tumors of the somatotrophs that secrete growth hormone. Cirrhosis is the end stage of chronic liver disease and commonly cause of death. It is characterized by diffuse hepatic fibrosis resulting in altered construction of the lobular parenchyma with widespread connective tissue septae, circumscribed regenerative nodules of hepatocytes and anas...

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ea0029p1535 | Pituitary Clinical | ICEECE2012

Adiponectin and cardiac structure in acromegaly

Gurbulak S. , Akin F. , Yerlikaya E. , Topsakal S. , Tanriverdi H. , Akdag B. , Kaptanoglu B.

Adiponectin, is an adipocyte derived hormone possess insulin-sensitizing, antiatherogenic, and antiinflammatory properties. The aim of this study to evaluate adiponectin levels at acromegalic patients according to healthy subjects in relation with ecocardiographic findings. We included 30 subjects (15 male, 15 female) were diagnosed as acromegaly and 30 healthy (10 male, 20 female) subjects. Mean ages of both group were similar. Serum glucose, insulin, GH, IGF1 (insulin like g...

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ea0029p1536 | Pituitary Clinical | ICEECE2012

A case of acromegaly diagnosed with diabetic ketoacidosis as a primary manifestation

Usui S. , Sue M. , Yoshihara A. , Oka R. , Ishikawa M. , Hiroi N. , Kuboki K. , Yoshino G.

Although diabetic ketoacidosis (DKA) is recognized one of complications of acromegaly, it is very rare as only five cases are reported as a primary manifestation.A 43-year-old Japanese woman, who had never pointed out impaired glucose tolerance, had emergency admitted by DKA. Her plasma glucose was 440 mg/dl, HbA1c 15.7%, urinary keton body (3+), BGA pH7.257, then she was cured by rehydration of saline and continues intravenous insulin injection. She was...

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ea0029p1537 | Pituitary Clinical | ICEECE2012

The role of long acting somatostatin analogues on glucose homeostasis in acromegaly

Yener Ozturk F. , Cil Sen E. , Velet S. , Shafi Zuhur S. , Karaman , Altuntas Y.

Introduction: Impaired glucose tolerance and diabetes mellitus are frequently seen complications of acromegaly. Insulin resistance due to chronic growth hormone (GH) excess and inhibition of insulin and glucagon secretion by long-acting somatostatin analogues (SA) used in the treatment are the main reasons of the impaired glucose tolerance.Objective: To determine the effect of long-acting SA treatment on glucose homeostasis regarding the insulin resistan...

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ea0029p1538 | Pituitary Clinical | ICEECE2012

Clinical features of inferior and lateral invasive expansion of GH-producing adenoma

Asano T. , Yamada H. , Aoki A. , Sasaki M. , Ikoma A. , Ishikawa S.

The present study was undertaken to determine morphological and biochemical characteristics of GH-producing tumor. We collected consecutively 15 patients with acromegaly, and they were 6 males and 9 females with the ages of 58.5±9.9 years. As for tumor size, 7 patients had macroadenoma, 5 had microadenoma and three had empty sella with some atypical expansions. Only 3 patients had intrasellar tumor and 2 patients had empty sella in MRI finding. Other 10 patients had atypi...

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ea0029p1539 | Pituitary Clinical | ICEECE2012

Predictive value of acute octreotide supression test in newly diagnosed acromegaly

Balcere I. , Strele I. , Klovins J. , Pirags V.

Background: It has been reported that primary treatment with somatostatin analogues (SSA) is effective in up to 60% of acromegaly patients, but predictive value of the acute octreotide suppression test (OST) for selection of patients with good response to depot SSA in long term treatment remains controversial.Patients and methods: Twelve medical therapy naive patients (mean age 44 years, female 75%) with active acromegaly were included in prospective stu...

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ea0029p1540 | Pituitary Clinical | ICEECE2012

An unusual plurihormonal pituitary adenoma

Batisse Lignier M. , Maqdasy S. , Mestre B. , Roche B. , Chazal J. , Tauveron I.

Introduction: Plurihormonality of pituitary adenoma can be defined as the ability to express more than one hormone. 130% of pituitary adenoma are plurihormonal. We describe a case of plurihormonal adenoma with GH and ACTH secretion and triple immunostaining for GH, ACTH and prolactin.Case report: A 40 years old patient presented with sudden weight gain central obesity, hypertension, menstrual disorders, acne, hirsutism suggesting hypercortisolism. ...

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ea0029p1541 | Pituitary Clinical | ICEECE2012

Results of pegvisomant therapy in patients with acromegaly

Kan E. , Atmaca A. , Ecemis G. , Atmaca H. , Colak R.

Introduction: Acromegaly is chronic debilitating disease related with excess GH and insülin-like growth factor 1 (IGF1) secretion. Pegvisomant is a GH receptor antagonist that competes with endogenous GH for its receptor and is often used as a medical therapy in patients with inadequate response to somatostatin analogs.Methods: Forty-six patients are followed with the diagnosis of acromegaly in our clinic. We present the results of six acromegalic p...

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ea0029p1542 | Pituitary Clinical | ICEECE2012

Panhypopituitarism and central diabetes insipidus: a case report

Hu Y.

Patient in the case, an 18-year-old male, complained of constant tiredness, frequent malaise, day time sleepiness, epigastric pain, poor appetite and consumption of great quantity of water. These conditions had persisted for 34 years. He had gone to many different physicians, with different tests taken, but without diagnose. Upon physical examination, the pale skin, scanty of pubic hair, and no presence of beard and axillary hair raised the possibility of Panhypopituitar...

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ea0029p1542.1 | Pituitary Clinical | ICEECE2012

Evaluation of the efficacy and safety of pasireotide LAR in patients with mild-to-moderate cushing’s disease: a randomized, double-blind, multicenter, phase III study design

Ligueros-Saylan M. , Zhang Y. , Newell-Price J. , Petersenn S. , Lymperopoulos S.

Background: Cushings disease is associated with high morbidity and mortality, and there are currently no approved medical therapies. Twice-daily pasireotide sc showed efficacy in patients with mostly moderate-to-severe (UFC≥2×ULN) Cushings disease in a large, randomized, double-blind, 12-month trial. A monthly long-acting release (LAR) formulation of pasireotide has been developed to provide a smoother pharmacokinetic profile, potentially a better effica...

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