Endocrine Abstracts

Introduction: Ectopic ACTH syndrome (EAS) is a rare cause of ACTH-dependent endogenous hypercortisolism.Objective: The objective of this study was to analyse the clinical, biochemical, and radiological features, management, and treatment outcome of patients with EAS.Design: It was a retrospective case-record study of 52 patients with EAS.Materials and methods: Clinical, biochemical, and radiological features ...

GHD in adults (AGHD) is a clinical syndrome associated with lack of positive well-being, depressed mood, feelings of social isolation, decreased energy, alterations in body composition with reduced bone and muscle mass, diminished exercise performance, and cardiac capacity. These manifestations are also common in adults with beta-thalassemia major (BTM). Performing provocative testing in all patients is cumbersome and expensive. Many studies suggested that IGF1 may be used for...

Introduction: Thyroid hormones influence GH/IGF1 axis, but previous studies reported discrepant results regarding serum IGF1 levels in hyperthyroidism. We have therefore investigated, at diagnosis, the relationship between serum IGF1 levels/IGF1 z scores and clinical and biological characteristics of Graves’ disease (GD) patients. We also compared IGF1 levels/IGF1 z scores, at diagnosis, between GD and autonomous hyperthyroidism patients.<p class="ab...

Somatotropin (GH) and IGF1 realise their influence on the system of intracellular metabolism and a number of important biochemical lymphocytes reactions through the receptor apparatus. It is allows to use the peripheral blood lymphocytes as the investigations object of intracellular metabolism disorders in acromegaly.Aim: To study the NAD- and NADP-dependent dehydrogenases activity in blood lymphocytes in active acromegaly patients.<p class="abstext"...

Objective: To evaluate the frequency of symptoms of Cushing’s disease (CD) at baseline and it dependence on different quantities.Material and methods: Clinical and laboratory data of 44 patients with CD (40 females and four males, 37.9±10.5 years old), duration of the disease 35.5 (22; 75) months.Results: Complaints: i) >80% – fatigability, weight gain, apathy, and headache, ii) 40–50% – loss of libido,...

Androgen receptor (AR, NR3C4) is a 110-kDa ligand-activated transcriptional factor that belongs to the steroid hormone receptor superfamily. It has broad developmental effects and its mutations may have a great impact on pubertal development, genesis of prostatic hyperplasia, and even prostate cancer. Commonly known endogenous ligands of AR are testosterone and 5α-dihydrotestosterone (DHT). In the last years, several drugs and environmental pollutants were identified to a...

Behcet’s disease (BD) is a chronic disease characterised by systemic involvement of blood vessels of all sizes on both arterial and venous circulation resulting in recurrent ulcers. The posterior infundibulo-hypophysitis, causing DI, has been commonly reported in association with systemic inflammatory/autoimmune disorders, however there are a handful of cases presenting with DI and Behcet’s disease.A 26-year-old African-American woman diagnosed...

An increased prevalence of acromegaly and pituitary tumors has recently been observed in high industrial density areas (Cannavò et al. J Endocrinol 2010) or after dioxin exposure (Pesatori et al. Eur J Endocrinol 2008). These data as well as vitro studies on endocrine disruptors (EDs) suggest that environmental pollutants may affect hormonal secretion and pituitary cell proliferation (Blake et al. Proc Soc Exp Biol...

Synapses are the key elements for signal transduction and plasticity in the brain. Despite a relatively large number of assumptions that have been made on the structure of mature cortical synapses in many other animal species, little is known about these structures in human. Hence, synapses in cortical layer 5 (L5), the main recipient layer of thalamocortical efferents, which representing the first station of cortical information processing were investigated structurally and q...

Background: Polycystic ovarian syndrome (PCOS) is a common reproductive-endocrine disorder seen in women; characterized by increased GnRH pulsatility, hyperandrogenism, and cyst formation in ovary. GnRH release is controlled by higher centres of brain namely, hypothalamus and pituitary through various feedback mechanisms, one of them being neurotransmitters. However, no clear data is available with respect to GnRH regulation by neurotransmitters in PCOS. The aim of the present...

Background: Metabolic complications (obesity, lipid abnormalities, and insulin resistance) are prevalent in acute lymphoblastic leukemia (ALL) survivors treated with cranial radiotherapy (CRT). The hypothalamus (HT) is a complex area involved in endocrine function and metabolic control. In ALL survivors, assessment of the volume of the HT in relation to metabolic parameters including ghrelin, a peptide stimulating food intake, has not been performed previously.<p class="ab...

Background: Survivors of childhood leukaemia (ALL) treated with cranial radiotherapy (CRT) are at risk for cognitive impairment. Whether the impairment progresses with follow-up time and if survivors with cognitive impairment have an increased risk for overweight, is unknown. We aimed to investigate the long-term cognitive functioning in ALL survivors treated with CRT in comparison to matched controls.Method: Cognitive functioning was investigated in 38 ...

The purpose of the study: To examine the incidence of neuroendocrine complications after radiation therapy (RT) of pituitary somatotropinomas.Materials and methods: 30 patients surveyed after receiving RT at a dose of 45 g in 25 fractions a day. Of these, 21 (70%) females, 9 (30%) men. The age of patients ranged from 36 to 71 years. 37% of them had pituitary macroadenoma with para-, supra-, and infrasellar growth. Duration of illness was 15 years on aver...

Stressful experiences produce profound physiological and behavioural disturbances that may contribute to many psychiatric disorders. Stress activates HPA axis whose end products glucocorticoids modulate immune cells and cytokine activity. Local effect of glucocorticoids depends not only on its concentration but also on the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11HSD1), which amplifies intracellular glucocorticoid concentration by the conversion of inactive 11-de...

Introduction: The oxidative stress is supposed to be key factor in multiple diseases.The aim of the study was to examine the effects of excessive GH secretion on the blood antioxidant system: total antioxidant capacity (TAC) of plasma; superoxide dismutase (SOD) and catalase activities (CAT); ceruloplasmin (CP); non-protein thiol (NT), and level of thiobarbituric acid reactive substances (TBARS).Materials: Eleven patients with acti...

Introduction: PATRO adults is an ongoing, international, open, longitudinal, non-interventional study of the long-term safety and efficacy of recombinant human GH (rhGH; Omnitrope, Sandoz). The study will provide further data on the long-term safety of rhGH in adult patients with severe GH deficiency (GHD). Here, we present safety data from an interim analysis.Methods: Adults who are receiving treatment with Omnitrope and who have provided informed conse...

Objective: To determine the percentage of patients with acromegaly who received lanreotide Autogel 120 mg (ATG120) in extended duration interval and to evaluate the mean costs of ATG120 administered as part of routine care in Poland.Methods: National, multicentre, non-interventional, observational prospective study with 2-years’ time horizon. The study population consisted of adult acromegaly patients who received at least three injections of ATG120...

Introduction: The clinical significance of the impact of GH on glucose homeostasis in adults with GH deficiency (GHD) remains unclear. We report the impact of 4 years of continuous GH therapy on HbA1c and progression to diabetes.Methods: Data were analysed from patients with adult-onset GHD (>20 years old) enrolled in NordiNet® International Outcome Study (IOS) (NCT00960128), an observational study, and treated with GH (Norditropin<su...

Long-term sequels of pituitary radiotherapy include hypopituitarism, optic nerve atrophy, sensorineural hearing loss, neurocognitive impairment and second intracranial neoplasms, the meningioma being the most frequent. The cumulative incidence of second cerebral tumours within 20 years of the radiation is 2% and, unlike its primary forms, they show a more aggressive atypical histology, and the age of appearance varies depending on the latency time, which in its turn is proport...

Purpose: IGF receptor 1 (IGF1R) and epidermal growth factor receptor (EGFR) are receptors tyrosine-kinase (RTK) whose altered signaling are critical factors in development of many types of tumours. These RTK are some of the main targets of the microRNA miR-7. This important tumor supressor miRNA has the ability to inhibit the motility, invasiveness and anchorage-independent growth, suggesting a strong therapeutic potential in many types of cancer. Pituitary adenomas (PA) are a...

The purpose of research: To study the dynamics of anthropometric and hormonal indicators of adolescent boys with physical and sexual development (ZFPR) and iodine deficiency disorders (IDD), received treatment for 12 months replacement therapy of thyroid (jodomarin, L-thyroxine, Berlin-Chemie).Material and methods: We have inspected and examined the whole for the period from 30th May 2012 to 15th October 2013 1066 adolescent boys in differ...

Somatostatin and dopamine receptors are the major Gi-coupled receptors in somatotrope cells that inhibit hormone secretion from the anterior pituitary. Here, we adapted a novel fluorescence-based screening assay to characterize somatostatin and dopamine receptor signaling in a time-resolved manner. This minimal-invasive technique provides a robust and reliable read out for ligand-induced receptor activation in permanent cell lines and primary pituitary culture. The ...

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

Introduction: Chronic tolvaptan (TV) therapy has been found to be safe and effective in the treatment of chronic SIADH. However, experience with modification of doses over time is limited.Methods: We conducted a retrospective analysis of weekly TV doses (mg) in 41 patients with chronic SIADH treated for a minimum of 3 months, seen a week following discharge and monthly thereafter. Serum sodium (SNa) goal was 137–140 mmol/l, with 50% TV dose reductio...

Goal: Identification of latent mosaicism and determination of a parental origin of an X chromosome in TS patients in Uzbek population.Methods: Molecular genetic studies are carried out in 35 patients with TS (26 with monosomy and nine with mosaicism) at the age of 7–16 and their parents with a set of DIATOMTMDNA prep 200 reagents. DNA amplification was performed in Applied Biosystems thermocyclers. PCR products were subjected to electrophoresis on 1...

Introduction: Cushing’s disease (CD) is responsible for 80% of endogenous Cushing’s syndrome (CS). However, distinguishing the cause of ACTH-dependent CS – CD vs ectopic CS – can be extremely difficult. Bilateral inferior petrosal sinus sampling (IPSS) has the highest diagnostic accuracy in this evaluation.Objectives: The aims of this study were to determine the accuracy of bilateral IPSS in the differential diagnosis of ACTH-dependen...

Introduction: Alterations in foetal growth lead to neonatal health risks and favour metabolic diseases during adult life. Therefore, the study of birth weight determination and its modifications is crucial for metabolic diseases prevention. Placental growth is a key factor in foetal growth. It has been suggested that insulin and the IGF system play an important role in foetal growth and placental development and function. Although, insulin and IGFs in the umbilical cord blood ...

Introduction: In a majority of Spanish hospitals, serum sodium levels (SNa) are determined by indirect electrode methodology (sodium in the liquid fraction of serum) divided by the total serum volume (mmol/l). To avoid over/underestimating SNa, a formula can be applied: SNa corrected for total proteins (TP)=SNa×93 divided by (99.1−(0.7×TP)). Hypoproteinaemia is frequent in patients receiving parenteral nutrition (PN), and is probably related to surgery, acute d...

Introduction: The main indications for the somatostatin analogues (SST-A) are acromegalies and/or neuroendocrine tumors. They can increase fecal fats, which could lead to the loss of fat soluble vitamins. There are few published studies showing the effects of the long-term use.Methods: Retrospective study of patients with SST-A indicated from our endocrinology department in the last 10 years. We analysed indications and different epidemiological, clinica...

Introduction: Hyponatremia is the most frequent electrolyte disorder in hospitalised patients. Our aim was to determine the incidence, mean hospital stay, readmission rate and mortality rate among patients with acute heart failure (HF) and hyponatremia.Methods: Retrospective analysis of data collected from the minimum data set (MDS) of Spanish National health System during 2005–2012 from discharged patients of Internal Medicine with HF and hyponatre...

Introduction: Giant prolactinomas are rare tumours, representing 2–3% of all prolactin (PRL)-secreting tumours. Their definition is restricted to pituitary adenomas with a diameter ≥4 or ≥2 cm of suprasellar extension, very high PRL concentrations (≥1000 ng/ml) and no concomitant GH or ACTH secretion. They are more common in young to middle-aged men. Endocrine symptoms are often present for a long period of time, but most times the diagnosis is made when...

TSH-secreting pituitary adenoma (thyrotropinoma) is a rare (0.5% of all pituitary adenomas) and usually benign pituitary lesion, arising from the monoclonal expansion of neoplastic thyrotrophes. Thyrotropinoma usually presents with symptoms thyrotoxicosis (milder compared to those originating from the primary thyroid disorders) and mass effects of the pituitary tumour.Aim: To describe the clinical course of thyrotropinoma presented with paroxysmal atrial...

Objective: To assess the sensitivity of granins – chromogranin A (CgA), secretogranin II (SgII), and secretoneurin (Sn) as biochemical and immunohistochemical markers of non-functioning pituitary adenomas (NFPAs):Methods: 50 patients with NFPAs were included in the study. Tissue samples were immunostained for pituitary hormones, Ki-67, αSU, CgA, SgII, and Sn. Furthermore, we have determined the levels of CgA, SgII in the serum and Sn in the pla...

Introduction: Hyponatremia is the most common electrolyte imbalance among hospitalised patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is considered the most frequent etiology on patients with euvolemic hiponatremia. Conventional treatment includes water restriction and salt tablets with limited efficacy and very slow onset of action in certain patients.Material and methods: Systematic sampling of all SIADH patients treated wit...

Brain ageing associates decreased neuronal plasticity, increased glucocorticoid and decreased retinoic acid (RA) signalling. We previously showed an interaction of these pathways on the regulation of a synaptic plasticity gene, BDNF. We thus investigated the effects of GC and RA on two BDNF-dependent genes: activity-regulated cytoskeleton protein (Arc) and Ca2+/calmodulin-dependent protein kinase II (CaMK). Dexamethasone (Dex, 10−6 M) and/or RA (10<...

Factors affecting the development of nephrolithiasis (NL) in primary hyperparathyroidism (PHPT) actively studied. CASR polymorphisms may be linked with the development of NL in PHPT. Supposed to the role of VDR in the development of nephrolithiasis in patients without PHPT.Objective: To assess the relationship of polymorphisms CASR and VDR with the development of the NL at PGPT.Methods: The study included 187 patients with PTPT (54...

Neuroimmunoendocrine changes of the pineal and thymic function, are now believed to pay an important role in the mechanisms of age-associated diseases development. Here we studied the morphofunctional and signal molecules unity of pineal gland and thymus during ageing. Autopsic pineal gland and thymus material sampled from people was divided into groups 1 – middle-aged people (60–74 years) and 2 – old people (75–89 years). Ultra-thin slices were used for el...

Background: Melatonin is mostly known as a circadian hormone, but it also has effects in a large number of cellular processes (cell differentiation, proliferation, apoptosis, redox balance). Although it was studied in many tumours, very little is known about his role in pharyngo-laryngeal carcinomas.Aim: To evaluate serum melatonin levels in patients with pharyngo-laryngeal malignant tumours preoperatively and after surgical excision of the malignancy.</...

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common causes of anovulatory and infertility. According to the widespread data it affects 3–10% of women in the procreative age. Although many research have been done, it is still unclear which of mechanisms are responsible for the development of PCOS. The most up-to-date scientific trial indicates that the evolution of PCOS is related to the activity of the endogenous opioid system but precise mechanism is...

Introduction: Several genetic syndromes are associated with familial pituitary adenomas. The penetrance of clinical manifestations of these syndromes is not ubiquitous and this might be the reason for the lack of detection of genetic mutations when only one or few genes are studied.Aim: Clinical characterisation and molecular genetic study of a panel with ten genes involved in formation of pituitary adenomas in familial setting.Mat...

Objective: Acromegaly has an important impact on health-related quality of life. The aim of study was to ascertain the quality of life of patients with uncontrolled vs controlled acromegaly and compared to those with non-functioning adenomas and healthy control group.Methods: 124 participants underwent a cross-sectional assessment including the quality of life (AcroQoL, WHOQoL BREF), psychiatric morbidity (GHQ-28) and acceptance of illness (AIS). The sam...

Introduction: The usefulness of acute octreotide suppression test (OST) in the selection of patients with acromegaly for chronic somatostatin analogues (SA) treatment is still controversial.Aim: To investigate the predictive value of OST for long-term responsiveness to long-acting SA.Materials and methods: Retrospective study of 25 drug-naive patients (13 males) with active acromegaly, subjected to an OST (hourly serum GH concentra...

The aim of this study was to evaluate our clinical experience in the treatment of acromegaly during 5-year follow-up period.Methods: Seventeen acromegaly patients (11 women and six men) monitored during 5-year follow-up period. A level of GH of <2.5 ng/ml and the normal IGF range were considered as the criterion for remission. The GH level and IGF1 level were evaluated every 6 months, while magnetic resonance imaging was taken every year during follo...

We have recently observed that the peroxisome proliferator receptor α was expressed by normal and tumoural pituitary tissues, in particular by somatotrophs. To elucidate its function, we have studied the effects of fenofibrate on cell proliferation and GH secretion in GH3 cells.Material and methods: GH3 cells were grown in Ham’s F10 and treated for 24, 48 and 72 h by different concentrations of fenofibrate (12.5–50 &#...

Radiotherapy (RT) may represent a useful tool in the treatment of GH-secreting tumours in the presence of a post-operative active disease and single dose stereotactic RT/gamma knife is the preferred option in most cases. The effects of RT on the control of hormone secretion are very slow and pharmacological treatment remains necessary for years. Some authors advocate withdrawal of somatostatin analogues (SSA) during RT, although the short-term effects of RT on hormone secretio...

Acromegaly is caused by excessive GH secretion from pituitary adenomas. Transphenoidal surgery is the first-choice treatment, but new drug therapies (e.g. somatostatin analogues, SSA) offer promising avenues for medical treatment. Complementary diagnostic tools may assist this strategy, helping to refine drug choice. Here, we investigate the associations between radiological features and molecular phenotype of pituitary tumours from acromegalic patients. This observational stu...

Background and aim: polycystic ovarian syndrome is a multi aetiological female endocrinopathy wherein one of the major target organs affected is adrenal. It is important to note that adrenal plays key role in evoking stress mediated responses in brain; which can in turn affect GnRH, the main regulator of HPG axis. Along with corticotrophin releasing factor (CRF), newly discovered neuropeptides- urocortin2 and RF-amide related peptide-3 (RFRP-3) (mammalian GnIH analogue) are al...

Introduction: Neuroendocrine neoplasms (NENs) are rare and heterogeneous neoplasms with variable biological behaviour but generally slow progression.Methods/design: 355 patients with NENs registered in our data-base have been studied (166 females, mean age: 52 years; range: 11–88), during the period 2004–2014. TNM system has been used for staging and proliferation index Ki-67 for grading.Results: Out of 355 patients, 35 (...

Introduction: Hyponatraemia is the commonest electrolyte disorders encountered in hospitals. The aetiology of hyponatraemia is based on clinic assessment and biochemical investigations. However, studies have shown that recommended guidelines are usually not implemented.Aim: Review of assessment (diagnosis) of Hyponatraemia and outcome based on length of stay (LOS) in hospitals.Methods: A systematic search using PUB Med and Med Line...

Introduction: Empty sella syndrome (EES) is a condition often discovered incidentally, where the sella turcica, the structure containing the pituitary gland, appears to be empty. Patients either remain asymptomatic or, rarely, manifest signs of declined pituitary function. Patients experiencing hypopituitarism are offered hormonal replacement. Autopsy studies estimated a 5% EES prevalence among healthy individuals.Case report: A 68-year-old post-menopaus...

Introduction: Cushing’s syndrome is a rare (0.004%) hormonal disorder, which develops due to hypercortisolaemia. Cushing’s disease refers to a corticothroph cell pituitary tumour overproducing ACTH, which induces abnormally increased cortisol production from the adrenal glands. Cushing’s disease is a causative factor of osteoporosis, hypertension, glucose intolerance and dyslipidaemia.Case report: A 50-year old woman was referred to our de...

Pituitary adenomas are usually benign. However, a significant number of pituitary adenomas show an aggressive behaviour, with local invasion, increased risk of recurrence after surgery and lack of therapeutic response. In this study, we aimed to determine whether invasive and non-invasive pituitary adenomas display differences in clinical features and molecular parameters. In this retrospective descriptive study, 46 pituitary adenomas were analysed. Invasiveness was defined as...

Germline mutations in the aryl hydrocarbon receptor interacting protein gene (AIP) predispose to pituitary adenomas in young patients, often presenting as familial isolated pituitary adenoma (FIPA) kindreds. Pituitary adenomas in patients with AIP mutations (AIPmut) are usually somatotropinomas, which are more aggressive and have poorer responses to somatostatin analogues than their non-mutated counterparts. Given the rarity of this condition, the molecular pathogenesis of the...

Introduction: Excess mortality due to hyponatraemia is well documented but it is not clear whether the mortality associated with SIADH is different to that associated with non-SIADH hyponatraemia (NSH).Methods/design: Prospective evaluation of all patients admitted with or developing hyponatraemia in a tertiary hospital (pNa <130 mmol/l) in January 2015. Diagnosis of SIADH was based on standard clinical and biochemical criteria (pNa, spot urine sodiu...

Background: Gastrin is an early incretin candidate, since it is released by oral glucose and potentiates the glucose-induced insulin secretion. It has been shown that only in hypoglycaemic or hyperglycaemic conditions gastrin release is influenced by changes in blood glucose and insulin concentrations.Aim: To evaluate whether there is a relation between fasting serum glucose and serum gastrin concentrations.Methods: Gastrin and glu...

Clinical manifestations and severity vary considerably primary hyperparathyroidism (PHPT) patients. Several studies indicate that the variation of clinical manifestations PHPT may be associated with genetic factors, in particular the VDR gene polymorphisms and CASR. The purpose of this study was to evaluate the effect of VDR gene polymorphisms and CASR on indicators calcium and phosphorus metabolism, levels of 25(OH)D, PTH, and condition of bone density in patients with PHPT.<...

Background: Copeptin is the C-terminal portion of the precursor of vasopressin. In contrast to vasopressin copeptin is stable in vitro and easy to measure. Similar kinetics of both peptides have been described in different trials. However, the physiological area of normality of copeptin has never been evaluated.Methods: We measured plasma copeptin, sodium, and osmolality levels in 93 healthy volunteers at baseline, during/after i.v. infusion of ...

Introduction: The aim of this report is to present the uncommon clinical presentation of a patient with a pancreatic NET.Case report: A 55-year-old man with personal history of hypertension, dyslipidaemia, and depression. He was referred to the outpatient for high levels of calcium in repeated assessments during the last year. He referred polyuria and polydipsia. Not clinical history of bone fractures, abdominal pain, or another digestive symptoms. Initi...

The secretion of adipocytokines is influenced by fat mass, but also by various situations related to acute stress (food deprivation, or critical state related to inflamatory or infectious syndromes). Adipocytokinic secretory profile could be therefore used for the diagnosis of the type of critical state, as well for the evolution and survival prognosis of patients. The modifications of adipocytokinic markers during the first hours after surgical intervention are insufficiently...

TSH is the main regulator of the thyroid hormones (THs) synthesis/secretion, which in turn exert a negative feedback mechanism on the Tshb mRNA expression in the pituitary gland by reducing their transcription rate. Some of triiodothyronine (T3) effects are also shown in short period of time, characterizing the non genomic actions of THs. It has been shown previously that T3 acts on posttranscriptional steps of TSH synthesis and reduces its secre...

Background: Somatostatin analogues are the most widely used medical treatment in acromegaly. The available long-acting formulations are administered parenterally (i.m. or deep s.c. injections). Results of a multicentre, baseline controlled, phase 3 study have recently showed that octreotide capsules are an effective and safe treatment in acromegaly. The Treatment Satisfaction Questionnaire for Medication (TQ15M), assessed in the phase 3 study, as exploratory endpoint, compared...

Introduction: Injectable somatostatin analogues (SRLs) are the standard medical management of acromegaly. Injection site adverse reactions reported for parenteral SRLs were examined in the literature and in the FDA Adverse Events Reporting System (AERS), and compared to the respective drug labels.Methods: PubMed was searched using criteria: period 1995–2013, drugs – octreotide (Sandostatin®), lanreotide (Somatuline®</s...