Endocrine Abstracts

Patients with hypopituitarism and untreated growth hormone (GH) deficiency have excess mortality. GH replacement therapy (GHRT) has many beneficial effects, but its impact on mortality has not been proven and there are still safety concerns regarding the potential cancer risk. We have therefore studied the mortality in non-functioning pituitary adenoma (NFPA) patients with and without GHRT. Only patients with NFPA were studied in order to eliminate the influence of the aetiolo...

Objective: Epidemiological evidence for a link between serum IGF1 concentration and cardiovascular disease in the general population and in patients with GH deficiency or hypersecretion has been demonstrated. However, the underlying mechanisms remain unresolved. We investigated associations between IGF1 levels within the reference range and different measures of cardiovascular function and risk factors in substituted GH deficient adults within a randomized clinical trial.<...

Introduction: Two aetiologies are responsible for postpartum hypopituitarism; Sheehan’s syndrome which develops following traumatic labour, and lymphocytic hypophysitis. Since management of lymphocytic hypophysitis does not require surgery in most cases, pathology is usually absent, and the clinical presentation, in combination with laboratory and imaging characteristics establish the diagnosis. We aimed to describe the various patterns of presentation, including assistin...

Introduction: Radiation-induced hypopituitarism is a well-recognized complication of cranial radiotherapy (cXRT) for childhood brain tumours when the hypothalamo–pituitary axis is within the irradiation field. Few data are available for survivors of adult brain tumours who have received cranial irradiation.Methods: We retrospectively reviewed medical records of patients referred to Endocrinology following cXRT for primary non-pituitary brain tumours...

AbstractNon-functioning pituitary adenomas (NFPAs) are the most common pituitary tumours, often presenting with chiasmal compression or hypopituitarism. Surgical resection, accompanied by radiotherapy (RTX) in selected cases, is the treatment of choice for compressive tumours. Long-term health consequences of NFPAs and their treatment are unclear. In this retrospective study, we aimed to assess long-term pituitary function, recurrence and mortality in a ...

Introduction: There is growing evidence that quality of life (QoL) in patients with adrenal insufficiency (AI) is impaired. Undertreatment with glucocorticoids is associated with symptoms such as fatigue and gastrointestinal complaints whereas overtreatment is associated with impaired QoL. However, evidence for this is derived from observational studies which are prone to bias. Therefore, the aim of the present study was to compare two different physiological doses of hydrocor...

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

Background: Endocrine Society guidelines classify macroprolactinomas as ‘resistant’ if there is failure to normalise prolactin, or to achieve radiological tumour shrinkage of >50%, on standard doses of dopamine agonist. In this context, escalation of treatment to maximal tolerable doses and/or referral for surgery is advised. However, we have recently observed several ‘discordant responders’, where tumour shrinkage lags significantly (>6 months) beh...

Background: Thyrotropinomas (TSHomas) are traditionally considered a rare, albeit important cause of thyrotoxicosis. Although early case series reported a predominance of invasive macroadenomas, emerging evidence suggests microadenomas are being increasingly diagnosed, and the clinical/biochemical phenotype appears to be more variable than previously suspected. We therefore performed detailed phenotyping of patients referred to our centre with a diagnosis of TSHoma over a 4-ye...