Pituitary - Clinical | 0049 | ECE2017 | 19th European Congress of Endocrinology

ea0049ep937 | Pituitary - Clinical | ECE2017

Four decades without diagnosis: Sheehan‘s syndrome, a retrospective analysis

Gokalp Deniz , Alpagat Gulistan , Tuzcu Alpaslan Kemal , Bahceci Mithat , Tuzcu Sadiye , Yakut Fatime , Yildirim Azat

Aim: Sheehans syndrome (SS) remains a frequent cause of hypopituitarism in undeveloped and developing countries, but due to improvements in obstetric care, it is rare in developed countries. We aimed to share the results of a retrospective study analyzing the demographic, clinical, imaging, and hormonal characteristics of a large group of patients with SS, and also increase awareness of this syndrome especially in developed countries.Methods: The m...

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ea0049ep938 | Pituitary - Clinical | ECE2017

Prevalence of discordant acromegaly after surgical treatment and its clinical implications in a third LEVEL hospital in Latinamerica

Perez Mireya , Pena Arturo , Rojas Carlos , Vergara Alma

Background: Acromegaly results from excess growth hormone (GH) secretion by a pituitary adenoma in 95% of the cases. Discordant acromegaly is defined by the elevation of GH with normal levels of insulin-like growth factor type 1 (IGF-1) or normal levels of GH associated with an elevation of IGF-1. Its an important situation in the follow-up period of patients with acromegaly because there is little information about patient treatment, comorbidities and follow-up. The objective...

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ea0049ep939 | Pituitary - Clinical | ECE2017

A case of IgG4-related hypophysitis with long-term cyclic evolution

Laura Iconaru , Felicia Baleanu , Raoul Muteganya , Rafik Karmali

Introduction: IgG4-related disease is a newly recognized entity associated with autoimmune conditions involving almost every organ system, characterized by elevated serum IgG4 as well as mass like tissue infiltration by IgG4-positive plasma cells. Pituitary gland can be involved and can presented as hypophysitis.Case description: We report a case of a 56-year-old man, who has been suffering for the nine last years of episodes of fatigue and headaches wit...

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ea0049ep940 | Pituitary - Clinical | ECE2017

Duhok/IRAQ acromegaly; one year of experience

Qasim Bayar

Background: Acromegaly is a rare hormonal disorder; the prevalence is ~60 cases/million population1, Incidence: 3.3 new cases/million/year1 Mortality rate 24 times that of general population2. It is usually the result of a somatotrope adenoma in more than 95% of cases.Aim: By June 2016, we were celebrating one year of experience in acromegaly. It was first time to open acromegaly service in Duhok city/Kurdistan region/IRAQ. This review will include...

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ea0049ep941 | Pituitary - Clinical | ECE2017

Presurgical medical treatment in Cushing’s disease

Moreno-Moreno Paloma , Barrera-Martin Ana , Ibanez-Costa Alejandro , Alhambra-Exposito Maria Rosa , Munoz-Jimenez Concepcion , Galvez-Moreno Maria Angeles , Castano-Fuentes Justo P , Luque-Huertas Raul M

Introduction: The duration of hypercortisolism in Cushings disease (CD) appears to be inversely related to the reversibility of complications, which in turn increase mortality. This makes it necessary to identify medical therapies capable of normalizing cortisol overproduction before transsphenoidal surgery. The aim of this study was to determine if the clinical data of patients with CD before surgery allow predicting the presence and/or abundance of somatostatin (ssts) ...

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ea0049ep942 | Pituitary - Clinical | ECE2017

Characteristics and 1-year follow-up of patients with profound hyponatremia due to primary polydipsia – a multicentre prospective observational study

Sailer Clara , Winzeler Bettina , Nigro Nicole , Suter-Widmer Isabelle , Arici Birsen , Bally Martina , Schuetz Philipp , Mueller Beat , Christ-Crain Mirjam

Introduction: Hyponatremia due to excessive fluid intake (i.e. primary polydipsia (PP)) is common. It may culminate in profound hyponatremia carrying considerable risk of morbidity. However, data on patients with PP leading to hyponatremia is largely lacking. Herein, we describe the characteristics of polydipsic patients hospitalised with profound hyponatremia, and assess one-year outcomes.Method: In this prospective observational study, we includ...

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ea0049ep943 | Pituitary - Clinical | ECE2017

Success rates of pituitary surgery in acromegaly – a tertiary centre experience in Romania

Betivoiu Minodora , Soare Iulia , Martin Sorina , Sirbu Anca , Albu Alice , Barbu Carmen , Fica Simona

Background: Pituitary surgery is the first treatment option for acromegaly. The reported success of pituitary surgery varies between 75 and 95% for microadenomas and 45 and 68% for macroadenomas. The aim of this study was to report our experience regarding the remission rate after pituitary surgery in acromegaly patients.Methods: This retrospective study included 70 patients diagnosed with acromegaly in our clinic between 2009 and 2016. The criteria used...

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ea0049ep944 | Pituitary - Clinical | ECE2017

Acromegaly and cardiovascular risk

Biagetti Betina , Aulinas Anna , Lopez Natividad , Garcia-Fernandez Esther , Arnau-Vives Maria Jose , Ciudin Andrea , Obiols Gabriel , Dalama Belen , Mesa Jordi

Background: Acromegaly (ACRO) is associated with increased cardiovascular morbidity and mortality, however, there is no evidence of an increase in ischemic heart disease in these patients. We hypothesized that non-classical cardiovascular risk factors such as epicardial fat (EF), interventricular septum thickness (IST), carotid intima-media thickness (CIMT), may be increased in ACRO and contribute to this higher cardiovascular morbidity.Objective: To eva...

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ea0049ep945 | Pituitary - Clinical | ECE2017

Pituitary insufficiency – etiopathogeny and diagnostic aspects

Crista Corina , Hotaran Georgiana

The study group was represented by 155 cases of pituitary insufficiency (age: 37.21±16.05; F/M=116/39) hospitalized in the Clinic of Endocrinology Timişoara during the period 20062014. The cases were classified into ethiopatogenic groups, as follows: iatrogenic pituitary insufficiency (23.87%), tumor compression (21.29%), ischemia (14.84%), idiopathic hypogonadotropic hypogonadism (3.87%), congenital pituitary insufficiency (6.45%), empty sella (6.45%), functio...

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ea0049ep946 | Pituitary - Clinical | ECE2017

Abstract unavailable....

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ea0049ep947 | Pituitary - Clinical | ECE2017

Long-term outcomes of medical therapy in patients with acromegaly: a retrospective analysis

Soare Iulia Simona , Betivoiu Minodora Andreea , Martin Sorina Carmen , Sirbu Anca Elena , Barbu Carmen Gabriela , Albu Alice Ioana , Fica Simona

Background: Acromegaly is a rare severe disease which, untreated, leads to increased cardiovascular and respiratory morbidity and mortality. Pituitary surgery is the first-line therapy, and medical treatment (somatostatin receptor ligands SRLs, dopamine agonists DA, and GH receptor antagonists GHRAs) is indicated for persistent disease. While selected patients are treated with DA and GHRAs, SRLs remain the mainstay of acromegaly therapy.Objective: The ai...

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ea0049ep948 | Pituitary - Clinical | ECE2017

Resistant prolactinomas: Retrospective study of ten cases

Castro Marta Araujo , Garcia Nuria Palacios , Pardo Javier Aller , Lopez Ainhoa Abad , Zarate Virginia Oses , Moreno Laura Mateos , Garcia Javier Estrada

About 1015% of prolactinomas (P) are resistant to Dopamine agonists (DA). We analyzed retrospectively ten resistant prolactinomas (RP) treated at our center between 1995 and 2014, to identify useful variables to predict DA resistance and its different patterns (biochemical resistance (BR), morphological resistance (MR) or both). BR is defined as the failure to normalize prolactin (PRL) levels with ≥ 2 mg/week of cabergoline (C) for at least 3 months. MR is consider...

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ea0049ep949 | Pituitary - Clinical | ECE2017

Ocular findings in adult subjects with congenital, lifetime, isolated, untreated growth hormone deficiency

Faro Augusto C N , Pereira-Gurgel Virginia M , Salvatori Roberto , Campos Viviane C , Melo Gustavo B , Oliveira Francielle T , Oliveira-Santos Alecia A , Oliveira Carla R P , Pereira Francisco A , Hellstrom Ann , Oliveira-Neto Luis A , Aguiar-Oliveira Manuel H

Ocular function is fundamental for environmental adaptation and survival capacity. Growth factors are thought to be necessary to reach a mature eyeball and consequent adequate vision. However, the consequences of the deficiency of circulating growth hormone (GH) and its effector insulin-like growth factor I (IGF-I) on the physical aspects of the human eye are still debated. A model of untreated isolated GH deficiency (IGHD) may clarify this issue. The aim of this study was to ...

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ea0049ep950 | Pituitary - Clinical | ECE2017

Evaluation of estrogen effects on the anterior pituitary hormones by using combined pituitary stimulation test (CPFT) in the Korean postmenopausal women

Kim Sung-Woon , Oh Seungjoon

Pituitary hormonal status was important for the evaluation of various diseased state of hypothalamo-pituitary target organ axis as well as tumorous condition. Measurement of growth hormone (GH), adrenocorticotrophic hormone (ACTH) and cortisol during insulin-induced hypoglycaemia were commonly used to assess pituitary condition on hypoglycaemia stress. Sexual axis was evaluated with target organ hormones, i.e. estradiol or testosterone and LHRH stimulated luteinizing hormone (...

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ea0049ep951 | Pituitary - Clinical | ECE2017

Acute presentation of cushing disease: severe hyperglycemia and refractory hypokalemia

Bello Carlos Tavares , Santos Francisco Sousa , Ferrinhos Catia , Serra Filipa Alves , Duarte Joao Sequeira , Vasconcelos Carlos

Introduction: Cushings syndrome (CS) is a rare disease resulting from prolonged exposure to supraphysiological levels of glucocorticoids. Cushings Disease is the most frequent cause of endogenous CS. This disease has a broad spectrum of clinical manifestations and is associated with an increased morbi-mortality. Diabetes Mellitus (DM) and hypokalemic alkalosis affects up to 50 and 10% of CS patients respectively. Disease onset and severity reflects the magnitude of...

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ea0049ep952 | Pituitary - Clinical | ECE2017

Uncomplicated pregnancy in a patient with McCune Albright syndrome (MAS) and active acromegaly

Larumbe Terroba , Soto Crespo , Goyogana Anacabe , Roman De Luis , De Linares Urbon Lopez , Olmedo Cuellar , Vina Ventosa , Baranda Calleja , Garcia Cabezas

Introduction: The association of acromegaly and polyostotic fibrous dysplasia is a rare entity that presents more difficulties in achieving an effective treatment than classical acromegaly. Pregnancy is infrequent and carries a high risk when acromegaly is active.Clínical case: A 27 year old woman surgically treated for facial asymmetry, without café-au-lait spots or precocious puberty, was evaluated in 1992 after a normal pregnancy. In the bio...

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ea0049ep953 | Pituitary - Clinical | ECE2017

Impact of etiology, age and gender on onset and severity of hyponatremia in patients with hypopituitarism

Miljic Dragana , Pekic Sandra , Doknic Mirjana , Nikolic-Djurovic Marina , Stojanovic Marko , Popovic Vera , Petakov Milan

Hyponatremia can unmask hypopituitarism and secondary adrenal insufficiency due to potent non-osmotic stimulation of vasopressin release under stressful conditions. Patients and methods: In a retrospective study 25 patients (13f/12m, age 58.9±18.6 years) with hyponatremia (119.7±10.5 mmol/l) were identified among 260 in-patients treated for hypopituitarism in our department over a decade. Results: Hyponatremia was recorded in 9.6% of our patients. In 84% it was the k...

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ea0049ep954 | Pituitary - Clinical | ECE2017

Changes in pituitary tumour biology and behaviour in FIPA patient with GH secreting aggressive pituitary macro adenoma

Miljic Dragana , Pekic Sandra , Doknic Mirjana , Nikolic-Djurovic Marina , Stojanovic Marko , Manojlovic-Gacic Emilija , Korbonits Marta , Trouillas Jaqueline , Vasiljevic Alexandre , Popovic Vera , Petakov Milan

40-year-old female patient presented with acromegaly in 2008 (GH 61 (g/L, IGF-1 774 ng/ml PRL 1500 mU/L). Macro-adenoma invading the right cavernous sinus was found on MRI and she underwent two pituitary surgeries revealing sparsely granulated GH adenoma with scattered PRL cells, low Ki 67 and negative p53 immuno-staining. Her second cousin was treated for macro prolactinoma. Both patients tested negative for germline mutations in the AIP and menin genes. Treatment with somato...

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ea0049ep955 | Pituitary - Clinical | ECE2017

Gambling and cabergoline

Silva-Fernandez Julia , Gomez-Alfonso Francisco Javier , Del Val-Zaballos Florentino , Torres-Arroyo Belvis , Gonzalez-Lazaro Paloma , de Agredos Alvaro Garcia-Manzanares Vazquez , Lopez-Iglesias Maria , Garcia-Ruiz Rafael , Gomez-Garcia Ines

Introduction: A link between Dopamine agonists and development of impulse control disorders is well recognized in the field of neurology. A similar finding in endocrine patients is emerging.Case report: We report the case of a 38-year-old man with pathological addiction to gambling associated with low dose cabergoline treatment for a mixed growth hormone (GH) and prolactin (PRL)-secreting pituitary adenoma. At the age of 29 he ...

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ea0049ep956 | Pituitary - Clinical | ECE2017

Rare causes of hypopituitarism in adults in a tertiary care institution

Djurdjevic Sandra Pekic , Doknic Mirjana , Miljic Dragana , Stojanovic Marko , Djurovic Marina Nikolic , Jemuovic Zvezdana , Stojanoska Milica Medic , Popovic Vera , Petakov Milan

Objective: Hypopituitarism is a rare disease,a pituitary adenoma and is treatment being the most common cause of it. In recent years there is increased reporting of rare causes of hypopituitarism acquired in adulthood, such as other sellar and parasellar masses, brain damage caused by radiation and traumatic brain injury (TBI), vascular lesions, infiltrative/immunological/inflammatory diseases and infectious diseases. Aim of our study was to increase the awareness to these rar...

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ea0049ep957 | Pituitary - Clinical | ECE2017

Recombinant Human Growth Hormone Treatment in liver transplant patient. Case report

Galesanu Corina

Background: Linear growth is often impaired after successful liver transplantation. Factors that negatively impacted growth are age, graft function and corticosteroid immunosuppression. Short-statured prepubertal liver transplant recipients who do not show sufficient compensatory growth after transplantation benefit from treatment with recombinant human growth hormone (rhGH).Cas report: We communicate the results after the first year of rhGH treatment in...

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ea0049ep958 | Pituitary - Clinical | ECE2017

Immune checkpoint inhibitors: an emerging cause of hypophysitis

Rizvi Ali , McAdams Brooke

Aim: To describe 2 cases of immune-mediated hypophysitis due to the therapeutic use of Ipilimumab, a cytotoxic T-lymphocyte antigen-4 (CTLA4)-blocking antibody.Case 1: A 62 year-old male with history of metastatic melanoma was started on Ipilimumab. After finishing the 4th at 2 months he complained of weakness, fatigue, and fever, prescribed ciprofloxacin and prednisone 20 mg daily, and felt better. 2 days later he was hospitalized with weakness, BP 86/6...

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ea0049ep959 | Pituitary - Clinical | ECE2017

A case of hypopituitarism caused by hemorrhagic fever with renal syndrome

Yu Seung Hee , Lee Kiyoung

Hemorrhagic fever with renal syndrome (HFRS) is a severe systemic infection caused by hantaviruses that included Hantaan, Seoul, Dobrava, Saaremaa, and Puumala. In Korea, the most common virus is Hantaan. The classical symptoms of HFRS are fever, hemorrhage, hypotension, and renal failure, but the clinical course can be very diverse. Among them, endocrinologic complications, such as hypopituitarism were developed rarely by HFRS. A 49 years-old man admitted our hospital with fe...

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ea0049ep960 | Pituitary - Clinical | ECE2017

Prevalence and Incidence of pituitary tumors: a nation-wide Population-based study using Korean National Health Insurance claims data

Park Kyeonghye , Choi Junggyu , Park Se Hee , Nam Joo Young , Song Sun Ok , Song Young Duk , Lee Eun Jig

Purpose: We conducted this study to determine the prevalence and incidence of pituitary tumors in South Korea.Methods: This is a nationwide population- based retrospective study. We analysed two national databases, the Korean National Health Insurance (NHI) claims database and Rare Intractable Disease (RID) registration database, which include information on every patients with pituitary tumor diagnosed through uniform criteria from 2009 to 2013. Pituita...

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ea0049ep961 | Pituitary - Clinical | ECE2017

Prevalence of acromegaly in eight counties of North-East Romania

Feraru Laura , Vulpoi Carmen , Mogos Voichita , Galesanu Corina , Branisteanu Dumitru , Ungureanu Maria-Christina , Leustean Letitia , Cristea Cristina , Mogos Simona , Buzduga Catalin , Balaceanu Raluca , Preda Cristina

Introduction: The prevalence of acromegaly is estimated to be 6-28/100000 but several studies suggest that acromegaly is underdiagnosed and its prevalence is underestimated.Aim: To measure the prevalence of clinically relevant acromegaly in a well-defined population using data from 01.04.2004 to 01.11.2016.Method: Cross-sectional study performed in 8 counties from the North-East Romania. Data of patients with acromegaly were collec...

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ea0049ep962 | Pituitary - Clinical | ECE2017

A male patient with acromegaly and metastatic renal cell carcinoma: lung, gluteal and scapular metastasis

Uc Ziynet Alphan , Demir Ozgur

Acromegaly is a chronic condition associated with an increased risk of cancer.Case presentation: A 41-year-old man admitted to our hospital with gluteal and scapular mass. He had a clinical history of acromegaly which had been diagnosed two years ago, and was treated with trans-sphenoidal surgery. After surgery, although remission was not achieved, he had no doctor visit and control. On physical examination he had typical acromegalic features and there w...

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ea0049ep963 | Pituitary - Clinical | ECE2017

Infundibular lesion presenting with central diabetes insipidus and hypogonadism

Bagir Gulay Simsek , Haydardedeoglu Filiz Eksi , Bakiner Okan , Bozkirli Emre , Ertorer M Eda

Introduction: Pituitary stalk lesions fall into three categories: congenital and developmental (rathke cleft cyst, ectopic neurohypophysis), inflammatory and infectious (hypophysitis, sarcoidosis, tuberculosis), and neoplastic (Langerhans cell histiocytosis, germinoma, metastatic tumors). Herein, we report a case with infundibular lesion presenting with central diabetes insipidus and hypogonadism.Case report: A 27-years old woman was admitted to our clin...

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ea0049ep964 | Pituitary - Clinical | ECE2017

Pregnancy in Cushing’s disease after treatment with surgery and cyber-knife radiosurgery

Oruk G Gonca , Olmezoglu Ali , Apaydin Melda , Guvenc Gonul

Women affected by Cushings disease (CD) are often infertile due to abnormal follicular development or anovulation. In these patients, first line treatment is pituitary surgery, which is effective in more than 83% of cases with microadenomas, but only in about 35% of those with macroadenomas. When surgery do not normalize circulating ACTH and cortisol concentrations, such drugs, e.g. ketoconazole or metirapone, and radiotherapy are used as adjuvant treatment. Concerning r...

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ea0049ep965 | Pituitary - Clinical | ECE2017

The clinic-hormonal description of patients with giant pituitary adenomas

Urmanova Yulduz , Alimova Kamola

The aim: To study the results of researches 35 patients with different pituitary tumours of sellar area, from them men 17 (48,6%%), women 18 (51,4%%).Materials and methods: Depending on sizes there are the adenomas of hypophysis, educed on CT/?RI, patients were up-diffused on two groups: the first group of patients is macroadenomas (from 20 to 30 mm) 17 (48,6%%), and second group of patients giant (more than 30 mm) &#15...

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ea0049ep966 | Pituitary - Clinical | ECE2017

Gender differences in real-life GH dosing patterns in adults with GH deficiency (AGHD): experience from a Registry in France

Borson-Chazot Francoise , Hacques Evguenia , Pascal-Vigneron Veronique , Salenave Sylvie , Villette Beatrice

Introduction: Usually GHD women require higher GH doses than males, especially those with exogenous oestrogens (guidelines). This fact was assessed in real-life practice in France.Methods: Data were from a Registry in 84 sites treating AGHD (Norditropin®) up to 5 years. Naïve patients did not receive GH 6 months before inclusion. Statistics were descriptive.Results: 328 patients (129 naïve) were included; mean age 49...

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ea0049ep967 | Pituitary - Clinical | ECE2017

Is there a role of immunohistochemical expression of pituitary hormones and proliferative marker ki-67 on long-term outcome in our acromegalic patients?

Sahin Mustafa , Keskin Caglar , Kiremitci Saba , Erden Esra , Canpolat Asena , Cinel Murat , Canlar Sule , Demir Ozgur , Gullu Sevim , Emral Rifat , Erdogan Murat Faik , Gedik Vedia , Baskal Nilgun , Corapcioglu Demet

Expression of hormones other than GH may affect the prognosis in acromegalic patients. Generally, Ki-67 is a well-known proliferative index used to predict remission in pituitary adenomas. We aimed to evaluate the relationship of immunohistochemical expression pituitary hormones, ki-67 and remission. Also we evaluated the role of pre, post-operative clinical and laboratory values, pathological characteristics on long-term remission. We included 64 acromegaly patients that were...

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ea0049ep968 | Pituitary - Clinical | ECE2017

Investigation of the pituitary functions long-term after the acute CNS infections

Cetinkaya Gamze , Kilic Aysegul Ulu , Karaca Zuleyha , Doganay Mehmet , Yuce Z T , Unluhizarci Kursad , Kelestimur Fahrettin , Tanriverdi Fatih

Objectives: Acute bacterial or viral CNS infections have been shown to result in hypopituitarism during the acute phase, and 624 months after the event in a few studies. However, there are no data in the literature regarding the long term pituitary functions after acute CNS infections. This cross-sectional study was designed to evaluate the pituitary functions long-term after the acute bacterial or viral CNS infections.Methods: 19 patients with age...

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ea0049ep969 | Pituitary - Clinical | ECE2017

A case with headache and pitosis: pituitary macroadenoma or ophtalmoplegic migraine?

Haydardedeoglu Filiz Eksi , Bagir Gulay Simsek , Bakiner Okan , Bozkirli Emre , Ertorer Melek Eda

Case: A 28-year old man was admitted to our hospital with complaints of three days of severe headache, diplopia and ptosis of the right eye. He had pituitary macroadenoma and had been on cabergolin 0.25 mg/week for the last six months. At physical examination, he demonstrated ptosis and inability to move the right eye medially. Magnetic resonance imaging showed a 13×12 mm pituitary mass with suprasellar extension and hemorrhage. Visual field analysis was abnormal except t...

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ea0049ep970 | Pituitary - Clinical | ECE2017

Somatostatin analogues-induced diabetes mellitus in acromegalic patients reverts after drug withdrawal: a long-term study

Cappellani Daniele , Urbani Claudio , Sardella Chiara , Marconcini Giulia , Marcocci Claudio , Rossi Giuseppe , Bogazzi Fausto

Context: Therapy with somatostatin analogues (SSAs) may have deleterious effects on glucose metabolism in patients with acromegaly, often leading to development of diabetes mellitus (DM).Aim of the study: To evaluate whether DM, which developed during therapy with SSAs, may revert after drug withdrawal and cure of acromegaly with pituitary adenomectomy.Design: Retrospective cohort study, in a tertiary referral center.<p class="...

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ea0049ep971 | Pituitary - Clinical | ECE2017

Pituitary metastases of lung cancer presenting with hypopituatrism

Yaylalı Guzin Fidan , Topsakal Senay , Değirmencioğlu Serkan , Fenkci Semin Melahat

Pituitary tumors are the most frequent intracranial neoplasm, affecting 11 000 of the world wide population. However metastases in this location are rare and uncommon presentation of systemic malignancy. Although diabetes insipidus secondary to cancer metastasis to the pituitary gland is a common manifestation, anterior pituitary failure is rare. We present a −57-year-old man with hypopituitarism secondary to pituatry metastasis from lung cancer.Ca...

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ea0049ep972 | Pituitary - Clinical | ECE2017

ACTH deficiency in patient with bilateral adrenal adenomas

Fenkci Semin Melahat , Topsakal Senay , Yaylalı Guzin Fidan

Introduction: ACTH deficiency is a rare disease with non-specific symptoms such as anorexia, fatigue and weight loss. Due to these silent symptoms the disease is easily overlooked and may escape detection for a long time, especially in elderly patient.Case: 67-year-old female patient applied with complaints of fatigue. Bilateral adrenal adenoma was detected during ultrasonographic evaluation and and patient was consulted to endocrinology clinic Her perso...

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ea0049ep973 | Pituitary - Clinical | ECE2017

Clinical, histological, molecular features and outcomes of craniopharyngiomas: Single centre experience in Toledo, Spain

Vicente Almudena , Moreno Beatriz , Olivar Monica , Martinez Ana , Mollejo Manuela , Sastre Julia , Lopez Jose

Background: Craniopharyngiomas (CPs) are epithelial tumors that typically arise in the suprasellar region. They are associated with high levels of morbidity related to tumour location and/or treatment-related injuries. Recent discoveries have also led to a better understanding of CP development and potential treatments.Objetive: To analyse the clinical, pathological, molecular features and outcomes of patients with CP.Design: Retro...

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ea0049ep974 | Pituitary - Clinical | ECE2017

Cushing’s disease: is there a Continuum from corticotroph hyperplasia to adenoma?

Gomes Ana Coelho , Neto Lia Lucas , Tortosa Francisco , Carvalho Maria Raquel , Barreiros Eduardo , Barreiros Luis , Miguens Jose , Bugalho Maria Joao

Introduction: Successful long-term management of patients with Cushings disease (CD) remains a challenge. Few studies have analyzed the long-term recurrence rates of CD after transsphenoidal surgery (TS).Objectives: 1) to compare the outcome of patients with and without postoperative criteria for cure; 2) to compare the outcome of patients with and without a histological diagnosis of adenoma.Methods: Retrospective, descriptiv...

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ea0049ep975 | Pituitary - Clinical | ECE2017

The use of increasing doses of cabergoline in the management of cabergoline-resistant prolactinomas

Vilar Lucio , Vilar Clarice , Albuquerque Jose Luciano , Gadelha Patricia , The Ana Carolina , Trovao Erik , Borges Thaise , Cardoso Izabela , Lyra Ruy

Introduction: Dopamine agonists (DA) are the ideal treatment for prolactinomas and cabergoline (CAB) is the drug of choice, for being much more effective and better tolerated than bromocriptine. However, 10-15% of patients with prolactinomas are considered to be resistant to CAB, as they dot not achieve prolactin (PRL) normalization, while in use of conventional doses of this drug.Objective: To evaluate the effiaccy of increasing doses of CAB in prolacti...

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ea0049ep976 | Pituitary - Clinical | ECE2017

Long-term efficacy of octreotide LAR in acromegaly patients, a prospective single centre study with 7 years follow up

Velija-Asimi Zelija , Burekovic Azra , Dizdarevic-Bostandzic Amela

Objective: The aim of this single centre prospective open trial was to evaluate the long-term efficacy of octreotide LAR in acromegaly patients.Methods: In total of 19 patients with acromegaly diagnosed at Endocrinology Department of Clinical Centre of University in Sarajevo, somatostatin sensitive (ten females and eight males, age range 4068 years, six patients with microadenoma and 12 patients with macroadenoma) were treated with octreotide. Foll...

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ea0049ep977 | Pituitary - Clinical | ECE2017

Is there a gender difference in clinically nonfunctional pituitary adenomas?

Duran Iffet Dağdelen , Gulcelik Neşe Ersoz , Berker Dilek , Guler Serdar

Introduction: Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumor type. They are usually recognized after they cause symptoms especially when tumor size increases and eventually invades adjacent structures. Nevertheless the discovery would also be accidental. In the literature some kind of gender difference is reported in NFAs behavioral results such as pituitary axis deficits or consequences of surgery however they resulted with contr...

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ea0049ep978 | Pituitary - Clinical | ECE2017

The value of early postoperative OGTT as a predictor of surgical outcome in patients with acromegaly after total transsphenoidal adenomectomy

Tsiberkin Alexandr , Cherebillo Vladislav , Tsoy Uliana , Dalmatova Anna , Belousova Lidiya , Grineva Elena

Introduction: Transsphenoidal surgery (TSS) is the treatment of choice for patients with acromegaly. However, even after radical surgery persistence of acromegaly may remain up to thirty percent by resent studies (Starnoni, 2016). Nadir growth hormone (GH) level less than 1.0 μg/l on an early postoperative oral glucose tolerance test (OGTT) have been suggested as early predictor of surgical remission (Kim 2012). However, the value of this approach remains to be defined.</...

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ea0049ep979 | Pituitary - Clinical | ECE2017

Giant macroprolactinoma in women still exist

Dragomir Laura , Florian Stefan , Valea Ana , Ghervan Cristina

Background: Prolactinomas are the most common hormone-secreting pituitary tumors and are a common cause of anovulation and infertility. Giant prolactinomas (0.54.4% of all pituitary tumors) are rare tumors characterized by their large size (>4 cm), compressive symptoms and extremely high prolactin secretion (>1000 ng/ml). Men are most commonly affected, with a reported male to female ratio of 9:1.Case report: We present the rare case of 53-...

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ea0049ep980 | Pituitary - Clinical | ECE2017

Associated neoplasia in Romanian acromegalic patients

Silea Simona , Galoiu Simona , Dumitrascu Anda , Niculescu Dan , Baciu Ionela , Poiana Catalina

Introduction: Acromegaly has various complications that significantly alter patients lives, one of which is developing neoplasia, a subject of high interest in the scientific community during the last years but without any firm conclusions.Aim: The main objective of this paper was to verify if Romanian acromegalic patients are susceptible to developing neoplasia and what types of tumors are associated with acromegaly. Another purpose of the paper w...

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ea0049ep981 | Pituitary - Clinical | ECE2017

Clinical and histopathologic characteristics of thyroid cancer in the patients with acromegaly

Bulbul Buket Yilmaz , Celik Mehmet , Can Nuray , Ayturk Semra , Tastekin Ebru , Sezer Atakan , Ustun Funda , Guldiken Sibel

Aim: There are some studies suggesting that the risk of developing cancers,especially thyroid cancer, is increased in the patients with acromegaly. The prevalence of thyroid cancer is 1.2-10.6% among the patients with acromegaly. In this study, we aimed to evaluate clinical and histopathologic characteristics of thyroid cancer among the patients with acromegaly.Method: We retrospectively evaluated the patients with acromegaly who had been followed-up by ...

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ea0049ep982 | Pituitary - Clinical | ECE2017

The triglyceride (TG)/HDL Cholesterol (TG/HDL-C) ratio as marker of adipose tissue dysfunction at patients with acromegaly

Khyzhnyak Oksana , Mykytyk Miroslava , Karachentsev Iurii

Background and aims: The ratio of TG/ HDL-C can identify cardiometabolic risk and cardiovascular disease. The visceral adiposity index (VAI) is a sex-specific index, in which measurements of body mass index and waist circumference are combined with TG and HDL-C concentrations. T? study association between VAI and TG/HDL-C and the value of TG/HDL-C ratio as a marker of disfunction of visceral adiposity tissue at patients with acromegaly.Subjects and metho...

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ea0049ep983 | Pituitary - Clinical | ECE2017

Anti-proliferative effects of high doses cabergoline in patients with prolactinoma

Khyzhnyak Oksana , Gogitidze Teona , Mykytyk Miroslava , Karachentsev Iurii , Barabash Nadiya , Manskaya Katerina

The aim of the study: To investigate the anti-proliferative effect of cabergoline (CAB) which was used in different regimes of suppressive therapy during 12 months in patients with prolactinoma (PROL).Subjects and methods: It was examined and underwent a 12 month course of treatment by selective dopamine agonist CAB 61 patients with PROL: microadenoma 42, macro&giant PROL - 19. (52 women/9 men) aged 1666 years. The total duration of the disease...

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ea0049ep984 | Pituitary - Clinical | ECE2017

Invasive macroprolactinomas and its response to treatment in male patients

Abreu Alin , Hernandez Jose , Velasco Margarita , Triana Pablo , Castano Orlando

Introduction: Prolactin-producing pituitary adenomas are the most common pituitary tumors in clinical practice. In men they are more aggressive and their response to pharmacological treatment is unknown.Objective: Describe the clinical characteristics and response according to the treatment of a group of male patients with invasive macroprolactinomas.Materials and methods: A retrospective descriptive study, a series of cases, in 30...

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ea0049ep985 | Pituitary - Clinical | ECE2017

Venous glucose levels, peak GH and peak cortisol during Insulin Tolerance Test using 0.15 UNITS/Kg and 0.1 UNITS/Kg body weight

Yeoh Phillip , Grossman Ashley , Chew Shern L , Bouloux Pierre , Khoo Bernad , Carroll Paul , Aylwin Simon , Baldweg Stephanie

Insulin Tolerance Test (ITT) is a procedure commonly done by Endocrine Specialist Nurse in endocrine department. We look at over 120 ITT results done in 2 endocrine centres using Insulin Actrapid 0.15 UNITS/kg and 0.10 UNITS/kg dose plotting the glucose levels at 30, 45 and 60 min. We also look at peak GH and peak cortisol on each of these groups.Aims: We wanted to know how many percentage of patients achieving hypoglycaemia below 0.5 mmol/l, 0.51....

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ea0049ep986 | Pituitary - Clinical | ECE2017

Long-term impact of primary medical and surgical therapy on bone density in men versus women with prolactinomas

Andereggen Lukas , Frey Janine , Andres Robert , El-Koussy Marwan , Beck Jurgen , Mariani Luigi , Christ Emanuel

Purpose: The prevalence of pathological bone densities in men and women with prolactinomas treated either primary surgically or medically are infrequently reported across large cohorts. In the present study, we aimed at comparing the impact of either therapeutic approach on the bone density in men vs women with prolactinomas.Methods: Retrospective case-note study including all consecutive patients with prolactinomas in whom osteodensitometry data was ava...

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ea0049ep987 | Pituitary - Clinical | ECE2017

Stenosis of the external auditory canal in an acromegalic patient: a novel complication

Kim Hee Kyung , Yoon Jee Hee , Jeong Yun Ah , Kang Ho-Cheol

Acromegaly is associated with a range of comorbidities, including cardiovascular disease, diabetes, hypertension and sleep apnea. Bony overgrowth and soft tissue thickening not only cause typical external features of acromegaly, but also debilitating musculoskeletal aches. Recently, a few papers reported auditory complications of acromegaly, but there has been no report on narrowing of the external auditory canal as a complication of acromegaly. A 58-year-old acromegalic patie...

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ea0049ep988 | Pituitary - Clinical | ECE2017

Is Pegvisomant correct choice for acromegaly patient with dilated cardiyomypathy?

Cinel Murat , Keskin Caglar , Emral Rifat , Corapcioglu Demet

Objectives: Acromegaly may arise with several clinical presentations and cardiac involvement is the most important factor affecting the course of the disease.Case: A 32-years old man admitted to hospital complaining with shortness of breath. After initial evaluation he was diagnosed as cardiac failure. Cardiac evaluation revealed that he had dilated cardiomyopathy with ejection fraction (EF) of 20%, global hypokinesia without valv...

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ea0049ep989 | Pituitary - Clinical | ECE2017

Preoperative HDDST in the prognosis of CD remission after transshenoidal endoscopic surgery

Natalya Gussaova , Ulyana Tsoy , Vladislav Cherebillo , Anna Dalmatova , Lidiya Belousova , Lyubov Mitrofanova , Elena Grineva

Purpose: Transsphenoidal endoscopic surgery (TSS) is the first-line treatment for Cushings disease (CD). Persistence and recurrence of hypercortisolism after TSS considered important problem. In this case search for CD remission predictors is actual.Aim: To study the role of preoperative oral high-dose dexamethasone suppression test (HDDST) in the prognosis of CD remission after TSS.Materials and methods: 60 patients with Cus...

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ea0049ep990 | Pituitary - Clinical | ECE2017

Somatostatin analogs in the treatment of acromegaly: single centre experience

Abraitiene Agne , Aleknaite Aiste , Zelnyte Gintare

Introduction: The purpose of this study was to evaluate effectiveness of somatostatin analog (SSA) treatment in patients with acromegaly.Methods: The study involved retrospective data collection from charts of 29 patients with acromegaly who received medical therapy at Vilnius University Hospital Santariskiu klinikos in 2016.Results: Patient population consisted of 10 males (34.5%) and 19 females (65.5%), mean age 58±26 years....

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ea0049ep991 | Pituitary - Clinical | ECE2017

Biochemical normalization in acromegaly after 79 months’ treatment with Pasireotide: case report

Bima Chiara , Chiloiro Sabrina , Iacovazzo Donato , Tartaglione Tommaso , Bracaccia Maria Elena , Giampietro Antonella , Bianchi Antonio , De Marinis Laura

Pasireotide, a multireceptor-targeted somatostatin analogue, was approved for the treatment of acromegaly, after being studied in two large, randomised, multi-center clinical trials. We reported the history of a 76 years old man affected by acromegaly, treated with Pasireotide long acting release (LAR) as first line therapy. Acromegaly was diagnosed in 2009, as the result of endocrinological investigation suggested by altered facial appearance and macroglossia. Hormonal assays...

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ea0049ep992 | Pituitary - Clinical | ECE2017

Abstract withdrawn....

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ea0049ep993 | Pituitary - Clinical | ECE2017

Abstract withdrawn....

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ea0049ep994 | Pituitary - Clinical | ECE2017

A eight successful pregnancies in six Algerian women with acromegaly: a monocenter study of Pierre and Marie Curie center.

Mimouni Safia

Introduction: Acromegaly usually results from GH hypersecretion elaborated by somatotrop adenoma. The occurrence of a pregnancy in an acromegaly is an infrequent event, but better described in recent years. It could be aggravate GH secretion and tumor volume.Objective: Describe eight pregnancies including twin pregnancy in six acromegalics patients hospitalized in the endocrinology department of the Pierre and Marie Curie center in Algiers.<p class="...

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ea0049ep995 | Pituitary - Clinical | ECE2017

Abstract withdrawn....

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ea0049ep996 | Pituitary - Clinical | ECE2017

Sheehan syndrome presenting 21 years later as severe heart failure

Ferreira Ana Goncalves , Alegria Sofia , Cordeiro Maria Carlos , Portugal Jorge

Introduction: Sheehan syndrome (SS) is caused by postpartum necrosis of the pituitary gland, associated with significant haemorrhage during or after delivery. It is rare in developed countries, but still frequent in underdeveloped ones. We present a rare presentation of this syndrome.Clinical case: A 48 years old black woman presented at the emergency department for long term fatigue and dyspnea that worsened a few days before. Her physical examination r...

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ea0049ep997 | Pituitary - Clinical | ECE2017

Localization of the catheters during Bilateral sampling of the inferior petrosal sinuses can impact diagnostic power?

Chiloiro Sabrina , Pedicelli Alessandro , Valente Iacopo , Tartaglione Tommaso , Bianchi Antonio , Giampietro Antonella , Bima Chiara , Lauretti Liverana , Anile Carmelo , Pontecorvi Alfredo , De Marinis Laura

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

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ea0049ep998 | Pituitary - Clinical | ECE2017

Ipilimumab-induced hypophysitis

Selfa Silvia Maria Maraver , Vega Maria Molina , Molero Inmaculada Gonzalez , Doblas Isabel Mancha , Madueno Francisco Tinahones

Hypophysitis are a heterogeneous group of inflammatory lesions affecting the hypophysis. Have been described hypophysitis secondary to administration of immunomodulatory drugs such as interferon and anti-cytotoxic T lymphocyte antigen-4 antibodies (CTLA-4). Ipilimumab is an anti-CTLA-4 human monoclonal antibody that blocks the union between CTLA-4 and B7 receptor on antigen-presenting cells causing an antitumoral effect and increasing the production of autoantibodies. Hypophys...

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ea0049ep999 | Pituitary - Clinical | ECE2017

Somatostatin Analogue Treatment of a Persistant TSH-Secreting Adenoma: a report of case

Unsal İlknur Ozturk , Cakal Erman , Apaydın Mahmut , Karakose Melia , Ucan Bekir , Ozbek Mustafa

Introduction: Thyrotropinomas are usually considered when the TSH level is inappropriately elevated or normal in a hyperthyroid patient with increased serum T4 levels, regardless of the presence of visible tumor on imaging. The prevalence of these adenomas, which account for 0.53% of all pituitary tumors has been estimated to be around one case per million. Most thyrotroph adenomas are large and invasive at diagnosis, and present with signs and symptoms of an ...

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ea0049ep1000 | Pituitary - Clinical | ECE2017

Spindle cell oncocytoma of adenohypophysis: report of a rare pituitary tumor

Pontinha Carlos Marques , Mafra Manuela , Cerqueira Luis , Sagarribay Amets , Fonseca Fernando , Agapito Ana

Introduction: Pituitary adenomas represent 95% of all sellar masses. Spindle cell oncocytoma (SCO), a rare histopathological entity (0.4% of all sellar tumours), clinically presents as a non-functional pituitary adenoma. According to WHO 2016 Classification of Tumours of the CNS it is a Grade l tumour, but prognosis remains uncertain since recurrence is frequently seen among the few cases reported.Clinical case: A 59 year-old man presented with progressi...

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ea0049ep1001 | Pituitary - Clinical | ECE2017

A case of pituitary apoplexy. a acute medical emergency and restitutio ad integrum

Rodriguez Pilar , Lainez Maria , Lopez Maria Jose , Roldan Eloisa , Rebollo Isabel

A 50-year-old woman with no history of interest who was admitted in hospital for progressive headache 2 weeks of evolution refractory to treatment that was accompanied by emetic syndrome and paresthesias in face and arms. A CT scan of the skull (urgency) was performed which was normal. Neurology improves with analgesia and steroids, presenting mild drowsiness and mild hyponatremia (121 mEq/l). A cerebral MRI was performed, showing a right subacute hemorrhagic adenoma of 1 cm t...

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ea0049ep1002 | Pituitary - Clinical | ECE2017

Resistant microprolactinoma with partial empty sella

Faki Sevgul , Polat Sefika Burcak , Aydin Cevdet , Ersoy Reyhan , Cakir Bekir

Introduction: Prolactinomas are the most common hormonally active pituitary tumors that account for 4060% of all pituitary adenomas and are usually successfully treated with dopamine agonists. Surgery or radiotherapy is reserved for drug intolerance/resistance or in neuro-ophthalmological emergencies. We present a patient with refractory microprolactinoma with empty sella treated by transsphenoidal surgery.Case: 42-year-old female patient admitted ...

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ea0049ep1003 | Pituitary - Clinical | ECE2017

Acromegaly: clinical experience and determinants of remission

Eraydin Ayten , Akarsu Ersin , Sayiner Zeynel A , Ozkaya Mesut , Erkutlu Ibrahim , Tabur Suzan , Araz Mustafa

Introduction: Acromegaly is a chronical and rare disease which is accompanied by excessive growth hormone (GH) secreting hypohysis tumor. In this study we presented acromegaly patients datas who admitted to our center between the years 19982016. We discussed patients charecteristics and we aimed to investigate the determinants which is effecting the remission rate of the patients.Method: 70 acromegaly patients datas were analyzed ...

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ea0049ep1004 | Pituitary - Clinical | ECE2017

A rare case of macroprolactinoma presenting with SIADH

Dukhan Khaled , Ashawesh Khaled

Case: A 52-year-old gentleman was admitted with dizziness and collapse. Past medical history revealed dyslipidemia treated with statin. Physical examination was unremarkable. Initial investigations were consistent with SIADH (sodium: 109 mmol/l, serum osmolality: 243 mOsm/kg, urine Na: 59 mmol/l and urine osmolality: 191 mOsm/kg). Urea, creatinine and random glucose were normal. CT Head showed pituitary enlargement with sellar expansion. Pituitary profile showed high prolactin...

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ea0049ep1005 | Pituitary - Clinical | ECE2017

Clinical characterization and comparison of patients with hipophysary tumors and primary empty sella

Abreu Alin , Casanova Maria Eugenia , Castano Orlando

Introduction: Non-functioning pituitary tumors and primary empty sella are a common pathology within the differential diagnosis of pituitary masses. The manifestations will depend on the size of the tumor and the compression of adjacent structures being the most frequent neurological symptoms. Clinically the two entities are very similar and no clinical tools are known to be able to help the differential diagnosis.Objective: Perform a clinical and compar...

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ea0049ep1006 | Pituitary - Clinical | ECE2017

Prolactinomas in men: retrospective analysis

Rego Teresa , Neves Carolina , Palha Ana Margarida , Cortez Luisa , Fonseca Fernando , Agapito Ana

Introdution: Prolactinomas in men are rare and the majority are macroadenomas. Some studies suggest that these tumors in men have higher proliferative activity and aggressiveness indicating gender-specific differences in biological behavior. Dopamine agonists (DA) are considered first-line therapy.Material/methods: Retrospective analysis of male patients diagnosed with prolactinoma between 2005 and 2016. Age at presentation, clinical, hormonal and image ...

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ea0049ep1007 | Pituitary - Clinical | ECE2017

Residual tumour diameter may influence reduced survival in females with nonfunctioning pituitary macroadenomas

Galoiu Simona , Burcea Iulia , Silea Simona , Voicu Oana , Baciu Ionela , Dumitrascu Anda , Caragheorgheopol Andra , Poiana Catalina

Objective: Patients with pituitary macroadenomas and concomitant hypopituitarism have a reduced life expectancy due to various comorbidities.Aim: To investigate mortality in patients with non-functioning pituitary adenomas (NFAs) and independent prognostic factors influencing survival.Design: Retrospective cohort study in a tertiary neuroendocrine university department.Methods: A total of 364 patients (177F/1...

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ea0049ep1008 | Pituitary - Clinical | ECE2017

Autoimmune hypophysitis with isolated corticotroph cell destruction due to Pembrolizumab treatment in a female patient with metastatic melanoma

Vasileiou Emmanouil , Tsentidis Charalampos , Bampilis Andreas , Ntova Vasiliki , Betsi Grigoria , Kassi Georgia

Introduction: Pembrolizumab is a programmed death receptor-1(PD-1)-blocking antibody, used in a variety of advanced malignant tumors with promising results, although adverse events are not rare.Case report: We present the case of an adult female, with negative personal and family history of autoimmune diseases, who developed malignant superficial melanoma of right wrist 6 years ago. She was initially treated with surgical resection (lesion and ipsilatera...

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ea0049ep1009 | Pituitary - Clinical | ECE2017

Aggressive pituitary tumors: a tertiary center experience

Lages Adriana , Paiva Isabel , Gomes Leonor , Oliveira Patricia , Belo Francisco , Oliveira Diana , Martins Diana , Ventura Mara , Cunha Nelson , Carrilho Francisco

Background: Pituitary adenomas (PA) are common intracranial tumors that are mainly considered benign. A small group of patients exhibit clinically aggressive behavior sometimes unrelated to the histopathological or radiological features.Methods: Twelve patients were selected harboring a PA with clinical features of aggressiveness. All the patients underwent pre and postoperative endocrinologic/neuroradiologic evaluation.Results: 10...

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ea0049ep1010 | Pituitary - Clinical | ECE2017

Hypertension, acromegaly and pegvisomant treatment: Experience from ACROSTUDY

Vila Greisa , Jan vanderLely Arrt , Neggers Sebastian , Luger Anton , Webb Susan , Biller Beverly , Jonsson Peter , Hey-Hadavi Judith

Introduction: Hypertension (HTN) is a major cardiovascular (CV) risk factor and independent predictor of the increased mortality in patients with acromegaly. Surgical cure of acromegaly is associated with improvement in blood pressure (BP) levels, however little is known on the effect of pegvisomant (PEGV) treatment on HTN.Methods/design: ACROSTUDY is an open-label, international, prospective, non-interventional study monitoring the long-term safety of P...

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ea0049ep1011 | Pituitary - Clinical | ECE2017

Assessment of macroprolactin through post-PEG monomeric prolactin measurement and comparison with gel fitration chromatography in hyperprolactinemic samples

Ribeiro-Oliveira Antonio , Gontijo Maria do Carmo D

Macroprolactin interference is a common problem in the interpretation of immunoassays for prolactin. Identifying macroprolactinemia can prevent errors in diagnosis and subsequent delivery of treatment to patients. The search for macroprolactin through polyethylene glycol (PEG) precipitation followed by percentage recovery is the most common used method in clinical laboratories. This study aimed to evaluate the implementation of macroprolactin assessment in hyperprolactinemic s...

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ea0049ep1012 | Pituitary - Clinical | ECE2017

Sheehan syndrome: Sequential hormone failure and late diagnosis

Costa Cristiana , Martins Ana Filipa , Araujo Alexandra , Vale Sonia do

Introduction: Postpartum infarction of the anterior pituitary, known as Sheehans syndrome, is a rare cause of hypopituitarism. In many cases, the hormones deficiency is sequential which implies late diagnoses.Case Report 1: A 51-year-old woman was observed because her mother had medullary thyroid carcinoma. She had no evidence of endocrine neoplasia. Nevertheless, she was experiencing fatigue, hair loss and dry skin for several months. Her history ...

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ea0049ep1013 | Pituitary - Clinical | ECE2017

Multimodal treatment in pituitary carcinoma arising from a ACTH-expressing pituitary macroadenoma with an unexpected long-term survival

Boguszewski Cesar , Schwambach Felipe , Manosso Karina , Pallone Sthefanie

Pituitary carcinoma (PC) is defined by the presence of pituitary tumor that is either not contiguous with the primary sellar tumor and/or has metastasized to distant sites. It is very rare and associated with poor prognosis, with a median survival of 12 months when systemic metastases are present, and 30 months when metastases are confined to the central nervous system. A 20 years-old man was first diagnosed with a nonfunctioning pituitary macroadenoma in 1981 and submitted to...

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ea0049ep1014 | Pituitary - Clinical | ECE2017

Renal prognosis of diabetic patients with and without central diabetes insipidus

Yatabe Junichi , Yatabe Midori , Babazono Tetsuya , Uchigata Yasuko , Ichihara Atsuhiro

Background: It has been suggested that higher arginine vasopressin (AVP) concentration may be associated with greater eGFR decline in diabetic patients not using inhibitors of the renin-angiotensin system (Diabetologia 2013). If excessive AVP action is detrimental to renal prognosis, then diabetic patients with central diabetes insipidus (CDI) may have relatively preserved renal function. Therefore, we aimed to compare long-term renal prognosis of diabetic patients with and wi...

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ea0049ep1015 | Pituitary - Clinical | ECE2017

Osilodrostat maintains normalized urinary free cortisol levels in a majority of patients with Cushing’s disease: Long-term results from an extension to the LINC-2 study

Young Jacques , Hatipogulu Betul , Molitch Mark E , Bertagna Xavier , Barbier Nathalie , Sauter Nicholas , Biller Beverly M K , Pivonello Rosario

Background: In the 22-week LINC-2 study, osilodrostat (LCI699), a potent oral 11β-hydroxylase inhibitor, normalized urinary free cortisol (UFC) levels in 15 of 19 patients with Cushings disease (CD). The most common AEs were nausea, diarrhea, asthenia, and adrenal insufficiency (n=6 each). Here, we report the 31-month efficacy and safety results from LINC-2 extension.Methods: Patients receiving clinical benefit at week 22 could enter ...

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ea0049ep1016 | Pituitary - Clinical | ECE2017

Acromegaly: assessing the clinical outcome through a 10-year experience at a tertiary care hospital in Pakistan

Tabassum Shehla , Islam Najmul

Background: Acromegaly is due to excess Growth hormone (GH) production, usually as result of pituitary adenoma. The diagnosis is often preceded by around 5 years of active but unrecognized disease. Clinical expression of the disease in each patient depend on the levels of GH and Insulin-like Growth Factor-1 (IGF-1), age, tumor size, and the delay in diagnosis. Successful remission after Trans-sphenoidal surgery (TSS) is reported to be found in 52.5% of cases in the developed c...

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ea0049ep1017 | Pituitary - Clinical | ECE2017

Evaluation of upper gastrointestinal system in acromegaly

Sisman Pinar , Pekgoz Murat , Sisman Mete , Cander Soner , Gul Ozen Oz , Erturk Erdinc , Ersoy Canan

Background: Because of prolong exposure to elevated endogenous growth hormone (GH) and insulin-like growth factor (IGF-1) levels in acromegaly, it is resulted in multipl comorbidities such as somatic growth, hypertension, diabetes and sleep apnea. Systemic complications caused by acromegaly include gastrointestinal (GIS) involvement. In our study it was planned to evaluate the upper GIS findings by using endoscopic and ultrasonographic methods in acromegaly patients.<p cla...

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ea0049ep1018 | Pituitary - Clinical | ECE2017

Disposition index in active acromegaly: A pilot study

Niculescu Dan Alexandru , Dusceac Roxana , Caragheorgheopol Andra , Popescu Nicoleta , Poiana Catalina

Background: Active acromegaly is characterized by decreased insulin sensitivity (ISen). However, insulin secretion (ISec) may not increase satisfactorily to compensate for the low ISen.Aim: To assess ISen and ISec and to calculate disposition index (DI) using an intravenous glucose tolerance test (IVGTT) in patients with active acromegaly.Methods: Twelve patients (7 men, 5 women) with active acromegaly and 2 normal subjects (2 men)...

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ea0049ep1019 | Pituitary - Clinical | ECE2017

In well-controlled patients with acromegaly, glucose homeostasis correlates with the level of disease control rather than with the type of treatment

Verroken Charlotte , Lapauw Bruno , T'Sjoen Guy

Objective: Acromegaly is often accompanied by abnormalities in glucose and lipid metabolism, which tend to ameliorate upon treatment. However, few studies have investigated whether glucose homeostasis and lipid profiles are differently affected by different treatment regimens. This study aimed to compare glucose homeostasis and lipid profiles in patients with acromegaly who are well-controlled after surgery or under stable treatment with long-acting somatostatin analogs (SSA) ...

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ea0049ep1020 | Pituitary - Clinical | ECE2017

European observational study of long-acting pasireotide for uncontrolled acromegaly: ACRONIS study design and rationale

Giustina Andrea , Enderle Gesine , Mesenka Daniela , Mondal Debolina , Schofl Christof

Introduction: Acromegaly is a rare, serious disease caused by the presence of a pituitary adenoma secreting an excessive amount of growth hormone (GH), which leads to a consequent increase in circulating insulin-like growth factor-1 (IGF-1) levels, and excessive skeletal growth and soft tissue enlargement. It is usually managed by surgery and/or treatment with somatostatin analogs (SSA). The ACRONIS study (CSOM230CIC05) will provide real-world evidence on the efficacy and safe...

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ea0049ep1021 | Pituitary - Clinical | ECE2017

Thyrotropin secreting microadenoma – case report of a patient with goiter

Vale Sonia do , Martins Ana Filipa , Lopez-Presa Dolores , Costa Cristiana , Miguens Jose

Introduction: The prevalence of pituitary thyrotropin secreting tumors (TSH-omas) is 1-2 cases per million inhabitants, most of them being macroadenomas. The differential diagnosis may be challenging, especially for microadenomas.Case Report: A 50-year-old male was observed at the endocrinology department with multinodular goiter. He noticed progressive neck enlargement over the previous months but denied other complaints. There was no family history of ...

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ea0049ep1022 | Pituitary - Clinical | ECE2017

Non-functioning pituitary adenoma; improved endocrine outcomes with increasing surgical experience: The Manchester Cohort

Giritharan Sumithra , Kearney Tara , Gnanalingham Kanna

Case notes of 150 consecutive patients (58% male) who underwent pituitary surgery by a single surgeon for non-functioning pituitary adenoma and endocrine follow up at our centre between July 2005 and February 2015 were reviewed. All patients underwent endoscopic transsphenoidal surgery as the first approach. Post-operative pituitary function was assessed by measurement of baseline pituitary hormonal profile and a glucagon stimulation test to assess ACTH and GH axis. Mean age a...

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ea0049ep1023 | Pituitary - Clinical | ECE2017

Polyuria and diabetes insipidus after surgery for pituitary tumors

Zunzunegui Nerea Egana , Garay Ismene Bilbao , Delgado Cristina Garcia , Iregui Izaskun Olaizola , Cordeu Maite Perez de Ciriza , Lopez Maria Luisa Antunano , Calafell Maite Aramburu , Sampron Nicolas , Arrieta Alfredo Yoldi , Iglesias Miguel Maria Goena

Introduction: Central diabetes insipidus (DI) is a common complication after pituitary surgery, but is transient in the majority of patients. The aim of our study is to determine the incidence and course of DI in the postoperative period and to characterize the factors associated with this disease.Methods: We performed a retrospective study of 44 patients (50% females) with a mean age of 54 years (2483), treated with transsphenoidal (TSS) or transf...

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ea0049ep1024 | Pituitary - Clinical | ECE2017

Etiology and some clinical characteristics of hypopituitarism over the years of follow up

Stojanoska Milica Medic , Vukovic Bojan , Bajkin Ivana , Icin Tijana , Milankov Andrijana , Novakovic Paro Jovanka , Prodanovic Jovana , Curic Nikola

The data of etiology and clinical characteristics of hypopituitarism in different countries differes. The aim of the study is to investigate etiology and some clinical characteristics of patients with hypopituitarism that were treated in the Clinical center of Vojvodina. The study was conducted as a retrospective study. There were 32 males and 28 female patients. Mean age was 52.2±17.5 years. Data was analized before and after substitution of hypopituitarism. Patients wer...

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ea0049ep1025 | Pituitary - Clinical | ECE2017

A novel DICER1 gene mutation in a 10-month-old boy presenting with ACTH-secreting pituitary blastoma and lung cystic dysplasia

Kalinin Alexey , Strebkova Natalia , Tiulpakov Anatoly , Vasiliev Eugene , Petrov Vasily , Kolodkina Anna , Kareva Maria , Mazerkina Nadezhda , Peterkova Valentina

Hypercortisolism due to Cushing disease is an extremely rare condition in children under one year of age. We present a case of a 10-month-old boy with lung cystic dysplasia and pituitary blastoma (ACTH-secreting). The disease manifested with symptoms of hydrothorax due to cystic dysplasia of the right lungs upper lobe. Surgical resection of the affected area has been carried out. Symptoms of endogenous hypercortisolism appeared soon after lung surgery. Cushing disease du...

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ea0049ep1026 | Pituitary - Clinical | ECE2017

Pituitary insufficiency following traumatic thoracic injury in adolescent male patient-case study

Gilis-Januszewska Aleksandra , Wilusz Malgorzata , Turek-Jabrocka Renata , Pantoflinski Jacek , Trofimiuk-Muldner Malgorzata , Kluczynski Lukasz , Hubalewska-Dydejczyk Alicja , Pach Dorota

Traumatic thoracic injuries in children and adolescents are rare, but could be connected with others traumas, often with traumatic brain injury (TBI). Based on data in the current literature, approximately 1520% of TBI patients develop chronic hypopituitarism. Growth hormone (GH) and ACTH deficiency are the most common, followed by gonadotropins and thyroid-stimulating hormone. The greatest challenge associated with endocrine complications in individuals with polytrauma ...

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ea0049ep1027 | Pituitary - Clinical | ECE2017

Potassium homeostasis in patients with acromegaly in comparison with hypertensive patients

Stormann Sylvere , Schilbach Katharina , Pichl Christine , Kosilek Robert P , Anders Hans-Joachim , Schopohl Jochen

Introduction: Acromegaly is characterized by chronic growth hormone (GH) excess and leads to numerous changes in bodily functions and comorbidity. We compared potassium homeostasis in patients with acromegaly to hypertensive controls.Methods: We prospectively assessed serum potassium, urinary potassium excretion, aldosterone and renin, acid-base balance as well as glomerular filtration rate according to the CKD-EPI formula in 71 patients with acromegaly ...

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ea0049ep1028 | Pituitary - Clinical | ECE2017

Russian hypothalamic and pituitary tumors registry (OGGO) data analysis: acromegaly

Lutsenko Alexander , Przhiyalkovskaya Elena , Pigarova Ekaterina , Belaya Zhanna , Rozhinskaya Liudmila , Stanoevich Irina

Objective: To analyze registry data on patients with acromegaly.Materials and methods: Russian hypothalamic and pituitary tumors registry database (on-line platform), which contains data on 3719 patients with acromegaly.Results: According to the database, highest prevalence of acromegaly per 100 000 inhabitants is registered in: Penza region (7.3), Kirov region (7.3), Krasnoyarsk region (6.2). Most common clinical presentations in ...

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ea0049ep1029 | Pituitary - Clinical | ECE2017

Adherence to hormone replacement therapy in patients with hyp-opituitarism using the Morisky 4-item scale: results of a pilot, prospective, cross-sectional study

Boguszewski Cesar , Abe Simone , Barbosa Bruna , Biondo Claudia , Takito Debora , Santos Kamila , Hayashi Sayuri , Amarilla Victor

Objective: To investigate adherence to hormone replacement therapy (HRT) in patients with hypopituitarism in a tertiary center outpatient clinic.Patients and methods: Prospective, cross-sectional study of patients with hypopituitarism on HRT for at least two pituitary deficiencies (independent of diabetes insipidus). Medication adherence was assessed using a validated Portuguese version of four-item Morisky scale, in which participants were asked to indi...

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ea0049ep1030 | Pituitary - Clinical | ECE2017

Hormone and tumor responses to primary or pre-operative therapy with somatostatin analogs in acromegaly and the relation with T2-weighted MRI signal

Picallo Maria , Centeno Rogelio Garcia , Guerra Aurelio Lopez , Olmedilla Yoko Lucia , Arnoriaga Maria , Requena Maria , Agreda Javier , Andia Victor , Sambo Marcel , Monereo Susana , Velez Maria Angeles , Weber Bettina , Atencia Jose

Objective: Study of the efficacy of SSA in the biochemical and tumour control and the relation between the T2-weighted MRI signal intensity and the response to SSA.Material and methods: 16 patients with GH-secreting pituitary adenomas (7♂/9♀) that received primary or pre-operative treatment with SSA. We classified them according to baseline T2-weighted MRI sequences as Hypo-intense (Ha) and No-Hypo-intense adenomas (no-Ha). Results expressed ...

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ea0049ep1031 | Pituitary - Clinical | ECE2017

Abstract withdrawn....

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ea0049ep1032 | Pituitary - Clinical | ECE2017

Does cyproterone acetate therapy contribute to the observed elevation in serum prolactin levels in trans women?

Defreyne Justine , Nota Nienke , Perreira Cecilia , Thomas Schreiner , Daphne Fisher Alessandra , Guy T'Sjoen

Objective: Hormonal treatment in trans women (MtF transgender persons) in Europe usually consists of estrogens and anti-androgens, e.g. cyproterone acetate (CPA). After initiation of cross-sex hormone therapy, an elevation in serum prolactin levels is frequently observed in trans women, which was previously attributed to estrogen agents. This analysis evaluates whether CPA contributes to the elevation of prolactin in trans women receiving cross-sex hormones.<p class="abste...

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ea0049ep1033 | Pituitary - Clinical | ECE2017

A rapidly resolving prolactinoma with cabergoline treatment

Yorulmaz Goknur , Akalin Aysen , Akcan Esra

Introduction: Prolactinomas are the most common pituitary tumors. Macroadenomas are rarely seen. Dopamine agonists such bromocriptin and cabergoline are the preferred treatments for prolactinomas. Herein, we report a patient with macroadenoma whose adenoma has resolved rapidly with cabergoline treatment.Case: A 49 year old male patient evaluated for weakness and headache. After detection of central hypothyroidism he was referred to our department. His pr...

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ea0049ep1034 | Pituitary - Clinical | ECE2017

Pregnancy outcome in women with prolactinomas exposed to dopamine agonists at early stages of gestation

Vorotnikova Svetlana , Skuridina Darya , Dzeranova Larisa , Pigarova Ekaterina , Belaya Zhanna

Introduction: Medical therapy with dopamine agonists is the best treatment for prolactinomas of any size or invasiveness and restores ovulatory cycles in 8090% of patients. Cabergoline currently suggested nearly exclusively rather than other dopamine agonists due to its excellent tolerability and long half-life. That is why the question of safety using of this drug during pregnancy and embryo-fetal development is actual.Aim: The aim of the study is...

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ea0049ep1035 | Pituitary - Clinical | ECE2017

Clinical and hormonal characteristics of patients with different types hypophysitis: a single-center experience

Imga Narin Nasiroglu , Yildirim Ali Erdem , Baser Ozden Ozdemir , Berker Dilek

Background: The inflammation of the pituitary gland known as hypophysitis. It is a rare disease accounting for approximately 0.240.88% of all pituitary diseases. Main forms of hypophysitis are histologically classified as lymphocytic, granulomatous, IgG4 related and xanthomatous. We aim to present ourpatients of hypophysitis with clinical,laboratoryand radiological features.Methods: We retrospectively reviewed our database of 1293 patients diagnose...

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ea0049ep1036 | Pituitary - Clinical | ECE2017

Comparative study of different methods for monomeric prolactin determination in patients with hyperprolactinemia

Vorotnikova Svetlana , Dzeranova Larisa , Pigarova Ekaterina , Il'in Aleksandr , Popova Nataliya , Vershinina Marina , Sukhanova Olga , Kadrina Nataliya , Shibina Larisa , Dedov Ivan

Introduction: Prolactin exists in various forms including the monomeric biologically active form (23 kDa) and a higher molecular weight form, bound most commonly to IgG, known as macroprolactin (>100 kDa). Macroprolactin lacks biological activity but can interfere in standard prolactin immunoassays and is one of the causes of false-positive results. In Russian Federation the most common method for macroprolactin determination is PEG precipitation test.<p class="abstext...

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ea0049ep1037 | Pituitary - Clinical | ECE2017

Pituitary Stalk Hemangioblastoma: a case report and review of the literature

Barbosa David , Faria Carolina , Osorio Ana Sofia , Nobre Ema , Bugalho Maria Joao

Introduction: Hemangioblastomas (HBL) in the pituitary stalk are extremely rare. Most pituitary stalk HBL reported in the literature were associated with von HippelLindau (VHL) disease.Case report: We report the case of a 34-year-old female patient with VHL disease diagnosed at the age of 18 with multiple complications (bilateral retinal and cerebellum HBL, renal cell carcinoma). Brain magnetic resonance imaging (MRI) demonstrated an hypointense su...

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ea0049ep1038 | Pituitary - Clinical | ECE2017

Impact of glucose metabolism disorders on IGF-1 levels in patients with acromegaly

Dogansen Sema Ciftci , Yalin Gulsah Yenidunya , Tanrikulu Seher , Yarman Sema

Objective: To evaluate the presence of glucose metabolism abnormalities and their impact on IGF-1 levels in patients with acromegaly.Methods: Ninety-three acromegalic patients (52 male/41 female) were included in this study who were seperated into three groups as normal glucose tolerance (NGT), prediabetes and diabetes mellitus (DM). Insulin resistance (IR) was calculated with homeostasis model assessment (HOMA). HOMA-IR >2.5 or ≤2.5 were defin...

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ea0049ep1039 | Pituitary - Clinical | ECE2017

Monthly pasireotide provides clinical benefit over 12 months in patients with Cushing’s disease

Pivonello Rosario , Bronstein Marcello , Schopohl Jochen , Delibasi Tuncay , Barkan Ariel , Suzaki Nori , Tauchmanova Libuse , Gupta Pritam , Petersenn Stefan , Lacroix Andre

Introduction: A monthly, long-acting formulation of pasireotide normalized or reduced mean urinary free cortisol (mUFC) in most patients with Cushings disease (CD) in a multicentre, double-blind, Phase III study. The effects of long-acting pasireotide on signs and symptoms of CD are reported here.Methods: Patients with persistent/recurrent (n=123) or de novo (non-surgical candidates; n=27) CD and mUFC≥1.55xULN...

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ea0049ep1040 | Pituitary - Clinical | ECE2017

Radiological study of clinically non-functioning pituitary macroadenomas: a single institutional experience

Moreno Cristina , Paja Miguel , Lizarraga Aitzol , Etxeberria Eider , Arrizabalaga Cristina , Ugarte Estibaliz , Izuzquiza Ana , Goni Fernando , Iglesias Natalia , Calles Laura

Introduction: When facing with non-functioning pituitary macroadenomas (NFPMA), radiological invasion is determinant to surgical approach, apart from histological biomarkers of pituitary tumor aggressiveness (Ki-67; p53 and mitotic index). Invasive tumors usually need additional surgery and/or radiotherapy. There are no much studies describing epidemiological data on aggressive pituitary tumors in clinical practice. We provide information regarding the radiological findings of...

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ea0049ep1041 | Pituitary - Clinical | ECE2017

Idiopathic isolated acquired ACTH deficiency– a case series from the Irish National Pituitary Network

Hannon Anne marie , Smith Diarmuid , Sherlock Mark , Hunter Steven , Thompson Chris

Idiopathic Isolated ATCH deficiency (IIAD) is a rare cause of secondary adrenal insufficiency characterised by ACTH deficiency with otherwise intact pituitary function. Our objective was to describe the presentation, the autoimmune associations and diagnostic findings observed in IIAD. We present a case series of 19 cases of idiopathic Isolated ACTH deficiency which were identified from the National Pituitary Register in Ireland. A chart and biochemical review was performed to...

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ea0049ep1042 | Pituitary - Clinical | ECE2017

Autonomic impairment in idiopathic diabetes insipidus

Barbot Mattia , Ceccato Filippo , Zilio Marialuisa , Albiger Nora , Boscaro Marco , Bilora Franca , Scaroni Carla

Introduction: Since DI was reported to be associated to increase mortality, the aim of this study is to evaluate the presence of autonomic dysfunction (AD) in patients with DI.Methods: We enrolled 12 patients (six females) with central idiopathic DI and 12 controls, matched for age, sex and common cardiovascular risk factors, who were evaluated using the tilt, lying-to-standing, hand grip, deep breath, Valsalva maneuver and Stroop tests.<p class="abs...

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ea0049ep1043 | Pituitary - Clinical | ECE2017

Salivary and serum cortisol levels by liquid chromatography tandem mass spectrometry after standard dose ACTH test in the diagnosis of central hypopituitarism

Morelli Valentina , Polledri Elisa , Mercadante Rosa , Sonzogni Beatrice , Mantovani Giovanna , Palmieri Serena , Malchiodi Elena , Verrua Elisa , Barbieri Anna Maria , Ferrante Emanuele , Arosio Maura , Fustinoni Silvia , Chiodini Iacopo

Objective: The diagnosis of central hypoadrenalism (HPAI) is a major clinical challenge. The gold standard procedure remains insuline tolerance test (ITT). Liquid chromatography tandem mass spectrometry (LC-MS/MS) is considered the best procedure for the evaluation of cortisol levels. This study aimed to evaluate cut-offs of serum (TM-SeC) and salivary cortisol (SaC) by LC-MS/MS and serum cortisol by ECLIA assay (E-SeC) after Standard dose ACTH test (SDCT) in diagnosing HPAI.<...

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ea0049ep1044 | Pituitary - Clinical | ECE2017

Risk and diagnosis of hypocortisolism after transsphenoidal surgery for sellar tumors

Sierra Milagros , Males David , Perez-Olivares Laura , Castano-Leon Ana Maria , Fernandez Jose , Paredes Igor , Serraclara Alicia , Calatayud Maria

Introduction: Transsphenoidal surgery (TS) is used for pituitary and suprasellar tumors. It has a risk of damaging the pituitary axis and developing hypocortisolism, a potential life threating risk.Objetive: Incidence of hypocortisolism after TS, postsurgery cortisol (PSC) levels that predict hypocortisolism and potential risk factors for hypocortisolism after TS.Methods: Prospective study in patients who underwent TS in 2016. Gluc...

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ea0049ep1045 | Pituitary - Clinical | ECE2017

Nivolumab and pembrolizumab induced hypophysitis

Vosjan-Noeverman Marleen , Brom Rob van den , Hospers Geke , Hiltermann Jeroen , Berg Gerrit van den

Introduction: Immune checkpoint blockade in cancer treatment causes frequent adverse events of auto-immune etiology. Ipilimumab (anti-CTLA-4 antibody) causes a hypophysitis in up to 10% of patients. In contrast, during treatment with nivolumab and pembrolizumab (both anti-PD-1 antibodies), hypophysitis is rare (<1%).Results: In the past year, we identified 4 cases of hypophysitis in patients treated with anti-PD-1 therapy (incidence 1% out of a total...

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ea0049ep1046 | Pituitary - Clinical | ECE2017

Heterogeneity of the patient pathway for adult growth hormone deficiency: Perspectives from a CEE Endocrinologists expert panel

Shimon Ilan , Badiu Corin , Bossowski Artur , Doknic Mirjana , Dzivite-Krisane Iveta , Hana Vaclav , Kollerova Jana , Natchev Natchev Emil , Pfeifer Marija , SzŨcs Nikolette , Hey-Hadavi Juliana , Gomez Roy

Introduction: Effective identification, diagnosis and management of growth hormone (GH) deficiency in adults are crucial for treating endocrinologists to provide the best in patient care. As such, it is important that we share our experiences to understand challenges and obstacles to enhance the patient journey. The objective of this project was to start identifying these challenges and obstacles.Methods and findings: In November 2016, an expert panel of...

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ea0049ep1047 | Pituitary - Clinical | ECE2017

Considerable delays to achieve adequate control in treating patients with acromegaly

Tzanela Marinella , Karapanou Olga , Giatra Christianna , Botoula Efstathia , Tiaka Elisabeth , Anastasia Lambraki , Tsagarakis Stylianos

Acromegaly is a rare disease that leads to considerable morbidity and mortality, both reversible by adequate control of the disease. However, patients that could be adequately controlled confront delays in achieving treatment targets. The aim of the present study was to estimate the time to disease control after diagnosis and the reason leading to control delays. We retrospectively studied 119 acromegalic patients (aged 46.4±12.5; 71 females). Following appropriate treatm...

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ea0049ep1048 | Pituitary - Clinical | ECE2017

Hyponatremia – the other face of diabetes insipidus complications

Bucur Madalina , Barbu Carmen

Diabetes insipidus is mainly associated with dehydration as a complication, hyponatremia being very rare. We report the case of a 75 years old female, from Switzerland, who presented with nausea and vomit, diarrhea, asthenia and general sickness at the emergency room, where blood tests revealed hyperglycemia of 320 mg/dl and hyponatremia of 115 mmol/l, the patient knowing to have diabetes insipidus and diabetes mellitus type II, with insulin and desmopressin. Following emergen...

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ea0049ep1049 | Pituitary - Clinical | ECE2017

Aggressive pituitary tumours: a multicenter study

Palha Ana , Gomes Leonor , Sequeira Duarte Joao , Marques Conceicao , Amaral Claudia , Amado Ana , Borges Fatima , Ribeiro Isabel , Barreiros Eduardo , Barreiros Luis , Miguens Jose , Joao Bugalho Maria , Lages Adriana , Paiva Isabel , Marques Olinda , Almeida Rui , Martins Teresa , Cortez Luisa , Agapito Ana , Fonseca Fernando

Introduction: Pituitary tumours are considered benign, however some exhibit an aggressive behavior. Defining a timely treatment is challenging due to absence of accurate prognostic predictors.Objective: To evaluate radiological and histopathological features of aggressive pituitary tumours.Methods: Multicenter and retrospective study. Criteria for aggressiveness were: invasion to sphenoid and/or cavernous sinus; growth progression ...

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ea0049ep1050 | Pituitary - Clinical | ECE2017

Effects of somatostatin analogs on glucose metabolism in acromegalic patients: a meta-analysis of prospective interventional studies

Feola Tiziana , Cozzolino Alessia , Simonelli Ilaria , Sbardella Emilia , Puliani Giulia , Giannetta Elisa , Pasqualetti Patrizio , Lenzi Andrea , Isidori Andrea M

Introduction: Glucose metabolism impairment is a common complication of acromegaly. Somatostatin analogs (SSAs) are used as both first and second line treatment. The effect of SSAs on glucose metabolism in acromegaly is still debated.Aim: To address the following questions: 1) do SSAs affect glucose metabolism? 2) does the effect correlate with disease control? 3) do different SSAs Lanreotide (LAN) and octreotide LAR (OCT) affect metabolism...

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ea0049ep1051 | Pituitary - Clinical | ECE2017

Prolactinomas diagnosed after menopause: presentation and outcomes from a large specialist centre

Santharam Sandhya , Tampourlou Metaxia , Arlt Wiebke , Ayuk John , Gittoes Neil , Toogood Andrew , Webster Rachel , Karavitaki Niki

Introduction: Most prolactinomas in females are diagnosed during the years of reproductive age and the majority are microadenomas. Prolactinomas diagnosed after menopause are very rare with limited published data on their presentation and outcomes.Aim: The aim of our study was to assess the presenting clinical, biochemical and imaging findings, as well as the outcomes of women diagnosed with a prolactinoma in the post-menopausal period.<p class="abst...

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ea0049ep1052 | Pituitary - Clinical | ECE2017

Ipilimumab induced hypophysitis – an insight from a case series in the United Kingdom

Kempegowda Punith , Quinn Lauren , Vijayan Melapatte Anitha , Jain Ankit , Steven Neil , Gleeson Helena , Toogood Andrew

Aims: To assess the incidence of Ipilimumab associated hypophysitis and its common presentations.Methods: All patients who developed Ipilimumab induced hypophysitis following treatment for Malignant melanoma at a large tertiary care centre in West Midlands, United Kingdom from 2012 to 2014 were included in the study. Patients with known pituitary disease prior to treatment and/or received other systemic immunotherapy following Ipilimumab treatment were e...

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ea0049ep1053 | Pituitary - Clinical | ECE2017

Mammary duct ectasia due to prolactin-secreting pituitary adenoma

Kalan Sarı Işılay , Gorar Suheyla , Kolağası Oykun

Introduction: Mammary duct ectasia (MDE) is an inflammatory breast disease characterised by dilation of major ducts and periductal inflammation. MDE occurs commonly in women undergoing menopause. The etiology has not been well defined but previous studies described an association between high prolactin and MDE.Case Report: A 42-year-old female was admitted to our hospital with complaints of galactorrhea, amenorrhea, mammary gland tenderness and breast di...

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ea0049ep1054 | Pituitary - Clinical | ECE2017

Quantitative analysis of the pituitary gland at magnetic resonance imaging in obese patients

Puliani Giulia , Lubrano Carla , Fiorelli Marco , Sbardella Emilia , Graziadio Chiara , Gianfrilli Daniele , Lenzi Andrea , Isidori Andrea M

Background: Hypothalamic-pituitary function and adipose tissue are deeply interconnected. Obesity has been linked to morpho-functional changes in several endocrine glands (thyroid, adrenal, gonads). No study has quantified the appearance of the pituitary gland in obese subjects.Aim: To measure pituitary signal intensity, homogeneity and texture of the pituitary gland at magnetic resonance (MR) in obese subjects free of focal pituitary disease.<p clas...

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ea0049ep1055 | Pituitary - Clinical | ECE2017

Hypogonadotropic hypogonadism in a patient with long-term primary hypothyroidism

Vaz de Castro Raquel , Maria Aragues Jose , Ferreira Florbela , Gomes Vania , Wessling Ana , Joao Bugalho Maria

Abstract: We report the case of a 65-year-old man who presented with erectile dysfunction to an appointment in our Endocrinology department. He referred fatigue, weight gain and constipation as secondary complaints that had been steadily evolving throughout the past 4 years. He denied other symptoms such as visual impairment or headaches as well as the consumption of any medications or drugs. His past medical history was unremarkable. On examination, BMI was 25.8 kg/m2</s...

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ea0049ep1056 | Pituitary - Clinical | ECE2017

Effects of pasireotide treatment on cardio-metabolic risk in patients with Cushing’s disease: an Italian, multicenter study

Albani Adriana , Ferrau Francesco , Messina Erika , Pivonello Rosario , Scaroni Carla , Giordano Carla , Cozzolino Alessia , Zilio Marialuisa , Guarnotta Valentina , Ciresi Alessandro , Iacuaniello Davide , Alibrandi Angela , Colao Annamaria , Cannavo Salvatore

: Patients with Cushings disease (CD) have increased cardiovascular risk due to metabolic alterations caused by glucocorticoids excess. Pasireotide, a multireceptor-targeted somatostatin analogue, is a therapeutic option in CD patients in whom surgery is not curative or not feasible. Pasireotide has been shown to be effective in controlling hypercortisolism and to improve metabolic features. Recently, the visceral adiposity index (VAI) has been proposed as a marker of vi...

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ea0049ep1057 | Pituitary - Clinical | ECE2017

DHEA-S as a marker of the secondary adrenal insufficiency following craniospinal irradiation

Yudina Alla , Pavlova Maria , Tselovalnikova Tatiana , Mazerkina Nadezhda , Arefyeva Irina , Gheludcova Olga

Abstract: The secondary adrenal insufficiency (SAI) is life-threatening disease. 3050% of patients have SAI following craniospinal irradiation (CSI). The gold standard of SAI diagnosis is the insulin tolerance test but it is demanding for patient and medical staff. The simple and reliable test would allow to use ITT rarely. The aim was to evaluate probability of using DHEA-S in SAI diagnosis. 41 patient after CSI non-pituitary brain tumors survivor and 23 hea...

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ea0049ep1058 | Pituitary - Clinical | ECE2017

Clinical and laboratorial reassessment of patients with isolated growth hormone deficiency during the transition phase

Saavedra Ana , Oliveira Juliana , Martins Alexandra , Azevedo Ana , Santos-Silva Rita , Castro Cintia , Rodrigues Elisabete , Carvalho Davide , Fontoura Manuel

Introduction: During childhood and puberty, growth hormone(GH) is essential for linear growth. Consequently, children with isolated GH deficiency(GHD) must receive replacement therapy. GH has also important metabolic actions. GHD in adults is associated with altered body composition. However, long-term consequences of GH treatment in adults is not sufficiently known.Objective: To evaluate GH treatment during pediatric age in patients with isolated GHD.</...

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ea0049ep1059 | Pituitary - Clinical | ECE2017

What should central diabetes insipidus and panhypopituitarism point out in a patient with lung adenocarcinoma in remission?

Canlar Sule , Keskin Caglar , Canpolat Asena Gokcay , Gullu Sevim , Corapcioglu Demet

Objectives: Pituitary gland is an uncommon site for metastasis of malignant tumors. Breast and lung are the most common cancer sites. Most pituitary metastases are asymptomatic, with only 7% symptomatic and central diabetes insipidus is the most common symptom.Case presentation: A 54 year-old woman presented with nause, emesis and diplopia to emergency department. Her relatives stated that she had poliuria, nocturia, polidipsia for three months. Her hist...

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ea0049ep1060 | Pituitary - Clinical | ECE2017

Is there any relationship between nonfunctional pituitary adenoma and arterial stiffness?

Cagir Yavuz , Altay Mustafa , Cakal Erman , Cagir Busra Betul , Akkan Tolga , Dagdeviren Murat , Beyan Esin

Introduction: In a recent study, it was determined that morbidity rates due to cardiovascular diseases were affected as a result of long-term follow-up in patients with nonfunctional pituitary adenoma. And cardio/cerebro vascular diseases were the most frequent cause of mortality when mortality rates were examined. In the literature, there are not enough studies evaluating this condition in patients with nonfunctional pituitary adenoma without traditional cardiovascular risk f...

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ea0049ep1061 | Pituitary - Clinical | ECE2017

A rare cause of hypophysitis: tuberculosis

Ates Ihsan , Yilmaz Nisbet

Hypophysitis is a heterogeneous inflammatory disease of pituitary gland. As it causes headache and visual defects, it mimics sellar tumors in clinical and radiological aspects. It may occur due to primary or secondary causes. Tuberculosis is one of the rare secondary causes of hypophysitis. A young male patient presented with fatigue and headache and diagnosed with tubercular hypophysitis as a result of performed tests is discussed hereby in the case report. A 30 year old male...

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ea0049ep1062 | Pituitary - Clinical | ECE2017

T2-weighted MRI signal and response to somatostatin analogs in acromegaly

Cerqueira Luis , Palha Ana , Cortez Luisa , Sagarribay Amets , Fonseca Fernando , Agapito Ana

Introduction: somatostatin analogs (SSA) are largely prescribed in acromegalic patients, whether as adjuvant or primary therapy. Response is variable and seems dependent of histological subtype. Intensity T2 signal in MRI has been related to granulation patern and accordingly with response to SSA.Objective: To evaluate whether T2 MRI signal is correlated with effectiveness of SSAMaterial and methods: Retrospective analysis of acrom...

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ea0049ep1063 | Pituitary - Clinical | ECE2017

“Toxic” Goiter Reveals Cushing’s Disease

Musat Madalina , Hortopan Dan , Oprea Luciana , Duceac Andreea , Manda Dana , Caragheorgheopol Andra , Iordachescu Carmen , Tupea Claudiu , Ciubotaru Vasile

Case presentation: Mrs. S presented in an endocrine clinic for fatigue, weight loss, restlessness and goiter. She was obese with a BMI of 51 kg/mp, hypertensive and had a medium size, nontender goiter. Lab test revealed hyperglycaemia, suppressed TSH (<0.03mUI/L), on two separate occasions, mid-normal fT4 and T3. Thyroid ultrasound revealed multinodular goiter. A diagnosis of polynodular goiter with subclinical hyperthyroidism was made and patient was commenced on thiamazo...

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ea0049ep1064 | Pituitary - Clinical | ECE2017

Low incidence of hyperprolactinemia following traumatic brain injury

Tortora Anna , La Sala Domenico , Tramontano Anna Luna , Bisogno Francesca , Angrisani Elisabetta , Carrano Mario , Vitale Mario

Background: Traumatic brain injury (TBI) is a major cause of disability and death, and a cause of neuroendocrine dysfunction. Partial or complete pituitary dysfunction is a frequent event occurring in 2550% of subjects after a TBI as result from damage to either the pituitary or the hypothalamus. This large variability depends on the screening methods and on the difficulty to predict the effects of the trauma on pituitary. Growth hormone deficiency and gonadotropin defic...

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ea0049ep1065 | Pituitary - Clinical | ECE2017

The pseudo-tumoral adénohypophysitis: A rare disorder of the postpartum

El Mghari Ghizlane , Elouarradi Nassiba , El Ansari Nawal

Introduction: The pseudo-tumoral lymphocytic adénohypophysitis is an autoimmune disorder responsible for anterior hypophysis insufficiensy.It is a rare cause of pituitary hypofunction which predominantly affects young women in the peripartum period. We report the case of a patient in whom the pseudo-tumoral lymphocytic adénohypophysitis was the cause of a pituitary failure.Case presentation: The patient was a 44 year-old woman, who presented wi...

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ea0049ep1066 | Pituitary - Clinical | ECE2017

Clinically nonfunctioning pituitary adenoma: a case report

Arkan Tugba , Halhalli Gokcen Selma Kilic , Acikgoz Seyyid Bilal

Objective and importance: Clinically nonfunctioning pituitary adenomas (NFPA) are the most common pituitary tumors after prolactinomas. The absence of clinical symptoms of hormonal hypersecretion can contribute to the late diagnosis of the disease.Clinical presentation: A 52-year-old man presented with muscle weakness, weight loss, fatigue and a long term history of depression. He had no headaches and no vision problems. Physical exam was unremarkable. N...

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ea0049ep1067 | Pituitary - Clinical | ECE2017

Nonfunctioning pituitary incidentaloma – delayed onset of acromegaly and concomitant primary adrenocortical insufficiency

Radian Serban , Deciu Diana , Lefter Antonia , Poiana Catalina

Introduction: Pituitary incidentaloma (PitInc), defined as an unsuspected mass observed on imaging studies performed for unrelated conditions. Most such lesions are not clinically significant at initial evaluation and current guidelines recommend periodic follow-up.Aim: To present a rare case of delayed onset of acromegaly in a patient with a nonfunctioning PitInc, raising the question of the utility of prolonged follow-up of PitInc.<p class="abstext...

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ea0049ep1068 | Pituitary - Clinical | ECE2017

Sheehan’s syndrome in clinical practice

Vlad Mihaela , Golu Ioana , Amzar Daniela , Balas Melania , Butaru Miruna , Milos Ioana , Zosin Ioana

Sheehans syndrome represents a rare cause of pituitary insufficiency, produced by an ischemic pituitary necrosis due to a severe haemorrhage at deliverance. Epidemiologic data indicate that, nowadays, this disease is quite rare in developed country.Aim: To determine and evaluate the clinical and hormonal characteristics of cases with Sheehans syndrome diagnosed and follow-up in our Clinic, during the last ten years.Subj...

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ea0049ep1069 | Pituitary - Clinical | ECE2017

Mental disorders in the hospitalized patients with Cushing’s disease

Almaev Denis , Starostina Elena , Belaya Janna , Komerdus Irina , Bobrov Aleksey

Objective: To study the frequency and features of mental disorders in hospitalized patients, suffering from Cushings disease (CD).Materials and methods: We studied 70 patients (59 women and 11 men) with verified diagnosis of CD, aged 41±12 years. Their mental health was evaluated with ICD-10 criteria and verified by the Mini-International Neuropsychiatric Interview questionnaire (MINI 6.0). 45 patients had overt hypercortisolism (untreated CD ...

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ea0049ep1070 | Pituitary - Clinical | ECE2017

Detailed assessment of hypothalamic damage in craniopharyngioma patients with obesity

Fjalldal Sigridur , Follin Cecilia , Gabery Sanaz , Sundgren Pia Maly , Bjorkman-Burtscher Isabella , Latt Jimmy , Mannfolk Peter , Nordstrom Carl-Henrik , Rylander Lars , Ekman Bertil , Palsson Anna , Petersen AEsa , Erfurth Eva-Marie

Background/objectives: Hypothalamic obesity (HO) occurs in 50% of patients with the pituitary tumor Craniopharyngioma (CP). Attempts have been made to predict the risk of HO based on hypothalamic (HT) damage on magnetic resonance imaging (MRI), but none have included volumetry. Qualitative and quantitative (volumetric) analyses of HT damage was performed. The results were explored in relation to feeding related peptides and body fat.Subjects/methods: A c...

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ea0049ep1071 | Pituitary - Clinical | ECE2017

Surgery versus expectant observation in clinically non-functioning pituitary adenomas – a 20-year single centre experience

Matta-Coelho Claudia , Almeida Rui , Marques Olinda

Background: Clinically non-functioning pituitary adenomas (NFPAs) are among the most common pituitary lesions. Its management includes surgery, radiation or observation. The authors aim to compare clinical characteristics and outcomes between patients submitted to surgery or expectant observation (EO).Methods: Retrospective review of medical records from 1996 to 2016. In our centre, there is only 1 pituitary surgeon and NFPAs patients are referred to sur...

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ea0049ep1072 | Pituitary - Clinical | ECE2017

Risk factors for progression of the surgical remnant of non-functioning pituitary adenomas in patients treated with dopamine agonists

Gonzalez Elena Fernandez , Nunez Miguel Sampedro , Levi Ana Ramos , Caon Ana Rabe , Hughet Isabel , Moreno Nerea Aguirre , Sanchez Clara Marijuan , Peris Begona Pla , Nieto Angeles Maillo , Andres Alicia Vicuna , Flores Pedro Martinez , Azpiroz Monica Marazuela

Introduction: Surgery is the treatment of choice for non-functioning pituitary adenomas (NFPA), but remnants are frequently observed. Management of these remnants include observation (OBS), radiotherapy (RT) and/or dopamine agonist (DA) therapy. In this study, we evaluate the progression-free survival (PFS) of NFPA with postoperative remnant and the potential factors involved.Methods: We performed a single-center ambispective study of a cohort of 72 pati...

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ea0049ep1073 | Pituitary - Clinical | ECE2017

Aggressive macroprolactinoma – exception to the rule

Belceanu Alina Daniela , Constantinescu Georgiana , Crumpei Iulia , Bursuc Anamaria , Rotariu Daniel , Constantinescu Aurora , Ciubotaru Vasile , Preda Cristina , Vulpoi Carmen

Background: Prolactinoma is the most frequent pituitary tumour. However, peculiar aspects may induce difficulties in their evolution and management. Malignant prolactinoma is exceptionally rare and it cannot be diagnosed on histological grounds alone. We report the case of a recurrent, possibly malignant macroprolactinoma.Case report: 46 years old female, addressed for bitemporal hemianopia, without other clinical signs. MRI confirmed a pituitary macroad...

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ea0049ep1074 | Pituitary - Clinical | ECE2017

Body composition and bone mineral density in male patients with isolated hypogonadotropic hypogonadism

Kałużna Małgorzata , Człapka-Matyasik Magdalena , Przeorska Dorota , Ziemnicka Katarzyna , Ruchała Marek

Isolated hypogonadotropic hypogonadism (IHH) is known to decrease bone mineral density due to lack of pubertal surge of gonadotropins and deficiency of sex steroid hormone. Gonadal steroid hormones imbalance affects body composition. Nineteen Caucasian men, 2248 year old (mean±S.D. 33±7.65) diagnosed with IHH (8 normosmic, 11 anosmic or hyposmic) were enrolled into the study. 14 patients were on hormone replacement therapy (HRT), 5 patients were ...

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ea0049ep1075 | Pituitary - Clinical | ECE2017

The E in POEMS syndrome: what to expect?

Caimari Francisca , D'Sa Shirley , Lunn Michael , Baldeweg Stephanie E

Introduction: POEMS syndrome is a rare multisystemic disorder including polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma-proliferative disorder and skin changes. We aim to describe the course of the endocrine disease in the context of this paraneoplastic syndrome.Methods: 69 patients with POEMS have been under the MDT care in our hospital. Data is currently available for 32 patients who attended the joint haematological/neurological/endocr...

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ea0049ep1076 | Pituitary - Clinical | ECE2017

Pituitary adenoma and elevated ACTH: not always corticotrophinoma

Cabac Mariana , Belceanu Alina Daniela , Crumpei Iulia , Tirnovan Mirela , Constantinescu Georgiana , Bursuc Anamaria , Constantinescu Aurora , Mogos Voichita , Vulpoi Carmen

Introduction: Hypothalamicpituitaryadrenal (HPA) axis activation is the main neuroendocrine response to an environmental challenge. Drug abuse may activate HPA axis by interaction with neuromodulation systems.Case report: 28 year old man, was admitted in the Neurology Department for persistent headache with spinal irradiation. With suspicion of multiple sclerosis, MRI revealed pituitary macroadenoma (14 mm diameter) and subcortical, paraventr...

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ea0049ep1077 | Pituitary - Clinical | ECE2017

Pituitary apoplexy – presentation, management and outcome in 35 cases

Costa Maria Manuel , Carvalho Bruno , Castedo Jose Luis , Vinha Eduardo , Pereira Josue , Bernardes Irene , Carvalho Davide

Introduction: Pituitary apoplexy is a rare disease which results of haemorrhage and/or infarction of pituitary gland. The optimal management of this problem still remains controversial between surgery and conservative treatment.Aims: To characterize the clinical presentation, diagnostic workup, treatment and follow up of patients with apoplexy. Methods:Retrospective study of 35 pituitary apoplexy followed in a portuguese hospital from 2006 to 2016.<p...

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ea0049ep1078 | Pituitary - Clinical | ECE2017

Inferior petrosal sinus sampling: experience of a terciary hospital

Costa Maria Manuel , Castedo Jose Luis , Vinha Eduardo , Pereira Josue , Bernardes Irene , Carvalho Davide

Introduction: Inferior Petrosal Sinus Sampling (IPSS) is the gold standard test to distinguish between Cushing Disease and ectopic ACTH secretion (EAS), mostly when the biochemical tests are discordant and/or there is no lesion in MRI.Aim: To evaluate the results of IPSS in the diagnosis of ACTH-dependent Cushing syndrome.Methods: Retrospective study that analysed IPSS results performed in the last decade in our centre and integrat...

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ea0049ep1079 | Pituitary - Clinical | ECE2017

Cushing syndrome and pregnancy: a systematic review including three new cases

China Diogo , Oliveira Ana Isabel , Belo Sandra , Carvalho Davide

Cushings Syndrome (CS) is an uncommon disease worldwide, being characterized by an increased production of glucocorticoids, and if left untreated can lead to serious consequences and women with CS rarely get pregnant. The aim of our work is to make a systematic review of the cases of pregnancy in patients with previously diagnosed CS, being performed an extensive research of the Medline and Web of Knowledge databases, and add three new cases observed in our institution. ...

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ea0049ep1080 | Pituitary - Clinical | ECE2017

20-year retrospective study of clinically non-functioning pituitary adenomas – a single center experience

Matta-Coelho Claudia , Almeida Rui , Marques Olinda

Background: Clinically non-functioning pituitary adenomas (NFPA) are the most common pituitary adenomas but their treatment remains challenging. Our aim is to describe clinical, imagiological and hormonal characteristics of patients with NFPA presenting at our department.Methods: Retrospective review of medical records of patients with NFPA at our centre from 1996 to 2016. Exclusion criteria: prolactin >100 ng/ml or histologic evidence of prolactinom...

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ea0049ep1081 | Pituitary - Clinical | ECE2017

Hypopituitarism and central diabetes insipidus in an HIV patient – a late complication of cerebral toxoplasmosis and/or antiretrovirals?

Oliveira Sofia Castro , Souteiro Pedro , Neves Joao Sergio , Nogueira Claudia , Neves Celestino , Freitas Paula , Carvalho Davide

Introduction: The endocrine system is often affected in the course of HIV infection. However, hypopituitarism and diabetes insipidus are uncommon disorders in these patients and have been related to drugs, infections of the central nervous system and neoplastic infiltration, in extremely rare cases.Case report: We present a case of a 42-year-old man with HIV infection known since 2005, but undergoing antiretroviral therapy only since 2010 (emtricitabine/...

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19th European Congress of Endocrinology

Pituitary - Clinical

BiosciAbstracts