Endocrine Abstracts

Acromegaly is a rare endocrine disorder caused by growth hormone (GH) secreting pituitary adenoma. The treatment of choice is transsphenoidal surgery. In patients with persistent disease after surgery medical therapy is recommended. First-line medical treatment include first generation long-acting somatostatin analogs: octreotide LAR and lanreotide autogel. Recently, pasireotide – a second generation somatostatin analog has been investigated in patients with acromegaly.</...

Background: Efficacy and safety of combination treatment of pasireotide LAR with pegvisomant (PEGV) has not been studied yet. Switching to Pasireotide LAR in patients previously controlled with long-acting somatostatin analogues (LA-SSAs) and PEGV could reduce the required PEGV dose to normalize serum IGF1 levels, while the effect on glucose metabolism is unknown.Methods: We enrolled 60 acromegaly patients >18 years with acromegaly who had normal IGF...

Evidences suggest that environmental contaminants exposure and/or the impairment of intracellular xenobiotic metabolizing system could affect pituitary pathophysiology. Glutathione-S-transferase-P1 (GSTP1) gene encodes for an enzyme that is involved in cellular detoxification mechanisms. GSTP1 altered activity or expression has been reported in some tumours.We aimed to assess the GSTP1 gene promoter methylation status in acromegaly patients and its contr...

Introduction: Trans-sphenoidal surgery (TSS) with minimally invasive techniques is the first choice in the treatment of paediatric Cushing’s disease (CD). The question is how can high remission rates be achieved with less invasive investigations and TSS. The developments in our centre treating 100 pediatric Cushing patients with long-term follow-up may add some helpful ideas.Material and methods: Data from our first series 1 (n=55) will be ...

Background: Octreotide s.c. depot is a novel, ready-to-use formulation administered via a thin needle, which may allow self-administration. In a phase 1 study in healthy volunteers, octreotide s.c. depot provided greater bioavailability with faster onset and greater IGF1 suppression than long-acting octreotide. Here, we present data from a phase 2 study evaluating pharmacokinetics (PK), efficacy, safety, and tolerability of octreotide s.c. depot in patients with acromegaly and...

Hypothalamic GH releasing hormone (GHRH) has hypnotic actions by increasing slow wave sleep (SWS) (non-rapid eye movement sleep, non-REM), which account for about 75% of sleep. Conversely, GH may stimulate the rapid eye movement sleep (REM). Patients with GH deficiency (GHD) often exhibit sleep problems leading to daytime fatigue and reduced quality of life (QoL). We have described a cohort of patients with isolated GHD (IGHD) due to GHRH resistance caused by a homozygous null...

Introduction: Hyponatremia (HN) is associated with worse clinical outcomes, and longer hospital lengths-of-stay than seen in eunatremic patients. The Syndrome of Inappropriate Antidiuresis (SIAD) is the most common cause of hyponatremia in hospitalization. We studied the relationship between correction of sustained SIAD-induced hyponatremia and visits to the Emergency Room (ERv) as well as hospital admissions (HA) in a case series.Methods: Retrospective,...

Introduction: Despite the significant risk of regrowth of non-functioning pituitary adenomas (NFAs) after primary treatment, systematic data on the probability of further tumour progression and the effectiveness of management approaches are lacking.Aims: Assess the probability of further regrowth(s), predictive factors and outcomes of management approaches in patients with NFA diagnosed with adenoma regrowth after primary treatment (surgery combined or n...

Context: Assessment of disease control in acromegaly depends on GH and IGF-I, but discordant values frequently occur. Further, the role of OGTT-suppressed GH (GHnadir) in somatostatin analogue (SA) treated patients is debated.Objective: To evaluate the effect of targeting either IGF-I or GH during SA treatment.Design: A randomized, investigator-initiated, multicentre trial.Patients and methods: 84 ...

Introduction: Adult patients with craniopharyngioma (CP) and hypothalamic (HT) damage have impaired cognitive function. The white matter (WM) changes behind these findings remain to be elucidated. Diffusion tensor imaging (DTI) is a MRI technique that quantifies microstructural damage in the WM. This is the first study of DTI, hippocampal (HC) and HT volume in relation to cognition in CP patients.Methods: A cross-sectional study of childhood onset CP was...

Background: Copeptin (pre-proAVP) secreted in equimolar amounts with vasopressin (AVP) closely reflects AVP release. Previously it was shown that copeptin is stimulated in standard pituitary function tests acting through hypothalamic centres. Furthermore, copeptin has been shown to subtly mirror stress potentially mediated via CRH. To further test a potential direct interaction of CRH with copeptin release which could augment AVP effects on pituitary function, we investigated ...

Hyperprolactinemia is associated with abnormalities in glucose and lipid profile with development of insulin resistance and metabolic syndrome (MetS), which have been found to be improved by treatment with cabergoline (CAB). The current study aimed at investigating hormonal and metabolic effects of long-term CAB withdrawal in patients with prolactinomas. In 46 patients (37 F, 9 M, aged 34.5±11.5 yrs, 36 microadenomas and 10 macroadenomas) anthropometric (weight, BMI, wais...