Searchable abstracts of presentations at key conferences in endocrinology
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20th European Congress of Endocrinology

Barcelona, Spain
19 May 2018 - 22 May 2018

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ECE 2018, 19 - 22 May 2018; Barcelona, Spain

ea0056p788 | Pituitary - Clinical | ECE2018

Sheehan’s syndrome: clinical and laboratory evaluation of 80 cases

Elfaleh Emna , Oueslati Ibtissem , Chihaoui Melika , Yazidi Meriem , Chaker Fatma , Rejeb Ons , Slimane Hedia

Introduction: Sheehan’s syndrome (SS) is defined as partial or complete hypopituitarism occurring due to massive postpartum uterine hemorrhage that leads to pituitary infarction. Patients with SS have varying degrees of anterior pituitary hormone deficiency. The aim of our study was to evaluate the clinical and hormonal characteristics of patients with SS.Methods: Eighteen patients with SS were enrolled in a retrospective and descriptive study. Medi...

ea0056p789 | Pituitary - Clinical | ECE2018

Metabolic and cardiovascular outcome in patients with Sheehan’s syndrome

Elfaleh Emna , Oueslati Ibtissem , Chihaoui Melika , Yazidi Meriem , Rejeb Ons , Chaker Fatma , Slimane Hedia

Introduction: Sheehan’s syndrome (SS) is postpartum hypopituitarism caused by necrosis of the pituitary gland. Patients with SS have varying degrees of anteriorpituitary hormone deficiency and have an increased mortality from cardiovascular disease. Inadequate hormone replacement is one of the possible causes of this increased mortality. The aim of our study was to assess metabolic and cardiovascular outcome in patients with SS.Methods: In a retrosp...

ea0056p790 | Pituitary - Clinical | ECE2018

Final results of NordiNet® international outcome study: key outcomes

Savendahl Lars , Puras Gediminas , Pedersen Birgitte Tonnes , Weber Matthias

Background: The NordiNet® International Outcome Study (IOS) (NCT00960128), a non-interventional study (2006–2016), assessed the effectiveness and safety of real-life treatment with Norditropin®. Out of 20,548 enrolled patients, 20,195 (paediatric/adult; 17,711/2484) were included in the full analysis set (FAS) and 12,938 (11,967/971) in the effectiveness analysis set (EAS). Outcomes were assessed in children with growth hormone deficiency (...

ea0056p791 | Pituitary - Clinical | ECE2018

Relationship between cortisol increment and basal cortisol: implications for the insulin tolerance test in assessing corticotrop insufficiency

Ach Mohamed Taieb , Zaouali Monia , Hasni Yosra , Abdelkarim Asma Ben , Maaroufi Amel , Maha Kacem , Chaieb Molka , Ach Koussay

Introduction: The insulin tolerance test (ITT) is accepted as the gold-standard test in the evaluation of adrenal and GH axis in patients with pituitary disorders. Diagnostic criteria that requires a minimum increment in serum cortisol is considered invalid although individuals who have a lower basal serum cortisol concentration because of recent ACTH deficiency may be maximally stimulated by ITT and thus able to further increase cortisol secretion without reaching the cut-off...

ea0056p792 | Pituitary - Clinical | ECE2018

A case of pituitary metastasis in female patient with an invasive breast carcinoma

Elfaleh Emna , Oueslati Ibtissem , Chihaoui Melika , Yazidi Meriem , Chaker Fatma , Rejeb Ons , Slimane Hedia

Introduction: Pituitary metastases are rare complications of malignancy, representing only 1% of surgical tumours of the pituitary gland. They are usually encountered in elderly patients with disseminated malignant disease. The most frequent are metastases of breast and lung cancer. In this report, we describe a rare case of a metastatic breast cancer to the pituitary gland.Observation: A 32-year-old female presented with blurred vision and diminished vi...

ea0056p793 | Pituitary - Clinical | ECE2018

Non-classical factors of cardiovascular risk in acromegaly

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

Background: Acromegaly (ACRO) is associated with greater cardiovascular morbidity and mortality, however, this is not entirely explained by the increase in classic cardiovascular risk factors (CVRF). C-reactive protein, galectin 3, adiponectin, B-type natriuretic peptide (BNP), apolipoprotein E, interleukin-6 and echocardiographic variables such as epicardial fat (EF) and interventricular septum thickness (IST) have been suggested as non-classical CVRF in the general populatio...

ea0056p794 | Pituitary - Clinical | ECE2018

A comparison of pituitary function in primary and secondary empty sella: preliminary data

Magnani Elisa , Chiara Decaroli Maria , Leoni Laura , Diazzi Chiara , Rochira Vincenzo

Background: Empty sella (ES), the herniation of the subarachnoid space within sella associated with a variable flattening of the pituitary gland, is classified as primary (PES) or secondary (SES) on the basis of etiological factors.Aim: To assess the differences between PES and SES in terms of pituitary function.Methods: Clinical, radiological and hormonal data were retrospectively extrapolated from the records of 85 patients with ...

ea0056p795 | Pituitary - Clinical | ECE2018

Thyroid autoimmunity in patients with empty sella syndrome

Arslan Abdulmuttalip , Senyurt Mahmut , Carlioglu Ayse , Durmaz Senay

Purpose: The aim of this study was to evaluate the association and frequency of thyroid autoimmunity in patients with empty sella syndrome and to evaluate the possible effects of thyroid auto-antibodies on clinical and laboratory findings in patients with empty sella syndrome.Materials and methods: We recruited 93 patients (female) and 22 male patients (mean age 55.51±14.82) who were admitted to the Endocrinology Clinic of Erzurum Regional Training ...

ea0056p796 | Pituitary - Clinical | ECE2018

Assessment of prevalence and severity of depressive symptoms in patients with acromegaly using the beck depression inventory II (BDI-II) – own observations

Malicka Joanna , Malicki Dariusz , Kurowska Maria , Potembska Emilia , Tarach Jerzy S.

Background: Prolonged exposure to excessive concentrations of GH and IGF-1 in acromegaly continues to affect patients’ appearance and negatively influences their self-evaluation, personal relations and morbidity. Besides chronic GH/IGF-1 excess could be deleterious to the brain through many mechanisms.Objectives: The aim of the study was to evaluate the influence of acromegaly on the prevalence and the severity of depressive symptoms in patients wit...

ea0056p797 | Pituitary - Clinical | ECE2018

Giant prolactinomas in men: clinical features and therapeutic outcomes

Arcano Karina , Jose Diez Juan , Rodriguez Victor , Bernal Carmen , Villabona Carles , Iglesias Pedro

Aims: To evaluate the clinical features and long-term therapeutic outcome of giant prolactinoma (gPRLoma) in men and to compare them with those of a group of male patients with non-gPRL macroprolactinomas (non-gPRLomas).Patients and methods: A retrospective and multicenter study of gPRLomas in men diagnosed in a 20-year period was performed. Clinical data and treatment outcome were registered. The diagnosis of gPRLoma was established when the maximal tum...

ea0056p798 | Pituitary - Clinical | ECE2018

Static and dynamic balances in acromegaly and impact of exercise on balance

Haliloglu Ozlem , Topsakal Nuri , Camliguney Filiz , Polat Korkmaz Ozge , Sahin Serdar , Cotuk Birol , Kadioglu Pinar , Erkut Oya

Purpose: Patients with acromegaly may have changes in balance due to visual disturbances, musculoskeletal abnormalities and changes in body composition. We aim to compare static and dynamic balances in patients with acromegaly and healthy controls and to evaluate effects of exercise on balance in patients with acromegaly.Methods: Twenty-two patients with acromegaly followed at the Endocrinology Outpatient Clinic of Istanbul University, Cerrahpasa Medical...

ea0056p799 | Pituitary - Clinical | ECE2018

Severe hypernatremia resulting in a locked-in syndrome

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

Introduction: Osmotic demyelination syndrome (ODS) is a well described, potentially devastating consequence of rapid alterations in plasma osmolality, classically occurring secondary to the excessively rapid correction of chronic hyponatraemia. We describe a case of diabetes insipidus (DI) resulting in a Locked-in syndrome (LIS) caused by a rapidly developing severe hypernatremia.Case report: A 43-year-old woman was admitted to the Internal Medicine ward...

ea0056p800 | Pituitary - Clinical | ECE2018

Thyroid autoimmunity and euthyroid hashimoto thyroiditis frequancy in patients with pituitary adenoma

Emin Budak Mehmet , Senyurt Mahmut , Carlioglu Ayse , Durmaz Senay

Purpose: The purpose of this study were to evaluate the relation thyroid autoimmunity and euthyroid hashimoto thyroiditis in patients diagnosed with pituitary adenoma and association of pituitary adenoma with clinical and laboratory findingsMaterials and methods: The retrospective study population included a total of 230 participants. A total of 189 patients (67 with prolactinoma, 35 with acromegaly, 4 with cushing disease and 83 with non-functional pitu...

ea0056p801 | Pituitary - Clinical | ECE2018

Gonadotroph pituitary macroadenoma inducing ovarian hyperstimulation syndrome

Dyrmishi Blertina , Olldashi Taulant , Puca Entela , Lumi Ema , Ylli Dorina

Case report: We report a young woman with ovarian hyper stimulation syndrome (OHSS), headache, visual field defect and pituitary macro adenoma. The patient was treated about four years ago as pituitary PRL-secreting adenoma with carbergoline. The evaluation of other hormones FSH, LH and Estradiol values wasn’t done. The patient presented to our hospital with abdominal pain and headaches and amenohrrea. The pregnancy test was negative and pelcic ultrasound demonstrated enl...

ea0056p802 | Pituitary - Clinical | ECE2018

Associated pituitary insufficiencies in children with growth hormone deficiency

Ach Taieb , Hasni Yosra , Abdelkarim Asma Ben , Maaroufi Amel , Kacem Maha , Chaieb Molka , Zaouali Monia , Ach Koussay

Context: GH deficiencies could be associated with other pituitary insufficiencies. Our main objective is to assess othe pituitary secretion in short stature patients.Patients and methods: Twenty three patients (17 boys, 6 girls) were included in the study for exploration of short stature, after oral and informed consent of their parents, from January 2016 to June 2017 in the Department of Endocrinology of the University Hospital of Farhat Hached Sousse. ...

ea0056p803 | Pituitary - Clinical | ECE2018

Metastasis – A rare cause of diabetes insipidus and pituitary insufficiency

Nemes Codruta Ioana

Introduction: Metastases in the pituitary gland are an uncommon presentation of carcinomas, lung and breast being the most common sites of the primary tumor. The most frequent clinical manifestations are diabetes insipidus, visual disturbances, cranial nerve paralysis and hypopituitarism.Case report: We report the case of a 64 years old man, smoker, with no chronic illness, with one year history of headache, and more recent asthenia, weight loss, poliuri...

ea0056p804 | Pituitary - Clinical | ECE2018

Endocrine abnormalities in primary empty sella syndrome

Belaid Rym , Mchirgui Nadia , Rojbi Imen , Ben Nacef Ibtissem , Jaidane Amel , Khiari Karima , Ouertani Haroun , Abdallah Nejib Ben

Background: The term primary empty sella (PES) makes reference to the herniation of the subarachnoid space within the sella turcica in patients with no history of pituitary tumor,surgery or radiotherapy. The aim of our study was to evaluate hormonal abnormalities associated with PES.Methods: Thirty-six patients with PES were retrospectively analysed over a 24-year period [1992-2016].Patients were evaluated for pituitary function with basal hormone levels...

ea0056p805 | Pituitary - Clinical | ECE2018

Long-term outcomes of different treatments for cushing disease: a retrospective study

Molero Inmaculada Gonzalez , Abuin Jose , Marin Monserrat Gonzalo , Doulatram Viyei , Arnes Juan Garcia , Arraez Miguel Angel , Olveira Gabriel

Introduction: Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone–secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality.Objetive: The study purpose was to describe the long term treatment outcomes for CD patients in our hospital.Methods: Retrospective analysis of the records of 36 patients with Cushing dise...

ea0056p806 | Pituitary - Clinical | ECE2018

Association between prolactin level and tumor size reduction at 3 months after cabergoline treatment in patients with macroprolactinoma

Kim Daham , Lee Youngki , Park Se Hee , Park Kyeong Hye , Ryong Ku Cheol , Kim Sun Ho , Lee Eun Jig

Objectives: Prolactin (PRL) normalization after 3 months of Cabergoline (CAB) treatment are useful predictors of responsiveness in patients with prolactinoma. However, differences within the PRL normalization cut-off value have not been identified.Methods: We reviewed the medical records of patients with prolactinomas who were treated with CAB as a primary drug at Severance Hospital. We included patients who had a full dataset of pituitary hormone assays...

ea0056p807 | Pituitary - Clinical | ECE2018

Predictors of clinical behavior of pituitary adenomas

Solak Mirsala , Dusek Tina , Kraljevic Ivana , Polovina Tanja Skoric , Balasko Annemarie , Melada Ante , Peterkovic Vjerislav , Kavanagh Marcel Marjanovic , Jakovcevic Antonia , Ozretic David , Kastelan Darko

The aim of this study was to investigate the expression of histological markers Ki-67, p53 and mitotic activity in pituitary adenomas and their correlation with the frequency of recurrence and progression of residual adenoma. The study comprised 94 patients treated at the Department of Endocrinology, University Hospital Center Zagreb in the period from 2005 to 2011. After the operation, 63.8% of patients had residual adenoma. In the minority of patients (12/60 patients, 20%) w...

ea0056p808 | Pituitary - Clinical | ECE2018

The comparison of combination test either with 1 μg acth test and glucagon test for the evaluation of hypothalamo-pituitary-adrenal axis in patients with pituitary disorders

Unluhizarci Kursad , Kokoglu Emel , Karaca Zuleyha , Tanriverdi Fatih , Kelestimur Fahrettin

The low-dose (1 μg) ACTH stimulation test or glucagon stimulation test (GST) are candidate tests for hypothalamo-pituitary-adrenal (HPA) axis evaluation in patients with pituitary disorders. In this study, we aimed to compare the combination of low-dose ACTH and GSTs (named as combination test) with each test results alone in the evaluation of HPA axis in patients with pituitary disorders whether combination test may overcome the problems when the test results are equivoc...

ea0056p809 | Pituitary - Clinical | ECE2018

Clinical parameters to distinguish silent corticotroph adenomas from other non-functioning pituitary adenomas

Kim Daham , Ku Cheol Ryong , Park Se Hee , Park Kyeong Hye , Moon Ju Hyung , Kim Eui Hyun , Kim Sun Ho , Lee Eun Jig

Silent corticotroph adenomas (SCAs) are difficult to distinguish from other non-functioning pituitary adenomas (NFPAs) preoperatively. This study assessed the preoperative clinical parameters associated with SCAs. After excluding patients with increased 24-h urinary free cortisol, 341 patients who underwent surgery for NFPAs during 2011–2016 with available preoperative combined pituitary function test (CPFT) and immunohistochemical staining results were enrolled. The pati...

ea0056p810 | Pituitary - Clinical | ECE2018

Male hypogonadism – when two endocrine causes merge in the same patient

Araujo Alexandra Novais , Wessling Ana , Bugalho Maria Joao

Introduction: Male hypogonadism is defined by lower levels of testosterone than expected for age-matched individuals. In primary or hypergonadotropic hypogonadism, LH and FSH show a compensatory elevation to low testosterone levels, while in the secondary or hypogonadotropic hypogonadism the low testosterone levels are a result of insufficient gonadotropin levels. Hyperprolactinemia is a cause of hypogonadotropic hypogonadism. It is not only caused by lactotroph adenomas (prol...

ea0056p811 | Pituitary - Clinical | ECE2018

The diagnostic utility of late night salivary cortisol (LNSF) and cortisone (LNSE) in Cushing’s Syndrome and their relationship to metabolic markers

Garrahy Aoife , Forde Hannah , O'Kelly Patrick , McGurren Karen , Tormey William , Smith Diarmuid , Javadpour Mohsen , Agha Amar

The diagnosis of Cushing’s Syndrome (CS) requires demonstration of excess circulating cortisol. Measurement of late night salivary cortisol (LNSF) has been advocated as a simple, non-invasive and reliable outpatient diagnostic tool for patients with suspected CS but the usefulness of its metabolite cortisone (LNSE) remains unclear. LNSE levels are approximately six times higher than LNSF in saliva due to the rapid action of 11β-hydroxysteroid dehydrogenase type 2 (11...

ea0056p812 | Pituitary - Clinical | ECE2018

Is elevated urotensin II level a predictor for increased cardiovascular risk in subjects with acromegaly?

Demirpence Mustafa , Guler Asli , Yilmaz Hamiyet , Sayin Ahmet , Pekcevik Yeliz , Turkon Hakan , Colak Ayfer , Ari Elif Merve , Aslanipour Behnaz , Kocabas Gokcen Unal , Calan Mehmet

Purpose: Acromegaly, an uncommon disease, is existed in the result of over production of growth hormone (GH). It is associated with increased cardiovascular risk factors and metabolic abnormalities. Urotensin II (UII), a secreted vasoactive peptide hormone, plays an essential role in the regulation of vascular tone, glucose metabolism and atherosclerosis. UII belonging to somatostatin superfamily activates somatostatin receptors as well. The aim of this study was to ascertain ...

ea0056p813 | Pituitary - Clinical | ECE2018

The association between Ki-67 proliferation index, P53 expression, mitotic index, tumor invasion and the risk of recurrence in pituitary adenomas

Hasanov Rovshan , Aydogan Berna Imge , Gullu Sevim

Background: The 4th edition of World Health Organization (WHO) classification of pituitary tumors recommended evaluation of tumor proliferation and invasion to identify aggressiveness. We aimed to assess the relationship between Ki-67, mitotic index, P53 expression, invasion and recurrence risk in pituitary adenomas.Methods: Among 601 patients who underwent TN/TS adenomectomy between 2001 and 2016, 101 patients (16.8%) who had tumors with Ki-67 index &#8...

ea0056p814 | Pituitary - Clinical | ECE2018

Pituitary enlargement due to the autoimmune thyroiditis mimicking a pituitary macroadenoma

Kiyici Sinem , Onlen Esen , Guclu Metin

Introduction: Pituitary tumorous hyperplasia with hyperprolactinemia has been described as a rare presentation of primary hypothyroidism. The loss of thyroxin feedback inhibition in primary hypothyroidism causes overproduction of thyrotropin-releasing-hormone (TRH), which results in secondary pituitary enlargement. TRH has a weak stimulatory effect on the lactotroph cells of the pituitary, so a mild to moderate increase in prolactin (PRL) levels is expected. This report descri...

ea0056p815 | Pituitary - Clinical | ECE2018

Intracranial germinoma with panhypopituitarism in a 18-year old patient

Ozyurt Semih , Celik Ozlem , Ozer Leyla

Intracranial germ cell tumors (GCTs) account for only 0.4–3.4% of all central nervous system (CNS) tumors. A 18 year old patient with an unremarkable medical history was presented to the ophtalmology outpatient clinic with a 2 month history of loss of vision at left eye and blurrred vision at right also headache and fatigue. Ophtalmological examination showed loss of visual acuity at left eye and decreased 0.05–0.1 at the right and bilateral optic atrophy. Further ph...

ea0056p816 | Pituitary - Clinical | ECE2018

Primary pituitary abscess: an unexpected diagnosis

Ozyurt Semih , Celik Ozlem , Ustun Cemal , Ceylan Savas

Pituitary abscess is a rare condition, with approximately 200 cases reported in the literatüre. Two-thirds of pituitary abscess which occurs without any of the aforementioned risk factors are primary type while remaining are secondary type-abscess. A 58 year old female patient presented with fatigue, headache and loss of appetite for two months. Laboratory analysis showed high ESR and CRP levels also hypocortisolism, hypothyroidism, hypogonadism. Pituitary MRI showed a ma...

ea0056p817 | Pituitary - Clinical | ECE2018

Diurnal melatonin profile in patients with pituitary adenomas

Khyzhnyak Oksana , Mykytyuk Miroslava , Kashkalda Dina , Gogitidze Teona , Barabash Nadiya , Karachentsev Yurii , Manska Katarina , Nikolaiev Roman

Introduction: The role of the pineal gland and its hormone, melatonin, in the regulation of hypothalamo-adenohypophysial system activity is well known. At the same time, studies of the circadian rhythm of melatonin secretion in patients with pituitary adenomas are few in number, because the evaluation of pineal activity is not generally included in the clinical investigation of patients with pituitary tumors.Aim: The present study analyzed the circadian ...

ea0056p818 | Pituitary - Clinical | ECE2018

Diabetes insipidus due to hypothalamitis and infundibulo-neurohypophysitis

Oruk G Gonca , Apaydin Melda

Autoimmune hypothalamitis has been implicated in idiopathic central diabetes insipidus (DI) due to antibodies against vasopressin producing hypothalamic cells. Lymphocytic infiltration of hypothalamus has been reported in patients with lymphocytic hypophysitis (LH) manifesting as hypopituitarism with DI. These patients can also have other associated autoimmune diseases. Here, we report a case of a male patient who presented with headache, poor orientation, partial hypopituitar...

ea0056p819 | Pituitary - Clinical | ECE2018

Age and severity of hyperthyroidism are determinants of thoracic vertebral fractures in patients with TSH-secreting pituitary adenoma

Frara Stefano , Losa Marco , Doga Mauro , Formenti Anna Maria , Mortini Pietro , Mazziotti Gherardo , Giustina Andrea

Introduction: Osteoporosis and vertebral fractures (VFs) commonly occur in overt and subclinical primary hyperthyroidism. In this clinical setting, bone damage is caused by the direct effects of thyroid hormone in excess on bone remodeling, although there is also evidence that low thyrotropin (TSH) values may play a role in driving fracture risk. In fact, TSH was shown to have direct inhibitory effects on osteoclastogenesis and bone resorption. Based on these data, one could a...

ea0056p820 | Pituitary - Clinical | ECE2018

Cushing disease after remission and prevalence of cardiovascular risk factors

Moreno-Moreno Paloma , Rebollo-Roman Angel , Alhambra-Exposito Maria Rosa , Munoz-Jimenez Concepcion , Galvez-Moreno Maria Angeles

Objective: Cardiovascular risk factors (CVRF) persist with notable prevalence in patients with Cushing’s disease (CD) after remission: obesity/overweight up to 40%, hypertension (HTA) up to 60%, type 2 diabetes (DM-2) up to 60% and dyslipidemia up to 30% of cases. Persistence of metabolic syndrome in patients with controlled CD seems to be related to the duration of the disease before remission. The aim of this study is to describe the prevalence of CVRF in patients with ...

ea0056p821 | Pituitary - Clinical | ECE2018

Clinical relevance of metabolic phenotype in hypopituitarism: what really matters?

Miljic Dragana , Pekic Sandra , Doknic Mirjana , stojanovic Marko , Nikolic-Djurovic Marina , Medic-Stojanoska Milica , Milosevic Verica , Sosic-Jurijevic Branka , Ajdzanovic Vladimir , Jemuovic Zvezdana , Soldatovic Ivan , Popovic Vera , Petakov Milan

Previous studies reported increased prevalence of metabolic syndrome (MS) and mortality rates from cardiovascular causes in hypopituitary patients. Fatty liver disease was added recently to this unfavorable cardio-metabolic phenotype. We studied the prevalence of MS and non-alcoholic fatty liver disease (NAFLD) in unselected cohort of 282 hypopituitary patients (146 male), mean age 49.2±15.1 years, on standard replacement therapy (76.4% received l-thyroxin, 76% hydrocorti...

ea0056p822 | Pituitary - Clinical | ECE2018

TSH-secreting pituitary adenomas: clinical and morphological characteristics and outcomes of surgical treatment

Astafyeva Liudmila , Kadashev Boris , Kalinin Pavel , Kutin Maxim , Fomichev Dmitriy , Sharipov Oleg , Sidneva Yuliya , Klochkova Irina , Shishkina Liudmila

Objective: To study the clinical, diagnostic and morphological characteristics and treatment outcomes of TSH-secreting pituitary tumors.Patients and methods: The study included 21 patients with pituitary adenoma and a normal or elevated TSH level and elevated fT4 and fT3 levels who were operated on at the Neurosurgical Institute in the period between 2002 and 2015. Before surgery, in the early postoperative period, and 6 months afte...

ea0056p823 | Pituitary - Clinical | ECE2018

Recovery of the adrenal function after pituitary surgery in patients with Cushing Disease: remission or recurrence?

Serban Andreea , Verrua Elisa , Sala Elisa , Locatelli Marco , Arosio Maura , Mantovani Giovanna , Ferrante Emanuele

Background: The treatment of choice in patients with Cushing Disease (CD) is pituitary surgery (PS). A successful PS is generally followed by adrenal insufficiency (AI). Although the remission rate after PS may reach 96.6% of cases, approximately 1/3 of cured patients experience the recurrence of the disease during lifetime. The aim of this study was to analyze the duration of AI in relation with the recurrence of CD.Materials and methods: We performed a...

ea0056p824 | Pituitary - Clinical | ECE2018

Hypothalamic involvement in diffuse large B-celllymphoma

Apaydin Melda , Oruk G Gonca , Rezanko Turkan Atasever , Yilmaz Asu Fergun

Non-hodgkin lymphoma (NHL) is a hematological tumor caused by abnormal lymphoid proliferation. NHL can arise in any part of the body, including central nervous system (CNS). However, hypothalamus involvement is a rare presentation. Here, we report a case of hypothalamic infiltration of NHL Diffuse Large B-cell lymphoma (DLBCL) in a 21 years old male patient with panhypopituitarism and diabetes insipidus. The patient was admitted to the hospital with a history of nausea, vomiti...

ea0056p825 | Pituitary - Clinical | ECE2018

Iceberg alert: undetected health problems in adults with Prader-Willi syndrome – multidisciplinary care could prevent ‘unexplained deaths’

Pellikaan Karlijn , Rosenberg Anna , Baan Janneke , Davidse Kirsten , de Graaff Laura

Introduction: A yearly mortality rate of 4% among young adult patients is unacceptable in any patient population. Nevertheless, in Prader-Willi syndrome (PWS), up to 4% of young patients die every year and this situation has been going on for decades. PWS is a complex hypothalamic disorder, combining hypotonia, intellectual disability (ID), pituitary hormone deficiencies and hyperphagia. Due to this lack of satiety, patients can literally eat themselves to death: overeating ca...

ea0056p826 | Pituitary - Clinical | ECE2018

Pituitary apoplexy in pregnancy lead to empty sella

Gen Ramazan , Avci Emel , Batmaz Leyla , Sezer Kerem , Akbay Esen

Pituitary apoplexy (PA) is an endocrine emergency characterized by acute, severe headache, visual disturbances, ophthalmoplegia, hypopituitarism and altered consciousness. This condition usually arises in an underlying pituitary adenoma. 27-year-old female without a known pitutary lesion presented to the emergency department in December 2015 with a 8-hour history of with sudden and severe frontal headache, fever, blurred vision, nausea, confusion at 36 weeks of gestation. The ...

ea0056p827 | Pituitary - Clinical | ECE2018

Benefits of pre-surgical treatment with somatostatin analogs in naive patients with acromegaly

Cornejo-Pareja Isabel M , Maraver-Selfa Silvia , Munoz-Garach Araceli , Gonzalez-Molero Inmaculada , Mancha-Doblas Isabel , Tinahones Francisco

Introduction: Somatostatin analogs (SS-analogs) are the treatment option when there is a persistent disease despite surgical intervention. They can be also recommended as a first line treatment if surgery is not appropriate (non-curative or contraindicated surgery).Objetive: To evaluate the effect of first-generation SS-analogs (lanreotide and octreotide) on tumour shrinkage and biochemical control in naive patients.Methods: We per...

ea0056p828 | Pituitary - Clinical | ECE2018

Temozolomide is effective for rapid control of hypercortisolism in aggressive acth-secreting pituitary tumors

Cappellani Daniele , Michela Gabelloni , Cosottini Mirco , Urbani Claudio , Marconcini Giulia , Manetti Luca , Marcocci Claudio , Bogazzi Fausto , Lupi Isabella

Background: Temozolomide is an alkylating chemoterapic agent that ties a methyl to guanine, causing a base-pair mismatch and a DNA damage, resulting in cell death. Due to its lipophilic nature and its ability to cross the blood-brain barrier, this drug was originally used for malignant gliomas and later for aggressive pituitary tumors and carcinomas. Temozolomide is now recommended as first-line chemotherapy by the recently published ESE Clinical Practice Guidelines. Here we p...

ea0056p829 | Pituitary - Clinical | ECE2018

Cancer in acromegaly: a case-control study

Gil Susana Mallea , Stalldecker Graciela , Diez Sabrina , Palazzo Adriana , Peressotti Bruno , Ballarino Carolina

Carcinomas are the third most frequent cause of complications in acromegalic patients. It has been suggested that diabetes potentiates the risk of cancer. To assess the frequency and type of malignant neoplasms in acromegalic patients and control group; to evaluate, in both groups, the relationship between IGF-I/GH and the development of cancer, and between glucose metabolism and cancer in two centers of Buenos Aires, Argentina. Retrospective, cross-sectional study; medical re...

ea0056p830 | Pituitary - Clinical | ECE2018

A rare case of acromegaly with normal IGF-1, severe chronic congestive heart failure, and impaired glucose tolerance

Kurowska Maria , Malicka Joanna , Zwolak Agnieszka , Tarach Jerzy S

Introduction: Acromegaly with normal IGF-1level is rarely diagnosed and is difficult to recognize. In acromegalic pa-tients with poorly controlled diabetes, malnutrition, hepatic injury, hepatic congestion due to heart fail-ure, inflammatory diseases, renal dysfunction, and malignant neoplasm, IGF-1 synthesis is inhibited and thus in such cases normal IGF-1 levels may be observed. The aim of the study is to present a rare case of a patient with acromegaly and normal IGF-1 leve...

ea0056p831 | Pituitary - Clinical | ECE2018

Two-dimensional speckle tracking echocardiography showed a slight impairment of left ventricular deformability in acromegalic patients at diagnosis and during follow-up

Urbani Claudio , Fabiani Iacopo , Siciliano Valeria , Cappellani Daniele , Mantuano Michele , Pugliese Nicola Riccardo , Marcocci Claudio , Di Bello Vitantonio , Bogazzi Fausto

Introduction: Acromegalic heart disease is characterized by concentric left ventricular (LV) hypertrophy and impaired LV function. Speckle tracking echocardiography (STE) allows a non-invasive and reproducible study of myocardial strain, a marker of cardiac deformability and early ventricular systolic dysfunction.Objectives: The aims of the study are: 1) evaluation of STE parameters in acromegalic patients at diagnosis and during the follow-up; 2) apprai...

ea0056p832 | Pituitary - Clinical | ECE2018

Trabecular bone score as skeletal fragility predictor in patients with acromegaly

Perez-Olivares Martin Laura , Calatayud Gutierrez Maria , Soledad Librizzi Maria , Gonzalez Mendez Violeta , Guadalix Iglesias Sonsoles , Hawkins Carranza Federico , Martinez Diaz-Guerra Guillermo

Introduction: Several studies have demonstrated a high incidence of vertebral fractures (VF) in acromegaly, not always correlated with bone mineral density (BMD) value adquired by dual X-ray absorptiometry (DEXA). At trabecular level, GH may alter bone microarchitecture (BM) that predisposes to bone fragility. Trabecular Bone Score (TBS), a textural parameter applied to DEXA to evaluate BM, could be useful to predict VF risk in these patients.Materials a...

ea0056p833 | Pituitary - Clinical | ECE2018

Registry for central diabetes insipidus in Russia: prevalence and etiologies of the disease

Pigarova Ekaterina , Dzeranova Larisa , Belaya Zhanna , Rozhinskaya Liudmila , Lutsenko Alexander , Melnichenko Galina , Dedov Ivan , Consortium CDI The

Introduction: Epidemiological data for central diabetes insipidus (CDI) are quite sparse.Objectives: To provide an epidemiological data on CDI in different regions of Russia (20 from 83 Federal regions).Materials and methods: We used the Russian Registry for Central Diabetes Insipidus (RCDI) to study the epidemiological features of CDI.Results: A total of 2004 patients with CDI were recorded, 47% women and 59...

ea0056p834 | Pituitary - Clinical | ECE2018

Two cases of silent corticotroph adenomas

Cinel Murat , Canlar Sule , Gullu Sevim

Introduction: Pituitary adenomas are mostly benign tumors which may be clinically functioning or non-functioning and ACTH secreting tumors make up 15% of them. Up to 20% of corticotroph adenomas which don’t have any biochemical or clinical evidence of hypercortisolism are known as silent corticotroph adenomas.Case 1: A 54 years old male presented with blurred of vision and headache that increasing in severity within six years. Physical examination a...

ea0056p835 | Pituitary - Clinical | ECE2018

IgG4-related neuroinfundibulo-hypophysitis treated by rituximab and corticosteroids

Lupi Isabella , Urbani Claudio , Manetti Luca , Cosottini Mirco , Brancatella Alessandro , Cappellani Daniele , Bogazzi Fausto

IgG4-related hypophysitis, a type of IgG4-related disease, is a rare condition. It appears to be sensitive to glucocorticoids in most patients, but its recurrence is likely.Clinical case: A 17 year-old girl was referred for hypotonic polyuria and polydipsia of 1 month duration. Water deprivation test was suggestive of central diabetes insipidus. Basal and dynamic assessment of pituitary anterior function were unremarkable. Patient did suffer from autoimm...

ea0056p836 | Pituitary - Clinical | ECE2018

Early postsurgery cortisol after transphenoidal surgery to predict adrenal insufficiency one year posturgery

Gonzalez Molero Inmaculada , Doulatram Viyey , Maraver Silvia , Gonzalo Marin Montse , Abuin Jose , Ruiz Garcia Ignacio , Angel Arraez Miguel , Tinahones Francisco , Olveira Gabriel

Aim: To assess a perioperative glucocorticoid protocol in transsphenoidal surgery (TSS)and the performance of early post-TSS 08:00 cortisol measurement to detect/exclude secondary adrenal insufficiency.Methods: We selected patients undergoing TSS.In patients with no cushing disease, we checked cortisol/Synachten presurgery, measured 3° postoperative 0800 a.m. cortisol(after 24 h without corticoids) and cortisol/Synachten 3-6 months post-surgery. We ...

ea0056p837 | Pituitary - Clinical | ECE2018

Cushing’s disease with negative or inconclusive MRI: reassessment of transphenoidal surgery at the age of medical treatment. Post operative remission rate in 184 patients including 86 with negative or inconclusive MRI

Cristante Justine , Lefournier Virginie , Sturm Nathalie , Guy Passagia Jean , Gay Emmanuel , Chabre Olivier

When pituitary MRI show a typical imaging of adenoma, it is agreed that transsphenoidal surgery is the reference treatment with remission achieved in about 80% of patients. If MRI is negative or inconclusive, some authors consider that the results of surgery are less successful, and propose medical treatment as a first line therapy, despite a disease control rate between 30 and 70%. Since 1990, our center chose to systematically explore patients with ACTH dependent hypercortic...

ea0056p838 | Pituitary - Clinical | ECE2018

Simultaneous coexistence of Cushing’s disease and renal cell carcinoma

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

Background: After the diagnosis of corticotropin (ACTH) dependent Cushing’s syndrome established, its cause must be determined. Cushing’s disease (CD) is caused by corticotropin (ACTH) secreting adenomas and it accounts for roughly 75-80% of all endogenous Cushing’s syndrome. These adenomas are almost always benign. Renal cell carcinoma (RCC) is the most seen kidney cancer. In this case report, a presentation of a patient who was diagnosed with concurrent CD and...

ea0056p839 | Pituitary - Clinical | ECE2018

The relationship between sleep apnea syndrome and metabolic parameters in patients with acromegaly

Bicer Buket , Oz Gul Ozen , Sen Nermin , Oztop Hikmet , Cander Soner , Ersoy Canan , Erturk Erdinc

Background: Acromegaly is a rare endocrine disorder characterized by sustained hypersecretion of growth hormone (GH) with concomitant elevation of insulin-like growth factor I (IGF-I) associated with acral enlargement, sleep apnea, cardiovascular and metabolic disorders. Its annual incidence is approximately six per million people. The most common cause of acromegaly is a somatotroph (growth hormone-secreting) adenoma of the anterior pituitary.Methods: A...

ea0056p840 | Pituitary - Clinical | ECE2018

Early postoperative GH level as biomarker for surgical outcome in patients with acromegaly

Tsiberkin Alexander , Tsoy Uliana , Cherebillo Vladislav , Gussaova Natalya , Dalmatova Anna , Polezhaev Andrej , Belousova Lidiya , Grineva Elena

Introduction: Persistence after transsphenoidal surgery remain a significant challenge in management of acromegaly. Value of basal growth hormone (GH) evaluation in early postoperative period as marker of acromegaly persistence has been proposed and discussed in the literature, but is not widely used in clinical practice.Aim: The goal of our study is to specify the value of basal GH level measurement 24 hours later after transsphenoidal surgery as postop...

ea0056p841 | Pituitary - Clinical | ECE2018

Optimal follow-up strategy based on the natural history of nonfunctioning pituitary adenomas

Hee Kim Jung , Dho Yun-Sik , Hwy Kim Yong , Hyun Lee Jung , Hyun Lee Ji , Ram Hong A. , Kyong Moon Min , Soo Shin Chan

Object: The natural history and proper algorithm for follow-up testing of nonfunctioning pituitary adenomas (NFPAs) are not well known, despite their relatively high prevalence. The aim of this study was to suggest the optimal follow-up algorithm for NFPAs, based on the natural history.Methods: We followed up on 197 patients with NFPAs without any treatment (including surgery and radiation) at the time of detection, in a single center, between March 2000...

ea0056p842 | Pituitary - Clinical | ECE2018

Thicknesses of Chorioretinal layers in Prolactinoma Patients: A Spectral Domain Optical Coherence Tomography Study

Evranos Berna , Faki Sevgul , Polat Sefika Burcak , Ugurlu Nagihan , Ersoy Reyhan , Cakir Bekir

Introduction: Prolactinoma is a type of pituitary tumor that produces excessive amount of the hormone prolactin. It is the most common type of hormonally-active pituitary tumor. These tumors can result in ocular complications such as vision loss and visual fields (VF) defect. In this study, we aimed to evaluate thicknesses of chorioretinal layers in patients with prolactinoma.Material and method: We enrolled 21 prolactinoma patients (13 females, 8 males ...

ea0056p843 | Pituitary - Clinical | ECE2018

Combined treatment of craniopharyngiomas

Kutin Maxim , Konovalov Aleksander , Kadashev Boris , Astafyeva Liudmila , Serova Nataliya , Kalinin Pavel , Fomichev Dmitriy , Mazerkina Nadezhda , Sidneva Yuliya , Trunin Yrii

Introduction: Craniopharyngiomas (CF)- benign epithelial tumors that develop from the remnants of Rathke’s pouch cells. Most often, CF manifest themselves in two age groups: in children 5–14 years old making 5.6–13% of intracranial tumors and in adults 50–74 years old making 2–5%.Materials and methods: In the last decade, the Institute annually for the surgical treatment received 100–120 patients with CF. The total number of...

ea0056p844 | Pituitary - Clinical | ECE2018

Vitamin D status in acromegaly: a comparative study

Mahjoubi Sana , Kandara Hajer , Mekni Sabrine , Laajili Olfa , Nagi Sonia , Amara Chayma Ben , Kamoun Ines , Salem Leila Ben

Background: The vitamin D is a pleiotropic hormone that plays a significant role on global health. However, vitamin D status in acromegaly has been poorly studied.The aim: The aim of this study was to assess the vitamin D status in acromegaly and compare it to a control group. Then to analyse bone remodeling and density markers based on the vitamin D levels.Methods: We conducted an evaluative cross sectional study in the Department...

ea0056p845 | Pituitary - Clinical | ECE2018

Hypernatraemia and mental disorders

Sidneva Yuliya , Astafyeva Liudmila , Kutin Maxim , Kalinin Pavel , Klochkova Irina

The problem of the influence of disturbances of Hyper- or Hyponatraemia is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. Electrolyte disbalance affected on the formation of mental disorders, their structure and dynamics in the literature has not been sufficiently studied. Perhaps there are certain factors and patterns of the influence of hypo- and hypernatraemia on mental activity with various lesions of the brain, which requi...

ea0056p846 | Pituitary - Clinical | ECE2018

The use of colonoscopic screening in acromegaly in our everyday practice revisited: how compliant with guidelines have we been?

Bilbao Ismene , Egana Nerea , Ciriza Maite Perez de , Olaizola Izaskun , Garcia Cristina , Agea Leire , Aranburu Maite , Yoldi Alfredo , Goena Miguel

Introduction: Although it has been suggested that there is a strong association between acromegaly and premalignant colonic lesions and colon cancer, it seems that in real – life practice the adherence to ACRO colonoscopy guidelines might be lower than expected (as recently shown by M.Parolin et cols).Methods: We retrospectively reviewed the case records of the 54 patients with acromegaly seen in our center since 1994.We analyzed the findings of 27 ...

ea0056p847 | Pituitary - Clinical | ECE2018

The Secret of the Ophtalmopathy

Simsir Ilgin Yildirim , Soyaltin Utku Erdem , Yurekli Banu Sarer , Yilmaz Mumtaz , Saygili Fusun

Although the first line therapy for prolactinoma is medical. Visual field defect due to pituitary mass would lead to surgery. Herein, we share the post-operative follow-up of a macroprolactinoma case.Case: A 57-year-old male patient was operated on for a giant pituitary adenoma, which was compressing the optic chiasm. The postop prolactin (PL) value was found to be higher than 200 ng/ml and cabergoline treatment was initiated. Two months after the operat...

ea0056p848 | Pituitary - Clinical | ECE2018

Tolvaptan usage in hyponatremic patients with syndrome of inappropriate secretion of antidiuretic hormone: a single-center experience

Akgur Suat , Oruc Aysegul , Yildiz Abdulmecit , Ersoy Canan , Gullulu Mustafa , Yavuz Mahmut , Dilek Kamil , Ersoy Alparslan

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder of impaired water excretion caused by inability to suppress secretion of antidiuretic hormone. The therapy of SIADH varies with severity of hyponatremia and presence or absence of symptoms. Non-peptide vasopressin receptor antagonists (vaptans) are effective at increasing sodium in euvolemic and hypervolemic states and appear safe. We aimed to evaluate the efficacy of tolvaptan in euvolemic h...

ea0056p849 | Pituitary - Clinical | ECE2018

Real-world data from NordiNet International Outcome Study (IOS) and ANSWER Program provide new insights into the safety of growth hormone in a large cohort of children with Noonan Syndrome

Dahlgren Jovanna , Pedersen Birgitte Tonnes , Roehrich Sebastian , Abuzzahab M. Jennifer

Objectives: Congenital heart disease, especially pulmonary stenosis, is a frequent comorbidity in patients with Noonan syndrome (NS). Patients with NS are also at increased risk of childhood leukaemia and solid tumours. Among solid tumours, brain tumours, including glioneuronal tumours, have been described in younger patients but remain rare. Current safety data do not indicate an association of growth hormone (GH) therapy with increased risk for development or progression of ...

ea0056p850 | Pituitary - Clinical | ECE2018

Hypophysitis: Experience of a single tertiary center

Kadioglu Pinar , Korkmaz Ozge Polat , Ozkaya Hande Mefkure , Haliloglu Ozlem , Sahin Serdar , Kantarci Fatma Eda Nuhoglu , Apaydin Tugce

Purpose: The authors review the clinical outcomes of patients with hypophysitis.Methods: Medical records of hypophysitis patients who were followed between 2007 and 2018 at Cerrahpasa Medical Faculty were evaluated retrospectively. Clinical, endocrinological, pathological and radiological findings and therapies were assessed.Results: Twenty patients (F/M:12/8) were identified with a mean age at diagnosis of 39.14±17.78 years. ...

ea0056p851 | Pituitary - Clinical | ECE2018

Pituitary adenomas in childhood and the transition period - clinical and genetic characterization of 49 patients at one tertiary care endocrine institution in Romania

Vladan Andreea , Radian Serban , Baciu Ionela , Gherlan Iuliana , Lefter Antonia , Galoiu Simona , Dumitrescu Cristina , Procopiuc Camelia , Badiu Corin , Poiana Catalina

Introduction: Pituitary adenomas (PAs) are rare in childhood and the transition period, can result from AIP/MEN1 mutations, are difficult to manage and severely impair quality-of-life.Aim: To describe the clinical and genetic characteristics of patients with PA onset before 21 years old.Patients and methods: Retrospective study (1980–2015). Clinical, imaging and hormonal data, AIP/MEN1 sequencing.<p class...

ea0056p852 | Pituitary - Clinical | ECE2018

Psychopathology in Cushing’s disease and acromegaly

Santos Alicia , Resmini Eugenia , Crespo Iris , Valassi Elena , Martinez Ma Antonia , Webb Susan M

Introduction: Cushing’s disease (CD) and acromegaly, despite their different specific symptoms, often present psychopathology (mainly depression and anxiety) even after hormonal normalization. However, their psychopathological profiles may be different. The aim of this study was to analyse the psychopathological profile in successfully treated Acromegaly and CD, and to compare both diseases. Current hormonal evaluation and time since endocrine control will also be analyse...

ea0056p853 | Pituitary - Clinical | ECE2018

Presence of empty sella in a patient with clinical and biochemical diagnosis of acromegaly

Bestepe Nagihan , Aydin Cevdet , Tam Abbas Ali , Ercan Karabekir , Ersoy Reyhan , Cakir Bekir

Introduction: Acromegaly is an acquired disorder related to excessive production of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). It is characterized by progressive somatic disfigurement and systemic manifestations. Empty sella (ES) is an anatomical condition comprising sella turcica that is partially or completely filled with cerebrospinal fluid mainly due to intrasellar herniation of subarachnoid space. Primary ES may be associated with endocrine dysfunction ...

ea0056p854 | Pituitary - Clinical | ECE2018

The metabolic disturbances in acromegaly patients in relation to total, acylated and unacylated ghrelin

Komarowska Hanna , Brominska Barbara , Sawicka-Gutaj Nadia , Jaskula-Switek Magdalena , Wasko Ryszard , Ruchala Marek , Kotwicka Malgorzata

Purpose: Acromegaly is a disease characterized by the excessive secretion of GH. Clinically, it is manifested by overgrowth of tissues and internal organs, which leads to characteristic phenotype. Patients with active acromegaly usually have impaired glucose metabolism. It significantly improves after achieving remission of the disease. Adversely, disturbances in lipid profile are not altering. Moreover, these parameters are even worse in successfully treated patients. Ghrelin...

ea0056p855 | Pituitary - Clinical | ECE2018

Hypopituitarism in primary empty sella

Tomsic Karin Zibar , Deskin Marin , Kraljevic Ivana , Dusek Tina , Solak Mirsala , Polovina Tanja Skoric , Balasko Annemarie , Kastelan Darko

Empty sella is characterized by the radiological appearance of an enlarged or deformed sella turcica which is completely or partially filled with cerebrospinal fluid resulting in a displacement of the normal pituitary gland. Primary empty sella (PES) refers to the empty sella appearance of unknown etiology, diagnosed after excluding a history of previous pituitary pathology. The prevalence of hypopituitarism in empty sella syndrome varies between 2 and 32% in different publish...

ea0056p856 | Pituitary - Clinical | ECE2018

A first-in-human pharmacokinetic, safety, and tolerability study of pasireotide subcutaneous depot

Tiberg Fredrik , Glantz Susanne , Strandgarden Kerstin , Darstein Christelle , Eisinger Johannes , Tauchmanova Libuse , Breitschaft Astrid

Background: Pasireotide is available in twice-daily subcutaneous (sc) and long-acting intramuscular (im) formulations. Pasireotide sc depot is an investigational extended-release sc formulation designed for improved handling and administration. Results are reported from a Phase I dose-escalating study.Methods: All subjects received a single dose of pasireotide sc (600 μg) and were randomized 12:2:2 to pasireotide sc depot as a single upper-thigh inj...

ea0056p857 | Pituitary - Clinical | ECE2018

HLA celiac haplotypes and Primary Autoimmune Hypophysitis in Caucasian patients

Chiloiro Sabrina , Capoluongo Ettore Domenico , Tartaglione Tommaso , Bianchi Antonio , Giampietro Antonella , Bima Chiara , Angelini Flavia , Arena Vincenzo , Pontecorvi Alfredo , De Marinis Laura

Purpose: Primary hypophysitis is a rare disease, with an autoimmune etiology. As few papers have investigated its genetic, our aim was to evaluate HLA status in a single-center series of patients.Patients and method: A retrospective, longitudinal and cross-sectional study was conducted. Consecutive Caucasian patients, with clinical or histological diagnosis of primary autoimmune hypophysitis (PAH), undergone determination of HLA genotype, anti-pituitary ...

ea0056p858 | Pituitary - Clinical | ECE2018

Consensus on the management of acromegaly in Spain

Bernabeu Ignacio , Camara Rosa , Marazuela Monica , Domingo Manel Puig

Objective: To find consensus on issues that may raise clinical doubts in the management of patients with acromegaly in Spain.Methods: Nominal group and Delphi methodology was followed. Four experts on acromegaly were selected, who defined important clinical questions in the management of acromegaly. A set recommendations were proposed to solve these questions. Subsequently, a group of 30 additional endocrinologits from all over Spain was selected accordi...

ea0056p859 | Pituitary - Clinical | ECE2018

PROMPT: a prospective study to assess efficacy and safety of metyrapone in endogenous Cushing’s syndrome

Nieman Lynnette , Akinci Baris , Beckers Albert , Bolanowski Marek , Hanzu Felicia Alexandra , Mezosi Emese , Tonjes Anke , Bostnavaron Martine , Jaspart Amelie , Borensztein Pascale , Boscaro Marco , Scaroni Carla

Introduction: Metyrapone blocks cortisol production by inhibiting 11ß-hydroxylation of 11-deoxycortisol, the last step of cortisol synthesis. Based on observational retrospective studies published over more than 50 years metyrapone is approved for the treatment of endogenous Cushing’s syndrome (CS) in 14 European countries. PROMPT is the first prospective study to document the safety and efficacy of metyrapone using modern assay techniques.Desi...

ea0056p860 | Pituitary - Clinical | ECE2018

Mind the gap between cortisol levels measured with second generation assays and current diagnostic thresholds for the diagnosis of adrenal insufficiency: a single center experience

Grassi Giorgia , Morelli Valentina , Polledri Elisa , Fustinoni Silvia , Chiodini Iacopo , Ceriotti Ferruccio , D'Agostino Simona , Mantovani Giovanna , Arosio Maura

Objective: The current cut-offs to diagnose adrenal insufficiency (AI) have been established using outdated immunoassays. More modern methods have demonstrated less cross-reactivity with other steroids. The aim of our study was to evaluate the correlation between the cortisol assay Roche Cortisol I (R1), the newly available Roche Cortisol II (R2) and liquid chromatography tandem mass spectrometry (LC-MS/MS), the gold standard procedure for the measurement of steroids.<p cl...

ea0056p861 | Pituitary - Clinical | ECE2018

An open-label, multicentre, single-arm, expanded-access study of subcutaneous (s.c.) pasireotide in patients with Cushing’s disease (CD)

Fleseriu Maria , Iweha Chioma , Salgado Luiz , Mazzuco Tania Longo , Patino Heather , Campigotto Federico , Maamari Ricardo , Limumpornpetch Padiporn

Introduction: Pasireotide sc has a proven favourable efficacy and safety profile in CD patients, as shown in clinical trials. Here, we report safety and efficacy results from an expanded-access study designed to allow CD patients to receive pasireotide until regulatory approval for commercial use and reimbursement was obtained in their country.Methods: Pasireotide-naïve adults with CD (mean 24-hour urinary free cortisol [mUFC; of three samples] exce...

ea0056p862 | Pituitary - Clinical | ECE2018

Growth hormone secretion in children treated for medulloblastoma

Kalinin Alexey , Strebkova Natalia , Zheludkova Olga , Kareva Maria

Medulloblastoma is the most common malignant brain tumor in childhood. Treatment of medulloblastoma includes surgery, radiation therapy and chemotherapy. Craniospinal radiation can cause adverse effects on the endocrine system, specifically on the hypothalamic-pituitary axis. Increasing survival rates of pediatric patients with brain tumors lead to increased concern regarding long-term quality of life, including the detection and correction of endocrine disorders. One of the m...

ea0056p863 | Pituitary - Clinical | ECE2018

Interim results of a non-interventional, observational study evaluating the long-term safety and efficacy of pasireotide sc in Cushing’s disease

Giordano Carla , Schopohl Jochen , Yuen Kevin C J , Kriemler-Krahn Ulrike , Li Jiang , Maamari Ricardo , Manetti Luca

Introduction: Subcutaneous (sc) pasireotide effectively reduces cortisol levels, improves signs/symptoms and is generally well tolerated in Cushing’s disease (CD) patients, as shown in previous clinical trials. We report interim results from a multicentre, real-world observational study evaluating the long-term safety and efficacy of pasireotide sc in clinical practice in CD patients.Methods: Adults with CD, for whom surgery has failed or is not an ...

ea0056p864 | Pituitary - Clinical | ECE2018

An immunohistochemical study on pituitary adenomas

Burcea Iulia Florentina , Capatina Cristina , Poiana Catalina

Introduction: Pituitary adenomas (PA) represent approximately 15% of all intracranial neoplasms, with a global incidence of 15,20 per million per year. The immunohistochemical analysis of PA is necessary for diagnosis and plays an important role in the modern classification system of pituitary tumors.Material and methods: Samples from 142 surgically resected PA were studied immunohistochemically using antisera for 6 anterior pituitary hormones. Reticulin...

ea0056p865 | Pituitary - Clinical | ECE2018

Inferior petrosal or cavernous sinus sampling in ACTH-dependent Cushing’s syndrome: a single center experience

Ruch Mirka Andree , Valavanis Antonios , Schmid Christoph , Tschopp Oliver

Objective: Most patients with ACTH-dependent Cushing’s syndrome have Cushing’s disease, i.e. a pituitary corticotroph adenoma, but the presence of another tumor secreting ACTH (although the prevalence of ectopic ACTH syndrome is lower) needs to be considered in the differential diagnosis. Distinguishing between these two etiologies can be difficult despite biochemical and radiological examinations. Previous research showed that inferior petrosal/cavernous sinus sampl...

ea0056p866 | Pituitary - Clinical | ECE2018

Relationship between pituitary adenoma size and transsphenoidal pituitary adenoma surgery outcomes: single-centre experience

Ramanciuckaite Martyna , Knispelis Robertas , Zalinkevicius Rimantas , Zilaitiene Birute , Verkauskiene Rasa

Introduction: Stereotactic radiotherapy and more relevant pharmacotherapy are widely used for PA’s treatment; however transsphenoidal surgery remains gold standard. Postoperative complications and endocrinological outcomes vary widely and are related with surgeon experience and tumor characteristics.The aim of this study: To determine relationship between pituitary adenoma size and transsphenoidal pituitary adenoma surgery outcomes.<p class="abs...

ea0056p867 | Pituitary - Clinical | ECE2018

Clinical and mri findings among 120 patients with macroproprolactinemia: results from a retrospective study

Vilar Lucio , Vilar Clarice , Albuquerque Luciano , The Ana Carolina , Trovao Erik , Gadelha Patricia , Lyra Ruy

Background: Macroprolactinemia is a condition where more of 60% of circulating PRL is made up of macroprolactin. It may be observed in both sexes (although women represent about 90% of published cases), and at all ages. As macroprolactin has low biological active and low bioavailibility, most patients are asymptomatic. The Endocrine Society guidelines recommend screening for macroprolactin only in asymptomatic hyperprolactinemic patients. However, some data from the literature...

ea0056p868 | Pituitary - Clinical | ECE2018

Hypothalamic-pituitary axis assessment in a clozapine treated patient with a pituitary adenoma

Adamidou Fotini , Komzia Paraskevi , Kalograni Fani , Anagnostis Panagiotis , Kita Marina

Background: Assessment of hypothalamic–pituitary adrenal axis in patients with schizophrenia is complex, as it involves both the disease process and antipsychotic medications. We present a case of a patient on long term clozapine with a concomitant pituitary adenoma who presented discordant responses to adrenal stimulation.Case: A 38-year old male was referred with chronic symptoms of reduced libido and associated low testosterone levels. He was tre...

ea0056p869 | Pituitary - Clinical | ECE2018

Comorbidities and symptoms among patients with acromegaly in italy: a longitudinal retrospective chart review study

Colao Annamaria , Grasso Ludovica , Cera Marialuisa Di , Cheng Wendy Y , Thompson-Leduc Philippe , Cheung Hoi Ching , Duh Mei Sheng , Neary Maureen P , Pedroncelli Alberto M , Maamari Ricardo , Pivonello Rosario

Acromegaly is a disorder characterized by overproduction of growth hormones (GH), which causes tissue growth in the body and comorbidities and symptoms. While prior studies examined comorbidities commonly associated with acromegaly, few have long follow-up periods necessary to characterize the long-term comorbidity profile of patients with acromegaly. There is limited literature on real-world treatment patterns of patients with acromegaly. This study describes the long-term pr...

ea0056p870 | Pituitary - Clinical | ECE2018

Safety and efficacy of long-acting Pasireotide monotherapy in acromegalic patients treated with a combination of first-generation somatostatin analogs and cabergoline or pegvisomant

Lasolle Helene , Ferriere Amandine , Nunes Marie-Laure , Haissaguerre Magalie , Tabarin Antoine

Introduction: Combination therapy using pegvisomant and cabergoline with first-generation long-acting somatostatin analogs (1GSSA) is a common procedure in acromegalic patients that are not fully controlled by surgery and 1GSSA. Pasireotide-LAR is a new multireceptor-targeted somatostatin receptor ligand that has superior efficacy over octreotide LAR to control GH and IGF1 levels. Little data is available about the efficacy and safety of pasireotide monotherapy in patients tre...

ea0056p871 | Pituitary - Clinical | ECE2018

Association between biochemical control and comorbidities and symptoms among patients with acromegaly in Italy: a longitudinal retrospective chart review study

Colao Annamaria , Grasso Ludovica , Cera Marialuisa Di , Cheng Wendy Y , Thompson-Leduc Philippe , Cheung Hoi Ching , Duh Mei Sheng , Neary Maureen P , Pedroncelli Alberto M , Maamari Ricardo , Pivonello Rosario

Acromegaly is a rare disorder characterized by the overproduction of growth hormone (GH) and elevated insulin-like growth factor-1 (IGF1). While some studies have investigated the potential associations between biochemical control (i.e., normalization of IGF-1 and/or GH) and comorbidities/symptoms, few studies have long-term follow-up. This study assessed the association between biochemical control and selected comorbidities/symptoms in patients with acromegaly using real worl...

ea0056p872 | Pituitary - Clinical | ECE2018

Trends of insulin-like growth factor 1, growth hormone, and biochemical control of patients with acromegaly in italy: a longitudinal retrospective chart review study

Colao Annamaria , Grasso Ludovica , Di Cera Marialuisa , Cheng Wendy Y , Thompson-Leduc Philippe , Ching Cheung Hoi , Sheng Duh Mei , Neary Maureen P , Pedroncelli Alberto M , Maamari Ricardo , Pivonello Rosario

Long-term biochemical control (i.e., normalization of growth hormone [GH] and insulin-like growth factor-1 [IGF1]) is the goal of treatment of acromegaly. Few studies have characterized the sustainability of GH/IGF1 levels in acromegaly patients. This study aimed to identify long-term time trends of GH, IGF1 levels, and biochemical control in patients with acromegaly using longitudinal real world data. Medical records of adult patients with a confirmed acromegaly diagnosis, &#...

ea0056p873 | Pituitary - Clinical | ECE2018

Pituitary intensity at magnetic resonance imaging is reduced in obese patients: results from the CHIASM study

Puliani Giulia , Sbardella Emilia , Cozzolino Alessia , Pozza Carlotta , Feola Tiziana , Gianfrilli Daniele , Lubrano Carla , Fiorelli Marco , Lenzi Andrea , Isidori Andrea M

Introduction: Even if obesity has been associated to several hormonal imbalances, pituitary appearance at Magnetic Resonance Imaging (MRI) in obese patients is understudied.Aim: To measure pituitary signal intensity and homogeneity at MRI in obese subjects free of focal pituitary disease, in the context of the CHIasM study (Changes in the Hypotalamic-pItuitary region of patients with Metabolic syndrome and obesity).Materials and me...

ea0056p874 | Pituitary - Clinical | ECE2018

The influence of levothyroxine (T4) treatment on metabolic parameters in central hypothyroidism (CH)

Medic-Stojanoska Milica , Vukovic Bojan , Bajkin Ivana , Prodanovic Jovana , Milosevic Natasa , Stojanoski Stefan , Novakovic-Paro Jovanka , Curic Nikola

Introduction: L thyroxin treatment of CH is monitored by free T4 (fT4) which should be above mid normal range for the assay. It is not clear whether these doses are adequate for regulating the metabolic disturbances accompanying CH.Aim: To determine whether T4 therapy leads to improvement of metabolic parameters in CH.Materials and methods: This was a retrospective study. Study group comprised of 60 hypopituitary patients with CH, ...

ea0056p875 | Pituitary - Clinical | ECE2018

Efficacy of pasireotide lar in first line somatostatin analogue resistant acromegaly patients: experience from a large and single centre Italian cohort

Chiloiro Sabrina , Giampietro Antonella , Bianchi Antonio , Tartaglione Tommaso , Bima Chiara , Piacentini Serena , Mirra Federica , Donfrancesco Federico , Lauretti Liverana , Anile Carmelo , Pontecorvi Alfredo , De Marinis Laura

Introduction: Pasireotide Lar is a new generation long-acting somatostatin multireceptor ligand, approved for the treatment of first line somatostatin analogue resistant patients. We aimed to review Pasireotide Lar efficacy data, in our series of patients affected by aggressive acromegaly.Patients: A retrospective longitudinal study was conducted on patients with aggressive acromegaly, resistant to first-line somatostatin analogues (SSA) and on treatment...

ea0056p876 | Pituitary - Clinical | ECE2018

The change in metabolic parametres of prolactinoma patients after therapy intervention

Dagdelen Duran Iffet , Ersoz Gulcelik Nese , Berker Dilek

Introduction: Prolactinoma is the prolactin secreting tumor of the pituitary gland which exerts mainly hypogonadal complaints and sometimes symptoms due to mass effect. Meanwhile it was mentioned to cause metabolic abnormalities such as increased fasting plasma glucose (FPG), Low Density Lipoprotein(LDL) cholesterol and triglycerides(TG). We studied whether some of these metabolic parametres of prolactinoma patients could be changed after the therapy.Met...

ea0056p877 | Pituitary - Clinical | ECE2018

“Silent” ACTH-secreting pituitary carcinoma: case report

Astafyeva Ludmila , Kalinin Pavel , Mikhailov Nikita , Trunin Yuriy , Kobyakov Grigiriy

Introduction: Pituitary carcinomas are extremely rare neoplasms and molecular events leading to malignant pituitary transformation are largely unknown.Case report: 36-year-old man turned to the clinic for visual and oculomotor disorders. A large endo-supra-latero(S)sellar tumor was found on MRI. There was also an increase in the level of ACTH in the blood (60,80 pmol/l (normal values 5–49)). The level of free cortisol in 24-hour urine was normal. En...

ea0056p878 | Pituitary - Clinical | ECE2018

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ea0056p879 | Pituitary - Clinical | ECE2018

Radiotherapy for pituitary adenomas – safety and efficacy analysis

Paredes Silvia , Ramos Rui , Almeida Rui , Marques Olinda

Introduction: Radiotherapy (RT) has been proven to be effective in controlling hormone production and tumor growth in pituitary adenomas (PA). Still, RT adverse effects had turned it an unattractive choice of treatment. The aim of this study was to evaluate the efficacy and safety of RT for patients with PA.Methods: We conducted a retrospective study of patients treated in our center, a central hospital, since 1998. Thirty-three patients were included, 6...

ea0056p880 | Pituitary - Clinical | ECE2018

Usefulness of stereotactic radiotherapy in acromegalic patient resistant to conventional treatment

Brominska Barbara , Komarowska Hanna , Ruchala Marek

Introduction: Acromegaly is a rare, chronic disease characterized by increased secretion of growth hormone, most commonly by autonomous adenoma of the anterior pituitary. Mortality is 2–3 times higher than in general population. So that, it is vital to achieve biochemical cure. We present a case in which patient was successfully treated with stereotactic radiotherapy (SRT)- CyberKnife and preserved pituitary function.Case report: A 39-years old men ...

ea0056p881 | Pituitary - Clinical | ECE2018

Subclinical left ventricular dysfunction in patients with naive acromegaly assessed by two-dimensional speckle tracking echocardiography (2D-STE)

Popielarz-Grygalewicz Agata , Ste Maria , Gesior Jakub , Konwicka Aleksandra , Grygalewicz Pawel , Zgliczynski Wojciech , Debrowski Marek

Introduction: Cardiac disease called acromegalic cardiomyopathy may be present in patients with acromegaly at diagnosis, however most echocardiographic studies showed that systolic function in these patients is normal. Speckle tracking echocardiography (STE) is a novel method that allows for the study of global longitudinal strain (GLS), a marker of early and subclinical left ventricular (LV) systolic dysfunction.Objective: To evaluate left ventricular G...

ea0056p882 | Pituitary - Clinical | ECE2018

Efficacy and tolerability of cabergoline in a cohort of 160 prolactinomas at weekly doses of up to 9 mg

Vilar Lucio , Vilar Clarice , Albuquerque Luciano , The Ana Carolina , Trovao Erik , Gadelha Patricia , Sampaio Icaro , Gomes Barbara , Ferreira Liana , Aroucha Priscila , Lyra Raissa , Fonseca Maira , Lyra Ruy

Background: Dopamine agonists are the mainstay of treatment for prolactinomas. Cabergoline (CAB) is preferable to bromocriptine due to its greater efficacy and better tolerability.Subjects and methods: The aim of this retrospective open trial was to evaluate the efficacy and tolerability of CAB in a cohort of 160 patients with prolactinomas routinely followed in Pernambuco Endocrine Research Center and Division of Endocrinology, Hospital das Clinicas, Fe...

ea0056p883 | Pituitary - Clinical | ECE2018

Pituitary apoplexy: 15 years of experience

Marques Bernardo , Oliveira Diana , Ventura Mara , Lages Adriana , Cunha Nelson , Catarino Diana , Fadiga Lucia , Bastos Margarida , Paiva Sandra , Paiva Isabel , Gomes Leonor , Carrilho Francisco

Introduction: Pituitary apoplexy (PA) is an endocrine emergency and usually presents with sudden headache and visual fields changes. Pituitary function assessment should be performed promptly and repeated throughout follow-up, regardless of the choice of treatment.Methods/design: Retrospective analysis of patients diagnosed with PA admitted to an Endocrinoloy Department of a tertiary hospital between 2002 and 2017. Review of patients’ medical record...

ea0056p884 | Pituitary - Clinical | ECE2018

Clinical and treatment outcomes in patients with craniopharyngiomas – single center experience

Polovina Tanja Skoric , Solak Mirsala , Kraljevic Ivana , Dusek Tina , Spanovic Nemanja , Balasko Anne-Marie , Kastelan Darko

Craniopharyngiomas are rare and histologically benign tumors that are associated with an unfavourable prognosis and controversial optimal treatment. The aim of this retrospective study was to review clinical presentation, natural history and therapeutic outcomes of patients with craniopharyngiomas treated in a single center between 1995 and 2017. In that period, 38 patients (16 children and 22 adults) were diagnosed with craniopharyngioma. Median age at the time of diagnosis i...

ea0056p885 | Pituitary - Clinical | ECE2018

Very high prolactin levels associated to domperidone therapy

Vilar Lucio , Vilar Clarice

Introduction: Prolactin (PRL) levels > 250 ng/ml are highly suggestive of prolactinomas though they may be also seen in other conditions, particularly macroprolactinemia, GH and PRL cosecreting tumors, and renal failure. Drug-induced hyperprolactinemia is typically associated with mild PRL elevation (usually <100 ng/ml). Higher levels (around 300 ng/ml) have been occasionally reported, particularly with risperidone, an atypical antipsychotic drug.<p class="abstext"...

ea0056p886 | Pituitary - Clinical | ECE2018

Acromegaly: surgical results and predictors for remission

Amado Ana , Figueiredo Goncalo , Ribeiro Isabel , Amaral Claudia , Borges Fatima , Cardoso Helena

Introduction: Acromegaly is a rare disease with significant morbidity and mortality. Surgical treatment is the first line treatment for these patients, with remission rates of >85% for microadenomas and 40–50% for macroadenomas.Objectives: Our objective was to characterize patients with acromegaly followed in our department and evaluate remission status after surgery. We also aimed to determine remission related factors.Me...

ea0056p887 | Pituitary - Clinical | ECE2018

Investigation and initial management of hyponatraemia

Kostoula Melina , Bravis Vassiliki , Ramli Rozana , Nogueira Edson , Dua Radhika , Daunt Anna

Hyponatraemia is the commonest electrolyte disturbance in clinical practice and accounts for 15–20% of emergency admissions to hospital. It is thought that up to 30% of hospitalized patients develop a degree of hyponatraemia at some point during their admission. It is therefore an important problem. Management of inpatients with hyponatraemia remains problematic and an audit of our practice at St Mary’s Hospital, Imperial College Healthcare NHS Trust, has confirmed t...

ea0056p888 | Pituitary - Clinical | ECE2018

Lanreotide autogel may be an effective approach for acromegalic patients who failed octreotide lar

Vilar Lucio , Vilar Clarice , Albuquerque Luciano , Trovao Erik , The Ana Carolina , Sampaio Icaro , Ferreira Liana , Cardoso Izabela , Borges Thaise , Aroucha Priscila , Gadelha Patricia , Lyra Ruy

Background: Growth hormone secreting pituitary gland adenomas specifically express somatostatin (SST)-2 and SST5 receptors. First-generation somatostatin analogs (octreotide and lanreotide) are the mainstay in the medical treatment of acromegaly, however the percentage of patients controlled with these drugs significantly varies in the different studies (20–70%). Many factors are involved in the resistance to SRL somatostatin analogs such as sst, AIP, E-cadherin, ZAC1, fi...