Endocrine Abstracts

Background: Differential diagnosis of ACTH-dependent hypercortisolism is crucial to indicate a proper treatment and is based on CRH-, high-dose dexamethasone suppression-test (HDDST) and pituitary MRI. However, up to 50% of cases of Cushing’s disease (CD) present a negative MRI or a visible lesion < 6 mm. In these patients, guidelines suggest to perform bilateral inferior petrosal sinus sampling (BIPSS) in order to establish a correct diagnosis. Aim of this study was ...

Background: Cushing’s syndrome (CS) has numerous comorbidities, including diabetes mellitus (DM). Levoketoconazole is a ketoconazole stereoisomer in clinical trials for treatment of CS.Methods: SONICS is a prospective, open-label, phase 3 maintenance-of-benefit study in adults with confirmed CS and mean urinary free cortisol (mUFC) of ≥1.5x upper limit of normal (ULN). Repeated hospitalization due to hyperglycemia or any complication related t...

Introduction: The silencing mechanisms of corticotroph tumors (CT) remain unclear. The most feasible hypothesis lies in a post-transcriptional deregulation of the POMC gene, precursor of ACTH. Micro RNAs (miRNAs) are small non-coding RNA molecules involved in the epigenetic regulation of gene expression through their inhibitory action on messenger RNA. miRNAs capable of inhibiting the expression of POMC have been described at the level of neurons of the hypot...

Introduction: Salivary cortisol measurement is a non-invasive and easy test to carry out. It is painless and does not cause stress.Aim: The aim of the present study was to evaluate the correlation between salivary cortisol (SaC) and serum cortisol (SeC) after 1 mg Dexamethasone (DXM) overnight and their diagnostic utility as screening test of Cushing’s syndrome (CS).Methods: We performed a prospective study in 92 patients with...

Introduction: Both cortisol and vasopressin are stress hormones. Earlier, our group demonstrated that serum concentrations of free cortisol at admissions to the Intensive Care Unit (ICU) were independent predictors of survival in critically ill patients. Other investigators have demonstrated that serum copeptin, a surrogate marker of vasopressin may also be a predictive factor in this patient population. The aim of our present study was to compare the prognostic roles of serum...

Cushing’s disease (CD) results in chronic exposure to increased levels of cortisol leading to alterations in white matter microarchitecture and adverse effects on cognitive functioning. Diffusion tensor imaging (DTI) is a novel technique used to evaluate the integrity of white matter (WM) architecture. There is little information on DTI changes in CD. We studied WM changes in CD using diffusion tensor imaging and compared with healthy controls. 16 patients with active CD ...

Pituitary neuroendocrine tumors (PitNETs) constitute approximately 15% of all intracranial tumors and comprise a varied type of neoplasms that, despite being rarely metastatic, can cause severe comorbidities and increased mortality related to the mass effects and hormonal hypersecretion. The high expression levels of somatostatin and dopamine receptors in these tumors has led to the use of somatostatin analogues (SSAs) and dopamine agonists (DAs) as pharmacological treatments....

Introduction: Dopamine agonists (DA), reference treatment for microprolactinomas, rarely allow long term remission. The performance of endoscopic pituitary surgery should be examined as first-line treatment.Objective: To evaluate the remission rate of microprolactinoma operated by endoscopic transphenoidal approachMethods: We retrospectively studied the surgical results of the 35 microprolactinomas operated between 2010 to 2017 in ...

Background: Prolactinomas are the most frequent secreting pituitary adenomas encountered in the clinical setting. Cabergoline is considered the mainstay medical treatment and transsphenoidal surgery (TSS) is recommended for patients that are medically resistant to dopamine agonist therapy. Resistance to dopamine agonists is commonly defined as failure to normalize prolactin and less than 50% decrease in tumor diameter at a maximal labeled dose of 2.0 mg/week. Pasireotide LAR (...

Introduction: Vicinity and adherence of hypothalamic nuclei to craniopharyngioma explain the high rate of complications and difficulties of removal of these tumors.Subjects and methods: In this retrospective study 50 patients (10 adults and 40 children or adolescents) harboring craniopharyngioma were included. These patients were operated mainly by a frontal approach. We evaluated the frequency of sleep disorders secondary to hypothalamic damage and thei...

Introduction: Prader-Willi Syndrome (PWS) is a complex syndrome including hyperphagia, pituitary hormone deficiencies, low muscle mass and cognitive impairment. Treatment with recombinant Growth Hormone (GH) has beneficial effects on body composition, physical performance, cognition, psychomotor development, respiratory function, and quality of life of patients with PWS. GH treatment has a narrow therapeutic range. Clinicians measure serum immunoreactive Insulin-like Growth Fa...