Endocrine Abstracts

Living with type 1 diabetes (T1D) is challenging and requires intensive glucose monitoring and titration of insulin in order to obtain near-normal glucose levels to reduce the risk of complications. However, changes in dietary intake and level of activity can cause large glucose excursions. Continuous glucose monitoring systems, either intermittently scanned either real-time, can provide a comprehensive picture of glucose profiles, allowing patients to make therapeutic adjustm...

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Objectives: Thyroid ultrasound (US) is a key examination for the management of thyroid nodules. Thyroid US is easily accessible, noninvasive, cost-effective and is a mandatory step in the workup of thyroid nodules. Thyroid US assessment of the risk of malignancy is crucial in patients with nodules, in order to select those who should have a fine needle aspiration (FNA) biopsy performed. Specific US features suggestive of malignancy have been recognized and described in literat...

Primary hyperparathyroidism (PHPT) is a common endocrine disorder that is characterized by hypercalcaemia and elevated or inappropriately normal levels of parathyroid hormone (PTH), which is excessively secreted from one or more parathyroid glands. Classical disease is nowadays only seldom seen due to widespread biochemical screening. Most patients are asymptomatic and have more subtle, but clinically important skeletal and renal involvement. A normocalcaemic variant of the di...

Tumours of the pituitary gland and sellar region represent approximately 15% of all brain tumours. The most common tumours are by far pituitary adenomas, confined to the sella. However, several types of tumours may involve the sellar region, reflecting its complex anatomy. The differential diagnosis of nonpituitary sellar masses is broad and includes inflammatory and infectious diseases, cell rest tumours, germ cell tumours, lipomas, gliomas, meningiomas, metastatic tumours, a...

Treatment with growth hormone (GH) during childhood and adolescence allows a considerable gain in adult height. SHOX deficiency explains some of the phenotypic characteristics in TS, principally short stature. Puberty has to be induced in most cases, and female sex hormone replacement therapy should continue during adult years. These issues are normally dealt with by the paediatrician, but once a TS female enters adulthood it is less clear who should be the primary care giver....

Klinefelter syndrome (47,XXY; KS) is still a diagnostic challenge. Many patients are misdiagnosed, or remain undiagnosed, and thereby prevention and treatment of associated comorbidities is often delayed. The presence of the additional X chromosome is associated with a number of health problems involving multiple organs and consequently are both morbidity and mortality significantly increased. The increased morbidity seen in KS is due to an increased risk of developing physica...

Nonclassical Congenital Adrenal Hyperplasia (NCAH) usually due to 21 Hydroxylase deficiency (21OHD) is an autosomal recessive disease, occurring in upto 1/200 of Caucasians and more often in certain ethnic groups. Common CYP21A2 mutations from most severe to mildest are; null, I2 splice, I172N, P30L, and V281L. Mutations leaving 20–70% of enzyme activity is responsible for NCAH, mostly caused by V281L mutation. About 25–50% of patients are homozygous or compound hete...

In recent years a number of paradigms have changed the way we go about therapy and its monitoring. So, what has changed? Bisphosphonates were until recently the cornerstone of osteoporosis treatment, but in the last few years new drugs and treatment concepts have appeared. Thus, anabolics such as teriparatide are established as the gold standard in patients with high risk of vertebral fractures. In addition, monoclonal antibodies against bone turnover regulators such as denosu...

Among the different functions of bone, the biomechanical one is the most evident. Biomechanical function of bone allows locomotion and protection of essential organs like brain and in a way can be considered as a survival function. Optimal bone strength maintenance through bone remodeling is an active energy consuming process. When a fracture occurs, two sides of the phenomenon should be evaluated: the trauma and the bone resistance including bone mass and bone quality. Bone r...

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Introduction: Due to improved pediatric care, life expectancy of children with complex genetic syndromes (CGS) is increasing. Many children with CGS now do reach adult age and have to make the transition to adult endocrine healthcare. However, many adult endocrinologists are not yet prepared for the increasing number of adults with CGS. Although patients receive multidisciplinary (MD) care at the pediatric department, MD care is not yet available for most adults with CGS. Also...

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Type 2 diabetes causes excess cardiovascular mortality and microvascular disease. Therefore, the results of the EMPA-REG OUTCOME trial were received with great excitement, since this was the first trial with cardiovascular end points to show a benefit for persons suffering from type 2 diabetes. The striking benefit of a 38% reduction in cardiovascular mortality during SGLT2 inhibitor treatment was surprising and exceeded what was expected based on the relatively modest reducti...