Endocrine Abstracts

Introduction: Acromegaly is a rare and misdiagnosed disease characterized by somatotropic hypersecretion. The purpose of this study is to describe the epidemiological, clinical, para-clinical, therapeutic features of Acromegaly disease.Patients and methods: This is a retrospective study including 10 patients with acromegaly in the Endocrinology Diabetology Department of Oujda’s Mohammed VI University Hospital, Morocco.Results:...

Introduction: In our country, Sheehan syndrome is one of the most common causes of pituitary insufficiency in female patients.Case: A 54-year-old female patient developed cardiac arrest after an elective hip replacement surgery, and after 5 minutes of cardio pulmonary resuscitation, the rhythm returned to normal and the patient was intubated. Since she was hypotensive, she was given the infusion of noradrenaline after dopamine infusion, but despite this ...

Introduction: Prediction of HPA (hypothalamus-pituitary-adrenal) activity after trans-sphenoidal pituitary surgery (NS) is essential for post-operative management. There is not unique behavior in this setting: most of specialists suggests 4-6 weeks of glucocorticoid supplementation and treatment interruption after demonstration of normal endogenous response. Some authors suggest early cortisol detection for the identification of patients requiring glucocorticoid therapy. Aim o...

Purpose: Transsphenoidal endoscopic surgery (TSS) is the first-line treatment for Cushing’s disease (CD). However, persistence 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) and pituitary magnetic resonance imaging (MRI) in the prognosis of CD remission after TSS.Ma...

Introduction: Although meningiomas often occurs in parasellar regions such as the tuberculum sellae, olfactory groove, and sphenoid wing, pure intrasellar meningiomas are extremely rare. Patients usually present with gradual visual deterioration secondary to compression of the optic apparatus. Obtaining a correct preoperative diagnosis will likely require a thorough clinical assessment including neuroimaging and endocrine studies.Case report: A 56 year-o...

Introduction: Erectile dysfunction (ED) is quite common. It poses a problem of diagnosis and management given the multiplicity of contributing factors and etiologies that can sometimes be unrecognized.Observations: We report 3 observations of patients followed for insulin-requiring diabetes. The average age was 51. They had ED for 3.5 years on overage. The clinical examination of our patients showed obesity or weight excess. The impact assessment of diab...

Background: Subclinical Cushing disease is defined by mild hypercortisolism that results from a corticotroph pituitary adenoma, without any typical sign of the disease. The patients often have coexisting metabolic diseases such as diabetes mellitus, and hypertension. Conversely, silent corticotroph adenomas demonstrate normal cortisol secretion, but positive immunochemistry for ACTH, most usually without ACTH hypersecretion, although they and can progress to clinical Cushing d...

Background: Empty sella (ES) is often an incidental imaging finding, associated or not with the following symptoms: headache, hypopituitarism or visual impairment. Two etiological forms are described: primary ES due to a combination of increased spinal fluid pressure and a defect in the sella diaphragm and secondary ES due to the shrinkage of the pituitary gland (after pituitary surgery, radiation, apoplexy, hypophysitis or neurosarcoidosis).Clinical cas...

Introduction: Acromegaly is an underdiagnosed condition that is responsible for multiple complications. The purpose of this work is to examine the prevalence of these complications at time of diagnosis.Patients and methods: This retrospective study included 10 patients diagnosed with acromegaly followed in the endocrinology – diabetology department of Mohamed VI university hospital.Results: Mean age at diagnosis was 49 years w...

Introduction: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominantly inherited endocrine tumor syndrome characterized by development of cancer in various endocrine organs, particularly in pituitary, parathyroid and pancreas. Moreover, in some cases, also non-endocrine tumors can be diagnosed, developing atypical phenotypes.Case report: We report herein the clinical history of a patient affected by MEN-1 syndrome who developed atypical feat...

Objective: Maxillofacial manifestations of acromegaly are well described (prognathism, inter-dental space enlargement, occlusion disorder, macroglossia, prominent cheekbones…) [1] but the dental and periodondal impact of this disease has been poorly investigated. The scientific literature on this topic is scarce, with controversies about gingival and cement enlargement. Our goal is to describe the oro-dental state of these patients as precisely as possible and to study t...

Introduction: GH deficiency (GHD) is a rare etiology of short stature. The lack of early diagnosis and adequate treatment have adverse consequences, especially the small final height with the resulting psychological impact. The aim of this study is to identify some of the predictive factors influencing stature gain during the first year of GH therapy.Materials and methods: This is a retrospective longitudinal study of 14 cases of complete GHD collected i...

Background: Endothelial dysfunction is considered an early step in the development of atherosclerosis, while an increased intima-media thickness (IMT) represents one of the earliest morphological changes in the arterial wall in the process of atherogenesis. Only a few studies have investigated endothelial dysfunction and IMT in GHD children and results are still inconsistent.Objective: Aim of our study was to evaluate the effects of GHD and GH treatment ...

Introduction: Measurement of copeptin is proposed for use in the differential diagnosis of polyuric syndrome.Aims: To evaluate the diagnostic value of copeptin levels in patients with polyuria syndrome.Materials and methods: The study included 17 patients with central diabetes insipidus (CDI), 3 patients with nephrogenic diabetes insipidus (NDI), 7 patients with primary polydipsia (PP) and 26 control subjects. In all individuals bl...

Introduction: Central diabetes insipidus is a rare disorder, characterized by a failure of the posterior pituitary to produce vasopressin that lead to hypotonic polyuria and polydipsia. Diabetes insipidus may be due to post-pituitary surgery, where sometimes the posterior lobe also has to be removed or damaged; other injury as fractures of the skull, trauma, infiltrative lesions, tumors/metastases, idiopathic or rare genetic causes. As the sensation of thirst is the key homeos...

Introduction: Effective acromegaly treatment in the era of somatostatin analog therapy may initially seem easy to apply. Several factors, modifiable or not, may be involved in every patient’s treatment. The aim of this study was to evaluate possible factors affecting effective acromegaly treatment.Methods: From the original pool of 25 patients, that were diagnosed with acromegaly in our department during the last 15 years, 18 are currently being fol...

Cushing’s is a challenging disease to diagnose. The diagnosis is often delayed because Cushing’s is frequently masked by its overlap with more common medical problems such as diabetes, high blood pressure, obesity and polycystic ovary syndrome. Cushing’s may be more common than previously thought. The patient is a 15-year-old girl who developed symptoms of hyperandrogenia about 3 years prior to her visit to the Endocrine medical research Center, Uzbekistan. The ...

Introduction: Pituitary adenoma has been exceptionally reported in Down’s syndrome (DS). We report the case of a 23 year-old patient diagnosed with Down’s syndrome, who was admitted to the Endocrinology Department for a macroprolactinoma.Case report: A 23 year-old woman, diagnosed with DS, presented with acute headaches and diplopia. She had no history of trauma, and physical examination showed signs of damaged third and sixth cranial nerves, a...

Introduction: Perioperative assessment of surgical outcome in acromegaly patients is essential due to significant persistence rate even after total adenomectomy. Grade of adenoma invasiveness and basal growth hormone (GH) level in early postoperative period have been considered as important factors.Aim: The aim of our study was to evaluate the correlation between the outcomes of surgery in patients with acromegaly and the grade of adenoma invasion assess...

Introduction: While iatrogenic Cushing’s syndrome is common, acquired isolated ACTH deficiency is a rare condition. Hypophysitis is the most common cause, and while most recently published cases are associated with immunotherapy, it may also be idiopathic. Hereby we present a case of cortical adrenal atrophy secondary to idiopathic acquired ACTH deficiency, in order to raise awareness about this condition.Material and Methods: Review of the patient&...

Cushing disease is a rare endocrine disorder characterised by excess production of adrenocorticotropic hormone (ACTH) from a pituitary adenoma causing an excessive stimulation of the adrenal glands resulting in hypercortisolism. Most common clinical presentation includes a combination of signs like central obesity, facial plethora,ecchymosis, purple skin striae, hirsutism, acne, muscle weakness and atrophy. Hypertension, glucose intolerance and diabetes, hypokalaemia and osteo...

Introduction: The ectopic posterior pituitary is a rare condition which is characterized by the ectopic location of posterior lobe of pituitary, pituitary stalk abnormalities, and associated clinical manifestations of anterior lobe related growth hormone dysfunction or less commonly multiple anterior pituitary dysfunctions. We describe the case of a young female who presented with short stature and was found to have ectopic posterior pituitary.Case prese...

It is known that adult growth hormone deficiency (GHD) is associated with oxidative stress (OS): both GH and IGF-1 exert antioxidant functions. OS is in turn related to systemic inflammation and cardiovascular/oncological risk. Discordant data concerning GH effects on antioxidants are reported. Moreover, no data are available in partial GHD, which can induce cardiovascular alterations. To evaluate oxidative damage on macromolecules and systemic inflammation, 80 patients, studi...

Hyponatraemia is commonly encountered in neurosurgical units. Salt wasting syndrome is rare, and thought to occur due to ANP- and BNP-mediated natriuresis, leading to hypovolemic hyponatraemia. A 31 year old male was transferred to the National Neurosurgical Unit with a 12 hour history of back pain, progressive lower limb weakness and sensory loss. MRI demonstrated an epidural haematoma, extending from C7 to T3, and he underwent emergency decompressive laminectomy. Vasopressin...

Transsphenoidal surgery (TSS) to resect a corticotroph adenoma is the first-line treatment for Cushing’s disease (CD); remission rates of up to 80% have been reported in cases of microadenomas. Endocrine Society guidelines define post-operative biochemical remission as morning serum cortisol <138 nmol/L within seven days of surgery. Our practice is to use a cut-off of <50 nmol/L at day 3 post-op to indicate biochemical remission. If serum cortisol on day 3 is 50&#...

Introduction: Cushing disease is the most common cause of endogenous hypercortisolemia and most frequently is caused by microadenomas, but rarely, only in 10% to 20% of cases, the adenomas are large enough to produce mass effect.1Case report: We present the case of a 63 years old female patient, diagnosed in 2007 with a 22/18 mm non-secreting pituitary adenoma and panhypopituitarism. She undergone transsphenoidal surgery twice, followed by gam...

Background: Innate, isolated hypogonadotropic hypogonadism is a rare disease and results in men in cryptorchidism and failed puberty. Migration leads to diagnosis of the disease also in developed countries only in adults.Case: A 28-year-old man was sent for endocrine workup because of failed development of primary sexual characteristics and missing secondary sex characteristics. He grew up in a rural place in Sri Lanka, his brothers and sisters developed...

Introduction: The glycogen storage disease (GSD) is a rare disorder of carbohydrate metabolism resulting from the defective synthesis and utilization of glycogen. GSD-1a is a subtype of GSD caused by a deficiency in glucose-6-phosphatase activity, which leads to decreased conversion of glucose-6-phosphate to glucose. The dominant features at presentation are hypoglycemia and lactic acidemia. Long-term complications include blood glucose lability, lactic acidemia, short stature...

Introduction: Hyponatremia is a common electrolyte disturbance in clinical practice, and is considered severe when Na+<125 mEq/L. In most patients, is caused by a single cause but, in selected cases, there are multiple factors that contribute together. Drugs are a common cause of electrolytes abnormalities and a careful drug history is important especially the interaction between them.Case report: We report the case of a 60-year-old male patient who ...

Acromegaly is a rare condition and is frequently associated with infertility. There are very few reported cases of pregnancy in these patients, particularly after surgery and radiosurgery. This is a case of a 29-year-old woman with a 1-year history of nasal obstruction, headache and amenorrhea. She was mother of a 5-year-old child and was trying to get pregnant again, unsuccessfully. Clinical examination revealed coarsening of the facial features, hand and feet enlargement, hy...

Introduction: Cushing’s disease (CD) is associated with metabolic and cardiovascular comorbidities that can be incompletely resolved after disease remission. Our objective was to evaluate the metabolic and cardiovascular status of patients with MC in remissionPatients and methods: We performed a retrospective study including 15 CD patients cured by pituitary surgery. Patient’s medical records were reviewed and information regarding blood pressu...

Prolactinoma is the most frequent pituitary tumour among women of childbearing age. Cabergoline (CAB) is the treatment of choice for most of these patients. However there remain prolactinomas completely or partially resistant to standard therapy, which is rare in microprolactinomas. We present a clinical case demonstrating a positive change of the response to treatment of partially resistant microprolactinoma. A female patient, born in 1989, initially presented with dysmenorrh...

Background: Sex differences in clinical picture of ACTH-dependent Cushing’s syndrome are controversial, except for the known higher prevalence in females. We compared a broad range of potential differences to enable a more accurate understanding of the clinical picture of sex-specific ACTH-dependent Cushing’s syndrome.Design: Cohort study.Methods: We included consecutive patients with ACTH-dependent Cushing’s syndrom...

Background: Adrenal crisis, the most feared complication of adrenal insufficiency, is a potentially life-threatening situation of acute glucocorticoid deficiency. After successful surgery, many patients with Cushing’s syndrome develop (transient) adrenal insufficiency. The incidence of adrenal crisis in patients treated for hypercortisolism is unknown.Methods: Cohort study including consecutive patients with Cushing’s syndrome with adrenal insu...

Early diagnostics it is IPA treats difficult questions of a modern neuroendocrinology as even highly informative computer tomographs and the magnetic resonant imaging (MRI) don’t give the correct answer to 30–55% of cases, and at microadenomas to 90% of cases.The purpose: Studying of structure it is IPA at MRI-research at patients with the verified diagnosis.Material and methods: Research included 325 patients with is IPA...

Introduction: Isolated adrenocorticotropic hormone (ACTH) deficiency (IAD) is a rare disease, which is characterized by secondary adrenal insufficiency with low cortisol production, and normal secretion of pituitary hormones other than ACTH. Although it is known that QT prolongation is sometimes observed in patients with IAD, reports on IAD in which the QT interval was sufficiently prolonged to cause Torsades de Pointes (TdP) are rare. We described the case of a patient with I...

PD-1/PD-L1 pathway is a key regulator in T-cell activation and tolerance. Nivolumab, pembrolizumab (a PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are monoclonal antibodies approved for treatment of advanced cancers. Autoimmune thyroid diseases are the most common immune-related adverse effects (IrAEs) occurring after anti-PD-1 or anti-PD-L1 therapy, whereas autoimmune hypophysitis is described more frequently in patients treated with anti-CTLA-4. IrAEs can be isolate...

Introduction: Previous results of our group, presented in the ECE last year, showed a lower gene expression of proconvertase PC1/3, involved in the processing of POMC, in silent corticotroph tumors (sCT) than in functioning ones (fCT), overall and in microadenomas. The aim of the present study was to quantify the protein expression of convertases involved in the processing of POMC (PC1/3) and in the degradation of ACTH (PC2, CPE and PAM) in a series of CT.</p...

Introduction: Lymphocytic hypophysitis (LH) is a heterogeneous inflammatory condition in the pituitary gland, which may cause hormonal deficiency. However, some patients with LH initially present with headache.Case: A 63-year-old woman complained of a severe headache for 1 month. Examination of cerebrospinal fluid (CSF) showed increased lymphocyte counts, indicating meningitis. Contrast-enhanced magnetic resonance imaging (MRI) revealed an expanding sell...

Background: Although the role of hypermethylation of certain tumor suppressor genes are known in pituitary adenomas little information is available regarding whole methylation-demethylation status and especially regarding its correlation with clinical parameters. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) is an easy and accurate method to detect the level of methylcytosine (5 mC) and the demethylation intermedier hydroxymethylcytosine (5 hmC) ...

Introduction: Pituitary Neuroendocrine Tumor (PitNET) subtypes present functioning and silent variants but the silencing mechanisms are still unknown. One of the possible hypotheses could be a decrease in the expression of the specific adenohypophyseal hormone genes. The aim of the present study was to analyze the expression of adenohypophyseal hormone genes in a series of PitNETs, in order to evaluate differences between functioning and silent PitNET subtypes, taking into acc...

Background: Tumour microenvironment (TME) can comprise >50% of the tumour mass and includes non-tumour cells like immune cells and fibroblasts, as well as extracellular matrix, signaling molecules, and blood and lymph vessels. In recent years, TME has begun to be considered both a prognostic tool and a therapeutic target. While the existence of TME is well accepted and described in numerous cancers, little is known about the TME of pituitary neuroendocrine tumours (PitNETs...

Background: Arginine vasopressin (AVP) is released upon osmotic stimulation or hypovolemia in order to maintain water balance. A recent study showed a role of AVP in haematopoiesis by stimulating red blood cell precursors, suggesting a higher risk of anaemia in patientis with AVP deficiency. The aim of this study was to explore the effect of low AVP levels in patients with central diabetes insipidus (cDI) and primary polydipsia (PP) on haemoglobin and the prevalence of anaemia...

Introduction: Silent somatotroph tumors (sST) are a pituitary neuroendocrine tumor subtype with positive immunostaining for growth hormone (GH) but without the presence of acromegaly. Unlike silent corticotroph tumors, there is little information in the literature on sST. The aim of the present study was to study the demographic, clinical and molecular characteristics in a series of ST in order to compare sST and functioning ST (fST).Methods: We have stu...

Introduction: Giant prolactinomas are rare pituitary tumours, more frequently found in men (9:1), defined by an unusually large size (>4 cm), significant extrasellar extension and prolactin levels above 1000 ng/ml. Although dopamine agonists (DA) are the first-line treatment, combined therapy with DA and surgery, or rarely radiotherapy, may be necessary particularly when tumour volume control is not achieved.Case presentation: A 60-year-old woman, wa...

Introduction: Glycogenosis is a group of hereditary diseases affecting the glycogen metabolism, due to mutations in enzymes involved in the transformation and synthesis of glucose (liver and muscle glycogenosis). Brain germ tumors are very infrequent. They are located mainly in pineal and sellar region. Central diabetes insipidus is the most frequent manifestation. Their prognosis and response to combined chemo/radiotherapy treatment are favorable.Case r...

Introduction: Thyrotropin (TSH) secreting pituitary adenomas (TSHomas) are very rare and account for less than 2% of all pituitary adenomas. They present with elevated levels of fT4 and normal to high levels of TSH. About 25% of TSHomas co-secrete other anterior pituitary hormones. Growth hormone (GH) is the most commonly co-secreted hormone, followed by prolactin (PRL) and gonadotropins. Herein, we report a case of pituitary adenoma with simultaneous secretion of TSH and GH.<...

Introduction: In acromegaly GH excess leads to impaired insulin sensitivity with an alteration of beta-cell function. The consequent hyperglycemia leads to a further increased cardiovascular risk and mortality.Case report: A 16 years old patient was first referred to the Department of Pediatrics in 2014 with accentuated growth since the age of 10. The reason of the first referral was a sport injury (head trauma during playing basketball). Sella MRI depic...

Introduction: Langerhans cell histiocytosis (LCH) is a rare disease that occurs mainly in childhood. In its multifocal form, the central nervous system may be affected, but rarely as the primary site of the disease. The prevalence of central diabetes insipidus (CDI) ranges from 10% to 50% and in most cases is established after the diagnosis of LCH. We report 2 cases of CDI that revealed a LCH.Observations: Case 1: A one-year old male patient was admitted...

Introduction: Langerhans cell histiocytosis (LCH) is a rare disease characterized by non-specific granulomatous deposits in many tissues. The hypothalamic-pituitary region is infiltrated in 5 to 50% of patients with LCH but most often in those with the multifocal form. Diabetes insipidus (DI), the most common hormonal abnormality, occurs in 15–50% of patients. Anterior pituitary deficiency occurs only in 5 to 20% of patients. We report the case of a patient with LCH who h...

Introduction: Short stature is a common manifestation of Noonan Syndrome (NS) that affects up to 70% of patients with this syndrome. We present 2 observations of NS associated with growth hormone (GH) deficiency.Observations: Case 1: A 7-year-old female patient was admitted for a growth delay (height at −4 SD and weight at -1 SD). On examination, she had a dysmorphic syndrome suggestive of NS: triangular face, hypertelorism, low-implanted ears, a w...

Background: Chromogranin A (CgA) belongs to the family of granins, proteins which are an integral part of the secretory granules of neuroendocrine cells in endocrine glands and the diffuse neuroendocrine system. While it has become standard clinical practice to measure serum CgA in neuroendocrine tumors, various other non-endocrine conditions may increase this marker’s concentration and lead to diagnostic problems.Case report: We present the case of...

Introduction: Cardiac disease called acromegalic cardiomyopathy may be present in patients with acromegaly at diagnosis, however most echocardiographic studies showed that systolic function, measured by ejection fraction (EF), 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. Some studies show subclini...

Objective: Several studies reported that a long-time therapy with somatostatin analogs (SSTa) in acromegaly could induce persistent remission event after drug withdrawal. The aim of this study was to evaluate GH/IGF-I secretion after SSTa discontinuation in a series of acromegalic patients.Materials and methods: Data of 21 patients regularly referred to our Centre and previously included in a multicentre study, have been updated at the last available fol...

Objective: The most common type of pituitary diseases are pituitary adenomas (PA) of different origin. Although non-metastasizing, they still cause increased mortality and morbidity. Clinically significant PAs affect around 0.1% of population during lifetime. Circulating cell free DNA (ccfDNA) is approximately 165 bp long DNA fragments which are released in bloodstream upon cell death. ccfDNA has been used to investigate presence and properties of various cancers. Data on ccfD...

Aim: In our study, we aimed at investigating cardiovascular risk predictability by conducting arterial stiffness measurement in patients with idiopathic hyperprolactinemia.Material – Method: The biochemical parameters and arterial stiffness analyses of 54 patients with idiopathic hyperprolactinemia, who had applied to our polyclinic in 2017 and 2018, and 55 healthy volunteers having similar characteristics with regard to age, sex and body mass index...

Introduction: McCune-Albright syndrome (MAS) consists of at least two of the following three conditions: polyostotic fibrous dysplasia (PFD), café-au-lait skin pigmentation and autonomous endocrine hyperfunction. The most common form of autonomous endocrine hyperfunction is precocious puberty, but other syndromes may be present, including acromegaly, hyperthyroidism, and Cushing syndrome. Acromegaly is seen in approximately 20% of patients with MAS. Treatment opt...

Background: Residual morbidity in patients with Cushing’s syndrome (CS) in remission significantly affects Quality of Life (QoL). While sustained muscle weakness is a frequent complaint in these patients, the impact of muscle dysfunction on their psychophysical wellbeing is currently unknown. Patients & methods: We included 28 female patients [mean(±SD) age, 50±12 years; mean (±SD) BMI, 26.7±3.8] and 26 age- and BMI-matched healthy controls. Mean (...

More than 90% of classic congenital adrenal hyperplasia (CAH) patients have defects in the cytochrome P450 enzyme steroid 21-hydroxylase, resulting in the inability to produce cortisol as well as the overproduction of androgens and androgen precursors such as 17-hydroxyprogesterone (17-OHP). Management of classic CAH can be challenging since patients are often unable to adequately balance the supraphysiologic doses of exogenous glucocorticoids required to suppress excess andro...

Background: The SAGIT® instrument, designed to assist clinicians in staging and managing acromegaly, is undergoing validation. A descriptive analysis of SAGIT Validation study baseline data revealed discrepancies between investigator-evaluated disease-control status, disease activity, hormonal control, and treatment decisions in acromegaly.Objective: To describe the baseline characteristics of patients in the SAGIT® valida...

Purpose: Patients with Cushing’s disease (CD) experience a wide range of physical and psychosocial health impacts. This can have a profound effect on patient’s quality of life (QOL), impairing areas such as body image, personal relationships and work performance. The CushingQoL is a valid and reliable disease-specific patient-reported outcome (PRO). When using a PRO in an interventional context it is critical to understand whether reported change is clinically meanin...

Background: Hyponatremia is the most common electrolyte disorder in hospitalized patients with pneumonia. Different studies have shown an association of admission hyponatremia and worse in-hospital outcome, but no data are available about the impact of hyponatremia at discharge on outcome.Material and methods: Data from a double-blind randomized study including 725 patients hospitalized with community-acquired pneumonia were analyzed. The primary aim of ...

Background: In children, Cushing’s disease (CD) presents with a combination of weight gain and slowed linear growth. First-line pituitary surgery is the treatment of choice for most patients. In paediatric patients, the transsphenoidal surgical success rate is 60%–98% when performed by an expert pituitary surgeon. There is a need for additional pharmacological interventions to control hypercortisolaemia, which are currently limited, in children and adolescents. In ph...

Introduction: Cushing’s Disease (CD) has been associated with the occurrence of psychopathologies, the most frequent of which are depression and anxiety. However, the extent of psychopathological disturbances of CD in the 21st century is elusive.Objectives: To explore psychopathologies and body image uneasiness (BIU) in untreated CD patients.Patients & methods: It was a prospective observational study enrolling 23 consecut...

Patients with prolactinomas may develop acromegaly during D2-agonists (DA), suggesting the existence of somatomammotroph adenomas with asynchronous secretion of GH and PRL. This may be due to the acquisition of somatotroph characteristics by lactotroph cells or to GH co-secretion by somatommammotroph cells unmasked after PRL inhibition by DA. The prevalence of silent acromegaly in prolactinomas during DA is 4.1%. The purpose of this study was to evaluate the somatotroph axis i...

Background: Pasireotide has proven efficacy in acromegaly and CD, although pasireotide-associated hyperglycaemia occurs in some patients. This Phase IV, randomized, open-label study investigated optimal management of pasireotide-associated hyperglycaemia uncontrolled by metformin/oral antidiabetic therapy (OAD) [NCT02060383].Methods: Adults with acromegaly or CD were enrolled and treated with long-acting pasireotide 40 mg/28 days or subcutaneous pasireot...

Introduction: The differential diagnosis of sellar masses is broad and includes - apart from the most common pituitary adenomas - other neoplasms such as craniopharyngiomas, germinomas, gliomas, meningiomas, and others. Hemangiopericytoma (HPC) is a rare vascular tumor arising from pericytes that may appear at any site of the body. We report an unusual case of an intrasellar HPC.Case Report: A 63-year-old woman was admitted to our hospital complaining ab...

Aim: Traumatic brain injury (TBI) is known to be associated with pituitary insufficiency (PI). We have recently shown that there was a relationship between miR-126-3p, miR-3610 and PI developing in follow up of patients with TBI. In this study, we aimed to test the effects of miR-126-3p on hypothalamus pituitary-adrenal (HPA) and Growth hormone-Insulin like growth factor (GH-IGF-1) axes.Materials and methods: miR126-3p microinjection was performed to mou...

The aim: To estimate secretory and proliferative activity of pituitary adenoma (isolated somatotropinoma (ST) and somatomammotropinoma (SMT).Subjects and methods: The study included 133 patients (total group: 45 male/88 female), aged 44.0±12.5 year old with acromegaly (95 – with ST and 38 – with SMT). There were estimated patient’s age, age of manifestation of acromegaly (agemanifest.), duration of period before diagnosis (...

Introduction: Cushing’s disease (CD) is five to six times more common than Cushing’s syndrome, with a peak incidence at 20–40 years. It is usually an ACTH-secreting microadenoma, the local invasion being associated with one third of macroadenomas. The treatment of choice is the transsphenoidal surgery, but nearly 50% of the patients with macroadenomas ultimately require additional treatment. Cabergoline appears to be an attractive treatment option for CD, consid...