Endocrine Abstracts

Hypopituitarism is a potential complication of trans-sphenoidal adenomectomy (TSA). Prediction of pituitary function (PF) recovery would inform hormonal replacement strategies. However, the frequency of re-testing of PF is variable across centres. The aim of this study was to determine rates, time and predictors of 6-weeks (6 w) recovery of hypothalamo-pituitary adrenal (HPA) and gonadal function after TSA.Methods: We performed a single-centre, retrospec...

Background: Radiotherapy is part of the complex treatment of pituitary tumors; it is an effective treatment for residual postoperative tumors or recurrent tumors, but cerebrovascular events and secondary intracranial tumors may occur during long term follow-up.Aim: To assess prevalence of cerebrovascular events, secondary intracranial tumors and other neoplasia in patients with non-acromegaly pituitary tumors and craniopharyngiomas submitted to radiother...

Aim: The aim of the study was to investigate the clinical and hormonal effectiveness of different modes of suppressive cabergoline (CAB) therapy during 12 months in patients with prolactinoma.Subjects and methods: It was examined and underwent a 12 month course of treatment by selective dopamine agonist CAB in 61 patients with prolactinoma (PROL) (9 male/ 52 female) aged 16–66 years. There were 40 women with microPROL, 12 with macro&giant PROL; ...

Introduction: Pituitary adenomas, second most common brain tumors, are mostly well controlled after surgery. However, some pituitary tumors present an aggressive evolution and are resistant to standard management. Immunotherapy with inhibitors of T-cell checkpoints have shown durable efficacy in a variety of malignancies. Moreover, immunotherapy has been associated with treatment-related hypophysitis, suggesting that pituitary could be a target of these treatments. Recently, i...

Pituitary adenomas consist of a group of highly heterogeneous intracranial tumours with variable presentation, clinical prognosis and management. High throughput sequencing was used in order to try and identify common de-regulated pathways and characterize tumours according to specific molecular behaviour. RNA sequencing (RNAseq) was chosen since it provides not only information regarding the expression profile but also the mutational load of each specific tumour analysed. 58 ...

The glucagon stimulation test (GST) may be used as a good alternative to the insulin tolerance test (ITT) in the diagnosis of secondary adrenal insufficiency (SAI). The aim of the study was to compare the GST and ITT for diagnostic SAI, to define cortisol cut-off points and factors affecting the appearance of false positive results in young adults followed CSI.Subjects and Methods: A retrospective study of 28 patients (median age 19 [17; 23]) at least 2 ...

Background: Hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a very common electrolyte disorder in older patients leading often to hospital admissions. Symptoms can vary between mild disabilities (e.g. nausea, dizziness, attention deficits, gait disturbance) to severe life-threatening conditions (e.g. seizures, coma). Treatment of SIADH is challenging in particular when fluid restriction is limited or even not effective in restoring n...

Introduction: Prolactinoma is the most common secretory pituitary adenomas. It has clinical and biological characteristics that depend on age, gender and tumor size. Prolactinoma of the old subject is a rare clinical form that was not sufficiently treated in the literature.Materiels and methods: It is a retrospective study including 77 cases of prolactinoma among which 3 cases aged over than 65 years. The collection of data was made between 2000 and 2017...

Background: The treatment of choice in prolactinomas are dopamine agonists, with surgery reserved for cases refractory to or poorly tolerant of pharmacotherapy. Little is known on the associations between clinical, neuroradiological and pathological features influencing the efficacy of transphenoidal surgery.The Aim: To evaluate clinical, neuroradiological and neuropathological aspects of surgically treated prolactinomas in women, with a particular empha...

Introduction: Acromegaly is a disease associated with increased secretion of growth hormone and subsequent growth of bones, soft tissues and internal organs. An important factor influencing therapeutic treatment in recent years is the patient’s quality of life associated with the disease. In patients with acromegaly, it is significantly affected by the occurrence of depression and anxiety - agents undergoing treatment, which, however, still appear undiagnosed.<p class...

Introduction: The pituitary stalk is the target of various congenital or acquired pathologies. In this context we report a cohort of 28 patients with pathology of the pituitary stalk to analyze their clinical, hormonal and radiological characteristics.Results: The average age of our patients was 28 years with extremes ranging from (15 to 64); Male dominance was noted in 60% of cases. The reason for consultation was either a staturo delay or a pubertal de...

Introduction: Spindle cell oncocytomas (SCO) of the pituitary are rare tumors accounting for 0.1–0.4% of all sellar tumors. Due to its rarity, little information is available regarding its pathogonesis. The altered gene expression and the possible pathogenetic role of microRNAs (miRNAs) have been identified in many tumor types, however, until now ther is no data regarding their role in pituitary oncocytoma.Materials and methods: Total RNA was extrac...

Introduction: Pituitary apoplexy (PA) is a rare incident defined by the occurrence of necrosis and/or haemorrhage of the pituitary gland. PA is a clinical syndrome characterized by the sudden onset of headache, vomiting, visual impairment and decreased consciousness in some cases. The objectives of our study are to describe its clinical, biological and imaging features as well as the management of PA in the region of Sfax.Patients and methods: It is a re...

Introduction: Non-functioning pituitary adenomas (NFPA) are characterised by the expression of somatostatin receptors (SSTR), which is analysed using immunohistochemical investigations. The presence of SSTR forms the basis for the clinical use of somatostatin analogues (SSA) in the treatment of these tumours.Aim: The study was undertaken to provide immunohistochemical analysis of SSTR and to correlate it with tumoral response to SSA therapy in NFPA.<...

Immunotherapy targeting the CTLA-4 and PD-1pathways has revolutionised the treatment of several cancer types, and is under investigation in many others. However, its use is associated with a variety of side effects, many of which associated with immune system activation. In metastatic melanoma, the combination of ipilimumab (an anti-CTLA-4 antibody) and nivolumab (an anti-PD-1 antibody) has been shown to have greater efficacy than either drug as monotherapy, though as expected...

Introduction: Non-functioning pituitary adenomas are relatively common. A large number of these tumors are asintomathic pituitary microadenomas, that are increasingly detected because of sensitive imaging techniques improves. Those tumors that require treatment are generally macroadenomas and come to medical attention because of mass effect (visual field defects, headache, …) and/or hypopituitarism.Objective: To assess non-functioning pituitary ade...

Background: Overt parathyroid bone disease is a rare entity. We present a case of primary hyperparathyroidism (PHPT) and osteitis fibrosa cystica with involvement of multiple facial bones and neurocranium. Although the initial differential diagnosis was between acromegaly and bone malignancy, endocrine assessment demonstrated PHPT, with favorable outcome after parathyroidectomy.Case report: A 59-year-old woman referred to our clinic with painful swelling...

Background: In patients with acromegaly, mortality depends most on achievement of control of GH/IGF1 levels. However, some of the complications of acromegaly still develop, despite successful control of disease. The aim of the study is to correlate mortality and morbidity with cumulative GH exposure in these patients compared to last GH/IGF1 level.Methods: We studied retrospectively 336 patients with acromegaly consecutively evaluated at least twice duri...

Purpose: According to modern guidelines late night serum cortisol measurement is not considered to be among the first steps for screening of hypercortisolism. But in some cases it may be useful as it allows identifying the loss of normal circadian rhythm of cortisol secretion. This test is not rarely used in hospitalized patients when Cushing’s syndrome is suspected. But the cutt-off point of nighttime serum cortisol level for the diagnosis of hypercortisolism is inconsis...

Introduction: Graves’ dermopathy (also known as pretibial myxedema, thyroid dermopathy, Jadassohn-Dösseker disease or myxedema tuberosum) is a rare extrathyroidal manifestation of Graves’ disease, which is almost always associated with Graves’ ophthalmopathy. Although pretibial myxedema is the most frequent localization of Graves’ dermopathy, the involvement of toes with or without the involvement of pretibial area may occur.Obje...

Background, aims: Acromegaly is caused by excessive growth hormone (GH) secretion, usually by a pituitary adenoma. Surgical removal of the GH-producing adenoma is the most effective treatment. Drug treatment is second-line option. Earlier work suggested Soluble (s)Klotho levels to be a supplementary biomarker to IGF-1. We tested whether IGF-1 and sKlotho serum levels show a concomitant reduction under medical treatment. If yes, is the extent of reduction in serum IGF-1 and sKl...

Introduction: Ipilimumab is a monoclonal antibody directed against CTLA-4 used primarily in treatment of malignant melanoma. Immunological side effects are common, amongst others it may lead to hypophysitis. We studied clinical characteristics of IpiH and compared it to cases of primary hypophysitis (PH).Methods: We conducted a retrospective single centre study in 75 hypophysitis patients (60 primary, 15 Ipilimumab-induced in patients with melanoma). Gro...

Introduction: Pituitary tumors are the most frequent intracranial neoplasm. However metastases in this location are rare and uncommon presentation of systemic malignancy. The clinical and radiologic features of most pituitary metastases can be characteristic and evocative but in no case pathognomic. The diabetes insipidus is the most common clinical manifestation of the disease. We report here four cases of pituitary metastases of lung cancer in an elderly patients mimiking pi...

Introduction: Hyponatremia after transnasal neurosurgery for pituitary adenomas is a serious and not so rare complication. It often occurs in a delayed manner after patient’s discharge and is a major cause of readmission. The pathogenesis of postneurosurgical hyponatremia is not clear yet.Aims: To study the role of posterior pituitary hormones (antidiuretic hormone (ADH) and apelin) and reaction of renin-aldosterone system (RAS) at hyponatremia mani...

Introduction: Growth hormone (GH) has multiple metabolic effects in adulthood, pointing to the need of identify those patients who would benefit of GH treatment after achievement of final height.Objective: To assess GH secretion, bone mineral density (BMD) and metabolic profile in patients with childhood-onset GH deficiency (GHD) after completion of recombinant GH (rGH) therapy for linear growth.Methodology: One hundred eleven pati...

Congenital isolated hypogonadotropic hypogonadism (CHH), is a condition characterized by a defect in development, migration and action of GnRH neurons. Numerous genes are involved in CHH. It can present with anosmia, hyposmia or normosmia. Two cases presented to our department with late onset delayed puberty. First case was a 29 year old with absence of secondary sexual characters along with micropenis and anosmia. His younger brother, 22 year old had similar complain...

Introduction: Central diabetes insipidus (CDI) is a heterogeneous condition characterized by the presence of polyuria and polydipsia due to a deficiency of arginine vasopressin. Frequently, CDI is wrongly considered idiopathic if not associated with other signs and symptoms.Case report: We report the case of a 50-year-old woman diagnosed with idiopathic central diabetes insipidus at the age of 34. The MRI scan of the hypothalamus and pituitary gland was ...

Introduction: Ectopic Cushing’s Syndrome (ECS) accounts for 5-10% of all cases of endogenous hypercortisolism. ACTH secreting intrathoracic masses is the most common cause of ECS. We present two patients with ectopic Cushing’s syndrome, with particularities in diagnosis.Case 1:: A 59-year-old female presented with arterial hypertension, and osteoporosis, along with weight gain and facial plethora, starting two years before. Screening tests were...

Background: Somatostatin analogues are the mainstay medical treatment of acromegaly. Side effect of this treatment includes gastrointestinal disturbances, cholelithiasis, and local reactions at injection sites. Herein we report an unusual case of local myofascitis after one-year treatment with deep subcutaneous injections of lanreotide Autogel in a patient with acromegalo-gigantism.Clinical case: A 25-year-old man was found to have an invasive macroadeno...

Thyrotropinoma (TSH-secreting pituitary adenomas, TSH-AG) are rare tumor of the pituitary (0.5–2% of all pituitary adenomas). Localization of the tumor with the appropriate neuroendocrine disorders has features in the clinic. This is due to the direct damage to the nucleus and structures of the pituitary with hypersecretion of TSH, which leads to overstimulation of the thyroid gland and the emergence of the clinical picture of ‘central’ hyperthyroidism. Differen...

Introduction: Prolactinomas are mostly benign tumours usually managed with pharmacological treatment. Some, however, seem to be resistant to dopamine agonists (DA) for unclear reasons. The relationship between T2W signal intensity (T2WSI) and response to treatment with somatostatin analogs is well described in acromegaly patients. Some evidence suggests that prolactinoma’s T2W hypointensity might be related to higher baseline prolactin levels and more resistance to DA.</p...

Background: Pituitary stalk lesions (PSL) are various changes located in the pituitary infundibulum. The underlying pathology and exact diagnosis are difficult to establish due to their difficult anatomical locus.Aim: To present the etiological spectrum of pituitary stalk lesions and their clinical and hormonal characteristics on the basis of long term observation in the pediatric/adult endocrinology departments of our university.M...

Introduction: Pituitary Stalk Interruption Syndrome (PSIS) is a distinct and rare clinical entity responsible for isolated or combined anterior pituitary insufficiency. The objective of this work is to describe the clinical, hormonal and radiological aspects of PSIS.Patients and methods: Observational descriptive study of the files of 5 patients including 4 cases of congenital PSIS and one acquired, followed in the endocrinology and diabetology departmen...

Introduction: Congenital idiopathic hypogonadotropic hypogonadism is a rare genetic disorder caused by an isolated defect in GnRH secretion by the hypothalamus or, less frequently, by a defect in the action of GnRH on pituitary gonadotropes. The majority of cases are sporadic but there are also family forms. We report a case of one family.Case report: These are 2 brothers with a family history of primary infertility in the maternal uncle. An 18-year-old ...

Children and adolescents treated for solid brain tumors with chemotherapy and craniospinal irradiation are at increased risk of metabolic changes development. Current follow-up guidelines for cancer survivors recommend to monitor fasting glucose and HbA1 levels for diabetes/impaired glucose tolerance screening in these patients. The aim of our study was to evaluate metabolic changes in children treated for medulloblastoma with oral glucose tolerance test (OGTT). We examined 63...

Introduction: DIPNECH is a preinvasive condition in which there is an idiopathic generalised proliferation of pulmonary neuroendocrine cells that can form tumourlets. There are very few cases described of ACTH secretion by these cells causing Cushing’s syndrome, some of them cyclic.Case report: A 41 year-old woman was sent to our Endocrinology outpatient clinic for menstrual disturbance, acne and excessive sweating. She had a recent diagnosis of DIP...

Introduction: Acromegaly is a clinical syndrome caused by excessive production of growth hormone (GH). It is associated with an increase in the incidence of cancers. Through this observation, we illustrate the rare association of a somatotropic adenoma with a nasopharyngeal carcinoma.Case report: 57-year-old woman, having hypertension, followed for an undifferentiated nasopharyngeal carcinoma since 2011 under radio-chemotherapy, having recurred in Januar...

Acromegaly is a rare endocrine disorder, caused by hypersecretion of growth hormone. Cardiovascular and metabolic complications reduce life expectancy. Early carbohydrate metabolism disorders and diabetes mellitus are frequently associated with acromegaly.Objective: The objective of this study was to evaluate the glycemic profile and cardiovascular complications in acromegaly.Methods: We performed a retrospective study. We included...

Purpose: The purpose is to draw attention to rare cases of Pituitary Macroadenoma co-secreting Growth Hormone and Thyroid Stimulating Hormone with Polynodular Goiter and their importance and approach in current practice.Background: Pituitary adenomas with no hormonal clinical picture are known as ‘silent’ tumors. They are rarely reported and lacking pathogenic explanations.Method: We describe a case of Pituitary Macroaden...

Introduction: Fanconi anemia (FA) is an autosomal recessive disease associated with chromosomal instability, it is marked by phenotypic heterogeneity. Patients with FS often exhibit growth retardation due to complex factors such as hypophosphatemia, metabolic acidosis, disturbed vitamin D metabolism. On the other hand, endocrinopathies are a common feature of FA specially such as Growth hormone deficiency (GHD). We report here two cases of Fanconi disease associated to GH defi...

Introduction: Acromegaly is a chronic disorder usually caused by growth hormone (GH)-secreting pituitary adenomas. Transsphenoidal surgery remains a treatment of choice for restoring GH to normal levels. The aim of this study was to illustrate the relationship between some factors and transsphenoidal surgery outcomes.Patients and methods: We retrospectively analysed the outcome of 31 patients with acromegaly after initial endoscopic transsphenoidal surge...

Introduction: Endoscopic transsphenoidal pituitary surgery has become the first line method for removal pituitary tumours. A new way to see the surgical field and the cooperation of two neurosurgeons has supposed a revolution in the area.Objetives: Analyse surgical outcomes and complications of a cohort of patients from a single center who underwent ETPS for Cushing disease.Methods: Descriptive prospective-retrospective study inclu...

Introduction: The pituitary adenoma is a benign hyperplasia of the pituitary gland; it often implies the presence of pathologies of the thyroid gland. The relation between the thyroid volume, the rate of IGF1 and the duration of the disease is not well specific, long time the secretion of GH and IGF1 have been associated with disorders of thyroid function.Presentation of the case: We report the observation of a 37-year-old woman operated on in 2016 with ...

Objective: Evaluate effect of hyperprolactinemia on breast’s conditions.Methods: Investigated 2 groups of patients with average age 34.9±7.5. The first group is 30 women with hyperprolactinemia. Inclusion criterion was an increase in prolactin level above 1000 mU/l with a double determination, as well as duration of at least 6 month, lack of taking antidepressants and oral contraceptives for last 3 month before the start of study, absence of co...

The diagnostic strategy in the face of stunted growth currently leaves an important place for brain imaging, which looks for growth hormone deficiency, a ‘craniopharyngioma’ tumor, or a malformation of the midline or pituitary region. The purpose of our work is to look for abnormalities of the pituitary area in case of stunted growth.Patients and methods: A retrospective descriptive and analytical study involving 69 patients (30 girls/9 boys) w...

Introduction: Endoscopic transsphenoidal pituitary surgery has become the first line method for removal pituitary tumours. A new way to see the surgical field and the cooperation of two neurosurgeons has supposed a revolution in the area.Objetives: Analyse surgical outcomes and complications of a cohort of patients from a single center who underwent ETPS for GH secreting pituitary tumours.Methods: Descriptive prospective-retrospect...

Aim: Dopamine agonist (DA) therapy is recommended as first-line treatment for prolactinomas, albeit with long treatment duration and high recurrence rate after treatment withdrawal. The aim of this retrospective study was to evaluate predictors for successful DA withdrawal.Methods: The study included 59 prolactinoma patients (39 female, 20 male; age 34 (18–82) years) that were treated with DA (35.6% on cabergoline); the duration of treatment was 71 ...

Abstract: Cushing’s syndrome (CS) during pregnancy is a rare condition with fewer an 200 cases reported in the literature, However, because CS results in increased fetal and maternal complications, its early diagnosis and treatment are critical. During pregnancy, 40-50% of cases are caused by adrenal adenomas, while Cushing’s disease (CD) accounts for only one third of the cases. We describe here 3 patients with CD who needed to be treated during pregnancy.<p cla...

Introduction: GH deficiency (GHD) represents less than 20% of short stature in children, the clinical, biological and radiological characteristics differ from one population to another.Methods: Our retrospective study describe 59 children (37 boys and 22 girls) with confirmed GHD. The average age of discovery was 95 months. About 20.3% of these children were born from a consanguineous marriage. Family history of anterior pituitary insufficiency was prese...

Purpose: To evaluate whether the degree of response to surgical pre-treatment with somatostatin receptor ligands (SRL) predicts alterations in blood glucose levels.Patients and methods: We retrospectively studied 181 patients attending the Unit of Neurosurgery of our Hospital prior to transsphenoidal surgery. All patients had a diagnosis of acromegaly (nadir GH during OGTT >0.4 ng/ml; and IGF-I above age-standardized UNL); diagnosis of diabetes (DM) ...

Introduction: Diamond-Blackfan anemia (DBA) is a severe congenital erythroid aplastic anemia with autosomal dominant inheritance. It is a rare disease (incidence 1/150000) and usually is discovered during the 2 first years after birth. Treatment includes steroids, blood transfusions and bone-marrow transplantation.Case report: A 31 year-old woman with DBA had received multiple treatments including transfusion support since birth. Consequently, she had de...

Intoduction: Pitiutary tumor is considered as the first etiology responsable of secondary hypopituitarism. Hypogonadotropic hypogonadism is the most commonly reported lesion.Meterials and methods: It is a retrospective study including 77 cases of prolactinoma. The data collection was done over 17 years, between 2000 and 2017.Results: Gonadotropic deficiency was confirmed in 48 patients (63.6%). A significant negative correlation wa...

Background: Craniopharyngiomas are rare, relatively benign, slowly growing intracranial tumors originating in pituitary gland embryonic tissue. They may present at any age, with two peaks of occurrence in children and in older adults. Clinical symptoms are the result of mass effects. Treatment options include surgery, radio- and chemotherapy and unfortunately are connected with a high ratio of postoperative pituitary insufficiency.Aim: To present the lon...

Background: PA is a clinical syndrome secondary to hemorrhage or infarction of pituitary tumour, presenting with sudden onset headache and oculomotor palsy. PA may be managed conservatively in patients without visual disturbances.Aim: To describe PA patients illustrating typical aspects and peculiarities.Results: Case 1, a 49 years old (yo) male, presented for loss of consciousness in the ER. MRI showed a giant pituitary tumour, wh...

Introduction: Infertility is a classic consequence of prolactinoma in women. The treatment of hyperprolactinemia allows the restoration of ovulatory cycles and therefore of fertility in 80–90% of cases.Methods and materials: The study is a retrospective cohort study done over 17 years from 2000 to 2017. It includes 77 cases of prolactinomas among which 12 women had one or more pregnancies after the diagnosis of prolactinoma.Re...

Background: Pegvisomant (PEG) is a second line medical treatment for active acromegalic patients. PEG efficacy is between 61.5 and 92% and even if it is administered daily its long half-life suggests a possible use with a non-daily regime.Aim: We aim to compare acromegalic patients on daily PEG administration (DP) with patients on non-daily PEG administration (NDP).Methods: We studied 43 acromegalic patients under PEG treatment bet...

Introduction: Suppression of TSH usually indicates hyperthyroidism. But the etiology of low TSH is very wide, including pituitary pathology. In this report we describe a case diagnosed and treated for hyperthyroidism. Later on, the persistence of suppressed TSH after therapy of hyperthyroidism was due to a GH-secreting pituitary adenoma.Case presentation: A 47-year old woman was referred to our clinic for investigations, due to thyroid pathology. The pat...

Introduction: Weakness is one of the most common complaints among the patients. Clinical manifestations of a hypopituitarism depend on the extent of hormone deficiency and may be non-specific and thus the diagnosis is often missed. The progressive loss of pituitary hormone secretion is usually a slow process, which can occur over a period of months or years.Clinical case: A 62 years old women who complained of mild weakness mostly in the evenings in the ...

Introduction: Clinical research studies over the last 15 years have reported a significant burden of hypopituitarism in survivors of traumatic brain injury (TBI). However, these endocrine anomalies remain underdiagnosed.Patients and methods: We are studying data from a series of 75 TBI patients. They had a basal hormonal test, and dynamic confirmation tests if necessary. Somatotropic deficiency was defined by growth hormone (GH) remaining under 3 μg...

Aggressive pituitary tumors (APT) causing Cushing’s Disease are very rare, difficult to treat. The majority of Crooke’s corticotropinomas are macroadenomas, exhibiting rapid growth, resistance to conventional treatments, a high recurrence rate. To date, there is no fully effective method of treatment for these tumors. Pituitary carcinomas (PC) are defined by distant metastasis. PC is exceedingly rare, comprising only 0.1–0.2% of all pituitary neoplasms but APT m...

Introduction: Clinically non-functioning pituitary adenomas (NFPA) are heterogeneous group. Some previous research has found that this type of pituitary adenomas may be smaller and have better prognostic in men. The aim of this study is to analyze if there are gender-related differences in NFPA.Material and methods: Retrospective study of patients with NFPA followed up in regional hospitals (Community of Madrid, Spain). All NFPA had molecular analysis. T...

Introduction and rationale: Cushing’s syndrome (CS) is a rare disease with hypercortisolism caused either by ACTH excess from a pituitary or non-pituitary tumor or by an ACTH-independent primary adrenal overproduction of cortisol. It is associated with significant comorbidities potentially lethal: hypertension, diabetes, coagulopathy, cardiovascular disease, infections, and osteoporotic fractures. It is usually managed by surgery and/or medical treatment with steroidogene...

Background: Secondary adrenal insufficiency is usually treated with hydrocortisone replacement therapy twice or thrice daily in varying doses to mimic the physiological rhythm of cortisol release. However, despite efforts to optimize treatment regimens patients report impaired quality of life (QoL), including important aspects such as fatigue. A possible explanation is a suboptimal imitation of cortisol release resulting in an inadequate substitution at certain times during th...

Introduction: Patients planned for first time surgery for clinically non-functioning pituitary adenoma (NFPA) were included in this prospective study.Aims: – To study the prevalence of hypothalamic-pituitary-adrenal (HPA) axis failure preoperatively and 3 months after surgery for clinically NFPA.– To investigate factors predicting risk of HPA axis failure postoperatively.Hypotheses<p class="abst...

Introduction: Isolated central hypothyroidism is a rare disease. Acquired causes for central hypothyroidism include iatrogenic, traumatic, immunologic, infiltrative, infectious, vascular or space-occupying lesions. Empty sella may present with endocrine dysfunction, mainly hyperprolactinemia and growth hormone or gonadotropin deficiency. Few cases of empty sella associated with isolated TSH deficiency were published.Case report: A 66-years-old female wit...

Introduction: Sheehan’s syndrome is a rare postpartum complication. Recurrent hypoglycaemia,though described is a rare complication of Sheehan syndrome. Here we report a case of Sheehan syndrome which presented with hypoglycemic coma.Case Presentation: We report the case of a 47-year-old woman who presented to the medical emergency unit with coma. There was no history of chest pain, fever, headache, vomiting, trauma, or seizures. She had no history ...

Introduction: Previous studies reported increased unfavorable metabolic phenotype in patients with active acromegaly.Aim of the study: We studied the metabolic phenotype in unselected cohort of 133 patients with active acromegaly (83 female, 62.4%), diagnosed at Clinic of Endocrinology, University Clinical Center, Belgrade, Serbia in the period 2007–2018. Mean age at diagnosis of acromegaly was 50.5±1.2 years and mean BMI was 28.4±0.4 kg/m...

Introduction: Clomiphene citrate (CC), a selective estrogen receptor modulator that increases LH and FSH secretion, improves hypogonadism and fertility outcomes. Moreover, there is limited evidence that it may also be helpful as add-on therapy to normalize IGF-1 levels in male acromegalic patients.Objective: To assess the effect impact of CC on serum IGF-1 and testosterone levels in male acromegalic patients not controlled by the combination of lanreotid...

Introduction: Persistent or intermittent postoperative discordance between growth hormone (GH) after OGTT and insulin-like growth factor-1 adjusted for age and gender (IGF-1) is up to 39% according to different studies. The aim of this study was to evaluate the impact of this discrepancy (normal GH and elevated IGF1 or vice versa) over the risk of biochemical and tumour recurrence after initial successful surgery for acromegaly.Methods: In this retrospec...

Pituitary apoplexy (PA) is a rare clinical syndrome due to sudden haemorrhage and/or infarction of the pituitary gland, usually within a pre-existent pituitary tumour. Even though some sporadic cases of PA associated with rare sellar lesions (such as Rathke cleft cysts) have been reported, in the vast majority of cases the syndrome occurs within a pituitary adenoma. At presentation, patients with PA usually complain of sudden and severe headache, often associated with visual l...

Introduction: Hypophysary aneurysms are rare, they account for 1% to 2% of all intracranial aneurysms (1) and can be mistaken for pituitary adenomas, since they can have similar symptoms and even radiological signs especially if it’s an aneurysm completely thrombosed as angiography will show only avascular mass (2).Clinical case: A 84 year old female with past medical history of hypertension, dyslipidemia and depressive disorder, presents to emergen...

According to state statistics service, Russia’s population in 2018 is more than 146.8 mil people. The total prevalence of acromegaly may range between 2.8 and 13.7 cases per 100,000 people and the annual incidence rates vary between 0.2 and 1.1 cases per 100,000 people (Lavrentaki A, et al. 2016). The epidemiological data for acromegaly in Russian population is lacking. The Russian hypothalamic and pituitary tumors registry was founded in 2004 and for 2018 it con...

Introduction: Cushing’s syndrome (CS) is certainly one of the most challenging disorders to physicians due to the difficulties that often appear during its investigation. The diagnosis of CS involves two steps: confirmation of hypercortisolism and determination of its etiology. Biochemical confirmation of the hypercortisolemic state must be established before any attempt for differential diagnosis. Failure to do so will result in misdiagnosis, inappropriate treatment, and...