Endocrine Abstracts

Introduction: Neuroendocrine tumors (NETs) are rare tumors that originate in cells from the neural crest, widely distributed in the body. Genitourinary (GU) NETs occurring in the bladder represent less than 1% of these primary malignancies. We present the case of a patient with two metachronous bladder tumors, of which one is NET.Case report: Male patient, 52–year-old, ex–smoker, known with hypertension, dyslipidemia and benign prostatic hype...

Measurement of electrical impedance has been proposed as a way to determine whether a hyponatremic patient is hypovolemic or euvolemic. We compare the usefulness of the physical examination (PE) with bioimpedance for determination of volemia in an outpatient hyponatremia clinic.Method: Descriptive prospective analysis. 11 patients attended at the hyponatremia clinic of a tertiary hospital were evaluated. Impedance was measured by a SECA, indicating the p...

Introduction: The most common cause of diabetes insipidus is idiopathic. In some rare cases, it can be secondary to metastasis to hypothalamic–pituitary region.Case report: We report a case of 68-years-old female patient presented to our clinic with complaints of polyuria and polydipsia. She had medical history of breast adenocarcinoma 6 years ago treated with surgery, neoadjuvant radiotherapy and 8 cycles of chimiotherapy. On physical examination ...

A 45 year old female was referred to the Endocrinology department with complains of severe fatigue and weakness from basic daily activities, also irregular menstrual circle during last five years. Twelve years back she had twin pregnancy, premature delivery on 29th week, and absence of lactation. Afterwards she gradually lost 6 kg of her body weight and her menstrual circle become sparse and disappeared five years back. 1.5 years ago type 1 diabetes was diagnosed (C-peptide be...

Menstrual irregularity is common in women with acromegaly, occurring in 40–84% of patients. Its pathogenesis is still not well established although it is usually attributed to prolactin excess and/or gonadotropin deficiency. Also, since the presence of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) receptors is demonstrated in the myometrium, a pathogenetic role of GH in the development of myoma is examined through different studies. Moreover, some of them ...

Acromegaly is a rare disorder caused by growth hormone (GH) and insulin-like growth factor I (IGF-I) overproduction, associated with increased morbidity and mortality. It has different complications, among which insulin resistance, prediabetes and diabetes mellitus are substantial. GH affects glucose metabolism through different mechanisms. The therapy of GH overproduction (for example surgical or radiotherapy) improves glucose metabolism, while different types of medical ther...

Introduction: Prolactinomas are rarely found in adolescents under 15 (incidence 0.1/1.000.000). They account for 50% of all types of pituitary adenomas in childhood and adolescence (2% of intracranial tumors). The mean time from onset of symptoms to diagnosis is 2.4 years on average for girls. In cases of macroadenomas, TSH and GH deficiency may coexist. The gold standard primary therapy is dopamine agonists. In case of non-response, or the presence of large prolactinomas with...

Introduction: Spacious sellar area predisposes to late diagnosis of nonfunctional pituitary adenomas and in males even the functional ones such as prolactinomas. Rising prevalence of obesity is mainly associated with sedentary lifestyle and excess of food intake. Only in rare cases has endocrine etiology such as Cushing disease, hypothyroidism or hypothalamic disorders.Case-report: A 29-year-old man was admitted to our hospital for chest pain, with a hig...

A 28-year-old female presented to the optician with visual disturbance, lethargy and headaches, which were initially attributed to long hours of IT work. Despite a trial of eye exercises she experienced worsening colour vision and acuity in the right eye, hence a further consultation with an optometrist. Examination did not reveal a visual field defect. Visual acuity was 6/6 with 9/17 ishihara plates in the right eye and 5/6 with 17/17 ishihara plates in the left. A further re...

Empty sella (ES) is characterized by herniation of the subarachnoid space within the sella, compression and flattening of the pituitary gland. Stretching of the pituitary stalk may also be seen. Empty sella is a frequent finding (5–23%) in autopsy series while it is < 0.01% in persons who undergo medical attention. Meanwhile there is an increase in sellar emptiness with age. Regarding pathophysiology and etiology, it may be primary to the incompetence of the diaphrag...

Introduction: Acromegaly (ACRO) is a rare disease of an excessive somatic growth and distorted proportions arising from hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). The aim Of this study is to investigate basic demographic parameters such as the age and gender related features, age at diagnosis of the disease, its clinical manifestations, biochemical control and structure of complications in Ukrainian patients with ACRO in a single neuroendoc...

Cabergoline has long been used to treat prolactinomas for symptomatic, radiological and biochemical resolution of pituitary tumours. As clinicians we are well-versed at screening for physical side effects, but are we holistic enough? We present two cases illustrating the damaging social consequences of cabergoline treatment for prolactinomas.Case 1A 49-year-old married father of two presented with a seizure in April 2018. MRI showe...

Introduction: Cushing’s syndrome (CS) has been associated with low quality of life, even after biochemical cure. However little data is available on long term follow-up. The aim of the study was to analyse 10-year follow-up of quality of life (QoL) in patients in remission of CS.Methods: 24 patients in remission of CS followed in Hospital Sant Pau were included in this study (3 men, 21 pituitary origin, 3 adrenal; mean baseline age 45.1 ± 14.1...

Introduction: The treatment of choice in persistent acromegaly after transsphenoidal adenomectomy is pharmacological treatment with first generation somatostatin analogs. They are effective in 25% to 45% of patients. Second generation somatostatin analog – pasireotide seems to be more effective.Aim: The aim of the study was to assess the efficacy and safety of pasireotide LAR in acromegaly patients resistant to first generation somatostatin analogs...

A 36-year-old male presented to the emergency department with a 24-hour history of mutism, paranoia and 3-day history of social withdrawal. He was unable to engage with healthcare professionals and the history was elicited from his mother. Due to a background of mild depression, an acute psychotic diagnosis was initially pursued. A CT scan on admission revealed a large pituitary lesion. A pituitary MRI scan thereafter demonstrated a large 25 × 30 × 18 mm sellar and s...

Introduction: Full blood count (FBC), C-reactive protein (CRP), albumin and serum inflammation-based scores reflect systemic inflammation and predict outcomes in oncological patients. While these are increasingly used in cancer, little is known in pituitary adenomas (PAs). We aimed to characterise FBC and inflammation-based scores in patients with PAs and investigate the usefulness of such parameters in predicting aggressive/refractory disease.Methods: W...

Aim: Evaluation of hypocortisolism and replacement treatment after transsphenoidal surgery pituitary adenomas and subsequent follow-up in Endocrinology offices.Material and methodWe conducted a retrospective intra-subject study of patients with pituitary adenomas who were undergone surgery. Clinical and analytical data were evaluated at baseline and after surgery between 2012–2018.Results: 30 patients (...

Introduction: The purpose of this study was to evaluate treatment options and effectiveness in patients with acromegaly.Methods: The study involved retrospective data collection from charts of 75 patients with acromegaly who was treated at Vilnius University Hospital Santaros klinikos.Results: Patient population consisted of 21 males (28%) and 54 females (72%), mean age at diagnosis 52 ± 13 years. In most of the cases, macroad...

Introduction: Pituitary apoplexy is defined as the acute onset of clinical symptoms associated with hemorrhage or infarction within a normal pituitary gland or previously known pituitary adenoma.Case report: A 47-year-old hypertensive Caucasian male patient with a known pituitary macroadenoma and family history of pituitary adenomas, was treated with thromboprophylaxis after a meniscus surgery. He was on treatment with non-steroidal anti-inflammatory med...

Background and Aim: Non-functioning pituitary adenomas (NFPAs) are hormonally inactive adenohypophyseal tumors. The absence of hormone hypersecretion and the lack of clinical manifestations delay the diagnosis and therefore symptoms of mass effect are frequently seen in NFPAs. The primary endpoint of this study was to evaluate the clinical presentation of patients with NFPAs and their therapeutic management. The secondary endpoint was to identify how gender and tumor size impa...

Background: Patients report a variety of persisting symptoms that reduce their quality of life after treatment for non-functioning pituitary adenomas (NFPA). Digital tools have the potential to improve patient-provider communication and patient outcomes by giving opportunities for patients to report their current status, which can be helpful in recognizing symptoms and identifying needs. Mapping patients’ symptoms, needs and preferences prior to the consultation can aid ...

Objective: Cushing’s disease (CD) is difficult to diagnose because of its rarity and because its most common symptoms can overlap with those of other more common conditions. Remission rates in the postoperative vary between 55–85%. Overall, the mean time to diagnosis was 38 months. The objective of this study was to describe whether there is any pre-surgical clinical data that predicts CD remission after TSS.Patients and Methods: Retrospectiv...

Objective: The aim of the study is to evaluate both the long-term consequences of exposure to dopamine agonists (CAB and BRC) at the beginning and during pregnancy, and the effects of pregnancy on remission.Methods: Thirty-seven prolactinoma patients who developed 58 pregnancies while receiving DAs treatment were included in this retrospective study. Age of gestation; both maximum residual tumor diameter and PRL levels before conception; the course of pr...

Both pituitary and adrenal gland metastases of lung cancer are very rare. A 79-year-old male patient with diabetes mellitus and hypertension was admitted to our hospital because of a mass in the lungs of the thorax CT. TSH: <0.005 UIU/ml (0.27–4.2), free T4: 0.794 ng/dl (0.93–1.7). Other pituitary hormones were also examined: FSH: 0.708 mIU/ml (1.5–12.4), LH: <0.1 mIU/ml (1.7–8.6), prolactin: 12.7 ng/ml (4.04–15.2), total testosterone: &#6...

Objectives: To describe the results of the bilateral inferior petrosal sinus sampling (BIPSS) performed in our hospital for differential diagnosis between Cushing disease (CD) and ectopic ACTH secretion (EAS), and evaluate if CRH stimulation during this test improves its diagnostic accuracy.Material and Methods: We retrospectively review 29 BIPSS performed in 26 patients (4 men, 22 women), with mean age of 44.7 year-old (range 28–69), diagnosed wit...

We describe four female patients with T2DM, presenting with nocturnal dizziness (ND), low capillary blood glucose & low BP, that was partially relieved with oral glucose & salt water. C1: MB 66 years, on background of hypertension (HT, valsartan + hydrochlorthiazide (HCT) + amlodipine (AM) ), hypothyroidism (T4D) (levothyroxine 700 mg/week) & IHD (pEF) presented, 3 years into her diagnosis, A1c 52 mmol/mol, with unsteady gait, frequent falls (normal-neurolo...

Introduction: The purpose of this study was to describe the clinical characteristics of patients with macroprolactinoma in a second level Hospital.Methods: Retrospective data collection of patients diagnosed with macroprolactinoma between 2002 and 2017 at Jerez University Hospital.Results: Complete Data were obtained from 22 patients. The mean age at diagnosis was 40.32 ± 18.3 years (men: 52.9 ± 14.2, women: 27.7 ± 1...

Background: Cushing’s disease is characterized by chronic ACTH hypersecretion, leading to hyperplasia of the adrenal zonae reticularis and fasciculata and, therefore, increased secretion of cortisol, androgens and DOC. Cushing’s disease is the most common form of Cushing’s syndrome, being responsible for approximately 80% of reported cases.Aim: To evaluate the curability rate of Cushing’s disease 1 year postoperatively.<p clas...

Introduction: Langerhans Cell Histiocytosis (HCL) is a rare granulomatous disease, unknown etiology, with a wide clinical spectrum. The pituitary is affected in 25% of cases, with diabetes insipidus being the earliest and most frequent feature. Although it is more common in pediatric age, it can also be developed by adults.Clinical case: A 39-year-old, caucasian, woman presents with polydipsia with 5L/day of water and an appetite for cold drinks, polyuri...

Introduction: The pituitary adenoma is the most frequent begnin pituitary tumor. They are labeled based on their size, tumors smaller than 1 cm called microadenomas and tumors bigger than 1 cm called macroadenomas. Moreover, they can be functional or non functional. Among the functional ones, gonadotroph adenomas represent 15 to 20%.ObservationWe report the case of a 27 years old women, who consulted for secondary amenorrhea for 1 ...

Kallmann syndrome is a rare congenital hypogonadotropic hypogonadism with variable degrees of hyposomia to anosmia. This syndrome can be transmitted as autosomal dominant, autosomal recessive and X-linked inheritance pattern. We are reporting two cases of young male siblings (17 and 16 years old) who are the offspring of unrelated parents, presenting with delayed puberty and both were complaining of hyposmia. Their older brother, aged 24 years, was diagnosed with isolated hypo...

Introduction: Ghrelin - a growth hormone (GH) secretagogue - presents a circadian rhythm with higher nocturnal concentration (similar to GH). As daily ghrelin production depended on food intake and nutritional state, we decided to assess ghrelin concentration at 60th at 90th minute after falling asleep and at 6:00 am (after 12 hours of fasting), and compare the results to determine the differences between nocturnal and morning ghrelin release in short children, both with idiop...

Introduction: The association between pituitary adenoma and hyperparathyroidism is the main feature of multiple endocrine neoplasia (MEN) 1 but also for a novel MEN4 syndrome. Germline mutations in the cyclin-dependent kinase (CDK) inhibitor 1b gene (CDKN1B) were identified in patients with MEN4. The most common phenotype of the 19 established cases of MEN4 that have been described since now is primary hyperparathyroidism (PHPT) followed by pituitary adenomas. There are a limi...

Background: Radiotherapy (conventional and/or radiosurgery) is an effective treatment option in patients with acromegaly when biochemical control of the disease cannot be achieved by medication and/or surgery. Purpose: The aim of our study was to evaluate the efficacy of gamma-knife radiosurgery or conventional radiotherapy in the treatment of GH-secreting pituitary adenomas.Materials and methods: We conducted a retrospective analysis of 22 acromegaly pa...

Multiple dose adjustments can sometimes be inefficient in reaching eumetabolic state in patients with hypothyroidism treated by levothyroxine sodium tablets.We report a case of 46-year-old female who has been on levothyroxine sodium tablet replacement therapy since 2004 without ever reaching eumetabolic state. As sellar MRI ruled out pituitary adenoma, investigation perform absorption test with 300 mg levothyroxine and test was positive in aspect of pres...

A 74-year- old gentleman was found to be hyponatraemic when he returned from birds watch trip with cellulitis of lower legs. He was generally fit and well apart from hypertension for which he had been on Amlodipine and Irbesartan. He was admitted with severe hyponatremia in July 2019 and was diagnosed with idiopathic SIADH as evidence of low serum osmolality (252 mosm/kg), high urine sodium (41mmol/l) and high urine osmolality (657mmol/kg). His Amlodipine and Irbesartan were r...

Background: Lu-NETs are a heterogeneous family of neoplasms ranging from quite indolent lesions with extremely aggressive tumors with very poor prognosis. These neuroendocrine entities are further summarized into two groups according to their biological aggressiveness: Well-differentiated: carcinoids typical (G1) and atypical (G2).Poorly-differentiate: SCLC (Combined) and LCNEC (Combined) (G3). Alarm signal on the aggressive evolution of the SCLCCase rep...

Introduction: CD8+ T-cell deficiency is a feature of many chronic autoimmune diseases. Its association with vitamin D deficiency was described and it has been suggested that vitamin d deficiency contribute to the increase of the incidence and the progression of autoimmune diseases.Herein we report a case of hypopituitarism and vitamin D deficiency in a patient with CD8+ T-cell deficiency.Observation: A 28-year-old woman was...

Introduction: Silent corticotropic adenoma (SCA) is defined by the absence of clinical manifestations of Cushing’s disease despite the presence of ACTH and/or its precursors in tumor cells. It is a rare entity that represents 10% of pituitary tumors. It is known for its increasing expansion. Its clinical presentation is dominated by symptoms of tumor mass effect. We report the case of a silent corticotropic adenoma revealed by headache.Case report:...

Introduction: Amenorrhea is a condition resulting from dysfunction of the hypothalamus, pituitary, ovaries, uterus, or vagina. Hyperprolactinemia is a relatively common endocrine disorder that produces amenorrhea by suppressing hypothalamic GnRH secretion. We describe a patient who had a Levonorgestrel intrauterine device (UID) since 5 years and who presented with amenorrhea in association with a macroprolactinoma.Case report: A 45 year- old -woman prese...

Introduction: Inferior petrosal sinus sampling (IPSS) is the gold standard test to differentiate Cushing’s disease from ectopic Cushing syndrome. IPSS may cause severe complications; however, overall rates are low. Subarachnoid hemorrhage (SAH) has been rarely reported after IPSS. Here we report a case who developed hypertensive emergency, left 6th cranial nerve palsy, and SAH after IPSS.Case: A sixty-two years-old female patient had a history of h...

Introduction: Infundibulo - hypophisitis is a rare type neuroendocrine disorder characterized by autoimmune inflammation and various pituitary disfunction. It currently has no clear diagnosis criteria.We present the 26 years–old women, first diagnosed with infundibular neurohypophisitis with clinical Diabetes Insipidus and later with other metabolic disorders.Case description: The patient, female, 26 years old came in the emergency room with extrem...

Acromegaly is a rare disease, which is mainly caused by benign tumour of the pituitary gland. Long-term presence of elevated growth hormone (GH) and insulin like growth factor 1 (IGF-1) levels accompanying this disease is associated with rheumatologic, cardiovascular, pulmonary and metabolic complications. Cardiovascular complications of acromegaly include a cardiomyopathy, arterial hypertension, arrhytmias, valvulopathy as well as endothelial dysfunction. Cardiovascular disea...

Introduction: Acromegaly is, in most cases, caused by growth hormone (GH) -secreting pituitary adenomas that lead to characteristic phenotypical changes. Its association with emty sella (ES) has been described and different theories has been given to explain such situation. Moreover, patients with acromegaly often develops different pathologies of the thyroid gland, however, the occurrence of grave’s disease (GD) is quite a rare situation. Here we report a case of a pati...

Introduction: Unexplained weight loss is a cause for concern; it might indicate an underlying condition, usualy a catabolic state. In empty sella, the progressive loss of pituitary hormone secretion is usually a slow process, with symptoms varying from one person to another and depends on the underlying cause. Usually the weight remain relatively constant or we could have several arguments for weight gain.Case report: A 57 years old man with significant ...

Developmental toxicity tests have been made by embryonic stem cell tests at the European Centre for the Validation of Alternative Methods or by embryonic body test in our laboratory. However, no neuronal-specific developmental toxicity test has been made yet. Therefore, this study was carried out using a 46C cell line, mouse embryonic stem cells with an endogenous Sox1-GFP reporter, to exploit the developmental neurotoxicity test. The expression of Sox1, a marker for neural pr...

The craniopharyngioma is a benign tumor, curable but aggressive by its localization involving the vital and visual prognosis of the patients. Treated mainly by surgery associated with radiotherapy which allows high long-term survival but at the expense of significant side effects, it nevertheless poses a problem of therapeutic management. The aim of this study is to illustrate the therapeutic difficulties in the management of craniopharyngiomaPatients an...

Introduction: Pituitary apoplexy is a rare complication in 2%-12% of pituitary adenomas, due to sudden hemorrhage or infarction. Patients with signs of meningeal irritation, important visual field defects, ocular paresis, decreased unilateral or bilateral visual acuity or altered consciousness are treated by neurosurgical intervention, while patients without these signs could be managed conservatively.Aim: To present a series of 4 cases with pituitary ap...

Despite advances in neurosurgical techniques, due to their size and their readily invasive nature, surgical resection of functional or non-functional pituitary macroadenomas is often only partial, justifying the use of any additional treatment (resumption of surgery, radiotherapy, treatment drug).Patients and Methods: 10 patients were included in the study (7 men middle-aged 56 and 3 women middle-aged 48). 4 patients followed for non-functional pituitary...

Pituitary adenomas are the most common cause of pituitary lesions. Atypical teratoid rhabdoid tumors are rare aggressive tumors of the central nervous system and are generally seen in children younger than 2 years of age, but also rarely in adults. Only 18 cases have been reported with pituitary involvement to 2018. Median survival in these tumors in adults is 21 months and the cause of death is usually tumor recurrence or leptomeningeal spread. Although surgery, chemotherapy ...

Introduction: Metastases in pituitary gland are extremely rare with a reported prevalence of 1% among all pituitary tumor resections and 1 to 3.6% among post-mortem studies (1). Breast and lung cancer are the most common sites of primary tumor that have been reported to metastasize in pituitary gland and about 7% of all metastases are symptomatic (2.3).Case report: A 62-year-old male with a 40-pack-year smoking history and no previous medical conditions ...

Introduction: Growth retardation in sickle cell children is common and multifactorial. Recent evidence suggests damage to the somatotropic axis. We report the case of a patient followed for homozygous sickle cell anemia and in whom we discover an associated GH deficiency.Observation: It is a 13 year old child followed for homozygous sickle cell anemia, splenectomized for 2 years, not polytransfused. We were sent to the hematology department before a dela...

Objective: Remission of Cushing’s disease (CD) in the postoperative vary between 55–85%, recurrence of up to 25%. Remission and recurrence rates vary dependent on tumor size and neurosurgical expertise. The objective of this study is to describe whether there are clinical data that help us to predece recurrence of CD after transsphenoidal surgery (TSS).Patients and Methods: Retrospective analysis of patients who underwent as TSS for CD. Varia...

Background: Pituitary gland metastasis is rarely the initial presentation of metastatic cancer. Most cases of pituitary gland metastasis are asymptomatic with diabetes insipidus being the most common symptomatic presentation. It can rarely present with symptoms of hormone underproduction such as anterior pituitary deficiency. Although pituitary gland metastasis is rare, it is underestimated, as it is commonly misdiagnosed with pituitary gland adenoma due to the lack of clear r...

Introduction: Dopamine agonists (DAs) consisting of cabergoline (CAB) or bromocriptine is the primary therapy in prolactinomas. DAs are also used in Parkinson’s disease and restless leg syndrome with much higher doses. As a result of reports related to doses in these patients, it is known that long term use of DAs can lead to fibrotic syndromes affecting heart and lung. Cardiac valvulopathies are the most common investigated side effects but there are case reports of ple...

Introduction: Acromegaly is a rare disease caused by excess production of growth hormone (GH) and is associated with multiple complications. The prevalence of associated complications and the mortality rate are associated with the duration of exposure to elevated GH levels, early diagnosis being imperative. Diagnosis of acromegaly is most frequently late, after several years of evolution, with the development of cardiovascular, respiratory, metabolic complications. The presenc...

Introduction: Gigantism represents a rare pathology in children, characterized by growth hormone (GH) excess, before epiphyseal fusion. It associates significant morbidity and decreased life expectancy, in lack of appropriate treatment.Case presentation: O.D., a male patient, 16 years old now, has been followed in our clinic since 2016, being diagnosed with gigantism in Bega Pediatric Clinic, at the age of 12 years 9 months. In 2014, the patient presente...

Preoperative evaluation of pituitary macroadenoma tumor consistency is important for neurosurgery. Thus, we aimed to retrospectively assess the role of contrast-enhanced fast imaging employing steady - state acquisition (FIESTA) in predicting the tumor consistency of pituitary macroadenomas.Objectives: In endoscopic endonasal transsphenoidal surgery of pituitary adenoma, after the removal of the lower component of the tumor, the upper component does not ...

Background: Intracranial Germ Cell Tumors (GCTs) are thought to originate from error of primordial germ cells migration during embryonic development, manifesting during first and second decade of life and accounts for 3-5% of all intracranial tumors.Methods: We report a case of a 22-year-old patient who presented with progressive visual loss with polyuria and polydipsia, harboring an intracranial germ cell tumor.Case presentation: ...

Introduction: Granulomatosis with polyangiitis (GPA) is a systemic vasculitis with necrotizing granulomatous inflammation. Any organ including the pituitary can be involved. Here we report a patient diagnosed with GPA who had nearly complete resolution of pituitary mass after cyclophosphamide and methylprednisolone treatment.Case46 year old female patient was admitted to the hospital after being examined by several departments for ...

Rationale: At present, there is no approved medical treatment for patients with clinically non-functioning pituitary adenoma. A number of open-label studies suggest that treatment with somatostatin analogues may prevent tumour progression in selected patients. In vivo assessment of somatostatin receptor status using 68Ga-DOTATATE PET could help to select patients responsive to treatment.Trial objective: To investigate the effect of the somatosta...

Background: Patients being cured of craniopharyngioma (CP) often suffer from severe hypothalamic obesity due to tumor localization or therapeutic interventions, which has a major impact on increased mortality and reduced quality of life. Gastric bypass surgery (GBS) was suggested to be an effective therapeutic option for weight reduction in those patients. However, long-term changes in body weight and postsurgical complications are unknown.Methods: 5 pat...

Introduction: Cushing’s disease is caused by endogenous hypercotisolism, due to the hypersecretion of the adenocorticotropic hormone (ACTH) by an ACTH-secreting pituitary adenoma. However, some patients with Cushing’s disease have no visible adenoma on MRI. The goal of this study is to review the clinical features, diagnosis and medical preparation of patients with Cushing’s disease.Material and Methods: A retrospective study including ...

Introduction: Multiple endocrine neoplasia type 1 (MEN1) is a rare disease, defined as a tumor developing in at least two endocrine glands including the anterior pituitary gland, the parathyroid glands and the duodeno-pancreatic endocrine tissue. This is an inherited disorder. However, sporadic cases account for 8–14%. We here report a case of MEN1 revealed by vitamin B12 deficiency.Observation: A 37-year-old young woman admitted to our department ...

Introduction: VonHippel Lindau (VHL) disease is an autosomal dominant disorder, responsible of the occurrence of multiple endocrine and non-endocrine lesions. When it comes to this hereditary syndrom., pheochromocytoma and pancreatic neuroendocrine tumors (pNET) require special monitoring and an appropriate treatment, The object of this case report is to highlight the different clinical presentation of the same lesion in the same patient and the difficulties in decisions&#8217...

Introduction: Cushing disease, as a state of chronic hypercortisolism, causes diverse, often nonspecific symptoms, possibly delaying the proper diagnosis.Case report: A 59-year-old woman with the history of type 2 diabetes mellitus, hypertension, osteoporosis and multiannual history of recurrent hospitalizations because of life-threatening multi-sited soft tissue and muscle abscesses, was admitted to the Department of Internal Medicine and Metabolic Dise...

Acromegaly is a rare disorder with a high morbidity and mortality rate. The diagnosis is typically prolonged over time due to a slow and hidden development of the disease. Current medical therapy for the treatment of acromegaly involves the administration of somatostatin analogues that effectively suppress excess hormone secretion. The objective of this study was to investigate the efficacy of octreotide therapy in acromegalic. A total of 32 patients have been treated with Oct...

Aim: To describe the clinical and analytical characteristics of patients with hypopituitarism in the Endocrinology Department.Materials and methods: This was a descriptive, retrospective study with 70 patients diagnosed with hypopituitarism in the Endocrinology Department´s outpatient consultations with a follow-up of up to 44 years. The qualitative variables were expressed in frequencies and the quantitative variables showed a normal distribution e...

Objective: To report a rare cause of ectopic adrenocorticotropic hormone (ACTH) secretion leading to Cushing syndrome.Methods: We describe the clinical presentation and management of a case of Cushing syndrome attributable to ectopic ACTH secretion from small cell cancer of the prostate.Results: In a 74-year-old man developed hypocalemia and heart failure. He was found to have severe hypokalemia (serum potassium, 2.37 mEq/l). Hormo...

Introduction: Dexamethasone Suppression Test (DST) is a useful approach in diagnosis and differential diagnosis of Cushing Syndrome (CS) despite its limitations. One of the major limitations is the difficulty to provide standard suppression dose depending on the variability of gastrointestinal absorption. One solution is for this testing serum Dexamethasone levels or test it with intravenous (iv) Dexamethasone In this case, we examined 3 patients to whom we applied intravenous...

Introduction: Acromegaly is a chronic disease caused by excess growth hormone (GH) release from an adenoma caused by somatotroph cells of pituitary gland.In acromegaly, it is known that the risk of thyroid and colon cancer is increased 8 and 4 times, respectively, compared to the normal population.Moderate hypercalcemia, due to vitaminD activation, is seen in acromegaly, but overt hypercalcemia, generally secondary to primary hyperparathyroidism, is rare.Combination of acromeg...

Introduction: Acromegaly is an insidious disease caused by chronic GH and IGF-I hypersecretion associated with increased morbidity and mortality, mostly from cardiovascular complications. The aim of this study is to compare cardiovascular risk factors, between patients with medical treatment vs cured.Materials and methods: This is a retrospective study of 37 acromegalic patients, 21 well controlled with medical treatment (IGF-I within the normal range fo...

Introduction: Medullary thyroid carcinoma (MTC) accounts for 3-9% of all thyroid cancers and only 0.7% develop paraneoplastic Cushing’s syndrome. However, incidence of endogenous Cushing’s syndrome is also low (1–3/million population/year), with a female preponderance, pituitary mediated ACTH production being responsible for up to 80% of these cases.Aim: To present the difficulties in the differential diagnosis of ACTH dependent hyperco...

Introduction: Combined pituitary hormone deficiency (CPHD) is characterized by impaired production of pituitary hormones. A possible cause are PROP-1 mutations (prophet of Pit-1 protein). It plays an essential role in the evolution of pituitary cells secreting GH, TSH, LH, FSH, prolactin; some patients may develop late ACTH deficiency. PROP 1 gene mutation is manifested with variable degrees of phenotype-genotype correlation, with growth failure as the first sign detected in e...

Introduction: Cushing’s disease (CD) is a potentially fatal disease caused by corticotrophic adenoma of the pituitary gland. Crooke Cell Adenomas (CCA) are a rare variant characterized by cytoplasmic ring deposits of cytokeratin filaments. They are usually aggressive macroadenomas with a higher rate of recurrence and malignancy.Clinical case: A 36 year old man, with 34 kg weight gain and uncontrolled hypertension for 4 years presented at the Emerge...

Craniopharyngioma is a slow growing benign epithelial tumor, growing from the pituitary stalk or pituitary gland in the sellar and/or parasellar region. Despite its benignity, the quality of life of patients is most often altered, due to the endocrine, visual and neuro-intellectual sequelae linked to the tumor itself and/or its treatment, as well as a high rate of recurrence. local. Early diagnosis remains the determining factor in prognosis. The objective of this study is to ...

Panhypopituitarism refers to decreased production of all of the pituitary hormones of the adenohypophysis with or without deficiency of neurohypophysis function. The development of the disorder is frequently insidious and the manifestations often depend on the etiology of the condition.Case report: In October 2019 a 57-year-old man collapsed in front of the hospital after being discharged from the cardiology clinic. The day before, he had undergone angio...

Introduction: Pituitary apoplexy is a rare and potentially life-threatening endocrine and neurosurgical emergency, most often linked to hemorrhage or necrosis of a pituitary adenoma.Observation: We report the case of a 45 year old patient, with a history of chronic headache, hospitalized in the emergency setting for the management of meningeal syndrome with severe headache associated with vomiting, a significant drop in visual acuity, exophthalmos and pt...

Introduction: Cushing syndrome could be missed initially, especially when the presenting features are common in the general population. Before proceeding to the hormonal tests we have to consider that recent studies have shown that up to 50% of patients with CD have different degrees of altered glucose metabolism, up to 80% of CS patients have hypertension independently of their age and sex and hypercorticism changes bone structure and causes vertebral fractures in approximate...

The term “undifferentiated connective tissue disease” (UCTD) represents a stage of disease where clinical symptoms and serological abnormalities suggest autoimmune disease, but they are not sufficient to fulfill the diagnostic criteria of any well-established connective tissue disease (CTD). A 73-year-old man was referred to the 3rd hospital of Tashkent Medical Academy with signs of kidney lesion and the history of treatment at two other medical settings.<p cla...

Background: Carcinoid crisis (CC) may rarely occur as a complication of general anesthesia/surgery or peptide receptor radionuclide therapy (PRRT) in patients with neuroendocrine tumor (NET). The incidence of CC as a complication of PRRT is underestimated and comes to 10% of all radioisotope therapies. Progressive organ dysfunction, decrease or increase in blood pressure SBP <80 mmHg or >180 mmHg, unexplained tachyarrhythmia with heart rate >120/ min, bronchoconstr...

Introduction: Acromegaly is a rare disease characterized by somatotropic hypersecretion. The disease is associated with multiple significant comorbidities and increased mortality. The purpose of this study is to describe the epidemiological, clinical, para-clinical and therapeutic features of Acromegaly disease.Patients and Methods: This is a retrospective study including 12 patients with acromegaly in the Endocrinology Diabetology Department of Oujda&#8...

Introduction: Prolactinomas are the most common pituitary adenomas. Dopamine agonists (DAs) are the treatment of choice for prolactinomas. Patients with prolactinomas normally are treated in ambulatory. In some patients there are challenges in therapy, and they need to be hospitalized.Objective: To study the clinical features and outcomes of in-patients with prolactinoma.Materials and methods: A retrospective analysis of 40 hospita...

Background: Neuroendocrine tumors (NETs) are relatively uncommon, accounting for 10 to 14 percent of all neuroendocrine neoplasms. Twelve percent to 22% of patiens are metastatic at presentation. The most frequent primary sites are the gastrointestinal tract (62–67%) and the lung (22–27%).Case presentation: We report the case of a 36-year-old female patient diagnosed with metastatic disease, with liver, lung and lymph nodes metastasis with un...

Introduction: Insulinoma is a rare tumor of the beta cells of the pancreas. The clinical manifestation is diverse with hypoglycemia and autonomic neurological symptoms. For diagnosis the Whipple’s triad needs to be present: signs of hypoglycemia, glucose level under 3 mmol/l and the cessation of symptoms after administration of iv. glucose. The fasting test confirms the diagnosis. The most commonly used imaging techniques that may localize the tumor are the abdominal ult...

Introduction: Acromegaly is a debilitating, indolent disease that develops over several years due to extended exposure to elevated growth hormone (GH) levels. It is most commonly caused by somatotropinomas. It represents a rare pathology with an incidence of 3–14 cases per 1 million inhabitants and a prevalence of 40 to 90 cases per 1 million inhabitants. Pituitary adenomas respresent a challenging disease in young patients. Transphenoidal surgery is the best therapeutic...

Introduction: Cushing’s disease (CD) is reported in 60-70% of all patients with Cushing’s syndrome (CS), but occurs only in approximately 33% of the reported CS cases in pregnancy. Nevertheless, despite its rarity, pregnancy in patients with CS can be troublesome because of the risk of maternal-fetal complications.Observation: A 28-year-old female patient was referred to our endocrinology department for a suspected CS with morphological alter...

Multiple endocrine neoplasia type 1 is a rare autosomal-dominant disorder. The most common endocrine tumors are parathyroid tumors, which cause hyperparathyroidism and hypercalcemia. Other tumors of MEN 1 include pituitary tumors for example prolactinomas and enteropancreatic tumors such as gastrinomas, insulinomas, VIPomas, carcinoid tumors. We report a case of a 31 year old male with MEN 1 presenting hypercalcemia with complaints of fatigue and weakness. On further questioni...

Introduction: Cushing’s syndrome is a rare condition, resulting from chronic exposure to excessive circulating levels of glucocorticoids. This condition is highly associated with complications such as cardiovascular and metabolic disorders. This study aims to review the clinical characteristics, diagnosis and treatment of patients with ACTH-dependent Cushing’s syndrome.Material and Methods: A descriptive and comparative study carried out in t...

Introduction: Multiple endocrine neoplasia type 1 (MEN-1) is a rare, autosomal dominant inherited disorder, characterized by a high predisposition to develop a wide spectrum of endocrine and nonendocrine tumors, mostly of parathyroids, endocrine pancreas, and anterior pituitary.Methods: Analysis of clinical and laboratory data, family history of multiple endocrine neoplasia.Results: A 19-year-old woman with autoimmune thyroiditis a...

Topical steroids are widely used by dermatologists and other physicians for the treatment of skin diseases such as diaper dermatitis. Iatrogenic Cushing syndrome may occur as an undesirable outcome of high-dose glucocorticoids treatments. This may also cause hypothalamus–hypophysis– adrenal axis suppression. While this situation may be caused more frequently with oral and topical glucocorticoid therapy, iatrogenic. Here, we report a 6 month-old boy with Cushing syn...

Introduction: Cushing’s disease is a rare condition observed in about 8–10% of patients with pituitary tumor. In the majority of cases, corticotroph adenomas are small, intrasellar and less than 10mm in diameter, while macroadenomas occur in 4–10% of the patients. An observation of two clinical cases is reported. The observationCase number 1: a female patient aged 31, hospitalized for suspected Cushing’s dis...

Introduction: Acromegaly increases morbidity and mortality and should be treated even in the asymptomatic phase. It is almost always caused by a GH-producing pituitary adenoma and although transsphenoidal surgery is the treatment of choice in most cases, in others, primary medical therapy is indicated.Clinical case: A 36-year-old female with a family history of thyroid functional pathology and diagnosed with micronodular goiter was evaluated in February ...

A 16 years old boy referred to neurosurgery due to sellar and suprasellar mass. He had a history of retro orbital headache in the last three years. he noticed increase in his height, enlargement of hands and feet. He had one year history of progressive decrease in vision mainly in the left. He did not enter puberty.Physical examinationsBMI 36 kg/m2 (more than 95 percentile), Tall height 190 (more than 97 percentile), Wei...