Searchable abstracts of presentations at key conferences in endocrinology
Previous issue | Volume 97 | BES2023

Belgian Endocrine Society 2023

BES 2023


ea0097001 | Section | BES2023

Hydrocortisone treatment increases cholesterol availability in prolonged septic mice: effect on adrenal and muscle functioning

Bruyn Lauren De , Arno Teblick , Oudenhove Tim Van , Perre Sarah Vander , Inge Derese , Lies Pauwels , Sarah Derde , Berghe Greet Van den , Lies Langouche

Background: Sepsis is hallmarked by an immediate and sustained decrease in total-, HDL-, and LDL- cholesterol, associated with poor outcome and suggested to be a potential contributor to adrenal failure and muscle weakness in the critically ill. Although the underlying mechanisms are unclear, this sepsis-induced hypocholesterolemia has been postulated to be due to an increased conversion of cholesterol to cortisol. We hypothesized that hydrocortisone (HC) trea...

ea0097002 | Section | BES2023

Protein tyrosine phosphatase receptor kappa regulates glycolysis, lipid metabolism and promotes hepatocyte reprogramming in obesity

Eduardo H Gilglioni , Li Ao , Wadsen St-Pierre-Wijckmans , Tzu-Keng Shen , Israel Perez-Chavez , Garnik Hovhannisyan , Daria Ezerina , Michela Lisjak , Andre Dias , Javier Negueruela , Mamnez Julia Bauza- , Jose Maria Herranz , Stephane Demine , Zheng Feng , Thibaut Vignane , Lukas Otero , Flavia Lambertucci , Alena Prasnicka , Jacques Deviere , Jose Antonio Encinas , Sumeet Pal Singh , Joris Messens , Milos Filipovic , Eric Trepo , Hayley Sharpe , Wei Wu , Esteban N Gurzov

Fat accumulation, lipogenesis and glycolysis are key contributors to hepatocyte metabolic reprogramming and the pathogenesis of non-alcoholic liver fatty liver disease (NAFLD). The molecular mechanisms affected by steatosis and inflammation in the obese state remain unknown. Here we report that obesity leads to dysregulated expression of protein-tyrosine phosphatases in human livers. Protein Tyrosine Phosphatase Receptor Kappa (PTPRK) levels were increased in hepatocytes by st...

ea0097003 | Section | BES2023

Low-dose anti-thymocyte globulin in combination with verapamil reverses hyperglycaemia in newly diagnosed diabetic NOD mice

P. J. Martens , M. Viaene , D. Ellis , N. Geukens , C Mathieu , C. Gysemans

Background: To arrest the immune-mediated destruction of the insulin-producing pancreatic beta cells in type 1 diabetes (T1D), interventional studies have predominantly focussed on two distinct approaches: arresting the ongoing immune response or protecting the pancreatic beta cells. Recently, both approaches using respectively low-dose anti-thymocyte globulin (ATG), an immune-depleting agent, and verapamil, a calcium channel blocker with beta cell protective ...

ea0097004 | Section | BES2023

Androgen Deprivation Modulates the Adrenocortical Stress Response

V. Sommers , M. Gentenaar , E. Viho , C. Helsen , V. Dubois , J. Kroon , B. Decallonne , F. Claessens , O.C. Meijer

Background and aim: Androgens and glucocorticoids are regulated via the hypothalamus-pituitary-gonadal (HPG) and hypothalamus-pituitary-adrenal (HPA) axis, respectively. We aimed to check possible interference of androgen deprivation with the HPA axis and circulating glucocorticoid levels. Androgen deprivation is most widely used in the treatment of prostate cancer, but is also applied in gender-affirming care and males with hypersexual disorder. Current insig...

ea0097005 | Section | BES2023

Insulin resistance is associated with worse CGM-derived parameters in people with type 1 diabetes

Isabel Clinck , Jonahtan Mertens , Kristien Wouters , Eveline Dirinck , Block Christophe De

Background: An increasing number of people with type 1 diabetes (TlD) have co-existing insulin resistance (IR). Our goal was to investigate whether IR is associated with continuous glucose monitor (CGM)-derived parameters (glucometrics) such as time in range (TIR), time above range (TAR), time below range (TBR) and glycaemic variability (CV).Methods: This is a retrospective analysis of two separate clinical studies (NCT0...

ea0097006 | Section | BES2023

Effects of Long-term Testosterone Treatment in Transgender People without Gender-Affirming Surgery: the ELANTES study

Karen Decaestecker , Jeroen Vervalcke , Visschere Pieter De , Steven Weyers , Guy T'Sjoen

Background: Since pelvic gender-affirming surgery (GAS) is no longer required for legal gender change, we expect a growing number of transgender men and gender nonbinary people who refrain from pelvic surgery. Little is known about the effects of long-term testosterone use on the reproductive organs. Polycystic ovaries and endometrial changes have been described in previous histology-based studies. Furthermore, cervical cancer screening (CCS) is still recommen...

ea0097007 | Section | BES2023

Dose Reduction of Cyproterone Acetate in Trans Women and the Effect on Patient- reported Outcomes: Results from the ENIGI Study

Tim Flamant , Jeroen Vervalcke , Guy T'Sjoen

Context: Cyproterone acetate (CPA) is an androgen receptor blocker often used for testosterone suppression as a part of gender-affirming hormonal treatment (GAHT) in transgender women. In recent years, more concerns have been raised towards an increased risk of meningioma development, linked to CPA use in higher doses (25 mg or more per day).Objectives: To determine if lower doses of CPA are equally effective in maintain...

ea0097008 | Section | BES2023

Post-Hypoglycemic Hyperglycemia Are Highly Relevant Markers For Stratification Of Glycemic Variability and Remission Status Of Pediatric Patients With New-Onset Type 1 Diabetes

Antoine A Harvengt , Olivier G Polle , Manon Martin , Aline van Maanen , Laurent Gatto , Philippe A Lysy

Aims: Recently, our team introduced the concept of post-hypoglycemic hyperglycemia (PHH) in the context that recovery of hypoglycemia impacts cardiovascular risk. GLUREDIA study aimed to evaluate whether PHH parameters correlated with glycemic homeostasis during the first year after type 1 diabetes onset and helped to distinguish pediatric patients undergoing partial remission or not.Methods: In the GLUREDIA study, longi...

ea0097009 | Section | BES2023

A retrospective study of people with familial hypercholesterolemia in a Belgian lipid clinic

V Ide , Cock D De , S Pazmino , R Vangoitsenhoven , Schueren B Van der , A Mertens

Background: Familial hypercholesterolemia (FH) is a genetic disease characterized by hypercholesterolemia and premature cardiovascular events. Early diagnosis and treatment can strongly reduce the cardiovascular burden.Objective: We aim to describe the characteristics of patients with heterozygous FH followed in a tertiary hospital in Belgium.Methods: We retrospectively studied a c...

ea0097010 | Section | BES2023

Cortical bone assessment and determinants in children and adolescents with Klinefelter syndrome

Maartje Hickmann , Elise Nauwynck , Caroline Ernst , Inneke Willekens , Jesse Vanbesien , Willem Staels , Schepper Jean De , Inge Gies

Aims: Several studies show a deficit in cortical bone in adults with Klinefelter syndrome (KS). A correlation between the adult cortical bone deficit and impaired bone accumulation during childhood or adolescence remains unclear. Therefore, we evaluated the cortical bone by automated digital X-ray radiogrammetry in KS children and adolescents and evaluated potential associations with hormonal, radiographic, and anthropometric factors implicated in bone mineral...

ea0097011 | Section | BES2023

Development of the KASAI score as a predictive tool for the uni- or bilateral form of primary hyperaldosteronism

G Pierman , D Maiter , RM Furnica

Adrenal venous sampling (AVS) is considered as the gold standard test for primary aldosteronism (PA) subtype diagnosis. However, it is also an invasive and technically challenging procedure. In order to reduce the use of AVS, we propose a new score predicting a unilateral (UPA) or bilateral (BPA) form of PA using biological and radiological parameters. The score was retrospectively developed on a cohort of 72 patients who underwent AVS at the Cliniques Universitaires St-Luc Br...

ea0097012 | Section | BES2023

Endocrine manifestations in 22q11.2 deletion syndrome: a retrospective single center cohort study

Eva Soubry , Karel David , Ann Swillen , Elfi Vergaelen , Op de Beeck Marie Docx , Margo Hulsmans , Sara Charleer , Brigitte Decallonne

Introduction and objective: Patients with the 22q11.2 deletion syndrome (22q11DS) frequently display cardiological and psychiatric diseases, but are also at increased risk for endocrine manifestations. The aim of this study was to evaluate the screening, prevalence, and management of hypoparathyroidism and thyroid disease in patients with 22q11DS, to evaluate the metabolic profile and to compare these results with current literature and guidelines.<p class...

ea0097013 | Section | BES2023

Acquired idiopathic isolated adrenocorticotropic hormone deficiency: a descriptive systematic review of a heterogeneous and underreported disease

Mieghem E Van , Block C De , Herdt C De

Purpose: Deficiency of the adrenocortical axis is, except for glucocorticoid-induced adrenal deficiency, most commonly associated with failure of multiple pituitary axes and is less common isolated. Isolated adrenocorticotropic hormone deficiency (IAD) has been first described by Steinberg et al. in 1954. Acquired idiopathic IAD is defined by a secondary adrenal insufficiency with otherwise normal pituitary function, absence of structural pituitary defects, no...

ea0097014 | Section | BES2023

In otherwise healthy young men, Trabecular Bone Score (TBS) is significantly lower in case of insulin resistance: an analysis of the SIBLOS study

Offel Steven Van , Charlotte Verroken , Stefan Goemaere , Bruno Lapauw

Background: Over the last two decades, type 2 diabetes mellitus (T2DM) has increasingly been recognized as a fracture risk factor, despite the occurrence of normal to even increased bone mineral density (BMD) (1). The dual energy X-ray absorptiometry (DXA) derived trabecular bone score (TBS) is considered to be a proxy of bone quality and has been reported to be diminished in diabetic patients (2) and insulin resistant, non-diabetic postmenopausal women (3).</...

ea0097015 | Section | BES2023

The thiazide challenge test differentiates primary hyperparathyroidism from secondary hyperparathyroidism due to idiopathic hypercalciuria

Ewout Verly , Charlotte Verroken , Bruno Lapauw

Background: Treatment of primary hyperparathyroidism (PHPT) and secondary hyperparathyroidism due to idiopathic hypercalciuria (SHPT-IH) is markedly different. Nevertheless, differentiating one from another remains a challenge and robust diagnostic tools are lacking. The thiazide challenge test (TCT) has been proposed to aid clinicians in their decision making. However, evidence supporting its use is non-existent.Materials and me...

ea0097016 | Section | BES2023

SHBG assay performance and the effect of SHBG assay choice on calculated free testosterone

Joeri Walravens , Tim Reyns , Eynde Tibbert Van Den , Joanne Adaway , Brian Keevil , Tom Fiers , Bruno Lapauw

Objective: To investigate performance of sex hormone binding globulin (SHBG) assays of different manufacturers and the effects of assay choice on calculated free testosterone (cFT).Methods: Anonymized serum samples of 113 men and 106 women were randomly selected from excess material from the routine clinical lab at the University Hospital of South Manchester. SHBG levels were measured using three different immunoassays (...

ea0097017 | Section | BES2023

Unilateral mydriasis as a first presentation of pituitary macroadenoma

Tim Ailliet , Axelle Cools , Haecke Helena Van , Nikolaas Vantomme , Sylvie Vandelanotte , Bruel Annick Van Den

Background: Pituitary adenomas are the most prevalent tumours in the sellar region and can either be functioning, with autonomous pituitary hormone secretion, or non-functioning. Clinically evident adenomas occur in 1 in 1,100 in the general population. Pituitary adenomas have traditionally been subdivided into microadenomas (<10 mm) or macroadenomas (≥ 10 mm), with macroadenomas comprising 48% of clinically relevant adenomas. Non-functioning pituita...

ea0097018 | Section | BES2023

Is this pancreatic NET responsible for an ectopic ACTH-dependent Cushing’s syndrome?

Johanna Angelini , Carole Bourmorck , Devuyst France , Driessens Natacha

Introduction: Cushing’s syndrome (CS) is a medical condition resulting from a chronic excessive exposure to glucocorticoids. ACTH-dependent CS are mostly caused by pituitary adenoma (about 80-85% of the cases) and, in a lower proportion, by ectopic ACTH secretion (about 10-15% of the cases). The exact origin of an ectopic secretion of ACTH is not always easy to identify. The most common locations are bronchus, lung and pancreas but it can also be located ...

ea0097019 | Section | BES2023

In search of the source; a challenging diagnostic work-up of ACTH dependent Cyclic Cushing syndrome

Stephanie Buyse , Bruno Lapauw

Introduction: Cyclic Cushing Syndrome (CCS) is a rare entity of Cushing’s syndrome (CS), characterized by a cyclic excretion of cortisol, resulting in periods of hypercortisolism intertwining with periods of hypo- or normocortisolism. Diagnosis of CS as such can be challenging, moreover the cyclicity of CCS may necessitate repeated testing. (1)Case: A 68 year old woman consulted because of periodically appearing ede...

ea0097020 | Section | BES2023

Hypercalcemia during pregnancy, how to manage it, discussion of a case study

T Carton , N Bahar , B Corvilain

Introduction: Hyperparathyroidism (HPT) during pregnancy is rare but requires a specific approach for its diagnosis HPT is associated with a high incidence of associated maternal, fetal and neonatal complications, including miscarriage (3,5x-fold higher than expected), IUGR, prematurity and pre-eclampsia(1,2,3). The severity of complications is proportional to degree of maternal calcium level.Case report: We report the c...

ea0097021 | Section | BES2023

A non-controlled Cushing disease treated with osilodrostat: A case report

L Depoorter , Block C De , Herdt C De

Introduction: Cushing disease (CD) is a rare pathology and associated with serious complications and an increased mortality (standardized mortality ratio 2.8) (1). The mortality risk is twice as high (standardized mortality ratio 5.7) if CD is biochemically not well controlled. Transsphenoidal tumor resection is the first line treatment. However, the need for second line treatment is high, as 5-50% of patients in remission after surgery relapse and consist of ...

ea0097022 | Section | BES2023

Primary infertility: a rare presentation of adrenocortical carcinoma

S Desmedt , Vijver A Van De , E Van Caenegem , S Vandewalle

Background: Adrenocortical carcinomas (ACC) are rare and aggressive endocrine tumours with an annual incidence of 1 to 2 per million.(1) Frequently, patients present with signs of hormonal excess. The majority are cortisol excreting carcinomas, followed by aldosterone or androgen excess.(2) Estrogen secreting ACC are extremely rare. We present a case of estradiol and progesterone excess in primary infertility caused by an ACC.Cas...

ea0097023 | Section | BES2023

A unique cause of hypermetabolic adrenal incidentaloma

Xavier Gilis , Thomas Servais , Marie-Cecile Nollevaux , Etienne Delgrange

Introduction/Background: Adrenal incidentaloma is defined as an asymptomatic adrenal mass greater than 1 cm, discovered during imaging performed for another purpose1. The main goal when discovering such a tumor is to rule out a hormonally active lesion or a malignant condition. Radiological characteristics on non-contrast CT or MRI can help to determine if a lesion is benign. If the lesion nature remains indeterminate after these exams, it is recomm...

ea0097024 | Section | BES2023

A case of calcitriol-mediated hypercalcemia in a patient with solid tumor

M. Lomre , N. Sirtaine , K. Van Den Eynde , P. Kleynen , C. Martinez-Mena , K.G. Poppe

Case report: A 50-year-old man was referred by his family doctor to the emergency room in September 2020 for intermittent abdominal pain in the right upper quadrant for several months. He also mentioned weight loss and several episodes of fever with chills. The patient was an active smoker, consumed large amounts of alcohol, and had no known medical history, nor taking any medication. At physical examination, the patient appeared pale and cachectic, with tende...

ea0097025 | Section | BES2023

An extremely rare cause of psychosis, hypokalemia, and metabolic alkalosis

N. Mutebi , Leu N. De , D. Unuane

Cushing’s syndrome (CS) remains a diagnostic challenge due to an overlap with other clinical conditions such as pseudo-Cushing, which can be triggered by major depression, alcoholism, and metabolic syndrome. The most prevalent cause of CS is iatrogenic. When Cushing’s syndrome is caused by endogenous cortisol secretion, most often an ACTH-secreting pituitary adenoma is the culprit and the syndrome is hence referred to as Cushing’s disease. In very rare cases CS ...

ea0097026 | Section | BES2023

Solving the puzzle of MEN2B syndrome in an adolescent girl

E Nauwynck , J Vanbesien , I Gies , C Ernst , S Raeymaeckers , G Verfaillie , W Waelput , F Vaeyens , J De Greve , J De Schepper , W Staels

Introduction: MEN2B is a rare genetic tumor syndrome that causes medullary thyroid cancer at a young age and may lead to pheochromocytoma later in life. Early diagnosis is crucial for thyroidectomy before metastasis. This case report aims to increase awareness of MEN2B signs and symptoms and the need for early referral and treatment.Case: A 10-year-old girl was referred for ultrasound imaging of a swollen submandibular g...

ea0097027 | Section | BES2023

Two family members with partial hypopituitarism and gingival fibromatosis caused by a missense mutation in KCNQ1

A Sabbe , Block C De , F Eyskens , Rademaecker M De , Herdt C De

Background: Childhood growth hormone deficiency (GHD) is a clinically heterogeneous condition and may have a genetic basis. Association with abnormalities of eyes, ears, palate and other parts of the forebrain or familial occurrence of GHD suggest a genetic cause (1). The occurrence of childhood GHD in association with gingival fibromatosis led to the identification of two autosomal dominant KCNQ1 missense variants (Arg116Leu and Pro369Leu). KCNQ1 gene encodes...

ea0097028 | Section | BES2023

A diagnostic conundrum in Bardet-Biedl syndrome: when genetics precede clinical diagnosis

Roy Nele Van , Sylvester Heerwegh , Dashty Husein , Joke Ruys , Peter Coremans

Introduction: Bardet-Biedl syndrome (BBS) is an autosomal recessive, monogenic syndrome of obesity, with an estimated prevalence of 1:160.000. BBS is caused by mutations in one of the twenty-six genes that play a role in the function of primary cilia (1). Early-onset obesity, post-axial polydactyly, retinitis pigmentosa, renal or genitourinary abnormalities, learning disabilities and hypogonadism are considered primary features. Diabetes, speech deficit, heari...

ea0097029 | Section | BES2023

Challenges in Pregnancy Diagnosis: A Case Report of Persistently Elevated hCG Levels

L Wauthier , L Courcelles , D Gruson

Serum or plasma human chorionic gonadotropin (hCG) immunoassays are a cornerstone in diagnosis and monitoring of pregnancy [1]. Although these assays show very satisfying performance, pathophysiological (e.g., menopause induced pituitary secretion of hCG, familial hCG syndrome, exogenous hCG injections) and analytical (e.g., interference of heterophilic antibodies or anti-hCG antibodies, lack of specificity of older assays) determinants may rarely cause false positive results ...