Endocrine Abstracts

Endocrine late effects following cancer therapy are increasingly recognized. Due to the radio-sensitivity of the thyroid gland both long-term effects on thyroid function and growth have been described. This includes problems of thyroid growth and function. Particularly the development of secondary neoplasms of the thyroid is greatly increased some 10 to 30 years following irradiation. This affects predominantly children before and during puberty. The longitudinal use of thyroi...

The pathophysiology of thyroid nodules is still widely undefined even though recent data from microarray studies hint towards a distinct group of candidate genes. Furthermore, a better understanding of new mechanisms involved in thyroid growth regulation like TGF-β, BMP and wnt signalling may open new avenues for treatment. Recent data derived from animal models of thyroid carcinomas suggest an action of thyroid hormones despite the loss of TSH receptor. Upon confirmation...

The diagnosis of TED is not always obvious and its management can be a challenging. Diagnosis as well as treatment should be performed in a multidisciplinary setting. Decision on treatment is based on a careful assessment of ophthalmological symptoms and the evaluation of the clinical activity of the disease using the clinical activity score. TED is classified into mild, moderate and sight threatening disease. An active inflammatory disease stage is followed by an inactive sta...

The anterior pituitary gland displays considerable plasticity with a proliferative response to oestrogen in a number of different situations including pregnancy. The nature of pituitary remodelling to this physiological demand is not clear.Using microarray analysis we found that oestrogen treatment of the rat in vivo increased expression of Wnt4 mRNA in adult rat pituitary tissue. Dual immunofluorescence analysis showed that this Wnt4 expression w...

Introduction: SIADH is frequently observed as a paraneoplastic secretion in many cancer types with the highest frequency described in small-cell lung cancer. The paraneoplastic secretion of ADH/vasopressin may induce hyponatraemia which is associated with increased morbidity and mortality. Conventional treatment of the condition consists of fluid restriction and demeclocycline. Tolvaptan, an oral V2-receptor antagonist, that directly targets the mechanism of SIADH, has been pr...

GH replacement (GHR) has resulted in a significant improvement in quality of life for many adults with GH deficiency. Many of these patients are previously irradiated survivors of malignancy, and as such are at high risk of recurrent (RN) or secondary neoplasms (SN). There is a particularly strong association between CNS irradiation and subsequent development of meningiomas, which are known to express GH receptors. There is uncertainty as to whether GHR increases the risk of d...

With the advent of vaptans as a therapeutic option, rapid and precise diagnosis of SIADH is essential. SIADH due to paraneoplastic stimulation of AVP is an expected but not the only cause of hyponatraemia in cancer patients. Therefore a precise evaluation of the cause of hyponatraemia is necessary before any therapeutic approach. Using Copeptin, a stable marker of AVP, which is stoichiometrically released with AVP, we evaluated 49 patients with hyponatremia due to various form...

Copeptin is a stable AVP marker and stoichiometrically released with AVP. It closely reflects changes in water balance. Its stimulation in severe stress has recently has been suggested in various pathophysiological conditions including myocardial infarction and stroke. Paraneoplastic stimulation of AVP/copeptin is expected in patients with cancer leading to hyponatraemia due to SIADH.Here, we evaluated copeptin levels in 50 patients with hyponatraemia du...

Case: A 44-year-old lady was diagnosed with Acromegaly (IGF-1 of 1315 ng/ml, prolactin 498 mu/l). She was also thyrotoxic clinically and biochemically with T4 29 pmol/l (normal 9-26), total T3 3.24 nmol/l (normal 0.9–2.2) but high TSH of 3.50 mu/l (normal 0.35–3.5). Further work-up with TRH testing and α-subunit measurement confirmed a TSHoma. Pituitary MRI scan showed a macroadenoma displacing optic chiasm and extending into cavernous sinu...

NIS and Tg are viewed as characteristic markers for thyrocytes. They are still expressed in a high percentage of differentiated and undifferentiated thyroid carcinomas but these data are obtained by conventional immunohistochemistry. Here we used tissue microarrays and confocal microscopy to compare subcellular localization of Tg and NIS in a large series of benign and malignant thyroid samples.Methods157 papillary (PTC), 56 follic...