Endocrine Abstracts

Paltusotine is a once-daily, oral selective nonpeptide somatostatin receptor type 2 (SST2) agonist, which is in clinical development for the treatment of acromegaly. Maintenance of insulin-like growth factor 1 (IGF-1) control and toleration was demonstrated in phase 2 studies evaluating paltusotine in biochemically controlled (IGF-1 ≤1xULN) [ACROBAT Evolve (NCT03792555)] and uncontrolled (1> IGF-1 ≤2.5xULN) [ACROBAT Edge (NCT03789656)] patients with acromegaly ...

Introduction: Selective transsphenoidal microadenomectomy (TSS) is the first-line treatment of paediatric Cushing’s disease (CD). Corticotroph adenomas in children are often small and difficult to visualize. We aimed to assess the utility of pituitary MRI and bilateral inferior petrosal sinus sampling (BIPSS) in confirming the diagnosis of CD and the localisation of the adenoma. We also report our early experience of STEALTH MRI (volumetric T1 weighted, contrast-enhanced ...

Coronavirus (COVID-19) caused by severe acute respiratory syndrome (SARS)-CoV-2, which leads to multi-organ disease. Covid-19 high mortality and morbidity arising from autoimmune destruction of the lungs due to pro-inflammatory cytokines storm, has enabled worldwide collaborative studies aimed at elucidating potential management strategies in order to overcome pandemic. The RECOVERY trial, a multi-centred trial involving 175 United Kingdom based hospitals. The results from thi...

Objectives: Thyroid disease in women of reproductive age is predominantly of autoimmune origin, and thyroid peroxidase antibodies (TPO-Ab) as well as thyroglobulin antibodies (Tg-Ab) are key markers of autoimmune hypothyroidism. Adding to this, much focus in pregnancy is on euthyroid women who are positive for thyroid autoantibodies. The observational findings are diverse, and evidence to substantiate the applied cut-offs for definition of thyroid autoantibody-positivity in ea...

Adrenocortical carcinoma (ACC) is a rare malignancy with limited treatment options and a heterogenous prognosis. The histological diagnosis of ACC is complex and there is increasing interest in identifying and validating new immunohistochemical markers. Delta-like non-canonical Notch ligand 1 (DLK1) is a cleavable single-pass transmembrane protein. In humans, DLK1 is present in many tissues during foetal development, is restricted to progenitor/stem cells in a few adult tissue...

Background: Multiple studies have shown that approximately 50-70% of patients with MEN1 die of causes directly related to MEN1 particularly gastroenteropancreatic (GEP) neuroendocrine tumors (NETs). While non-functional GEP-NETs are the most common in the general population, gastrinomas (40%) are the most common functional GEP-NETs in patients with MEN1. c-Met is a proto-oncogene that encodes for c-MET, a tyrosine kinase receptor which promotes tumor cell motility, proliferati...

Background: Grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) are rare, aggressive tumors with poor prognosis. The WHO 2017 classification further subdivided G3 NENs into G3 neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Current guidelines favor medical management in most of these patients, and the role of surgical management is not well-defined. We performed a systematic literature review and meta-analysis of surgical management vs ...

Background: Grade 3 (G3) gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) are aggressive tumors with poor survival outcomes for which medical management is usually recommended. This study sought to evaluate outcomes of surgically treated G3 GEP-NEN patients.Methods: A single-institutional prospective NEN database was reviewed. Patients with G3 GEP-NENs based on World Health Organization (WHO) 2019 definitions included well-differentiated neur...

Context: Suboptimal thyroid function in pregnancy is associated with adverse obstetric outcomes but it is unclear whether levothyroxine treatment, initiated during pregnancy is beneficial.Design & Participants: Retrospective analysis of the Controlled Antenatal Thyroid Screening (CATS) study with obstetric outcomes obtained through data-linkage in the Secure Anonymised Information Linkage (SAIL) databank. We studied 13,224 pregnant women; 12,608 had ...

Background: Although MRI remains the investigation of choice for pituitary imaging, it does not provide information about the ‘functionality’ of lesions (e.g. residual adenoma vs post-surgical scar tissue), and cannot reliably identify all microadenomas. These limitations are of particular relevance in acromegaly where clinical and biochemical evidence of disease activity mandates (further) treatment.Methods: We hypothesised that i) imaging wit...