Endocrine Abstracts

Background: Hypoparathyroidism is an endocrine disorder characterized by hypocalcemia due to low levels of parathyroid hormone (PTH). Activated vitamin D (calcitriol) and calcium supplementation may be difficult in patients with malabsorption, as calcium requires an acid environment to dissolve. In this setting, subcutaneous administration of PTH analogues may be effective in reducing the dosage of oral calcium and vitamin D supplementation.Case report: ...

Background: In 2014 a new Italian classification system of thyroid cytology divided the indeterminate TIR3 category in two groups, TIR3A and TIR3B, aiming to reduce unnecessary thyroidectomies. The reported risk of malignancy is: TIR3A: <10%, suggesting follow-up and possible FNA repetition after 6 months, and TIR3B: 15-30%, recommending surgery.Objectives: We aimed to: evaluate the histological prevalence of malignancy in TIR3A and TIR3B nodules in ...

Background: Cushing syndrome (CS) represents a challenging disease. The major difficulty is to distinguish between the two main etiologies of ACTH-dependent hypercortisolism. However, in rare cases, the concomitant presence of both an ACTH-dependent and a primary adrenal disease should be considered.Case report: We evaluated a 67-year-old woman for a severe ACTH-dependent CS (midnight serum cortisol 332 ng/ml; urinary free cortisol [UFC] 3000 mcg/day; co...

Background: Diffuse large B-cell lymphoma is the most common non-Hodgkin’s lymphoma (NHL). It can involve extranodal sites in about 30%, but the involvement of endocrine organs is rare (adrenal involvement is estimated<0.2%) and correlates with poor prognosis. In contrast to pituitary metastases from solid tumors, NHL involvement of the anterior lobe of the pituitary is more frequently seen.Case presentation: A 84-year-old woman presented to the...

Background: Cushing’s syndrome (CS) in medullary thyroid cancer (MTC) is rare with less than 60 cases reported. Less than 1% of MTC develop ectopic ACTH-dependent CS and this correlated with metastasis at diagnosis and poor prognosis.Case presentation: A 32-year-old male was referred to our department for suspected CS. Initial evaluation showed hypokalemia(2.4 mmol/l) and severe ACTH-dependent CS (Cortisol h8:678ng/ml; ACTH:249pg/ml; urinary free co...

Background: Lenvatinib is an oral chemotherapy for metastatic radioiodine-refractory differentiated thyroid cancer (RRDTC) which significantly improves progression free survival (PFS). It has been proved that higher rates of dose interruption or reduction of Lenvatinib have a negative impact on PFS. Patients with active cancer, such as RRDTC, have an increased risk of contracting Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) and developing complications, especial...

Background: Immune checkpoint inhibitors (ICI), anticancer therapy blocking specific molecules expressed in tumor microenvironment, are associated to several endocrine side effects. In particular, the use of PD-1/PD-L1 inhibitors is related to a higher incidence of thyroid dysfunction. The most frequent form of thyrotoxicosis is a destructive thyroiditis, which can evolve into hypothyroidism.Patient findings:We report the case of an 85 years-old patient,...

Background: Overt hyperthyroidism can have a negative impact on pregnancy’s outcome, if not correctly treated. Furthermore anti thyroid treatment are burned by possible side effects.Objectives: We describe the experience of our center in the management of endogenous hyperthyroidism in pregnancy. evaluating the effects of the disease and treatments on fetal and maternal health.Methods: We observed 36 pregnancies (4 twins and 1 ...

Background: Steroid synthesis inhibitors, like metyrapone, osilodrostat, and ketoconazole are used as second-line treatment in all types of endogenous Cushing’s syndrome (CS). However, a direct comparison of these three drugs is missing. This study aimed to compare these drugs in the short-term therapy of CS.Design: Retrospective multicenter study involving 15 European centers.Methods: Patients with CS treated with metyrapone,...

Background: Steroid synthesis inhibitors, like metyrapone, osilodrostat, and ketoconazole are used as second-line treatment in all types of endogenous Cushing’s syndrome (CS). However, a direct comparison of these three drugs is missing. This study aimed to compare these drugs in the short-term therapy of CS.Design: Retrospective multicenter study involving 16 centers worldwide.Methods: Patients with CS treated with metyrapone...