Endocrine Abstracts

Introduction: Pregnancy results in a significant change in pituitary gland size and function.Due to this physiological adaptation, management of pituitary adenomas during pregnancy represents a particularly complex challenge. Aim of this study was to focus on a single referral institution experience with special attention to this subgroup of patients: pregnant woman affected by pituitary adenoma.Materials and methods: This is a des...

Introduction: Pasireotide long acting release (LAR) is approved for second line treatment of acromegaly. We present 3 patients with aggressive acromegaly treated with a personalized de-escalation approach.Case 1: A 61-year-old female affected by acromegaly reisistant on first-line SSAs. In 2015 therapy was switched to pasireotide LAR 60 mg every 28 days. After two years, the IGF-I level touched the lower age range and therapy was downscaled to pasireotid...

Background: Cushing’s disease, the most common cause of endogenous Cushing’s syndrome, is caused by a pituitary tumor secreting adrenocorticotropic hormone (ACTH). Careful selection of treatment and management of the disease and associated comorbidities are necessary to improve prognosis.Case Presentation: A 32-year-old patient came to our observation for appearance of weight gain with abdominal obesity, hirsutism and amenorrhea. On suspicion o...

Introduction: Non functioning pituitary adenomas (NFPAs) are the most common type of pituitary tumors and are often invasive, resulting in high relapse rates. The post-surgical treatment for NFPAs remains a debated issue and include radiation therapy and additional surgery. Several clinical studies have demonstrated that dopaminergic and somatostatin receptors (SSTRs) are widely expressed in NFPAs. Furthermore, recent studies have shown the potential effectiveness of somatosta...

Acromegalic osteopathy is an emerging complication of chronic GH excess characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures (VFs). Medical therapies may exert direct effects on peripheral targets leading to improvement of clinical outcomes regardless of biochemical control of acromegaly. In this longitudinal study, we compared the effects pegvisomant (PegV) and somatostatin receptor ligands (SRLs) on VF risk ...

Pasireotide, a multireceptor-targeted somatostatin analogue, was approved for the treatment of acromegaly, after being studied in two large, randomised, multi-center clinical trials. We reported the history of a 76 years old man affected by acromegaly, treated with Pasireotide long acting release (LAR) as first line therapy. Acromegaly was diagnosed in 2009, as the result of endocrinological investigation suggested by altered facial appearance and macroglossia. Hormonal assays...

Introduction: In 2004, the WHO defined atypical pituitary adenomas (APAs) those with Ki-67 >3%, excessive p53 expression and increased mitotic activity. The usefulness of this classification is still controversial.Aim: To compare the clinical and prognostic features in a series of typical and atypical pituitary adenomas.Materials and methods: We retrospectively reviewed 343 consecutive PAs. APAs represented 18.7% of the cases. ...

Introduction: Acromegaly (Acro) is characterized by insulin sensitivityreduction, glucose intolerance (IGT) and diabetes mellitus (DM2 in 15%–38% of patients). Studies that investigated action of medical therapies for acro on glucose metabolism, didn’t provide conclusive data. Association between blood glucose (BG) levels and serum IGF-I levels in patients with DM2 and acro has been suggested, however,IGF-I levels and hemoglobin A1c (HbA1c) correlation is still con...

Introduction: Osteoporosis is a disease characterized by a low bone mass and the development of nontraumatic fractures, most commonly in the spine. However, bone mineral density (BMD) alone is not completely satisfactory in vertebral fracture risk assessment.Aim of the study: To identify clinical and laboratoristic factors associated with an increased risk of vertebral fractures in osteoporotic Caucasian women and to define a new clinically relevant scal...

Adult GHD patients may have reduced BMD with high risk of vertebral and non-vertebral fractures which is thought to be reverted by long-term rhGH replacement therapy. In this study we aimed at identifying the determinant factors of vertebral fractures, as assessed by a radiological morphometric approach, in a cohort of adult patients with untreated GHD. Forty-two patients (27 males, 15 females; median age: 48 years, range: 30–67) with untreated severe (as defined by a pea...