Endocrine Abstracts

Background: Despite the benign nature of pituitary adenomas, microscopic examination of surgical specimens showed that dural invasion occurs in about 42-85% of cases. No studies about dura mater invasion were conducted specifically in acromegaly, so the aim of the present study was to evaluate the relationship between histologically verified dural invasion and the “aggressiveness” features of GH-secreting adenomas.Methods: A prospective study i...

Acromegaly is due to increased GH secretion usually sustained by a GH-secreting pituitary adenoma. Somatostatin analogues (SSA) can control GH hypersecretion in 60% of patients and tumor volume in 30%. The disease control is, in turn, associated with lower mortality and therefore to verify the optimal control of the disease activity is of critical importance to adapt the dose and the choice of alternative treatment. The criteria for optimized disease control had been assumed a...

Introduction: Somatostatin analogues (SSA) are one of the main effective drug used in acromegaly. Sludge and/or cholelithiasis development represents oneof the more common side effect. The aim of the study was to analyze the frequency of biliary adverse events (BAE) and possible predictive factors, to propose a work-up strategy for their management.Method: This is a single centre, longitudinalretrospective study; we enrolled 91 acromegaly patients during...

Background: When evaluating a patient for central adrenal insufficiency (CAI), there is a wide range of morning cortisol values for which no final conclusion on hypothalamus-pituitary-adrenal (HPA) axis function can be drawn; in these cases, a stimulation test is required. Aim of this study was to develop an integrated model for the prediction of CAI when morning cortisol is in the grey zone, here defined as 40.0-160.0 μg/l.Methods: Overall, 119 pat...

Purpose: The aim of this study was to identify any predictive factors for need of high doses of cabergoline (CAB) in prolactinomas and to study any relationship between adverse events onset and CAB cumulative dose.Methods: Forty-two patients harboring resistant prolactinomas (High Dose group-HD; cabergoline dose ≥ 3.5 mg/week) were matched by gender, age and pituitary tumor diameter at diagnosis with subjects under standard doses (Standard Dose gro...

Introduction: The diagnosis of GH deficiency (GHD) in adults is based on a reduced GH response to provocative tests. The proportion of patients with low GH response to provocative tests increases with the number of other pituitary hormone deficiencies and several studies involving panhypopituitary patients have shown that under certain circumstances GH stimulation tests may be unnecessary to diagnose GHD.Objective: Aim of this study was to re-evaluate th...

Rationale: In the diagnosis of hypopituitarism, the glucagon stimulation test allows for the simultaneous and safe evaluation of the somatotropic and corticotropic axes; recent data have highlighted a stimulating action also on the neurohypophyseal secretion of arginine-vasopressin. This procedure involves the intramuscular or subcutaneous administration of 1-1.5 mg of glucagon based on the patient’s weight (respectively less or more than 90 kg). Nowadays no data are avai...

Patients with prolactinomas may develop acromegaly during D2-agonists (DA), suggesting the existence of somatomammotroph adenomas with asynchronous secretion of GH and PRL. This may be due to the acquisition of somatotroph characteristics by lactotroph cells or to GH co-secretion by somatommammotroph cells unmasked after PRL inhibition by DA. The prevalence of silent acromegaly in prolactinomas during DA is 4.1%. The purpose of this study was to evaluate the somatotroph axis i...

Introduction: Prediction of HPA (hypothalamus-pituitary-adrenal) activity after trans-sphenoidal pituitary surgery (NS) is essential for post-operative management. There is not unique behavior in this setting: most of specialists suggests 4-6 weeks of glucocorticoid supplementation and treatment interruption after demonstration of normal endogenous response. Some authors suggest early cortisol detection for the identification of patients requiring glucocorticoid therapy. Aim o...