Endocrine Abstracts

Background: The diagnosis of neuroendocrine carcinoma of the cervix is rare, they are less than 2% of cervical cancers, and it is considered an unusual entity of diagnosis. In Peru there is only one published case record of this histological type of neoplasm. Methods: Data was taken from a patient from the electronic medical record of the Alberto Sabogal Sologuren National Hospital in Lima - Peru, who received treatment with etoposide and cisplatin (EP),...

Introduction: Hypoaldosteronism can be induced by a deficit of aldosterone production (AldDef) or a mineralocorticoid resistance (MinRes). Experts have proposed to use hyperkalemia-based aldosterone values for this purpose. However, there is no a range of aldosterone values indicating one of this type of hypoaldosteronism. In 2008, Adam W. R.1 hypothesized that the factored aldosterone (FAldo) could be useful differentiating hypoaldosteronism secondary to MinRes fro...

Tolvaptan (TV), an ADH V2-receptor blocker, is useful in treating SIADH-induced hyponatremia. Maximum aquaresis following 15 mg TV occurs on day 1, when excess body water is greatest. This can cause a sharp rise in natremia, and poses a risk of overcorrection. Our aim was to evaluate an initial dose of 7.5 mg.Methods: We studied 7 hospitalized patients with SIADH (4 females), median age 80 (57–95), with nadir natremias (Nap) ranging from ...

Introduction: Hypoaldosteronism is characterized by the development of hyperkalemia, but can also induce hypovolemic hyponatremia. Trimethroprim can cause hypoaldosteronism through mineralocorticoid resistance. That hypoaldosteronism can induce hyponatremia in absence of Addison’s disease has been questioned. We studied the electrolyte disturbances found following initiation of trimetroprim therapy.Material and methods: Retrospective, analytical. La...

Introduction: Primary hyperparathyroidism (PHP) has been postulated to be a cause of primary hyperaldosteronism (PHA). In fact, PTH receptors have been detected in aldosteronoma tissue. Hyperaldosteronism can also induce elevation of PTH levels, as increased circulating volume increases calciuria, with secondary elevation of PTH levels as serum calcium levels rise. We studied the prevalence of PHP in a group of patients diagnosed with PHA either following or simultaneously wit...

Inroduction: Polydipsia -excessive oral intake of liquids, with/without thirst- can induce euvolemic hyponatremia. Adequate inhibition of AVP secretion induced by low plasma osmolality (POsm) is reflected in a urinary osmolality (UOsm) ≤100 mOsm/kg. However, increased fluid intake can also reveal underlying non-osmotic AVP secretion, induced by pain, nausea, and/or SIADH, with UOsm >100. Iatrogenic polydipsia is characterized by increased liquid intake without thirst...

Introduction: Primary hyperaldosteronism (PH) is characterized by autonomous adrenal aldosterone (A) hypersecretion. Unilateral adrenalectomy is the treatment of choice, when adrenal vein sampling (AVS) indicates lateralization of A secretion. To assure that each adrenal vein (AV) has been correctly sampled, cortisol levels in each adrenal vein must be higher than in the inferior vena cava. The adrenal gland cortisol/vena cava cortisol ratio is referred to as the selectivity i...

Introduction: Euvolemic hyponatremia (HN) caused by the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) can predate a diagnosis of malignancy. It is thus essential to accurately diagnose the etiology of HN/SIADH when detected.Methods: Retrospective, descriptive study of all 52 oncological/hematological malignancy patients diagnosed with SIADH in our Department between January 2011 and December 2016. HN was detected via computerized Prima...

Introduction: Hypoaldosteronism (HA), a cause of hypovolemic hyponatremia (HN) with urinary(U) sodium(Na) loss, is often underdiagnosed. We studied 28 patients with an episode of HA-induced moderate/severe hyponatremia.Methods: Retrospective 2012–2015. In all patients, Nadir(N) serum(S) Na <130 mmol/l (corrected for total proteins and glycemia), low internal yugular venous pressure, low ocular pressure. Addison’s Disease ruled (ACTH, cortis...

Context: Fluid restriction (FR) is recommended as first line therapy for SIAD by both the European1 and the American guidelines2 for management of SIAD. Not all patients respond to FR however, and the American guidelines have identified clinical predictors of failure to respond to FR. These include 1.Urine osmolality (UOsm) >500 mOsm/Kg 2. Furst formula (ratio UNa+UK/pNa) > 1, and 3. 24 hour-urine volume<1500 mlObjective...