Endocrine Abstracts

Graves’ disease is characterized by the occurrence of antibodies against thyroid-stimulating hormone (TSH) receptor that stimulate the gland to produce T4 and T3. It can be accompanied by an infiltrative orbitopathy and oftalmopathy. Another seldom- regognized feature of this disease is thymic hyperplasia.The authors report the case of a 22-year-old woman with Graves’ disease (TSH receptor antibodies 178 U/l) with exuberant oftalmopathy and an ...

Introduction: RET germline mutation in codon 634 of exon 11 is one of the most frequent mutations of classical multiple endocrine neoplasia type 2A (MEN2A). Virtually all patients with classical MEN2A develop medullary thyroid carcinoma (MTC), which is often the first manifestation of the disease and usually occurs early in life. Pheochromocytomas (PHEOs) tend to be diagnosed several years later or simultaneously with the MTC.Case report: The pa...

Introduction: Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting, and a single parathyroid adenoma is usually the culprit. Clinical presentation is commonly dictated by hypercalcemia. Symptoms can range from mild non-specific malaise and gastrointestinal disturbances, through bone disease, kidney stones, cardiovascular and neuromuscular dysfunction to, ultimately, coma and death. However, the vast majority of patien...

Introduction: Hypothyroidism can affect the nervous system, commonly causing mono and polyneuropathies which show a variable frequency and pattern. Its mechanisms are not fully understood. Symptoms usually correlate better with the duration of the dysfunction rather than with its severity and typically improve significantly after medical therapy.Case report: A 58-year-old woman was admitted at our hospital with a one-year history of progressive weakness ...

Pheocromocytoma is a catecholamine-secreting tumor that arises from chromaffin cells of the adrenal medulla. In general, they are unilateral and the treatment of choise is complete surgical resection. Surgery and other medical procedures such as chemotherapy or radiotherapy may result in massive catecholamine release that can be fatal. Some form of preoperative pharmacologic preparation is indicated for all patients to control blood pressure, arrhytmia and promote intravascula...

Introduction: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold-standard for the differential diagnosis of ACTH-dependent Cushing Syndrome when the pituitary adenoma on MRI is doubtful or absent. This study aimed to analyze whether BIPSS can influence the outcome in patients with Cushing disease (CD).Methods: Retrospective, descriptive study. Forty-two patients with CD submitted to transsphenoidal surgery (TS) between 2005 and 2016 were divi...

Introduction: Successful long-term management of patients with Cushing’s disease (CD) remains a challenge. Few studies have analyzed the long-term recurrence rates of CD after transsphenoidal surgery (TS).Objectives: 1) to compare the outcome of patients with and without postoperative criteria for cure; 2) to compare the outcome of patients with and without a histological diagnosis of adenoma.Methods: Retrospective, descriptiv...

Introduction: Cushing’s disease (CD) is responsible for 80% of endogenous Cushing’s syndrome (CS). However, distinguishing the cause of ACTH-dependent CS – CD vs ectopic CS – can be extremely difficult. Bilateral inferior petrosal sinus sampling (IPSS) has the highest diagnostic accuracy in this evaluation.Objectives: The aims of this study were to determine the accuracy of bilateral IPSS in the differential diagnosis of ACTH-dependen...

Introduction: The fine needle aspiration cytology (FNAC) of thyroid nodules is the procedure of choice in the diagnostic approach of nodular thyroid disease. Despite showing a sensitivity of 83% and a specificity of 92%, many of the results are non-diagnostic. One of the factors that can contribute to this number is the proper procedure of the smear.Objective: To compare the FNAC’s results in our team with and without the contribution of an expert C...

Introduction: Diabetic foot infection imposes a significant burden and is a major cause of non-traumatic limb amputation. Antibiotic therapy plays a crucial role in the management these patients. In our institution, empirical antibiotic therapy is tailored to the presence of risk factors for multidrug-resistant microorganisms. For patients without risk factors, empirical intravenous amoxicillin-clavulanate at a dose 2.2 g every 8h is used. For patients with risk factors such a...