Endocrine Abstracts

Aim: This guideline (GL) is aimed at providing a reference for the management of prolactin (PRL)-secreting pituitary adenoma in non-pregnant adults.Methods: For each question, the panel identified potentially relevant outcomes, which were then rated for their impact on therapeutic choices.Results: The present GL provides recommendations about the roles of pharmacological and neurosurgical treatment for the management of prolactinom...

Pasireotide (SOM230) is a multireceptor ligand somatostatin analogue with high binding affinity to somatostatin receptor subtype 5, which is predominantly expressed in ACTH-secreting pituitary adenomas. It is indicated for the treatment of adult patients with Cushing’s disease (CD) for whom pituitary surgery is not an option or has not been curative. Our study evaluated the effects of pasireotide, administered for 12 months at a dose of 600–900 μg/daily, in five...

Background: Pituitary tumours (PT) are generally benign, but they can rarely show an aggressive behaviour, invade surrounding structures and/or grow/recur despite multimodal treatment, making their management extremely challenging. According to the latest guidelines, temozolomide (TMZ) can be an option after failure of standard therapies in aggressive PT, while little data are available on alternative approaches such as peptide receptor radionuclide therapy (PRRT). Herein we r...

Mortality risk is increased in acromegalics, due to cerebrovascular and cardiovascular events. These events are namely related to atherosclerotic vascular alterations, both at coronary and peripheral level. Systemic comorbidities increase the risk of atherosclerosis, but the role of GH and IGF-1 excess is still debated. To evaluate the relationship between GH/IGF-1 excess, systemic atherogenic complications and vascular alterations we investigated stiffness index (β), pul...

Background: Hypophosphatasia (HPP) is a rare metabolic, inherited disease of bone metabolism, caused by loss-of-function mutations within the gene coding for TNSALP, that result in a decrease in serum ALP concentrations and consequent accumulation of ALP substrates outside of the cell, including inorganic pyrophosphate which inhibits bone mineralization. HPP leads to a variety of clinical manifestations across all ages and its prognosis is conditioned principally by the skelet...

Background: Pituitary adenomas in children/adolescents represent around 3% of all intracranial neoplasms. They are more frequently hormone-secreting lesions, usually diagnosed in early childhood and late adolescence. Female gender is generally prevalent, because of most evident symptoms (i.e., irregular periods, galactorrhea, etc.). Giant pituitary adenomas (GA) very rarely occur in pediatric age, posing frequent challenges in their management.Patients a...

Chronic hypercortisolism is associated with dramatic increase in fragility fractures. The evaluation of skeletal fragility in Cushing’s syndrome (CS) is a clinical challenge, since fractures may occur even in presence of normal bone mineral density (BMD). Recently, measurement of bone marrow fat (BMF) by vertebral magnetic resonance spectroscopy (MRS) was proposed as alternative tool for evaluating skeletal fragility in primary and secondary osteoporosis. Noteworthy, rece...

Context: Chronic hypercortisolism is known to impact the hypothalamus-pituitary-thyroid (HPT) axis, through a disruption of both thyrotropin-releasing-hormone and thyroid-stimulating hormone (TSH) release. These changes, in turn, are responsible for reduced triiodothyronine (T3) and thyroxine (T4) synthesis and secretion, eventually resulting in central hypothyroidism (C-Hypo). However, data on magnitude and timing of recovery of the above abnormalities are still controversial...

Pasireotide is the first pituitary-directed approved therapy for Cushing’s disease (CD), effective in reducing UFC >50% in about half of patients, and with a good tolerability profile but associated with a relatively high incidence of hyperglicemia. The aim of this study was to evaluate efficacy and safety of long-term treatment with pasireotide (PAS) in patients with CD. Methods: We retrospectively evaluated 17 consecutive patients (11 females) with CD treated with P...

Introduction: First-generation SRL (fg-SRL) represent the treatment of choice in acromegaly patients with post-neurosurgical adenomatous remnant and GH-hypersecretion. Anyway, approximately 60% of patients do not achieve adequate disease control. The main predictors of resistance include male sex, young age, invasiveness of the lesion and its hyperintensity on T2-weighted MRI scans; but also, SSTR2 expression, the cytokeratin pattern, Ki-67 and the presence of AIP gene mutatio...