Endocrine Abstracts

Background: Hypoglycemia is a common complication of Diabetes Mellitus treatment, especially in patients receiving intensive therapy. It can cause severe clinical consequences and is an obstacle to achieve glycemic targets.Methods: Retrospective study of severe hypoglycemia due to insulin or oral drug therapy that lead to hospitalization in a central hospital. We reviewed the medical records in the last 7 years (2006–2012) for blood glucose levels a...

The vast majority of thyroid cancers are solid. Predominantly cystic tumors occur in <3% cases. Guidelines report as US characteristics consistently associated with a higher risk of malignancy eccentric position of the solid component, acute angle interface and microcalcifications and as less robustly associated lobulated margins and increased vascularity of the solid portion. We reviewed the US characteristics of predominantly cystic papillary carcinomas confirmed on hist...

BackgroundFalse positive results are common in the screening of pheochromocytoma. Even in high risk patients with disorders related to multiple endocrine neoplasia it’s crucial to exclude possible interferences with analytical methods.Clinical caseA 69 year-old man was submitted to total thyroidectomy, due to a 11 mm hypoechogenic nodule suspicious of papillary carcinoma (FNA). Histology confirmed medull...

Introduction: Pharmacologically induced false positive results in urinary free cortisol levels (UFCL) have been ascribed to 11βHSD-2 inhibition or direct interference on HPLC. Few drugs have been implicated by mechanisms not yet confirmed.Case Reports: We report 3 patients with active pulmonary tuberculosis (TB) and very high UFCL, 2-6× above the upper limit of reference [mean levels 3411 μg/24 h (RR 167-827)]. The 2 males and the woman ag...

Background: Basal tumor markers are valuable in preoperative evaluation of medullary thyroid carcinoma (Calcitonin and CEA), but are insensitive and nonspecific for papilary thyroid cancer (thyroglobulin). Even if their utility is questionable or not recomended in the evaluation of thyroid nodules, in some cases refered to endocrinology department they are available and can be misleading. We present two cases of thyroid nodules with very high preoperative tumor markers.<p ...

Background: Subacute thyroiditis is an inflammatory condition, most likely of viral origin, which typically presents wit low anterior neck pain, fever and transient thyrotoxicosis. Ultrasonography (US) usually shows a diffuse thyroid enlargement with ill-defined hypoechoic areas.Case: A 55-year old women was admitted in the emergency room, with 2 weeks of anterior neck pain, cervical compressive symptoms of dysphagia, fever and palpitations. On physical ...

Background: Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. There’s an overlap between benign and malignant disease clinical presentation, but the presence of very high calcium levels (>14 mg/dl), markedly raised levels of PTH, palpable neck mass or severe bone/kidney disease is more common in parathyroid carcinoma. We present a case of primary hyperparathyroidism due to a parathyroid carcinoma, with unusual presentation.Ca...

Struma ovarii is a form of mature teratoma, a rare germ cell tumor, containing more than 50% thyroid tissue. Malignancy is uncommon. Non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) inside struma ovarii was never described. A 32 y.o. female with previous history of ovarian cysts was admitted in the emergency room with painfull acute abdominal distention. The MRI revealed a right adnexal mass, predominantly cystic with 82x66x80 mm and surrou...

We present a case of Inactivating PTH/PTHrP signalling disorder (IPPSD) revealed in aduthood in the context of respiratory alkalosis caused by covid-19 infection that led to worsening of the preexisting hypocalcemia and intensification of the usual hypocalcemic symptoms. A 39 year old female with history of subclinical hypothyroidism and bilateral cataracts was admited due to hypoxemia in the context of severe covid-19 infection with bilateral pulmonary infiltrates. She was vi...

Introduction: Amiodarone use may be associated with secondary severe organ dysfunction. Thyrotoxicosis develops in 15% cases. Primary bilateral adrenal lymphoma is a rare malignancy. If frequently presents bilaterally and with symptoms of adrenal insufficiency. Symptomatology for both conditions is nonspecific, especially in the elderly, and a high suspicion index is necessary for appropriate diagnosis.Case report: A 78 year old female presented to the e...