Endocrine Abstracts

Background: Macroprolactinemia is a condition where more of 60% of circulating PRL is made up of macroprolactin. It may be observed in both sexes (although women represent about 90% of published cases), and at all ages. As macroprolactin has low biological active and low bioavailibility, most patients are asymptomatic. The Endocrine Society guidelines recommend screening for macroprolactin only in asymptomatic hyperprolactinemic patients. However, some data from the literature...

Abstract: Cushing’s syndrome (CS) during pregnancy is a rare condition with fewer an 200 cases reported in the literature, However, because CS results in increased fetal and maternal complications, its early diagnosis and treatment are critical. During pregnancy, 40-50% of cases are caused by adrenal adenomas, while Cushing’s disease (CD) accounts for only one third of the cases. We describe here 3 patients with CD who needed to be treated during pregnancy.<p cla...

Introduction: Clomiphene citrate (CC), a selective estrogen receptor modulator that increases LH and FSH secretion, improves hypogonadism and fertility outcomes. Moreover, there is limited evidence that it may also be helpful as add-on therapy to normalize IGF-1 levels in male acromegalic patients.Objective: To assess the effect impact of CC on serum IGF-1 and testosterone levels in male acromegalic patients not controlled by the combination of lanreotid...

Case report: A giant prolactinoma (size=5.2×4.1×3.2 cm; PRL=6 400 ng/mL) was diagnosed in an amenorrheic 19-year old girl who presented to the emergency room complaining of headaches and bilateral decrease in visual acuity for 10 days. The patient was started on cabergoline (CAB) in progressive doses up to 3 mg/week. PRL levels decreased from 6 400 to 4 600 ng/dl within 60 days, with improvement of visual complaints and visual fields defects. The dose was subsequentl...

Introduction: Dopamine agonists (DA) are the ideal treatment for prolactinomas and cabergoline (CAB) is the drug of choice, for being much more effective and better tolerated than bromocriptine. However, 10-15% of patients with prolactinomas are considered to be resistant to CAB, as they dot not achieve prolactin (PRL) normalization, while in use of conventional doses of this drug.Objective: To evaluate the effiaccy of increasing doses of CAB in prolacti...

Introduction: Cushing’s syndrome (CS) is certainly one of the most challenging disorders to physicians due to the difficulties that often appear during its investigation. The diagnosis of CS involves two steps: confirmation of hypercortisolism and determination of its etiology. Biochemical confirmation of the hypercortisolemic state must be established before any attempt for differential diagnosis. Failure to do so will result in misdiagnosis, inappropriate treatment, and...

Patients and methods: We retrospectively analysed the clinical and biochemical characteristics of a cohort of 150 patients with endogenous Cushing’s syndrome (CS). Cushing’s disease (CD) accounted for 61.3% of cases (n=92), ectopic ACTH secretion (EAS) 7.3% (n=11), and adrenal diseases 31.3% (n=47). Among CD cases, there were 19 macroadenomas (20.6%), a female predominance (60.5%) and a median age of 33 years old (range 14–55). Bronchi...

Background: Dopamine agonists (DA) are the treatment of choice of prolactinomas. Cabergoline is preferable to bromocriptine due to its greater effectiveness and better tolerabilitiy. However, up to 30–50% of male patients may persist with low levels of testosterone despite prolactin (PRL) normalization under DA therapy or the use of the maximum tolerated dose of DA. The aim of this prospective open study was to evaluate the efficacy of the SERM clomiphene citrate (CC) in ...

Background: Dopamine agonists are the mainstay of treatment for prolactinomas. Cabergoline (CAB) is preferable to bromocriptine due to its greater efficacy and better tolerability.Subjects and methods: The aim of this retrospective open trial was to evaluate the efficacy and tolerability of CAB in a cohort of 160 patients with prolactinomas routinely followed in Pernambuco Endocrine Research Center and Division of Endocrinology, Hospital das Clinicas, Fe...

Background: Growth hormone secreting pituitary gland adenomas specifically express somatostatin (SST)-2 and SST5 receptors. First-generation somatostatin analogs (octreotide and lanreotide) are the mainstay in the medical treatment of acromegaly, however the percentage of patients controlled with these drugs significantly varies in the different studies (20–70%). Many factors are involved in the resistance to SRL somatostatin analogs such as sst, AIP, E-cadherin, ZAC1, fi...