Endocrine Abstracts

Acromegaly is a rare endocrine disorder mostly caused by a growth hormone (GH)-secreting pituitary adenoma. The aim of treatment is to normalize GH/IGF1 levels to limit disease burden. Growth hormone hypersecretion is associated with an increased cancer risk; cases of Acromegaly complicated by lymphoma have been reported. We share a clinical case characterized by suboptimal treatment, potentially leading to advancing orbital lymphoma. This 49-year-old man was diagnosed with Ac...

Conventional glucocorticoids (CGCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), resulting in increased metabolic morbidity and impaired quality of life (QoL). Non-physiological cortisol pattern and elevated evening cortisol levels may be responsible for the increased risk of metabolic disorders observed in AI patients under CGCs. Once daily dual-release-hydrocortisone (DR-HC), which better reproduces physiological daily cortisol profile, si...

Chronic cortisol excess as a consequence of ACTH overproduction from a pituitary tumour is responsible for the development of Cushing’s disease (CD). The first-line treatment for CD is pituitary surgery, but medical treatment is an alternative second-line approach to control cortisol excess. Among pharmacological agents, the adrenal-blocking drug ketoconazole (KT), is able to control cortisol excess in the majority of patients with CD. During KT treatment, the adrenal blo...

: Patients with Cushing’s disease (CD) have increased cardiovascular risk due to metabolic alterations caused by glucocorticoids excess. Pasireotide, a multireceptor-targeted somatostatin analogue, is a therapeutic option in CD patients in whom surgery is not curative or not feasible. Pasireotide has been shown to be effective in controlling hypercortisolism and to improve metabolic features. Recently, the visceral adiposity index (VAI) has been proposed as a marker of vi...

Conventional glucocorticoids (GCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), with a significant impact on morbidity and mortality. Possible explanations are supra-physiological doses and impaired cortisol profile. In particular, elevated evening cortisol levels were related to glucose tolerance and insulin sensitivity alterations and visceral obesity. Once-daily-dual-release-hydrocortisone (OD-DR-HC), better reproducing the physiological ...

In patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, life-long glucocorticoid (GC) treatment is often required to replace cortisol deficiency and to avoid the ACTH-dependent androgen levels increase. However, in these patients, the multiple daily doses required with conventional GCs can cause cortisol overexposure, leading to an increased risk of metabolic syndrome (MS), an impaired quality of life (QoL), and poor treatment compliance (TC). T...

Life-long glucocorticoid (GC) treatment is needed in patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency in order to replace cortisol deficiency and to control ACTH and consequently androgen levels. Therefore, patients with CAH tend to have an increased risk of metabolic syndrome (MS), probably due to cortisol overexposure, caused by multiple daily doses of conventional GCs, unable to mimic cortisol circadian rhythm. The current study aimed at i...

Introduction: Bilateral inferior petrosal sinus sampling (BIPSS) is the test that offers the highest diagnostic accuracy in the differential diagnosis between pituitary and ectopic Cushng’s syndrome (CS). The aim of this study was to compare the diagnostic accuracy of BIPSS performed in the last six years, after the change in the technical procedure with that performed in the past period in Naples centre.Patients and methods: Seventeen patients with...

Introduction: Generously supported by IPSEN)-->Glucocorticoids (GC) have a stimulatory effect on neutrophils and an inhibitory effect on the other leukocyte subpopulations. A potential stimulatory effect on erythropoiesis has been also hypothesized. The aim of our study was to evaluate the effect of pasireotide treatment on hemochrome parameters in patients with endogenous pituitary-dependent glucocorticoid excess or Cushing’s d...

Adrenal insufficiency is a rare endocrine disorder characterized by low levels of cortisol associated with increased mortality, also due to inadequate replacement therapy. The replacement with the thrice-daily immediate release hydrocortisone (IRH), in contrast to the once-daily modified-release hydrocortisone (MRH), more appropriately mimicking the physiological circadian rhythm of cortisol (PCRC), is associated with metabolic disorders, mainly due to the non-physiological pe...