Endocrine Abstracts

PD-1/PD-L1 pathway is a key regulator in T-cell activation and tolerance. Nivolumab, pembrolizumab (a PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are monoclonal antibodies approved for treatment of advanced cancers. Autoimmune thyroid diseases are the most common immune-related adverse effects (IrAEs) occurring after anti-PD-1 or anti-PD-L1 therapy, whereas autoimmune hypophysitis is described more frequently in patients treated with anti-CTLA-4. IrAEs can be isolate...

Context: Monoclonal antibodies to Immune Check Point inhibitors (ICPis) are powerful anti-cancer drugs. They trigger the immune system against cancer cells, blocking inhibitory signals of T-Cells. However, ICPi therapy can also stimulate autoimmune reactions, inducing the so-called immune-related adverse events (irAEs). Endocrinopathies are common iRAEs and thyroid disfunction is the most common endocrinopathy during ICP therapy. We report three cases of thyroid disfunction du...

Four patients with autoimmune hypophysitis were followed since the diagnosis of the disease. All presented with severe headache, decreased libido, astenia. Case 1 and 3 presented polyuria and polydipsia. At MRI pituitary was enlarged, with high gadolinum uptake and stalk enlargement.Case 1, male 41 years. MRI volume: AP 13 mm, CC 7 mm. Hormonal assessment: central hypothyroidism, hypoadrenalism, hypogonadism, normal GH and IGF1, hyperprolactinemia, centr...

Serum pituitary antibodies (Pit Abs) and tumor infiltrating lymphocytes (TILs) have been described in a small percentage of pituitary adenomas but their clinical significance remains unknown.Aim of the study was to assess Pit Abs and TILs prevalence in patients with pituitary adenomas and to determine their influence on the clinical outcome. In this prevalence case–control study were enrolled 291 pituitary adenoma cases, (110 non-secreting, 30 ACTH-...

IgG4-related hypophysitis, a type of IgG4-related disease, is a rare condition. It appears to be sensitive to glucocorticoids in most patients, but its recurrence is likely.Clinical case: A 17 year-old girl was referred for hypotonic polyuria and polydipsia of 1 month duration. Water deprivation test was suggestive of central diabetes insipidus. Basal and dynamic assessment of pituitary anterior function were unremarkable. Patient did suffer from autoimm...

We report the clinical history of a 21-years old young female who, in February 2021, presented abdominal pain and biliary vomiting that lasted for two months. An esophagus-gastroduodenoscopy revealed a duodenal ulcerative lesion and proton pump inhibitory therapy was started with clinical benefit. One month later, the patient presented a facial acneiform rush with hirsutism for which she was referred to our attention. An abdominal MRI documented a well-circumscribed hyper-vasc...

Background: Temozolomide is an alkylating chemoterapic agent that ties a methyl to guanine, causing a base-pair mismatch and a DNA damage, resulting in cell death. Due to its lipophilic nature and its ability to cross the blood-brain barrier, this drug was originally used for malignant gliomas and later for aggressive pituitary tumors and carcinomas. Temozolomide is now recommended as first-line chemotherapy by the recently published ESE Clinical Practice Guidelines. Here we p...

Objective: Destructive thyroiditis is the most common endocrine immune related adverse event (iRAEs) in patients treated with anti-PD1/PD-L1 agents. Given its self-limited course, current guidelines recommend no treatment for this iRAE. Nevertheless in patients with enlarged thyroid volume and a poor performance status, thyrotoxicosis may be particularly severe and harmful. Aim of the study is to evaluate if steroid treatment might be useful in improving thyrotoxicosis in subj...

Introduction: Polychlorinated biphenyls (PCBs) are environmental pollutants that modulate endocrine functions, induce tumorigenesis, and regulate apoptosis in several tissues; however, their effects on the apoptosis of pituitary cells is unknown.The aim of this study was to evaluate the PCBs influence on the apoptosis of normal pituitary cells and elucidate the molecular mechanisms involved.Methods: Primary cell cultures from mouse...

Pituitary antibodies have been measured mainly to identify patients whose disease is caused or sustained by pituitary-specific autoimmunity. Although reported in over 100 publications, this antibody test has variable results and limited clinical utility. Our goals were to: identify major sources of variability; test them experimentally for establishing an optimized immunofluorescence protocol; assess prevalence and significance of pituitary antibodies in patients with pituitar...