Searchable abstracts of presentations at key conferences in endocrinology

ea0077cmw1.1 | Pituitary challenges: Prompt, practical and post-op | SFEBES2021

Apoplexy

Karavitaki Niki

Pituitary tumour apoplexy is a condition that occurs as a result of acute haemorrhage and/or infarction within a pituitary tumour (most commonly non-functioning pituitary adenoma), which may or may not be previously known. The clinical presentation occurs within a few hours or days and is due to sudden expansion of the pituitary gland. Manifestations cover a wide range including very intense and frequently retro-orbital...

ea0077ns1.2 | Acromegaly | SFEBES2021

Biochemical cure – is this enough?

Karavitaki Niki

Acromegaly is a condition associated with many co-morbidities and increased mortality. Over the last decades, advances in the management of this condition have led to improvement of the prognosis of the patients. Nonetheless, achievement of biochemical targets by various treatment modalities does not always translate to reversal of acromegaly-related morbidities. These include alterations in cardiovascular function, sleep apnoea syndromes, negative impact on b...

ea0065hdi2.4 | How do I. . .? 2 | SFEBES2019

How do I decide when to initiate dopamine agonist withdrawal?

Karavitaki Niki

Dopamine agonists (DA) are the first line treatment for patients with symptomatic prolactinoma and aims to lower prolactin, reduce adenoma size and restore gonadal function. This treatment is effective in the majority of patients and DA resistance s reported in around 10% of patients on cabergoline and 20–30% of those on bromocriptine. Established consensus on the optimal duration of DA therapy is lacking. Given the potential adverse effects of DAs in the...

ea0049s13.1 | Challenging pituitary diseases | ECE2017

Hypophysitis

Karavitaki Niki

Hypophysitis is a rare inflammatory condition of the pituitary gland. Its pathogenesis is poorly understood and new variants have been recently described. It can be primary (isolated inflammation of the gland, not related with medications, systemic inflammatory disorders, infections, or other diseases), or secondary (associated with systemic inflammatory processes (as sarcoidosis, Wegener’s granulomatosis, Crohn’s disease, Takayasu’s arteritis, Cogan’s synd...

ea0044s1.3 | Challenges in pituitary disease | SFEBES2016

Quality of life in patients with pituitary disease

Karavitaki Niki

Pituitary disease covers a wide spectrum of conditions associated with considerable physical, psychological and cognitive manifestations, a number of which persist even after successful treatment of the pituitary gland disorder.Quality of life (QoL) is defined as ‘the functional effect of an illness and its consequent therapy upon a patient, as perceived by the patient’’. In the last years, the area of QoL in patients with pituitary diseas...

ea0031s8.1 | Non functioning pituitary tumours (Supported by <emphasis role="italic">Endocrine-Related Cancer</emphasis> and the Pituitary Foundation) | SFEBES2013

Epidemiology and natural history of pituitary tumours

Karavitaki Niki

Non-functioning pituitary adenomas (NFAs) are benign pituitary neoplasms arising from the adenohypophyseal cells. They are not associated with clinical evidence of hormonal hypersecretion and have a prevalence of 22 cases/100 000 people. They are diagnosed more commonly in males (2/3 of the NFA cases) and based on a recent UK community-based cross-sectional study, the median age at their diagnosis is 52 years (males 51 and females 43). At presentation, the majority is macroade...

ea0019s52 | Improving mortality and morbidity in pituitary disease | SFEBES2009

Why craniopharyngioma remains a condition with a high mortality and morbidity?

Karavitaki Niki

Craniopharyngiomas are rare, sellar/parasellar tumours diagnosed during childhood or adult life.Despite their benign histological appearance, they are associated with substantial morbidity (endocrine, visual, hypothalamic, as well as neurobehavioural and cognitive) compromising psychosocial integration, quality of life and survival. These complications are the result of the damage by the primary (they tend to be large lesions, most of which with signific...

ea0028p255 | Pituitary | SFEBES2012

Ipilimumab induced hypophysitis - an evolving clinical entity

Juszczak Agata , Karavitaki Niki , Grossman Ashley

Introduction: Ipilimumab (Yervoy, BMS) is a human monoclonal antibody increasingly used in oncology. It targets cytotoxic T lymphocytes antigen 4 (CTLA-4) promoting their proliferation and augmenting an anti-tumour response. It is licensed for the treatment of unresectable or metastatic melanoma and multiple clinical trials using this medication for other malignancies are ongoing. Ipilimumab related adverse reactions are mainly autoimmune and occur in 61% of patients, of which...

ea0025p249 | Pituitary | SFEBES2011

Prospective assessment of pituitary function in patients with macroprolactinoma treated with cabergoline

Karavitaki Niki , Dobrescu Ruxandra , Wass John

Background: Patients with macroprolactinoma often present with pituitary hormone deficits associated with hyperprolactinaemia or mass effect. Restoration of normoprolactinaemia and tumour shrinkage by dopamine agonist is expected to reverse, at least partially, the pituitary dysfunction. Studies assessing prospectively the pituitary function in subjects with macroprolactinoma treated with cabergoline are lacking.Aim: To check the time course of recovery ...

ea0019p246 | Pituitary | SFEBES2009

The high dose dexamethasone suppression test is dead

Siamatras Thomas , Karavitaki Niki , Wass JAH

Introduction: The diagnosis of Cushing’s syndrome (CS) requires a screening test of high sensitivity, followed by biochemical evaluation aiming to identify the aetiology of hypercortisolism. The high-dose dexamethasone suppression test (HDDST) with the corticotropin-releasing hormone (CRH) test is commonly used for the differential diagnosis of ACTH-depended Cushing’s syndrome. However, the diagnostic utility of the HDDST has been questioned.Ai...