Endocrine Abstracts

Almost all cases of prolactinomas are benign intrasellar micro- or macroadenomas. Very rarely benign prolactinomas are located outside the sella and in most of these cases the tumors are located in the sphenoidal sinus.We here report a 35 year old woman who presented to the clinic with secondary amenorrhoea and galactorrhoea. Initial laboratory testing revealed mild hyperprolactinemia between 1100 and 1600 μU/ml and hypogonadotropic hypogonadism wit...

The OGTT is the gold standard for confirmation or exclusion of acromegaly in treatment-naïve patients as well as after surgery. According to former guidelines, acromegaly is ruled out if the growth hormone (GH) nadir lies below 1.0 μg/l and 0.4 μg/l pre- and postoperatively, respectively. We present the case of a 40-year-old man who presented to the outpatient clinic in 2014 for endocrinological evaluation after an elevated IGF-I concentration had occasionally b...

We present the case of a 67-year-old man who presented to the outpatient clinic for endocrinological evaluation after partial resection of an atypical pituitary adenoma (APA). Pathohistological assessment of two independent and experienced neuropathologists resulted in a diagnosis of APA with unusually high proliferation indices (Ki67 10–20%/p53 30%) and immunoreactivity for LH, FSH and the alpha-subunit. Clinical examination as well as laboratory testing revealed no sign...

Background: Soluble alpha klotho (sαKL) is a circulating protein that has been linked to the growth hormone (GH) axis. We previously showed its association to disease activity in patients with acromegaly, with considerable robustness towards biological confounders. However, there is scarce data in literature regarding the analytical performance of the assay, and pre-analytical stability of sαKL in blood samples. Objective: We aimed to evaluate ...

Introduction: Pasireotide is a potent somatostatin analogue (SSA) and used in therapy-refractory acromegaly, commonly after failure of treatment with first-generation SSA. However, it may induce severe hyperglycemia, which usually occurs rapidly after initiation of therapy and in general gradually improves over time. We here present two cases of young male patients who developed severe pasireotide-induced hyperglycemia after several years of treatment.Ca...

We previously have shown in a cohort of 236 non-fasted women that before and after a short high intensity exercise protocol (HIP) till exhaustion serum concentrations of 20 and 22 kD growth hormone (hGH) are highly correlated (P<0.0001). Although the GH response to exercise exhibited huge inter-individual differences, the 20 kD/22 kD-GH-ratio remained unchanged (9.6% vs 11.1%, P=0.313). A subgroup of the women was also studied under fasted conditions in a...

Introduction: Acromegaly is characterized by chronic growth hormone (GH) excess and leads to numerous changes in bodily functions and comorbidity. We compared potassium homeostasis in patients with acromegaly to hypertensive controls.Methods: We prospectively assessed serum potassium, urinary potassium excretion, aldosterone and renin, acid-base balance as well as glomerular filtration rate according to the CKD-EPI formula in 71 patients with acromegaly ...

Introduction: Acromegaly is a slowly progressing systemic disease that leads to numerous changes in metabolism and organ function. A large cross-sectional study showed signs of subclinical airway obstruction in female patients. We performed a longitudinal study of lung function testing to compare parameters of airway obstruction in male and female patients with acromegaly over time.Methods: 40 patients with acromegaly (24 male, 16 female) underwent repea...

Background: We recently have shown a close association of high concentrations of soluble alpha klotho (sαKL) to disease activity in acromegaly. Small pilot studies suggested that sαKL concentrations might be reduced in GH deficiency (GHD) and increase after recombinant human GH (rhGH) therapy. Our aim was to evaluate the potential of sαKL as a biomarker in GHD.Methods: We evaluated sαKL in comparison to the classical biomarkers GH, IG...

GH suppression during OGTT is the gold-standard test in diagnosis and monitoring of acromegaly. However, discrepancies between GH nadir and IGF-I have been described and have triggered search for factors modifying the extent of GH suppression. Cut-offs at 1.0 or 0.4 ng/ml are currently recommended with modern, highly sensitive GH assays. To establish assay specific GH nadir cutoffs for the 22kD GH specific IDS-iSYS assay, we examined 381 subjects (319 females, 62 males) with n...