Endocrine Abstracts

Diagnosis and differential diagnosis of Cushing’s syndrome belongs to the most difficult ones in clinical endocrinology and is essential for optimal management of this syndrome. Clinical presentation of Cushing’s syndrome and frequency of particular clinical signs with respect to their importance for diagnosis and differential diagnosis of Cushing’s syndrome will be discussed. Subsequently, biochemical tests used for confirmation of Cushing’s syndrome will ...

Acromegaly is a rare condition caused by overproduction of growth hormone (GH). Early diagnosis, optimal treatment and follow-up is essential for prognosis of patients with acromegaly. Surgery is first choice treatment of acromegaly. Cure rates range around 80% (63–100%) in GH secreting microadenomas, however only about 50% (40–72) in macroadenomas. If not curable, surgery has to be followed by other treatment modalities to achieve treatment goals that are according ...

Acromegaly is usually diagnosed after several years of duration. The multimodal therapy – surgery, radiotherpy, pharmacotherapy – is necessary in the majority of patients. Register of sellar tumors (RESET) collecting data of patients from eight tertiary centers in the Czech and Slovak Republics since the year 2000 was established in 2008.Aim of analysis: Evaluation of diagnostics of acromegaly and effectiveness of its treatment in a daily pract...

Introduction: In the past 10 years, endoscopic resection of pituitary adenomas has become an alternative to microsurgical resection with the additional advantage of increasing the patient’s postoperative comfort. This analysis explored whether endoscopic resection can reduce the risk of postoperative neurohypophyseal dysfunction.Material and methods: We rated and compared the need to administer desmopressin during the first four postoperative days a...

Introduction: Salivary cortisol measurement, representing free cortisol, seems to be a promissing alternative method to serum cortisol. Besides its use in the diagnostics of hypercortisolism, it could be of help in evaluation of adrenocortical reserve. It might be useful especially in patients on estrogen replacement, which modulates transcortin and hence total cortisol levels.Aims: Compare the reliability of salivary vs. serum cortisol assessment during...

Certain degree of hypopituitarism has been revealed in a significant number of patients who suffered traumatic brain injuries or subarachnoid hemorrhage. Microhemorrhages, necrosis, tissue infarcts and vasoconstriction are reported as mechanism of hypothalamo-pituitary dysfunction. Assessment of hypothalamo-pituitary endocrine functions in patients with chronic subdural hematomas has not been published yet, although dysfunction of hypothalamo-pituitary unit can be expected (he...

Fibroblast growth factor-21 (FGF-21) is a novel regulator of metabolic homeostasis that improved diabetes compensation and dyslipidemia in diabetic mice and monkeys. However, little is known about its regulation in humans. Cushing’s syndrome (CS) is characterized by endogenous hypercortisolism and is often associated with numerous metabolic abnormalities. The objective of this study was to test the hypothesis that CS is associated with altered levels of FGF 21 that may in...

Radiation therapy is used in the treatment of pituitary adenomas, especially in failures of neurosurgery and pharmacotherapy to reduce the size of adenomas and normalize their hypersecretion. Conventional fractionated radiotherapy has achieved good results, but only after a long latency, with considerable postradiation morbidity and with very frequent appearance of hypopituitarism. The focal stereotactic targeting allowed by Leksell gamma-knife (LGK) was supposed to decrease t...

ACTH test is widely accepted as diagnostic tool in suspicion on peripheral as well as on central hypocorticism. The optimal dose of tetracosactide for determination of hypocorticism is still matter of debate. The 250 μg as a standard dose of tetracosactide has been approved for diagnosis of congenital adrenal hyperplasia (CAH) many years ago. Moreover, current limited availability of tetracosactide and its increased financial cost on the market raised the question whether...

The aim of the study was a detailed analysis and a comparison of hypothalamic–pituitary–adrenal axis tests and cortisol metabolites analysis during these tests. This procedure might enable to design new diagnosis algorithms of hypocorticalism and normal levels for salivary cortisol estimation for early diagnostic of patients with hypothalamic–pituitary–adrenal axis disorder as well as to give us a possibility to reveal adrenal disorder in patients on estrog...