Searchable abstracts of presentations at key conferences in endocrinology

ea0073ep8 | Adrenal and Cardiovascular Endocrinology | ECE2021

Very large adrenal nodule and Cushing syndrome – when histology differs from the clinical suspicion

Lavrador Mariana , Moreno Carolina , Luísa Barros , Paiva Isabel

IntroductionThe malignancy risk of an adrenal nodule is based on clinical symptoms (rapid onset of hypercortisolism and hyperandrogenism; mass symptoms) and imaging characteristics. These suspicious criteria include boundary irregularities, heterogeneity, dimension>6 cm and density>20 HU (CT). However, these are not absolute criteria.Case reportWe report the case of a 43 years-old female patient with a histor...

ea0081p481 | Thyroid | ECE2022

Unexpected alterations in thyroid status: a case of alemtuzumab-induced Graves’ disease with fluctuating course

Filipa Araujo Barbara , Lavrador Mariana , Araujo Catia , Ribeiro Ana , Paiva Sandra , Paiva Isabel

Introduction: Alemtuzumab is a humanized anti-CD52 monoclonal antibody approved for the treatment of relapsing−remitting multiple sclerosis (RRMS). Through an immune reconstitution mechanism, it leads to thyroid autoimmunity in 35% of cases, with Graves’ disease (GD) being the most common presentation. Alemtuzumab-induced GD exhibits distinctive clinical and immunological features, with rarely reported cases of fluctuating thyroid status with documented both blockin...

ea0081ep62 | Adrenal and Cardiovascular Endocrinology | ECE2022

Synchronous adrenal gland masses in a patient: clinical case

Ferreira Mafalda Martins , Lavrador Mariana , Araujo Catia , Guiomar Joana Reis , Moreno Carolina , Oliveira Patricia , Paiva Isabel

We describe the case of a 69-year-old woman with bilateral adrenal incidentalomas identified in CT-scan: on the right, a 57 mm heterogeneous mass with <10 Hounsfield units(HU) with absolute washout of 16%; on the left a 13 mm mass with 35UH, intense contrast enhancement but washout of 66%. She had a recent onset of diabetes, hypertension, androgenic alopecia and facial hair. The systolic blood pressure remained persistently >160 mmHg despite receiving four antihyperten...

ea0081ep63 | Adrenal and Cardiovascular Endocrinology | ECE2022

Malignant pheochromocytoma with bone, pulmonary and brain metastases

Araujo Catia , Ferreira Mafalda Martins , Lavrador Mariana , Moreno Carolina , Oliveira Patricia , Baptista Carla , Paiva Isabel

Introduction: Pheochromocytomas are rare neuroendocrine tumors whose malignancy is defined by the presence of metastases that may appear several years later. The appropriate follow-up time remains uncertain.Clinical Case: We present the case of a woman with a history of pheochromocytoma who underwent complete resection at 48 years old. The genetic evaluation was negative for mutations on RET, VHL, SDHB or SDHD genes. At 66 years old, a thoracic vertebral...

ea0081ep149 | Calcium and Bone | ECE2022

Bone mineral density in patients with addison disease versus congenital adrenal hyperplasia

Lavrador Mariana , Araujo Barbara Filipa , Carreira Ana , Paiva Sandra , Barros Luisa , Paiva Isabel

Introduction: The treatment of Primary Adrenal Insufficiency involves the chronic use of glucocorticoids. The balance between the dose needed to supply the cortisol deficit and the possible consequences of overtreatment is a challenge. In patients with Addison disease (AD), androgens deficiency is an additional factor for osteoporosis.Objective: To evaluate if there are differences in bone mineral density (BMD) in patients with Addison’s disease ver...

ea0081ep165 | Calcium and Bone | ECE2022

Reduced bone mineral density in primary adrenal insufficiency: consequences of long-term treatment

Araujo Barbara Filipa , Lavrador Mariana , Araujo Catia , Ferreira Mafalda , Barros Luisa , Paiva Sandra , Paiva Isabel

Introduction: The effects of long-term replacement therapy of primary adrenal insufficiency (PAI) are still a matter of debate. Glucocorticoid (GC) replacement regimens do not completely mimic the endogenous hormonal production and their monitoring is sometimes difficult. Therefore, some patients are exposed to mild GC excess with potential complications, such as hypertension, diabetes, and skeletal fragility. Data on bone mineral density (BMD) in PAI is still scarce and contr...

ea0081ep171 | Calcium and Bone | ECE2022

A sporadic case of pseudohypoparathyroidism type Ib and fahr’s syndrome

Araujo Catia , Ferreira Mafalda Martins , Araujo Barbara Filipa , Lavrador Mariana , Baptista Carla , Bastos Margarida , Paiva Isabel

Introduction: Pseudohypoparathyroidism is a heterogeneous disease characterized by hypocalcemia, hyperphosphatemia and parathyroid hormone resistance. The distinct pseudohypoparathyroidism types are distinguished by physical features, the coexistence of other hormone resistances and genetic defects. Pseudohypoparathyroidism type Ib is more often associated with sporadic cases, unlike others types.Clinical Case: Male, born in France, diagnosed with pseudo...

ea0081ep810 | Pituitary and Neuroendocrinology | ECE2022

Hypopituitarism in adults - the importance of clinical suspicion

Rita Elvas Ana , Lavrador Mariana , Melo Miguel , Barros Lui sa , Gomes Maria Leonor , Paiva Isabel

Introduction: Hypopituitarism is a rare entity that can have different aetiologies. Symptoms are usually progressive and non-specific; therefore, many patients are underdiagnosed and untreated. We present a clinical case of a patient presenting septic shock, hyponatremia and central hypothyroidism.Case report: A 46-year-old man was admitted in ICU for septic shock of unknown origin and multiorgan failure. Hormonal profile showed central hypothyroidism, p...

ea0081ep881 | Reproductive and Developmental Endocrinology | ECE2022

Noonan Syndrome, Dandy-Walker variant and delayed puberty- a rare association

Lavrador Mariana , Fadiga Lu cia , Ferreira Mafalda Martins , Barros Lui sa , Paiva Isabel

Introduction: The Dandy-Walker complex (DW) comprises a rare intracranial malformation of the posterior fossa and multiple organ anomalies. The association with endocrine pathology is rare - described in isolated cases (Kallman syndrome, primary hypothyroidism (PH) and central precocious puberty). Noonan syndrome (NS) is a genetic disease usually diagnosed at birth, with variable phenotype. Most cases have AD transmission, with the PTPN11 gene mutation responsible for 50%....

ea0073aep107 | Calcium and Bone | ECE2021

New variant of the casr gene (c.2459c > t) associated with primary hypoparathyrodism – a case report

Lavrador Mariana , Lages Adriana , Bárbara Araújo , Luísa Barros , Paiva Isabel

BackgroundAutosomal dominant hypocalcaemia, caused by either inherited or de novo mutations in calcium-sensing receptor gene (CASR), is biochemically characterized by the presence of hypocalcaemia, hypercalciuria and inappropriately low levels of PTH. Receptor-activating mutations induce an increase sensitivity to calcium by parathyroid and renal cells, leading to suppression of PTH synthesis and consequently hypocalcaemia. Clinical manifestations are va...