Endocrine Abstracts

The thyroid pathology is an area of special interest in our department. Hyperthyroidism represents 3.4% of the 8144 patients followed.The aim of this study is to characterize the therapeutic approach in patients with Grave’s disease (GD) and toxic nodular disease (TND).Retrospective study of 217 patients diagnosed with GD and TND, evaluated according parameters of therapeutic option, efficacy, relapse rate and associated compl...

Introduction: Thyroid hormones play an important role in bone metabolism. The potential action of prolonged levothyroxine therapy on bone mass reduction is still a matter of debate.Objective: The aim of the present study was to assess the effects of levothyroxine treatment on bone mineral density (BMD) and biochemical bone turnover markers.Methods: We determined thyroid function – TSH and free T4 (FT4), r...

Backgroud: Primary hyperparathyroidism is the most common cause of hypercalcemia, which is associated with an increased frequency of hypertension. However, there are no data on the prevalence of primary hyperparathyroidism in patients who present with hypertension.Clinical case: We present the case of a 40-year-old woman with a history of hypertension for ten years. In 2017 she was referred for evaluation of hypercalcemia. The patient denied any symptoms...

Introduction: Cushing’s Syndrome secondary to inhaled or topic corticosteroids is very rare, although there are reports of a link to cytochrome inhibitors. Ritonavir, a protease inhibitor used for treatment in human immunodeficiency virus (HIV) infection, is a potent inhibitor of cytochrome P450 3A4.The case: A 41 years old man - with personal history of asthma, HIV infection diagnosed in 2002 and hepatitis C infection since 1999 – was sent to ...

Levothyroxine (L-T4) is the mainstay of treatment of hypothyroidism. Marked elevation of thyrotropin (TSH) in patients on high replacement doses is rare and can result from malabsorption, drug interaction or poor compliance. The levothyroxine absorption test is required to distinguish these causes and has proved to be safe. This test measures the serum free thyroxine (FT4) response to 1 mg of oral L-T4 over 4–24 h.Clinical cases: Case no 1: A 28-yea...

Introduction: Insulin autoimmune syndrome (IAS) is a clinical condition characterized by the presence of autoantibodies to insulin or insulin receptors in patients not previously treated with insulin. This syndrome has been reported mainly in Asia, and it is a rare cause of hypoglycemia in Caucasians. So far there are no reports of IAS in patients with type 2 diabetes mellitus never treated with insulin.Case report: The authors describe a 59-year-old Cau...

Background: Obesity is related to an increased cardiovascular risk, namely coronary heart disease risk (CHDr). Type 2 diabetes (T2D) is frequently associated with obesity and, by itself, is an important CHDr factor. Interventions that induce weight loss would be expected to attenuate CHDr in obese patients.Aims: To evaluate variation in cardiovascular risk profile one year after adjustable gastric banding (AGB), in obese patients (with and without T2D); ...

Introduction: Adrenal incidentalomas are asymptomatic adrenal masses found accidentally during routine examination, not intended for adrenal pathology evaluation. The functionality of these lesions must be further investigated. Rarely, bilateral adrenal nodular hyperplasia can be detected in a patient with Cushing’s disease. The authors present the case of a patient with possible autonomous cortisol secretion of adrenal origin that eventually emerged as Cushing’s dis...

Introduction: Non-islet cell tumor induced hypoglycemia (NICTH) is a paraneoplastic phenomenon involving many types of tumors. It is associated with the secretion of incompletely processed precursors of IGF-2 resulting in a persistent insulin-like activity and hypoglycemia. Most commonly, IGF-2–linked hypoglycemia has been observed in patients with solid mesenchymal or epithelial tumors. Typically, elevated IGF-2 levels are associated with suppressed plasma levels of insu...

Background: Distal symmetric polyneuropathy (DSPN) is one of the most prevalent chronic complications of diabetes and the most common cause in the pathway to diabetic foot ulceration. Screening for DSPN enables early intervention and prevention of complications. The Semmes-Weinstein Monofilament Examination (SWME) is currently the method of choice to screen DSPN, but ideally two neurologic tests should be used. The Michigan Neuropathy Screening Instrument (MNSI), which evaluat...