Endocrine Abstracts

Context: Amiodarone is a widely used anti-arrhythmic medication, however associated with a 15-20% rate of thyroid adverse effects. Amiodarone-induced thyrotoxicosis (AIT) is a complex disease due to diagnostic difficulties and therapeutic challenges. AIT patients often receive initial therapy for thyrotoxicosis before admission to a referral center. Whether the first-line medical therapy (i.e. therapies for thyrotoxicosis at first diagnosis of AIT) may affect the outcome of AI...

Four patients with autoimmune hypophysitis were followed since the diagnosis of the disease. All presented with severe headache, decreased libido, astenia. Case 1 and 3 presented polyuria and polydipsia. At MRI pituitary was enlarged, with high gadolinum uptake and stalk enlargement.Case 1, male 41 years. MRI volume: AP 13 mm, CC 7 mm. Hormonal assessment: central hypothyroidism, hypoadrenalism, hypogonadism, normal GH and IGF1, hyperprolactinemia, centr...

Patients with active Cushing’s syndrome (CS) have an increased coagulability and thrombotic tendency. High glucocorticoids concentrations increase plasma clotting factors, especially von Willebrand factor (vWf) and reduced fibrinolytic capacity. Thromboemobolic complications, mainly in the postsurgical phase, have been reported.Aim of this longitudinal study was to evaluate haemostatic and fibrinolytic markers in patients with active Cushing’s ...

The Nelson’s syndrome (NS) is characterized by hyperpigmentation, sellar growing mass, and increased plasma ACTH concentrations The management of NS remains difficult: neurosurgery represent the first choice therapy. Many drugs have been used with variable results: cyproeptadine, GABA-agonists, somatostatin analogues, chemiotherapy, PPAR-γ-agonists, and dopamin-agonists.Aim of this study was to evaluate the efficacy of cabergoline administratio...

Serum pituitary antibodies (Pit Abs) and tumor infiltrating lymphocytes (TILs) have been described in a small percentage of pituitary adenomas but their clinical significance remains unknown.Aim of the study was to assess Pit Abs and TILs prevalence in patients with pituitary adenomas and to determine their influence on the clinical outcome. In this prevalence case–control study were enrolled 291 pituitary adenoma cases, (110 non-secreting, 30 ACTH-...

Pituitary GH secretion is regulated by the interplay of at least two hypothalamic hormones, GH-releasing hormone (GHRH) and somatostatin, through their interaction with specific cell surface receptors on the anterior pituitary somatotrophs. A third type of receptor, the growth hormone secretagogue receptor, called GHS receptor type 1a (GHSR1a), was identified in the pituitary and the hypothalamus. Ghrelin is an acylated peptide produced predominantly by stomach and a natural l...

IgG4-related hypophysitis, a type of IgG4-related disease, is a rare condition. It appears to be sensitive to glucocorticoids in most patients, but its recurrence is likely.Clinical case: A 17 year-old girl was referred for hypotonic polyuria and polydipsia of 1 month duration. Water deprivation test was suggestive of central diabetes insipidus. Basal and dynamic assessment of pituitary anterior function were unremarkable. Patient did suffer from autoimm...

Background: Cushing Syndrome (CS) is associated with metabolic disturbances, including obesity. The 1 mg Dexamethasone Suppression Test (1mgDST) is widely used to assess cortisol regulation in suspected CS patients. However, its interpretation may require adjustments based on individual factors, such as body mass index (BMI), due to obesity’s influence on cortisol metabolism. The literature offers differing cutoff values for obese patients. This study aimed to establish B...

We report the clinical history of a 21-years old young female who, in February 2021, presented abdominal pain and biliary vomiting that lasted for two months. An esophagus-gastroduodenoscopy revealed a duodenal ulcerative lesion and proton pump inhibitory therapy was started with clinical benefit. One month later, the patient presented a facial acneiform rush with hirsutism for which she was referred to our attention. An abdominal MRI documented a well-circumscribed hyper-vasc...

Background: Amiodarone-induced thyrotoxicosis (AIT) is a challenging disease associated with increased morbidity and mortality. The European Thyroid Association guidelines define the role for total thyroidectomy in the management of AIT. However, these recommendations were based on small series, which often lead to heterogeneous results and, importantly, did not identify patients who may benefit from surgery.Materials and methods: Observational longitudi...