Endocrine Abstracts

Introduction: Congenital adrenal hyperplasia (CAH) is the most frequent cause of primary adrenal insufficiency (PAI) in infants and children. The list of genetic causes of PAI has grown extensively in recent years(1). Associated features can provide a clue to identify the underlying defect.Case presentation: A 21-year-old female was referred for endocrinological advice about pregnancy. She had been diagnosed with isolated aldosteron deficiency...

Introduction: The tyrosine kinase inhibitor (TKI) lenvatinib, used in radioiodine-refractory differentiated thyroid cancer, is usually well-tolerated. However, severe side effects can occur. We describe a life-threatening complication under lenvatinib, followed by a challenging treatment with levothyroxine (LT4).Case Report: A 62-year-old man was diagnosed with a bone-metastasized Hurthle cell thyroid carcinoma (pT3N0M1). He underwent a total thyroidecto...

Background: An adrenal incidentaloma is defined as an adrenal mass larger than 1 cm, detected on imaging performed for an indication other than evaluation of adrenal disease. Following the European Society of Endocrinology clinical practice guideline, assessment of malignancy by imaging and hormone excess should be done simultaneously(1). To investigate whether an adrenal mass is functionally active, a thorough clinical examination is required, extended with a 1mg o...

Background: In a phase 3b, open-label study (NCT02354508) assessing efficacy and safety of long-acting pasireotide in patients with uncontrolled acromegaly after ≥3 months of treatment with first-generation SSAs, 18/123 (15%) patients achieved the primary endpoint of mean growth hormone (mGH) <1.0 μg/l and insulin-like growth factor-1 (IGF-1) <ULN (upper limit of normal) at week 36. Here, we present the results from the extension phase of this study.<p c...

The calcium-sensing receptor (CaSR) plays a central role in regulating parathyroid hormone (PTH) secretion in response to changes in extracellular calcium. The CaSR is a G-protein-coupled receptor and ligand binding results in stimulation of phospholipase C (PLC) activity, causing accumulation of inositol 1,4,5-triphosphate (IP3) and the rapid release of calcium ions from intracellular stores. Given the pivotal role of the CaSR in calcium homeostasis, we decided to ...

To estimate the point prevalence of active Cushing’s disease (CD) in Belgium, all endocrinologists were invited to perform a retrospective chart review of the CD patients they had been treating between 1-1-2009 and 31-12-2010.Only patients requiring cortisol lowering therapy because of cortisol excess could be included, such as de novo patients (n=53), previously diagnosed patients with persisting/recurrent disease after pituitary surgery a...

Background: Osilodrostat (potent oral 11β-hydroxylase inhibitor) provided rapid normalisation of mean urinary free cortisol (mUFC) in Cushing’s disease (CD) patients during the 48-week (W) core period of LINC 4 (NCT02697734) and was well tolerated. We report long-term efficacy and safety results from the LINC 4 core and extension phases.Methods: 73 adults with CD and mUFC >1.3 upper limit of normal (ULN) were enrolled. LINC 4 comprised a 12...

Background: Cushing’s disease (CD) is associated with hypercortisolism-induced cardiovascular morbidity and mortality and impaired patient quality of life (QoL). We report long-term effects of osilodrostat (potent 11β-hydroxylase inhibitor) on cardiovascular/metabolic-related risk factors, physical features of hypercortisolism and QoL in CD patients following the core and extension phases of the LINC 4 study (NCT02697734).Methods: LINC 4 compri...

Background: Treatment of neuro-endocrine tumors (NETs) is often challenging, given the heterogeneity of primary tumor sites, the individual disease complexity and the variety of treatment options. If patients are progressive during first-line treatment with somatostatin analogues (SSA), peptide receptor radionuclide therapy (PRRT) is a validated treatment for somatostatin receptor overexpressing neuroendocrine tumors. The NETTER-1 trial has demonstrated a pronounced positive e...

Background: Pasireotide is a multireceptor-targeted somatostatin analogue that predominantly binds to somatostatin receptor subtype 5 (SSTR5) and provides sustained control of urinary free cortisol (UFC) levels in some patients with Cushing’s disease (CD). Cabergoline is a dopamine D2 receptor agonist with efficacy in some patients with CD. Most corticotropinomas co-express SSTR5 and D2, providing rationale for combination treatment with pasireotide and cabergoline. Resul...