Endocrine Abstracts

The spontaneous remission of Cushing disease (CD) might be a phase of cyclic disease, but could also be explained by an ACTH-microadenoma infarction or hemorrhage, with clinical pictures ranging from asymptomatic hypercortisolism normalization to dramatic hypocortisolism. We describe the case of a 23-years-old woman, referred for amenorrhea lasting for 5 months, overweight and acne. Physical examination showed mild hirsutism, acne, round face with a hint at rubeosis, abdominal...

SARS-CoV-2 has rapidly spread from China throughout the world leading to a pandemic. COVID-19 can be severe enough to cause hospitalization and death. Many patients with endocrine disorders share many of the recognized risk factors for severe disease and have potential additional risks due to corticosteroid replacement therapy or alteration in blood electrolytes. We here report three cases of COVID-19 in patients with post-surgical hypopituitarism and documented hypocortisolem...

Patients with Cushing’s syndrome (CS) commonly develop osteopenia–osteoporosis; the recovery of bone mass after remission of hypercortisolism is not well documented. The present study addresses this issue.Patients and methods: Twenty patients (6M, 14F, 2 post-menopausal), aged 15–64 years (median 36), 15 with Cushing’s disease, 2 with ectopic ACTH syndrome, 3 with ACTH-indipendent CS were studied. BMD (t and z scores) at...

Background and objective: Mitotane is the main option of treatment for advanced adrenocortical carcinoma (ACC). However, limited evidence is available regarding practical management of mitotane treatment and its eventual combination with chemotherapy or radiotherapy. The aim of the study is to do a survey on the use of mitotane for advanced ACC in expert Italian centers, analyzing data of the LYSOSAFE database.Methods: Retrospective analysis of patients ...

An increase in basal and Pentagastrin (Pg) stimulated calcitonin (CT) concentration is a specific feature of medullary thyroid carcinoma (MTC). Routine basal CT measurement in nodular thyroid diseases is controversial. Pg stimulation is expected to increase the basal CT specificity in MTC screening, although false positive responses in patients without MTC have been reported.Aim: To report the diagnostic accuracy of Pg-stimulated CT in surgically treated...

Background and objective: Mitotane is widely used as post-operative adjuvant treatment of adrenocortical carcinoma. However, the management of therapy is largely empirical. Mitotane monitoring is recommended but we do not know what impact target concentrations do have on patient outcome. The aim of the study is to evaluate its use in expert Italian centers, analyzing data of Lysosafe Online® database.Methods: Retrospective analysis of patients repor...

Background: Adrenocortical carcinoma (ACC) has an aggressive but heterogenous behaviour. ENSAT stage and Ki67 proliferation index are used to predict clinical outcome but are limited in distinguishing patients with best outcome. We aimed to validate the prognostic role of clinical and histopathological parameters alone or combined by applying a previously proposed points-based score (mGRAS, Lippert JCEM 2018) to a large multicentre cohort of ACC patients.<p class="abstext"...

Metyrapone treatment in endogenous Cushing’s syndrome. Results from a prospective multicenter, open-label, phase III/IV study: PROMPTBackground: Metyrapone is a steroidogenesis inhibitor approved in Europe for the treatment of endogenous Cushing’s syndrome (CS) based on observational retrospective studies published over more than 50 years. We present data from the first prospective study designed to confirm metyrapone efficacy and good tolera...

BackgroundRetrospective studies led to European approval of the steroidogenesis inhibitor Metyrapone for the treatment of endogenous Cushing’s syndrome (CS). We prospectively showed good efficacy and safety of Metyrapone after 12 weeks (Wk12) treatment in the phase III/IV PROMPT study and now report results of an extension study (EXT) sponsored by HRA Pharma Rare Diseases.DesignThis was a single arm, ope...

BackgroundThe ESE-ENSAT guidelines suggest adjuvant mitotane for patients with adrenocortical carcinoma (ACC) at high risk of recurrence following radical surgery. This indication has a limited evidence base, lacking results from randomized controlled trials. No suggestion is available in low-risk patients, since studies did not stratify patients for prognosis. The randomized controlled study ADIUVO compared the efficacy of adjuvant mitotane (MIT) treatm...