Endocrine Abstracts

Background: SARS-CoV-2 infection is characterized by aspecific symptoms (e.g., fever, cough) and can be complicated by viral pneumonia and many other manifestations can occur. Endocrinological complications have also been described. Pheochromocytomas are rare tumors located in the adrenal medulla, causing symptoms due to catecholamines overproduction and abrupt release. Catecholamines release can be continuous or intermittent and there can be several triggers including stress,...

Background: Cushing syndrome (CS) represents a challenging disease. The major difficulty is to distinguish between the two main etiologies of ACTH-dependent hypercortisolism. However, in rare cases, the concomitant presence of both an ACTH-dependent and a primary adrenal disease should be considered.Case report: We evaluated a 67-year-old woman for a severe ACTH-dependent CS (midnight serum cortisol 332 ng/ml; urinary free cortisol [UFC] 3000 mcg/day; co...

Introduction: The approach for initial thyroid hormone suppression in patients who undergo surgery for differentiated thyroid cancer (DTC), is based upon the risk of disease recurrence. In particular, recent American Thyroid Association guidelines suggest to maintain TSH levels between 0.1 and 0.5 mU/l and less than 0.1 mU/l for patients with ‘intermediate’ and ‘high’ risk respectively. The aim of the study is to identify the major predictive factors of LT4...

Background: Cushing’s syndrome (CS) in medullary thyroid cancer (MTC) is rare with less than 60 cases reported. Less than 1% of MTC develop ectopic ACTH-dependent CS and this correlated with metastasis at diagnosis and poor prognosis.Case presentation: A 32-year-old male was referred to our department for suspected CS. Initial evaluation showed hypokalemia(2.4 mmol/l) and severe ACTH-dependent CS (Cortisol h8:678ng/ml; ACTH:249pg/ml; urinary free co...

Background: In a previous publication we identified the major predictive factors of levothyroxine (LT4) requirement and proposed an efficient nomogram to calculate LT4 substitutive starting dose after total thyroidectomy for benign disease. The aim of this study was to assess whether the LT4 requirement differs between the tablet and the soft gel capsules formulations.Methods: One hundred and three consecutive patients su...

Thyroglobulin (Tg) is a highly sensitive tumor marker of differentiated thyroid cancer (DTC). To optimize the sensitivity, guidelines recommend Tg measurement after stimulation with recombinant TSH (rh-TSH) 6–12 months after radio remnant ablation (RRA). Based on recent evidence in Literature, it is possible to avoid the measurement of Tg after stimulation with rh-TSH (S-Tg) in presence of undetectable values of basal Tg (B-Tg) if high functional sensitivity (0.1 ng/ml) m...

Introduction: Differentiated thyroid cancer (DTC) is the most frequent endocrine cancer. After surgery followed, if any, by 131I radio remnant ablation (RRA), follow-up monitoring consists of neck ultrasonography (US) and measurements of thyroglobulin (Tg) levels and anti-Tg antibodies (Ac-Tg) both on levothyroxine (L-T4) therapy and after recombinant TSH (rTSH). The aim of our study is to define a cut-off of Tg before RRA (RRA-Tg) during <...

A 73 years old man came to our observation for severe dysphagia and loss of weight (10 kg in 1 month). About 30 years before he had myocardial infarction and he underwent coronary artery bypass graft. One week before the first medical evaluation, patient suspended all drugs per os because he could not swallow pills and food. Thyroid function test revealed a severe hyperthyroidism (FT3 11.9 pg/ml; FT4 40 pg/ml; TSH <0.01 μU/ml). Anti-TSH ...

Cushing’s disease (CD) is the most common cause of endogenous Cushing’s syndrome in children and adolescents and represents a rare cause of short stature. A 14-year-old boy came to our attention for progressive weight gain and short stature. Birth length and weight were normal; clinical history was negative for use of glucocorticoids. At examination, height was 140 cm (3th centile), weight was 37.7 kg (10th centile). Tanner stage was: G2, PH 3, testis 3 ml. Hypothyro...

Subclinical CS, mild hypercortisolism without overt clinical manifestations, is the most frequent (5–8%) hormonal abnormality detected in patients with secreting adrenal incidentalomas.Unclear clinical features and mild hypercortisolism make the diagnosis problematic, although laboratory criteria have recently been reviewed. In these cases, scintiscan is a central tool to define the adrenal functional activity.A 60-year-old ma...