Endocrine Abstracts

Background: The treatment of choice in patients with Cushing Disease (CD) is pituitary surgery (PS). A successful PS is generally followed by adrenal insufficiency (AI). Although the remission rate after PS may reach 96.6% of cases, approximately 1/3 of cured patients experience the recurrence of the disease during lifetime. The aim of this study was to analyze the duration of AI in relation with the recurrence of CD.Materials and methods: We performed a...

Patients with Cushing disease (CD) are at increased risk of venous thromboembolism (VTE). It was surmised, but not conclusively shown that the risk is related to plasma hypercoagulability secondary to the effect of glucocorticoids. This study aimed at investigating the thrombin-forming potential of patients with CD in the presence of a functioning protein C system by adding its main physiological activator, thrombomodulin. Under these experimental conditions, which mimic close...

Background: Routine clinical use of arginine-vasopressin (AVP) is limited by its small molecular size and pre-analytical errors. In contrast, copeptin – a peptide of 39 amino acids co-secreted with arginine-vasopressin (AVP) - is a stable protein and its measurement represents a reliable measure of AVP concentration. The aim of this study was to analyze diagnostic role of copeptin in diagnosis of diabetes insipidus (DI) in patients treated for hypothalamic-pituitary disea...

Background: In a previous study, we retrospectively analysed a group of patients with high insulin growth factor 1 (IGF1) but normal growth hormone (GH) suppression, identifying among them a subgroup of “micromegalic” patients presenting with clinical features of acromegaly and high rate of comorbidities. We therefore expanded our cohort of patients, extended the follow-up time and collected preliminary data on treatment response aiming to better characterize this co...

Objective: Several studies reported that a long-time therapy with somatostatin analogs (SSTa) in acromegaly could induce persistent remission event after drug withdrawal. The aim of this study was to evaluate GH/IGF-I secretion after SSTa discontinuation in a series of acromegalic patients.Materials and methods: Data of 21 patients regularly referred to our Centre and previously included in a multicentre study, have been updated at the last available fol...

Background: In acromegalic patients, quality of life reduction and neuropsychological impairment are common, in addition to well-known complications related to the pituitary adenoma and to the GH/IGF-I excess. Acromegalic patients need a lot of outpatient visits and a multidisciplinary approach during the management of the disease and its comorbidities. Aim of the project is to analyze the role of an electronic health device (eHD) with remote monitoring in management of acrome...

Reduced health-related quality of life (HRQoL) and impairment in neurocognitive functions are a possible complaint in patients with pituitary adenoma. Psychiatric comorbidities in Cushing’s disease are well known. However recent studies showed HRQoL reduction and psychiatric symptoms in patients with pituitary disease with or without hormonal excess. Aim of this study is to analyse HRQoL, psychiatric symptoms and neurocognitive functions in patients with pituitary adenoma...

Introduction: Non-functioning pituitary adenomas (NFPA) accounts for about 40% of all pituitary tumors. One or more anteropituitary deficiencies are present at diagnosis in 60–80% of NFPA. Hypopituitarism classically appears with the following order: GH→FSH/LH→TSH→ACTH. Aim of the study was to evaluate the incidence and the order of appearance of pituitary deficiencies in patients with NFPA.Materials and methods: We retrospectively...

Background: Patients with Cushing’s Syndrome (CS) have a high risk of venous thromboembolism (VTE) related to a hypercoagulable state. Previous studies showed increased levels of procoagulant factors but also an elevation of some of the anticoagulants factors and fibrinolytic enzymes. Once patients achieve disease remission, there is a significant decrease of some procoagulant factors but if these alterations are completely reversible is still unclear. Compared to tradit...

Introduction: The diagnosis of acromegaly is confirmed in the presence of high IGF-1 levels and inadequate suppression of growth hormone (GH) after glucose load. According to guidelines, a GH nadir (GHn)>0.4 ng/ml is considered diagnostic with ultrasensitive assays. However, some acromegalic patients with lower GHn, also called ‘micromegalic’, are reported, but a systematic collection of their clinical features is unavailable.Aim of the s...