Endocrine Abstracts

Pasireotide (Pas) is a multireceptor-targeted somatostatin analogue approved for the treatment of patients with Cushing’s Disease (CD) who fail or are poor candidates to surgery. Pas markedly improves signs and symptoms of the disease, reduces urinary free cortisol (UFC) up to its normalization in 55% of patients and pituitary tumour size in up to 100%. Here we present a patient with severe recurrent CD treated with Pas and showing opposite results between hormonal levels...

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: Acromegaly is associated with increased prevalence of thyroid diseases, particularly of differentiated thyroid carcinoma.Aim: To assess prevalence of thyroid diseases and thyroid cancer in patients with acromegaly.Patients and methods: Forty (10 M/30 F) acromegalic patients, 14 residents in iodine deficient areas, aged 47±12.8 years, were retrospectively reviewed. Mean duration of acromegaly was 7.6±9.5 years ...

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...

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: Subclinical hypothyroidism (SH) is a frequent clinical condition with a prevalence of 3–15% in general population. It is defined by elevated TSH levels with normal thyroid hormones [free thyroxine (FT4) and free triiodothyronine (FT3)]. Similar to prolactin, high TSH levels may be caused by macroTSH, a large molecular sized TSH with a low bioactivity. The aim of the study was to assess the prevalence of macroTSH in patients with subclinical hypothyroidism....

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...

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...

Background: Differential diagnosis of ACTH-dependent hypercortisolism is crucial to indicate a proper treatment and is based on CRH-, high-dose dexamethasone suppression-test (HDDST) and pituitary MRI. However, up to 50% of cases of Cushing’s disease (CD) present a negative MRI or a visible lesion < 6 mm. In these patients, guidelines suggest to perform bilateral inferior petrosal sinus sampling (BIPSS) in order to establish a correct diagnosis. Aim of this study was ...

Background: Pituitary tumors are mostly sporadic, but in less than 5% of cases they can be associated to genetic syndromes, so harbouring germline mutations. Familial pituitary tumors are often more aggressive, so it’s important to detect them, for both a better early diagnosis and genetic counselling. Before the development of Next-Generation Sequencing (NGS), Sanger sequencing was the most widely used method of DNA sequencing. Therefore, DNA samples were analysed follo...