Endocrine Abstracts

Introduction: Ipilimumab is a monoclonal antibody directed against CTLA-4 used primarily in treatment of malignant melanoma. Immunological side effects are common, amongst others it may lead to hypophysitis. We studied clinical characteristics of IpiH and compared it to cases of primary hypophysitis (PH).Methods: We conducted a retrospective single centre study in 75 hypophysitis patients (60 primary, 15 Ipilimumab-induced in patients with melanoma). Gro...

The OGTT is the gold standard for confirmation or exclusion of acromegaly in treatment-naïve patients as well as after surgery. According to former guidelines, acromegaly is ruled out if the growth hormone (GH) nadir lies below 1.0 μg/l and 0.4 μg/l pre- and postoperatively, respectively. We present the case of a 40-year-old man who presented to the outpatient clinic in 2014 for endocrinological evaluation after an elevated IGF-I concentration had occasionally b...

Introduction: Acromegaly is a rare disease resulting from GH excess mostly due to pituitary adenomas. It is associated with changes of most organ systems and multiple comorbidities. The impact of GH and IGF-I excess on renal function in acromegaly is unclear.Methods: We investigated 66 acromegalic patients from our outpatient clinic (32 female, 34 male, mean age 61.5±12.9 years, women 10 years older than men). The renal function was assessed by bloo...

We present the case of a 67-year-old man who presented to the outpatient clinic for endocrinological evaluation after partial resection of an atypical pituitary adenoma (APA). Pathohistological assessment of two independent and experienced neuropathologists resulted in a diagnosis of APA with unusually high proliferation indices (Ki67 10–20%/p53 30%) and immunoreactivity for LH, FSH and the alpha-subunit. Clinical examination as well as laboratory testing revealed no sign...

Background: Soluble alpha klotho (sαKL) is a circulating protein that has been linked to the growth hormone (GH) axis. We previously showed its association to disease activity in patients with acromegaly, with considerable robustness towards biological confounders. However, there is scarce data in literature regarding the analytical performance of the assay, and pre-analytical stability of sαKL in blood samples. Objective: We aimed to evaluate ...

Background: Although the prognosis inGuillain-Barré syndrome (GBS) is generally good, the protracted and sometimes incomplete recovery is a heavy burden for patients. Animal studies suggest that treatment with growth hormone (GH) could stimulate myelin repair and thus accelerate functional recovery in acute polyneuropathy. We report on the first use of GH in GBS.Objective: To monitor safety and tolerability as well as to evaluate the effect of off-l...

Introduction: Pasireotide is a potent somatostatin analogue (SSA) and used in therapy-refractory acromegaly, commonly after failure of treatment with first-generation SSA. However, it may induce severe hyperglycemia, which usually occurs rapidly after initiation of therapy and in general gradually improves over time. We here present two cases of young male patients who developed severe pasireotide-induced hyperglycemia after several years of treatment.Ca...

Introduction: Acromegaly is characterized by chronic growth hormone (GH) excess and leads to numerous changes in bodily functions and comorbidity. We compared potassium homeostasis in patients with acromegaly to hypertensive controls.Methods: We prospectively assessed serum potassium, urinary potassium excretion, aldosterone and renin, acid-base balance as well as glomerular filtration rate according to the CKD-EPI formula in 71 patients with acromegaly ...

Somatostatin analogues (SSA) are the mainstay of pituitary-targeted pharmacological treatment in acromegaly, but are characterized by high incidence of resistance in half of cases. The successful management of acromegaly involves in addition to targeting biochemical control the treatment of the metabolic comorbidities and hypopituitarism. In this study we analysed the impact of the concomitant antidiabetic treatment and hormone replacement on the response to SSA. Data were col...

Introduction: Somatostatin analogues (SSA) present the treatment of choice in patients with previously poorly controlled acromegaly.Methods: We conducted a retrospective analysis of acromegalic patients enrolled in the Network of Excellence for Neuroendocrine Tumors Munich and treated with the SSA lanreotide.Results: Fifty-six acromegalic patients (25 females; mean age 59 years; 33 with macroadenoma) switched to lanreotide from pre...