Searchable abstracts of presentations at key conferences in endocrinology

ea0063p708 | Pituitary and Neuroendocrinology 2 | ECE2019

Hypophysitis secondary to anti-pd1/pd-l1 blockade: variations in presentation, four distinct cases

Lanzolla Giulia , Viola Nicola , Brancatella Alessandro , Latrofa Francesco , Marcocci Claudio , Vitti Paolo , Lupi Isabella

PD-1/PD-L1 pathway is a key regulator in T-cell activation and tolerance. Nivolumab, pembrolizumab (a PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are monoclonal antibodies approved for treatment of advanced cancers. Autoimmune thyroid diseases are the most common immune-related adverse effects (IrAEs) occurring after anti-PD-1 or anti-PD-L1 therapy, whereas autoimmune hypophysitis is described more frequently in patients treated with anti-CTLA-4. IrAEs can be isolate...

ea0063p765 | Thyroid 2 | ECE2019

Thyroid disfunction during treatment with Nivolumab: nuances in clinical presentation

Brancatella Alessandro , Viola Nicola , Lanzolla Giulia , Vitti Paolo , Marcocci Claudio , Latrofa Francesco , Lupi Isabella

Context: Monoclonal antibodies to Immune Check Point inhibitors (ICPis) are powerful anti-cancer drugs. They trigger the immune system against cancer cells, blocking inhibitory signals of T-Cells. However, ICPi therapy can also stimulate autoimmune reactions, inducing the so-called immune-related adverse events (irAEs). Endocrinopathies are common iRAEs and thyroid disfunction is the most common endocrinopathy during ICP therapy. We report three cases of thyroid disfunction du...

ea0073aep880 | Late Breaking | ECE2021

Subacute thyroiditis at the time of SARS-CoV-2 pandemic

Brancatella Alessandro , Viola Nicola , Rutigliano Grazia , Daniele Sgrò , Santini Ferruccio , Latrofa Francesco

BackgroundSubacute thyroiditis (SAT) has been related to acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated the incidence and the severity of SAT due to SARS-CoV-2.MethodsA cross-sectional, retrospective study was conducted at the Endocrinology Unit of University-Hospital of Pisa, Italy. All patients experiencing SAT arisen within a period of 15 days earlier and yet untreated, assessed from J...

ea0084ps1-01-04 | COVID & Thyroid Disease | ETA2022

Subacute thyroiditis: The severity depends on the causative agent and the treatment requires a lower glucocorticoid dose than that recommended by the guidelines

Viola Nicola , Brancatella Alessandro , Sgro Daniele , Casula Mauro , Santini Ferruccio , Latrofa Francesco

Subacute thyroiditis (SAT) is an inflammation of the thyroid gland characterized by varying degrees of severity regarding thyrotoxicosis, inflammation and the incidence of hypothyroidism. The present study aims to identify whether the severity of SAT depends on the causative agent involved and to identify what is the optimal therapy. To this purpose we retrospectively evaluated 402 patients referred to of the University Hospital of Pisa because of to a SAT from January 2011 to...

ea0081p126 | Endocrine-Related Cancer | ECE2022

Ultrasound and cytological features of thyroid nodules with aggressive behavior: from histology to clinic

Sgro Daniele , Greco Giuseppe , Brancatella Alessandro , Viola Nicola , Casula Mauro , Torregrossa Liborio , Rago Teresa , Santini Ferruccio , Latrofa Francesco

Fine-Needle Aspiration Biopsy (FNAB) is the recommended diagnostic tool for differentiating malignant from benign thyroid nodules and provides indication for surgical decisions. According to the Italian system, thyroid nodules are classified as TIR 1/1C, TIR 2, TIR 3A, TIR3B, TIR4 or TIR5, which correspond to Thy I, Thy II, Thy III, Thy IV, Thy V and Thy VI categories of the Bethesda system. TIR 3 identifies the indeterminate nodules. Surgery is usually recommended for TIR 3B,...

ea0081p464 | Thyroid | ECE2022

Steroid treatment in the management of destructive thyrotoxicosis induced by PD1 blockade

Brancatella Alessandro , Pierotti Laura , Lupi Isabella , Montanelli Lucia , Viola Nicola , Sgro Daniele , Sardella Chiara , Antonangeli Lucia , Brogioni Sandra , Cremolini Chiara , Marcocci Claudio , Santini Ferruccio , Latrofa Francesco

Objective: Destructive thyroiditis is the most common endocrine immune related adverse event (iRAEs) in patients treated with anti-PD1/PD-L1 agents. Given its self-limited course, current guidelines recommend no treatment for this iRAE. Nevertheless in patients with enlarged thyroid volume and a poor performance status, thyrotoxicosis may be particularly severe and harmful. Aim of the study is to evaluate if steroid treatment might be useful in improving thyrotoxicosis in subj...

ea0070aep332 | Diabetes, Obesity, Metabolism and Nutrition | ECE2020

Immune checkpoint inhibitors (ICIs) and ‘Fulminant Diabetes’: Two emblematic cases

Sgro’ Daniele , Giannarelli Rosa , Aragona Michele , Viola Nicola , Cosentino Giada , Brancatella Alessandro , Latrofa Francesco , Del Prato Stefano , Santini Ferruccio , Marcocci Claudio , Lupi Isabella

Context: Programmed cell death protein 1/programmed cell death protein ligand 1 (PD-1/PD-L1) are key regulators in T-cell activation and tolerance. Nivolumab (PD-1 inhibitor) and Atezolizumab (PD-L1 inhibitor) are monoclonal antibodies approved for the treatment of several types of advanced cancers. Immune checkpoint inhibition caused by these drugs can result in immune-related adverse events (irAEs) New-onset diabetes mellitus has been reported in fewer than 1% of patients an...

ea0073aep875 | Late Breaking | ECE2021

Management of thyrotoxicosis induced by PD1 or PD-L1 blockade

Brancatella Alessandro , Lupi Isabella , Viola Nicola , Daniele Sgrò , Montanelli Lucia , Sardella Chiara , Molinaro Eleonora , Piaggi Paolo , Elisei Rossella , Marcocci Claudio , Santini Ferruccio , Latrofa Francesco

BackgroundThyrotoxicosis is a common immune-related adverse event in patients treated with PD1 or PD-L1 blockade. A detailed endocrinological assessment, including thyroid ultrasound and scintigraphy is missing, as are data on response to treatment and follow-up. Aim of the study was to better characterize the thyrotoxicosis secondary to immune checkpoint inhibitors, gaining insights into pathogenesis and informing management.Metho...

ea0070aep914 | Thyroid | ECE2020

Thyroid imaging in the management of anti-PD1/PD-L1 induced thyrotoxicosis

Brancatella Alessandro , Lupi Isabella , Viola Nicola , Sgrò Daniele , Antonangeli Lucia , Montanelli Lucia , Sardella Chiara , Brogioni Sandra , Ricci Debora , Bianchi Francesca , Piaggi Paolo , Santini Ferruccio , Marcocci Claudio , Latrofa Francesco

Context: Thyrotoxicosis is the most common endocrine adverse event due totreatment with anti-PD1 and anti-PD-L1. The most common form is destructive thyrotoxicosis whereas persistent, supposedly autoimmune hyperthyroidism (Graves’ hyperthyroidism) is rare. The possible role of thyroid imaging (neck ultrasound and scintigraphy) in the differential diagnosis has never evaluated.Aim: To evaluate the usefulness of neck ultrasound and 99Tc- s...