Endocrine Abstracts

Introduction: First-line somatostatin analogue treatment may be an effective alternative option to surgery for some patients with GH-secreting pituitary macroadenoma. The PRIMARYS study aimed to investigate the impact of primary lanreotide Autogel 120 mg treatment on tumour volume and GH/IGF1 control in treatment-naïve acromegalic patients over a one-year time course.Methods: PRIMARYS was an international, multicentre, open-label, single arm, phase ...

Introduction: Generously supported by IPSEN)-->Surgery is recognized first-line therapy for acromegalic patients but tumour size and GH/IGF1 control has also been observed after primary somatostatin analogue treatment. This is the first study of therapy with high-dose lanreotide Autogel over one year in a large cohort of treatment-naïve acromegalic patients.Methods: In this international, multicentre, open...

IntroductionDuring pregnancy, women with Graves’ disease are at risk of maternal and fetal hyperthyroidism caused by stimulating TSH receptor antibody. Here we report the unusual case of a woman with recurrent Graves’ disease who developed central hypothyroidism transiently during pregnancy.Case report and resultsA 26-year-old woman was treated by antithyroid drug for a third episode of hyperthyroid...

Glucocorticoid resistance syndrome, a rare genetic disease, is often associated with glucocorticoid receptor (GR) loss-of-function mutations. Six patients carrying heterozygous mutations of NR3C1 gene encoding GR, either missense R477S, Q501H, L672P or non-sense R469X, R491X, Y660X mutations were studied. Surprisingly, NR3C1 mutation carriers presented with low kalemia, low plasma renin and aldosterone levels associated or not with arterial hypertension, cons...

Introduction: Abnormalities of glycoregulation are frequent in acromegaly (15-38%) secondary to insulin resistance related to GH/IGF-1 hyper-secretion. The frequency of gestational diabetes (GD) in women with acromegaly was reported in the French multicenter study (JCEM, 2010, 95, 4680) as increased mainly in the absence of pre-gestational control of GH/IGF-1 hyper-secretion. The aim of this study was to evaluate the frequency of GD in a cohort of acromegalic women, and compar...

Background: In PRIMARYS, lanreotide Autogel (LAN) 120 mg/28 days reduced tumour volume (TV), and GH/IGF-1 levels in patients with GH-secreting macroadenomas. In post-hoc analyses, we investigated predictive factors for treatment responses.Methods: PRIMARYS, a 48-week, international, open-label study, involved 90 treatment-naïve patients with GH-secreting macroadenomas receiving LAN. Factors predictive for hormonal control (HC; GH ≤2.5...

Introduction: Pituitary MRI T2-signal intensity may be associated with the response to somatostatin analogue therapy in acromegalic patients. Here, we explore how best to evaluate MRI T2-signal intensity of GH-secreting pituitary macroadenoma using data from the PRIMARYS study (NCT00690898; EudraCT2007-000155-34).Methods: PRIMARYS assessed tumour volume reduction (TVR) on MRI in treatment-naïve acromegalic patients with GH-secreting pituitary macroa...

Introduction: SDH genes mutations are associated with hereditary phaeochromocytoma and paraganglioma syndromes. We describe the case of a patient with SDHC related familial paraganglioma and pituitary adenoma.Case: A 65-year old man consulted for an incidentally discovered 7 cm abdominal mass on CT-scan, lateral to the right kidney, invading inferior vena cava, associated to a retroperitoneal adenomegaly and a lesion on the body of L2 vertebra with spina...

Objective: To determine the outcome of pregnancy in hypopituitary women.Background: Rare situation, not studied enough: only two previous studies concerning 9 and 19 patients (Overton et Hall).Design: Multicentric, descriptive, prospective and retrospective study.Material and methods: Twenty-one pregnancies were registered in 14 hypopituitary women (defined as gonadotropic deficiency associated with at least ...

In normal woman, placental GH secretion increases during gestation and induces an increase of IGF-1 concentrations. In acromegalic women, increased pituitary GH secretion seems autonomous and IGF-1 increases in late stage of pregnancy related to placental GH. In a cohort of 46 women (mean age 31.7±4.5 years), acromegaly was due to micro (n=7) and macro (n=39) adenomas. Before the beginning of 59 pregnancies, women have been treated by transphenoidal surgery ...