Endocrine Abstracts

Background: Nivolumab is a monoclonal antibody specific for human PD-1 (programmed cell death protein-1), a checkpoint molecule highly expressed in several cancers. Nivolumab is an immunotherapeutic strategy for human cancer, but it can interfere with endocrine system.Case reports: We report four cases regarding nivolumab-associated endocrinopathies: (i) Male, 55-year-old, with previous normal cortisol and adrenocorticotropic hormone (ACTH) levels, treat...

Introduction: Bilateral inferior petrosal sinus sampling (BIPSS) is the gold-standard for the differential diagnosis of ACTH-dependent Cushing Syndrome when the pituitary adenoma on MRI is doubtful or absent. This study aimed to analyze whether BIPSS can influence the outcome in patients with Cushing disease (CD).Methods: Retrospective, descriptive study. Forty-two patients with CD submitted to transsphenoidal surgery (TS) between 2005 and 2016 were divi...

Introduction: Successful long-term management of patients with Cushing’s disease (CD) remains a challenge. Few studies have analyzed the long-term recurrence rates of CD after transsphenoidal surgery (TS).Objectives: 1) to compare the outcome of patients with and without postoperative criteria for cure; 2) to compare the outcome of patients with and without a histological diagnosis of adenoma.Methods: Retrospective, descriptiv...

Introduction: During childhood and puberty, growth hormone(GH) is essential for linear growth. Consequently, children with isolated GH deficiency(GHD) must receive replacement therapy. GH has also important metabolic actions. GHD in adults is associated with altered body composition. However, long-term consequences of GH treatment in adults is not sufficiently known.Objective: To evaluate GH treatment during pediatric age in patients with isolated GHD.</...

Hashimoto’s thyroiditis (HT) is the most common chronic autoimmune thyroid disease, which is characterized by alteration of the thyroid function. HT is a multifactorial disorder and several candidate genetic loci have been identified as contributing to HT. The transcription factor Nrf2, encoded by the NFE2L2 gene, is an important regulator of the cellular protection against oxidative stress. The relevance of selenoproteins in follicular thyroid cell physiology and in mole...

Introduction: Given the significant impact of thyroid function on body weight, energy metabolism and adipocytes physiology, our aim was to study the impact of subclinical thyroid dysfunction in plasmatic levels of adipokines and ICAM-1 (intercellular adhesion molecule 1).Methods: We evaluated 98 patients with autoimmune thyroid disease divided into three groups: 30 who were euthyroid (TSH=0.35–4.94 UI/ml), 35 with subclinical hypothyroidism (hypoSC,...

Introduction: The diagnosis of Cushing’s syndrome is often challenging considering that none of the used laboratory tests has an ideal diagnostic accuracy. The complexity of the diagnosis increases in cyclic disorder, which is characterized by repeated episodes of cortisol excess followed by periods of normal cortisol secretion.Case report: A 32-year-old woman with history of arterial hypertension and obesity presented with weight gain, hirsutism, a...

Introduction: Rhino-orbito-cerebral mucormycosis is a rare invasive fungal infection more common in diabetic and elderly patients. The presentation is acute, severe and rapidly progressive to disseminated infection. The diagnosis is done by the identification of risk factors, clinical and radiologic signs and tissue biopsy consistent with mucormycosis. The mortality rate is high, so timely diagnosis and intervention lead to better outcomes.Clinical case:...

Background: The key physiologic defences against hypoglycaemia are the decrease in insulin and the increased secretion of glucose counterregulatory hormones, namely glucagon and epinephrine. The absence of warning signs of impending neuroglycopenia is known as hypoglycaemic unawareness.Case report: Male, 26 year-old, without relevant medical history and with normal body mass index, presented with hypertension, palpitations and diaphoresis. Clinical suspi...

Background: Transphenoidal surgery is still the best initial therapy for Cushing’s disease (CD), with a high probability of cure and few risks or complications. However, pharmacotherapy has a role as primary or adjunctive therapy: when surgery is delayed, in case of postoperative persistence or recurrence of hypercortisolism, or while waiting for radiotherapy effectiveness. Ketoconazole, a steroidogenesis inhibitor, is nowadays the main drug used to CD control by reducing...