Endocrine Abstracts

Adrenocortical carcinoma (ACC) is a rare malignancy, but accounts for up to 11% of adrenal masses investigated in referral centres. Diagnosis remains a challenge. Up to two thirds are biochemically inactive, resulting from de facto enzyme deficiencies in the steroid hormone biosynthetic pathways, as shown by urine steroid profiling by gas chromatography-mass spectrometry. Increased metabolites of pathway intermediates in ACC discriminate it from benign adrenal lesions...

Background: Mitotane is an adrenolytic chemotherapy, currently accepted as first line adjuvant therapy in adrenocortical carcinoma. Mitotane has a narrow therapeutic window. Serum levels of >14 mg/l are required to achieve a cytotoxic effect and levels of >20 mg/l are potentially toxic. There are two strategies for mitotane initiation: a low-dose regimen (3 g) and a high-dose regimen (increase to 6g/day over 4 days and reduce to 4.5 g/day after 10 days).<p class="...

Fine-needle aspiration biopsy (FNAB) is the tool of choice for evaluating thyroid nodules but there is a significant percentage of insufficient or indeterminate aspirates and falsely reassuring results have been reported in up to 6% of cases.We aimed to examine our experience with FNAB among a large cohort of unselected patients with thyroid nodules.239 consecutive patients (211 women) underwent FNA of a thyroid nodule between July...

Background: Kopetschke et al. (2009) suggested that nearly thirty per-cent of adrenal/extra-adrenal phaeochromocytoma were found incidentally1. However, they included cases from 1973 to 2007, whereas in the modern era CT and MR investigations are requested more frequently and earlier in the diagnostic algorithm.Methods: We report a pilot series of consecutive referrals to a tertiary centre for adrenal and extra-adrenal phaeochromocytoma from July ...

The pituitary-expressed growth hormone 1 gene was screened for mutation in a group of 74 Spanish children with familial short stature resulting in the identification of a novel Ile179Met missense mutation. Variant and wild-type GH were expressed in insect cells and functional studies were performed. The Ile179Met variant was shown to exhibit a similar degree of resistance to proteolysis as wild-type GH, indicating that the introduction of Met does not cause significant ...

Introduction: First-line treatment for congenital adrenal hyperplasia (CAH) is hydrocortisone1. When adequate control is not achieved, prednisolone (or its prodrug prednisone) are often used. However, there has been no formal comparison of disease control in CAH comparing prednis(ol)one vs hydrocortisone and patients are often on a glucocorticoid dose that exceeds the guideline recommended dose of hydrocortisone (≤25 mg/day)1,2. We report an interim...

Background: Adrenocortical tumours (adenoma or carcinoma) present in well-recognised ways: hormones excess (Cushing’s, Conn’s, virilisation) or hormonally silent with symptoms of mass effect, or found incidentally on imaging. We present 3 cases of adrenal tumours, referred to our regional adrenal multidisciplinary meeting with unusual presenting features.Case 1: post-menopausal bleeding: A previously well 57-year-old female presented with vagin...

Introduction: BC patients have a high prevalence of anti-TPO-autoantibodies (TPOAb), which seem to be protective in BC patients. We hypothesized the presence of T-lymphocytes citotoxicity against a common antigen between thyroid and BC cells.Aim: To evaluate the possible expression of TPO gene in BC.Materials: Frozen tissue specimens: 8 BC, 5 peri-tumoral breast tissues (PT), 3 pancreatic adenocarcinoma (P), 2 kidney cancers (K) an...

Background: Adrenal venous sampling (AVS) is considered the gold standard for lateralisation of aldosterone production in patients with primary aldosteronism (PA). However, in some patients AVS is not technically successful and management may depend on radiological findings.Aim: To determine 1) the success rate of AVS and 2) the outcomes after surgery related to the lateralisation modality.Method: 156 patients were included who pre...

The vasoactive peptide adrenomedullin (ADM) has effects on several vascular beds including the cerebral circulation. The peptide has a positive impact on blood-brain-barrier (BBB) integrity, and transcription of ADM mRNA is enhanced by pro-inflammatory cytokines, IL-1 and TNF-alpha in neuronal cell types. The current study has investigated whether ADM may be a marker for disease progression, in vivo in experimental allergic encephalomyelitis (EAE), a model of the human disease...