Endocrine Abstracts

Background: In steroid dependent patients the knowledge of steroid dose change during illness and stress is of paramount importance.Objectives: i) To assess patient’s knowledge of steroid management during acute illness and stressful condition. ii) To evaluate whether there is a relation between patient knowledge and admission with documented adrenal crisis. iii) To improve medical access to information about patients on steroid at Emergency Departm...

Introduction: Paraneoplastic Cushing’ syndrome (CS) represents 5–10% of all CS and has a severe prognosis due to severe metabolic imbalance, denutrition, associated infections, and progression of tumoural underlying pathology.A 67 years old woman presented with mental confusion, progressive weight loss, severe oedema and kypokalaemia, without typical features of Cushing or hyperpigmentation. Investigations revealed paraneoplastic Cushing’s...

In autoimmune thyroid disease some diverse neurological alterations like dementia, psychosis or peripheral neuropathy, are described. Hashimoto’s encephalopathy (EH) is a serious form of these neurological alterations. We describe three cases with different presentation and morphologic normal tests where cerebral SPECT was diagnostic.Case n°1. A 32-year-old male diagnosed of autoimmune hypothyroidism which presents paresthetics and muscular sti...

IntroductionRecent studies in patients with Addison’s disease (AD) have shown that this condition, even if treated, is fraught with significant morbidity. In this context, we report a retrospective study which concerned 32 patients with AD in order to determine the deleterious effects of long-term glucocorticoid substitution, mainly on the occurrence of type 2 diabetes.ResultsIn the 32 patients followed ...

A 36 year old man presented with a six month history of palpitations. An ECG in a different hospital had showed a sinus tachycardia. An echocardiogram had also been performed and reported as normal. There were no apparent clinical features to suggest Cushing’s Syndrome (BMI 26 kg/m2). Resting pulse was 86/min. BP was 140/90. Examination was otherwise unremarkable.Baseline biochemical and haematological investigations including TFT, FBC we...

Because of quite variable clinical manifestations of Cushing’s syndrome and overlap with more common medical problems, its diagnosis is frequently mistaken, with consequent considerable delay from the first presentation to a different primary and secondary care physicians to a final diagnosis, often made by endocrinologist. The diagnostic latency in reported studies vary from six months to ten years. We report a case of a 54-years-old female admitted to the hospital thro...

In the last decade, new evidence on Cushing’s syndrome (CS) complications and therapies have gradually emerged. CS is associated with well known systemic complications, mainly including metabolic syndrome, cardiovascular disease, immune and infectious disorders, skeletal diseases, neuropsychiatric disorders, as well as impairment of gonadal function with impact on reproduction and sexuality. However, more recently several studies specifically focused on muscle and brain s...

Alzheimer’s disease (AD) is a neurodegenerative disease that manifests itself in the gradual loss of cognitive and behavioral functions. In humans, glucagon is processed in pancreatic alpha cells located next to insulin-secreting beta cells, suggesting a local interaction. Glucagon is also produced in the intestinal L-cells and in small amounts in the hypothalamus. The main function of glucagon is to counteract the effects of insulin and thus maintain balanced blood gluco...

Objective: Interindividual variation in glucocorticoid sensitivity can be partly explained by polymorphisms in the GC receptor gene. The most frequent polymorphisms of the GR gene (N363S and BclI) are associated with increased BMI, less lean mass, higher cholesterol and insulin levels. In the present study we investigated the role of the N363S and the BclI polymorphisms in patients with adrenal disease to evaluate their prevalence and the possible clinic and hormone correlatio...

Ectopic Cushing’s syndrome (CS) is commonly caused by malignancy, often behaves aggressively and may not clinically manifest with features of hypercortisolism due to its rapid course and associated cachexia. This may mislead clinicians into discounting the diagnosis in patients with more indolent features of CS. We present a 41 year old woman with an 8 year history of Cushingoid features with associated hypertension, obesity and Type 2 Diabetes. Investigations confirmed C...