Endocrine Abstracts

Background: The differential diagnosis between central diabetes insipidus and primary polydipsia is challenging. To date, the most reliable approaches are copeptin measurement after hypertonic saline infusion or arginine, which is a known growth hormone secretagogue but has recently been shown also to stimulate the neurohypophysis. Similar to arginine, glucagon is also known to stimulate growth hormone release, but its effect on the neurohypophysis and in the differential diag...

Background: Differential diagnosis of hyponatremia is challenging, particularly for thiazide associated hyponatremia (TAH), as patients might have either volume depletion in need for fluid substitution or syndrome of inappropriate antidiuresis (SIAD)-like presentation requiring fluid restriction. Urine indices are of little utility, because they are influenced by thiazide therapy. Apparent strong ion difference (aSID) describes the relation between sodium, potassium and chlori...

Background: Hyperthyroidism caused by autonomous functioning thyroid nodules (ATN) is usually treated with I-131. Recently, radiofrequency ablation (RFA) has emerged as a promising alternative but it is not yet incorporated in guidelines.Aims: Assessment of efficacy of RFA treatment in patients with hyperthyroidism caused by ATN and factors that may affect treatment success.Methods: Retrospective analysis of patients treated for hy...

Several reports of Graves’ disease (GD) onset after COVID-19 vaccination were recently published. The mechanism underlying GD occurrence in these cases could be related to the autoimmune syndrome induced by adjuvants (ASIA), a condition triggered by several vaccine adjuvants and excipients leading to dysfunctional immune response causing different conditions and endocrinopathies in genetically predisposed subjects. In Italy, population campaign for COVID-19 vaccination st...

The management of loco-regional metastases in patients with differentiated thyroid carcinoma is still debated. Current American Thyroid Association guidelines state that in this context the main goal is to differentiate between low-volume metastatic disease that will progress and that remaining stable over time.Aim of our study was to evaluate the behavior of suspicious or cytologically confirmed lymph node metastases, detected after initial treatment (i...

Background: Cervical lymph node metastases at histology are common findings in differentiated thyroid cancer (DTC); however, their impact on clinical outcome is debated.Material and method: 1332 DTC patients, performed the first 131 I treatment between January 2010 and September 2012 and were divided into 2 groups: absence (Nx/N0) or presence (N1) of lymph node metastases at histology. The latter group was further split in central compartment ...

Radioiodine refractory differentiated thyroid cancer can be effectively treated with multi-tyrosine-kinase inhibitors (mTKI). Due to their pleiotropic mechanism of action, these drugs may cause different side effects. Hypocalcaemia has been reported in up to 35% of patients treated with mTKI, but little is known about its pathophysiology and clinical relevance. We report the case of a 78 years old woman treated for a multifocal papillary thyroid cancer, infiltrating perithyroi...

Introduction: Zellweger Spectrum Disorders, one of the two groups of Peroxisome Biogenesis Disorders (PBD-ZSD) are rare, complex autosomal recessive genetic anomalies characterised by mutations in any of the PEX genes which are responsible for defective peroxisomes activity. The peroxisomes are organelles that play a primary role mainly in the lipid metabolism of almost all the cells of the body, hence their defective biosynthesis, assembly or biochemical functions turn PBD-ZS...

Background: The 1 mg overnight dexamethasone suppression test (ONDST) is recommended for the differential diagnosis of Cushing’s syndrome and the investigation of adrenal incidentalomas. However, diagnostic performance of the test relies on accurate methods to quantitate cortisol in serum. Although the variable performance of serum cortisol immunoassays has been well-documented, little has been published on their performance following the ONDST.Aims...

Background: In the last decades, the clinical profile of PHPT in Western Countries has changed from a highly symptomatic to a largely asymptomatic disease. However, a substantial stability in its clinical features has been reported in the last two decades. The usual management, including time to diagnosis and treatment, of PHPT during the Covid-19 pandemic has been changed and likely slowed down. Whether further changes in the clinical presentation of PHPT have occurred during...