Endocrine Abstracts

Background: Diabetes is an important risk factor for major adverse cardiovascular events (MACE). Although the increased risk for MACE is well known, the impact on the in-hospital outcomes remains incompletely understood. Our aim was to evaluate the interrelation between diabetes and MACE in a central hospital in the North of Portugal between 2009 and 2015.Methods: We evaluated retrospectively the hospitalizations due to MACE including stroke or transient...

Introduction: Rituximab is indicated in patients with active rheumatoid arthritis (RA), which through the Fab domain, binds to the CD20 antigen on the surface of B lymphocytes, generating lysis of B cells, present in the thyroid, by cytotoxicity dependent on complement, as a result of the binding of C1q, mediated by the Fc domain, destroying the thyroid follicles, by infiltration of inflammatory cells (1) (2).Objective: Describe the characteristics of pa...

Introduction: Differentiated thyroid carcinoma is usually associated with a good prognosis. However, some of these tumors (5%) are radioiodine refractory and have different progression, associated with poor prognosis. In these situations, some tyrosine kinase inhibitors (TKI) can be used. We present a clinical case showing the difficulties in the follow-up and treatment of these patients.Clinical case: A 60 years old woman, with a “multicentric papi...

IntroductionHypoparathyroidism still remains the only hormone-deficiency related disorder whose standard treatment is not based on replacing the missing hormone. In the last few years, there has been growing evidence on the use of recombinant human PTH, mostly with subcutaneous injections of rhPTH(1–34). More recently, some clinicians have tried to administer teriparatide through a continuous delivery system using insulin pumps.<p class="abstext...

IntroductionHeterozygous familial hypercholesterolemia is one of the most common genetic disorders and it is associated with an at least ten times higher risk of coronary heart disease. Frequently, it is necessary to medicate the patients with PCSK9 inhibitors (PCSK9i) so they can reach LDL-c target values. In Portugal, the only evolocumab is available and the most commonly reported adverse effects are local pruritus and upper airway symptoms.<p clas...

IntroductionCurrent rise in use of monoclonal antibodies to Immune Check Point inhibitors (ICPIs) has led to the appearance of a great variety of immune-related adverse effects (irAEs), mainly affecting gastrointestinal tract, skin, liver and endocrinological system. With a variable prevalence (4–21%), thyroid dysfunction (TD) is the most common immune-mediated endocrinopathy. However, in the literature, it occurs in different patterns and levels of...

Background: Ectopic ACTH secretion from metastatic acinic cell carcinoma (ACC) of the parotid gland is extremely rare. ACC is an uncommon, typically indolent, salivary gland neoplasm. Herein, we report a case of a high-grade ACC later diagnosed with Cushing’s syndrome (CS).Case presentation: A 60-year-old man presented with a laterocervical mass. Computed tomography (CT) documented a 39×38 mm mass on the parotid gland and homolateral cervical l...

Background: Cut-offs for basal cortisol (early morning) have been determined to predict the 30-minute cortisol level post-synacthen, but not for determining when patients with suspected tertiary adrenal insufficiency (AI) are weaned off glucocorticoids.Aims: The aim of this study was to compare the predictive values of basal cortisol, basal ACTH and basal cortisol:ACTH ratio to determine appropriate thresholds to reduce ...

Background: Syncope and pre-syncope are well recognised symptoms of primary adrenal insufficiency (AI). Some guidelines(1) recommend screening for AI in all patients who present with symptoms of orthostatic intolerance. However, the incidence of AI in these patients is unknown.Aims: The aim of the study was to determine the incidence of AI in patients referred to a cardiac autonomic dysfunction clinic at a sin...

Background: The current screening test for adrenal insufficiency (AI) involves patients attending hospital for an “early” morning serum cortisol sample, generally taken some considerable time after the child has woken. This risks missing the morning cortisol peak, leading to false positive results. It requires venepuncture, which is unpleasant for children. Saliva collection is non-invasive, simple and can be undertaken on waking at home, providing a...