Endocrine Abstracts

BackgroundCushing syndrome (CS) is caused by prolonged exposure to elevated cortisol levels and it’s classified as either ACTH-dependent or ACTH independent CS. The most common form of endogenous ACTH CS is Cushing disease (CD); ACTH-independent CS is caused by various adrenal abnormalities. First-line therapy in CS is the resection of the underlying tumor in all cases. After surgical cure of CS, most patients develop transient secondary adrenal ins...

Background: In patients with acromegaly, mortality depends most on achievement of control of GH/IGF1 levels. However, some of the complications of acromegaly still develop, despite successful control of disease. The aim of the study is to correlate mortality and morbidity with cumulative GH exposure in these patients compared to last GH/IGF1 level.Methods: We studied retrospectively 336 patients with acromegaly consecutively evaluated at least twice duri...

Background: Cushing’s syndrome is represented by the cummulation of signs and symptoms of excess glucocorticoids and has many potential causes. Approximately 20 percent of all cases are represented by ACTH-independent adrenal tumors – with a majority of these being represented by cortisol secreting adrenal adenomas. Generally, a large adrenal tumor has over 5 cm in diameter and the risk of it being malignant raises proportionately with the dimensions. Large adrenal t...

Introduction: Carney complex is a rare autosomal dominant genetic disorder which develops secondary to mutation in the PRKAR1A gene located in the 17q22-24 region. It is commonly characterised by the association between spotty skin pigmentation, cardiac myxoma and secretory endocrine tumors.Case presentation: A 15.8-year-old boy known with PRKAR1A mutation diagnosed based on his personal history – cutaneous papiloma of the neck resected at the age o...

Background: Dopamine agonists (DA) have excellent result in controlling both hyperprolactinemia and tumor volume in macroprolactinomas. However, even after long term DA treatment, withdrawal of dopamine agonists results in recurrence of hyperprolactinemia in a significant proportion of patients.Aim: To assess recurrence rate of hyperprolactinemia after DA withdrawal in a large series of patients treated in a tertiar...

Background: Dopamine agonists (DA) have excellent result in controlling both hyperprolactinemia and tumor volume in macroprolactinomas. However, even after long term DA treatment, withdrawal of dopamine agonists results in recurrence of hyperprolactinemia in a significant proportion of patients.Aim: To assess recurrence rate of hyperprolactinemia after DA withdrawal in a large series of patients treated in a tertiar...

Introduction: Acromegalic bone disease is characterized by an increased prevalence of fragility vertebral fractures (VFs). However, an effective, non-invasive and cost-efficient imaging technique that can diagnose early bone alterations in this category of patients is yet to found. The use of bone mineral density (BMD) is not as useful as in other causes of osteoporosis as excess GH leads to specific microarchitectural alteration of trabecular bone, which don’t translate ...

Background: Dopamine agonists (DA) are the first-line treatment for macroprolactinomas. However, up to 10% of patients fail to respond to medical therapy.Aim: To assess biochemical resistance rate to DA treatment in a large series of patients with macroprolactinoma and to analyze possibilities to overcome this resistance.Patients and methods: 195 patients with macroprolactinomas, treated with DA for at least 2 years, were retrospec...

Introduction: The incidence of parathyroid carcinoma in primary hyperparathyroidism is less than 1% and the association with ACTH-independent Cushing syndrome is very rare.Case report: A 40-year-old female was admitted for weight gain and reddish-purple striae. One month earlier she had a ¾ parathyroidectomy for primary hyperparathyroidism with histopathological examination showing a parathyroid carcinoma and two parathyroid adenomas. She also had a...

Objective: Patients with pituitary macroadenomas and concomitant hypopituitarism have a reduced life expectancy due to various comorbidities.Aim: To investigate mortality in patients with non-functioning pituitary adenomas (NFAs) and independent prognostic factors influencing survival.Design: Retrospective cohort study in a tertiary neuroendocrine university department.Methods: A total of 364 patients (177F/1...