Endocrine Abstracts

Introduction: Rhino-orbito-cerebral mucormycosis is a rare invasive fungal infection more common in diabetic and elderly patients. The presentation is acute, severe and rapidly progressive to disseminated infection. The diagnosis is done by the identification of risk factors, clinical and radiologic signs and tissue biopsy consistent with mucormycosis. The mortality rate is high, so timely diagnosis and intervention lead to better outcomes.Clinical case:...

Background: The key physiologic defences against hypoglycaemia are the decrease in insulin and the increased secretion of glucose counterregulatory hormones, namely glucagon and epinephrine. The absence of warning signs of impending neuroglycopenia is known as hypoglycaemic unawareness.Case report: Male, 26 year-old, without relevant medical history and with normal body mass index, presented with hypertension, palpitations and diaphoresis. Clinical suspi...

Background: Transphenoidal surgery is still the best initial therapy for Cushing’s disease (CD), with a high probability of cure and few risks or complications. However, pharmacotherapy has a role as primary or adjunctive therapy: when surgery is delayed, in case of postoperative persistence or recurrence of hypercortisolism, or while waiting for radiotherapy effectiveness. Ketoconazole, a steroidogenesis inhibitor, is nowadays the main drug used to CD control by reducing...

Introduction: Cushing’s disease (CD) presents a marked female preponderance, with a female-to-male ratio of 3–8:1, but whether this skewed gender distribution has any relevance to the presentation and outcomes of CD is not well understood.Aim: To evaluate sex-related differences in the presentation of CD, as regards: biochemical indices of hypercortisolism; complications of disease and outcomes.Methods: Observational, ret...

Introduction: Immunossupression is a possible consequence of hypercortisolism, putting these patients in a state of increased risk of infections.Case report: Female, 19 years old. In July 2014 she seek for medical care because she became feverish and developed an erythematous rash on her face/trunk with subsequent widespread to the entire body. She was admitted in the ICU with the diagnosis of severe varicella with acute cholestatic hepatitis and conflue...

Introduction: Cushing’s Disease results of corticotrophin (ACTH) hypersecretion from pituitary which increases cortisol production. WHO classified pituitary tumors as typical adenoma, atypical adenoma and carcinoma. Diagnostic criteria for an atypical adenoma include invasive growth, elevated mitotic index, Ki-67 labeling index greater than 3% and extensive p53 immunoreactivity.Case Report: Sixty-eight years-old man presented to our consult with his...

Introduction: Pheochromocytomasand paragangliomas are tumors derived from chromaffin cells which result from mutations of at least six different genes as autosomal dominant disorders.Aim: To evaluate the existence of correlations between genetic alterations and clinical data in 16 patients with pheochromocytomas and/or paragangliomas.Methods: From 2007 to 2009, 13 patients with pheochromocytoma [3 men, medium age 39 years (14&#8211...

Introduction: Plasma glucose concentration at 1h(1hPG) during an oral glucose tolerance test(OGTT) may be a better predictor of future diabetes mellitus(DM) than 2-h post load glucose concentration(2hPG). HIV-infected individuals may have differential risk of DM compared to the general population, and the optimal diagnosis algorithm for DM in HIV-infected persons remain unclear. We evaluated the agreement of the methods 1 hPG vs 2 hPG) for the diagnosis of pre-D...

Hyponatremia is a common disorder, especially among the elderly, and an important morbidity and mortality cause. Empty sella syndrome, on the other hand, is a rare entity, more common in women between their fourth and sixth decade of life, and endocrine dysfunction has been reported in 10–60% of the cases. A 68-year-old man, with a past medical history of essential hypertension and glaucoma, presented at the emergency room due to malaise, asthenia, somnolence and anorexi...

Introduction: Cushing’s syndrome (CS) is a well-known cause of bone loss and osteoporotic fractures, which may be the initial manifestation of the disease and may present 2 years before CS diagnosis. Trabecular bone is usually the most seriously affected, and vertebrae and ribs are the typical fracture locations.Case report: A 37-year-old man with dyslipidemia and obesity was observed due to uncontrolled hypertension and osteoporosis. He complained ...