Endocrine Abstracts

Context: Mitotane due to its adrenolytic action is highly effective in long-term management of ACTH-dependent Cushing’s syndrome (CS). However, the slow onset of its anticortisolic effect makes its use problematic in severe CS, when very rapid therapeutic response is required. Association with metyrapone and ketoconazole, rapidly acting steroidogenesis inhibitors, could warrant CS control while waiting for the full efficiency of mitotane and thus avoid urgently performed ...

Objective: Somatostatin analogues (SSA) are widely used for the treatment of patients with neuroendocrine tumors. These drugs are able to influence glucose metabolism by an inhibitory effect of insulin secretion, but the clinical impact of this effect is uncertain. Most of the data on this topic have been obtained from studies including patients in acromegaly, one the major indication for SSA, which are limited in terms of numerosity and study duration. Therefore, we have carr...

In normal woman, placental GH secretion increases during gestation and induces an increase of IGF-1 concentrations. In acromegalic women, increased pituitary GH secretion seems autonomous and IGF-1 increases in late stage of pregnancy related to placental GH. In a cohort of 46 women (mean age 31.7±4.5 years), acromegaly was due to micro (n=7) and macro (n=39) adenomas. Before the beginning of 59 pregnancies, women have been treated by transphenoidal surgery ...

Patients with adult onset GHD (AO-GHD) manifest features of the metabolic syndrome (MetS) (abdominal obesity, dyslipidemia and insulin resistance), a condition associated with increased risk of diabetes mellitus (DM).We assessed metabolic status before and after 2 years of GH treatment and the occurrence of de novo DM in 712 patients with AO-GHD from HypoCCS drawn from the US (32.2%) and Europe (67.8%). Patients were divided into four BMI categori...

Hypercalcemic complications of PHPT include renal, cardiovascular, gastrointestinal, neuromuscular and neuropsychiatric issues, all potentially impacting negatively on HRQOL. As control of the hypercalcemia associated with PHPT might improve HRQOL, the SF-36 and a 6-item scale on cognitive functioning (CF) were included in a phase 2, single-arm study evaluating the ability of cinacalcet to control serum calcium levels in 17 patients with intractable PHPT. Mean±S.E....

Context: Acromegaly can be complicated by cardiomyopathy. Treatment with somatostatin analogs has been shown to improve some cardiac parameters, but most published clinical trials involved few patients and were not randomized or controlled. In addition, their results are rather variable.Objective: To conduct a meta-analysis aimed at obtaining a more accurate picture of the effect of somatostatin analogs on the heart in patients with acromegaly.<p cla...

A 20 yr old woman was referred for primary amenorrhea. At examination BMI was 19 and displayed a pubertal development at S4P4. Hormonal evaluation showed normal prolactin, low estradiol (18 pg/ml) and gonadotropins (LH=1.5IU; FSH=1.9 IU/L). Testosterone was normal (0.25 ng/ml) but curiously plasma progesterone (P) was increased (from 3.9 to 5 ng/ml). Initial ovarian sonography and adrenal CT scan didn’t show any abnormal mass. ACTH stimulation tests showed normal response...

Context: Cervical ultrasound is a frequently used and an accessible operator-dependent tool, which contributes to the characterization of thyroid nodules and to the preoperative localization of pathological parathyroid glands. However, thyroid nodules may be confused with parathyroid lesions. There is no study directly comparing thyroid and parathyroid nodules on ultrasound.Objectives: 1) To describe the ultrasonographic characteristics of parathyroid le...

Context: Hypogonadotropic hypogonadism (HH), defined by LH and FSH deficiencies, lead to impairment in testicular growth, testicular hormonal secretions and spermatogenesis. HH can have a prenatal (congenital HH, CHH) or post-natal (acquired HH, HHA) onset. Direct comparison of reproductive phenotypes (RP) between CHH and AHH has not been systematically performed in large series representative of these two populations.Patients and methods: 60 normal men,...

Objectives: X-linked hypophosphatemic Rickets (XLHR) is characterized by phosphate wasting and decreased production of 1,25OH-vitamin D, due, in most patients, to elevated FGF23 and PHEX mutation. In children, the disease has been extensively studied because of the devastating presentation of rickets, teeth abcesses, and growth retardation. In adults, however, metabolic complications, such as hyperparathyroidism or consequences on glucose and lipid metabolism of FGF23 excess, ...