Endocrine Abstracts

Current issues relating to pituitary incidentalomas include definitional limits, difficulties in their diagnosis resulting in hidden dangers, unknown pathogeny and management based on expectation. The prevalence of pituitary incidentalomas depends on the method of investigation: 3.2–27% in necroptic studies or 10–23% by imaging (MRI or CT), compared to only 0.1% clinically expressed pituitary adenomas. Diagnosis requires at least imaging and hormonal assays. However,...

Introduction: Thyrotropinomas are rare pituitary tumours. Neurosurgery is considered the first-line treatment, followed by medical therapy with somatostatin analogues or radiotherapy.Case reports: We present two cases of thyrotropinomas with different therapeutic approaches. Case 1: A 63-year old man presented with severe thyrotoxicosis. Biochemical evaluation showed inappropriate TSH secretion (TSH=7.5 mU/l, FT4=45.5 pmol/l); computed tomogra...

Background: Few cases of hypersensitivity of thyroid–pituitary feedback in hypothyroid children were reported.Aim: To present a family with asymptomatic, severe biochemical primary autoimmune hypothyroidism who showed a marked sensitivity of pituitary feedback to levothyroxine treatment.Methods: TSH was measured by 3rd generation immunoassay kit.Case report: R.G, woman, aged 22, presented for asymptomati...

Background: Risk stratification could be lifesaving in acute pulmonary embolism (PE). Echocardiographic (ECHO) acute right ventricular dysfunction (RVD) is the actual ‘gold standard’ in risk assessment of patients with PE. We previously demonstrated that plasma BNP levels were significantly higher in patients with PE and acute RVD on ECHO versus patients with normal right ventricular (RV) function on ECHO.Aim and objective: Evaluation of the li...

Pituitary apoplexy in patients with Nelson’s syndrome has rarely been described. We report the case of a 33-year-old woman with a history of bilateral adrenalectomy for Cushing’s disease three years previously. Following adrenalectomy, despite adequate replacement therapy with prednisone and fludrocortisone, she became hyperpigmented, morning serum ACTH level rose from 185 to over 1250 pg/ml (normal range 10–60) and the pituitary tumour increased from 0.8/0.3 to...

The clinical spectrum of chronic hypocalcemia mimics various neurological and psychiatric pathologies. Although infrequently encountered, the diagnosis of non-iatrogenic primary hypoparathyroidism has to be considered in order to avoid severe complications or at least to improve neurological manifestations.We present two unrelated cases of primary hypoparathyroidism clinically manifested in adulthood (case 1) and childhood (case 2). Very low-levels of PT...

Introduction: In normal subjects GH is a hyperglycemic hormone as opposed to insulin-like growth factor 1 (IGF1). Active acromegaly is associated with insulin resistance (IR) and glucose intolerance although both GH and IGF1 are elevated. Our objective was to assess whether GH, IGF1 or both are risk factors for IR and glucose intolerance in acromegaly.Methods: Basal serum IGF1 and GH, glucose and insulin during an oral glucose tolerance test were measure...

Introduction: Acromegaly is associated with an increased mortality in untreated patients. Recent papers suggest an improvement of survival in the last years.Aims: To assess mortality ratio and to identify prognostic factors associated with mortality in acromegaly in the last decade.Methods: 297 patients (186 F/111 M, mean age 49.8±0.7 years) with acromegaly admitted in a single Neuroendocrinology Department between Jan 2001 an...

Introduction: Isolated acquired ACTH deficiency is rare; it may be due to hypophysitis and association with other autoimmune diseases was reported.Case report: E.L, female, aged 34, was diagnosed with primary autoimmune hypothyroidism and premature ovarian failure; levothyroxine and estroprogestins were administered. Suddenly, the patient developed vomiting, shivers without fever and soon coma installed, with tonic-clonic seizures. There was no history o...

Background: We previously demonstrated plasma BNP to be a valuable biomarker of right ventricular dysfunction (RVD) in patients with acute pulmonary embolism (PE). Several specific ECG abnormalities related to the right ventricular strain were described in patients with PE.Objective: Assessment of the correlation of plasma BNP levels with ECG signs of RVD in patients with PE.Methods: Seventy patients with confirmed acute PE, 42(60%...