Endocrine Abstracts

Objectives: A role of IgG4 in Graves’ disease (GD) has been proposed, although the available data are conflicting. In addition, an association between Graves’ orbitopathy (GO) and IgG4-related disease has been postulated, but no firm demonstration has been obtained. Thus, the aim of the present study was to investigate the role of IgG4 in GD.Methods: We performed a cross-sectional investigation in 351 consecutive patients (F=284, M=67; age 48.2...

Context: Mutations of cytochrome P450 24 subfamily A member 1 (CYP24A1) gene are associated with Idiopathic Infantile Hypercalcemia (IIH), a disease recently related to vitamin D catabolism impairment.Aim of the study: Report of clinical and biochemical features of a large family with a novel mutation of CYP24A1.Methods: We performed dosage of total calcium, ionized calcium, 24 h urinary calcium, PTH, 25-OH-Vitamin D (25-O...

We report the case of a 35 yrs- old man, who was referred to our Department in 2012, for symptomatic nephrolithiasis and low bone mass. Biochemical evaluation showed moderate hypercalcemia [albumin-corrected calcium 13.1 mg/dl (8.6–10.2) and markedly elevated PTH levels [1391 pg/ml (13–65)] consistent with the diagnosis of primary hyperparathyroidism (PHPT). Neck ultrasound revealed three enlarged parathyroid glands. The patient underwent right superior and inferior ...

PD-1/PD-L1 pathway is a key regulator in T-cell activation and tolerance. Nivolumab, pembrolizumab (a PD-1 inhibitors) and atezolizumab (a PD-L1 inhibitor) are monoclonal antibodies approved for treatment of advanced cancers. Autoimmune thyroid diseases are the most common immune-related adverse effects (IrAEs) occurring after anti-PD-1 or anti-PD-L1 therapy, whereas autoimmune hypophysitis is described more frequently in patients treated with anti-CTLA-4. IrAEs can be isolate...

Context: Monoclonal antibodies to Immune Check Point inhibitors (ICPis) are powerful anti-cancer drugs. They trigger the immune system against cancer cells, blocking inhibitory signals of T-Cells. However, ICPi therapy can also stimulate autoimmune reactions, inducing the so-called immune-related adverse events (irAEs). Endocrinopathies are common iRAEs and thyroid disfunction is the most common endocrinopathy during ICP therapy. We report three cases of thyroid disfunction du...

Context: Teriparatide may represent a possible treatment for hypoparathyroidism when oral supplementation with calcium and calcitriol fail to maintain adequate serum calcium level (SCL). The switch from teriparitide to oral calcium and calcitriol could be challenging and there is no consensus for clinical management.Case presentation: A 50-year-old man was admitted at our Department for teriparatide discontinuation. Three years before admission, the pati...

Primary hyperparathyroidism (PHPT) is mostly due to a benign parathyroid tumor (99%). Some have parathyroid ‘atypical adenomas’, rare tumors with histological features of parathyroid cancer (PC) (fibrous trabeculae, thick fibrous bands, mitotic figures in parenchymal cells), without local invasion or metastasis. We evaluated 20 patients with histological diagnosis of atypical adenomas. Patients were 13 women and seven males (mean age: 55±13 yrs). Nineteen patien...

Patients with chronic hypoparathyroidism (HypoPT) treated with oral calcium and active vitamin D metabolites are at risk of renal complications, because of the lack of action of PTH at the renal tubule. In the present study we evaluated 90 patients (68 females and 22 males; age: 51.8±14.1 yrs) with chronic postoperative Hypo (PO-HypoPT) diagnosed since at least 3 years. All patients were treated with calcitriol and 35 (39%) with oral calcium two patients were also treated...

Context: Therapy with somatostatin analogues (SSAs) may have deleterious effects on glucose metabolism in patients with acromegaly, often leading to development of diabetes mellitus (DM).Aim of the study: To evaluate whether DM, which developed during therapy with SSAs, may revert after drug withdrawal and cure of acromegaly with pituitary adenomectomy.Design: Retrospective cohort study, in a tertiary referral center.<p class="...

Oxidative stress plays a crucial role in the pathogenesis of Graves’ Orbitopathy (GO), supporting the use of antioxidants in GO patients. Selenium has a beneficial effect, but other antioxidants have not been investigated. Here we evaluated several antioxidants in primary cultures of orbital fibroblasts from GO patients and control subjects. The following substances were tested: Vitamin C (Vit-C), N-Acetyl-l-Cysteine (NAC), melatonin (Mel), retinol (Ret), beta-carotene (b...