Endocrine Abstracts

Ectopic ACTH syndrome accounts for approximately 20% of all cases of ACTH-dependent Cushing’s syndrome. The most common causes are oat cell carcinomas, bronchial and foregut carcinoid tumors, pancreatic islet cell tumors and pheochromocytomas. Rarely, ectopic CRH-secretion occurs by peripheral tumors, especially carcinoids. Whereas the screening for hypercortisolism followed by analysis of ACTH is well established, the distinction between pituitary adenomas and ectopic so...

Background: Since signs and symptoms of pheochromocytomas are unspecific, diagnosis is crucially dependent on biochemical evidence of excessive catecholamine production. Diagnostic workup was previously based on measurement of urinary catecholamines. Subsequently it was shown that pheochromocytomas contain high amounts of catechol-O-methyltransferase (COMT), the enzyme that converts epinephrine to metanephrine and norepinephrine to normetanephrine. This metabolism occur...

Aim: Somatostatin mediates its effects via five known receptor subtypes sst1-sst5. The somatostatin analogue octreotide, which binds preferentially to sst2 and to a lesser extent to sst3 and sst5, may be used prior to surgery of GH-secreting tumors. To investigate the variable response rates of such treatment, we analyzed sst expression levels in tumor tissue.Methods: 44 patients with acromegaly (20m, 24f, 48.7+/...

Introduction: Pasireotide (SOM230) is a multi-receptor targeted somatostatin analogue with high binding affinity for sst1,2,3 and sst5. In a Phase II study of pasireotide in patients with active acromegaly, 27% achieved biochemical control after 1 month of octreotide s.c. followed by 3 months of pasireotide, and pituitary tumor volume decreased by >20% in 39% of patients. Results from the study’s extension phase are presented.<p class="abstex...

Introduction: Measurements of plasma metanephrines (META) and normetanephrines (NOR) have been advocated as first-line tests for the diagnosis of pheochromocytoma. This study assessed the impact of several potential confounders, which may influence the correct diagnosis.Methods: Eight healthy males (age 26.8±1.7; BMI 23.1±0.8) were tested on 6 separate days. Tests were performed in supine rest with blood sampling via i.v. canullas at 0900 h fol...

Introduction: In a recent 16-week Phase II study in patients with de novo, persistent or recurrent acromegaly, pasireotide effectively controlled GH and/or IGF-I levels in 56% of patients, and reduced tumor volume by >20% in 39% of patients. We present preliminary 6-month results from the ongoing extension phase of this study.Methods: This extension study enrolled patients who achieved biochemical control (GH ≤2.5 μg/l and normalize...

Introduction: Optimizing glucocorticoid (GC) therapy in patients with congenital adrenal hyperplasia (CAH) remains a challenge. While overdosing may result in Cushing’s syndrome, underdosing is associated with female virilization and adrenal insufficiency. This study evaluated day-profiling of salivary 17-hydroxyprogesterone (17OHP) for the biochemical control of adolescents with CAH due to 21-hydroxylase deficiency.Methods: Twelve patients (4 males...

Introduction: Pasireotide (SOM230) is a novel multi-ligand somatostatin analogue with high binding affinity for four of the five somatostatin receptor subtypes (sst1,2,3 and sst5). A randomized study of 59 patients showed that pasireotide effectively controls GH and IGF-I levels in patients with acromegaly and reduces pituitary tumor size. The impact of pasireotide on GH levels during glucose suppression and glucose metabolism in 12 patients enrolled in t...

Objectives: The insulin tolerance test (ITT) is considered the gold standard to evaluate corticotropic function in patients with suspected pituitary disease, but is limited by several contraindications. As an alternative, we evaluated the diagnostic value of basal cortisol in serum and saliva.Methods: volunteers (V) and 61 patients with suspected pituitary disease (P) were enrolled into this study. Basal serum and saliva samples were collected simultaneo...

Aim: Progressive medullary (MTC) or iodine-negative papillary (PTC) or follicular (FTC) thyroid carcinomas present a challenge due to limited treatment options. The aim of this study was to evaluate the response to chemotherapy with doxorubicin.Methods: 22 patients (12 female, 10 male, mean 61 years) with PTC or FTC received chemotherapy with doxorubicin. Tumors were histologically classified as follicular in 14 (64%) patients, including 6 (27%) oncocyta...