Endocrine Abstracts

Introduction: A rare cause of adrenal incidentaloma is congenital adrenal hyperplasia (CAH). Nonclassic CAH is one of the most frequent autosomal recessive disorders. Most cases of nonclassic CAH are never diagnosed due to very mild symptoms.Case report: A 62-year-old woman admitted at our Department for right adrenal incidentaloma sized 39×34×38 mm confirmed by MRI. She was asymptomatic. Her past medical history included stabile hypertension, ...

Background: Abdominal obesity, which in fact is a metabolic syndrome (MS), is related to decreased testosterone, insulin resistance (IR), increased inflammatory factors, non-alcoholic fat liver disease (NAFLD) and risk of early atherosclerosis. Elevated inflammatory markers (CRP) may interfere with insulin signal transduction at the neuronal level inducing hypogonadotropic hypogonadism.Objective: To examine testosterone relationship with abdominal obesit...

Hyponatremia can unmask hypopituitarism and secondary adrenal insufficiency due to potent non-osmotic stimulation of vasopressin release under stressful conditions. Patients and methods: In a retrospective study 25 patients (13f/12m, age 58.9±18.6 years) with hyponatremia (119.7±10.5 mmol/l) were identified among 260 in-patients treated for hypopituitarism in our department over a decade. Results: Hyponatremia was recorded in 9.6% of our patients. In 84% it was the k...

Introduction: Skeletal complications are among most persistent and invalidating systemic impacts of acromegaly. Assessment of bone health in acromegaly by dual-X-ray absorptiometry (DXA) alone might be insufficient or even misleading.Patients and methods: Patients with acromegaly (n=170) were classified as active (n=104), operatively cured (n=34) or medically controlled (n=32). We excluded patients with metabolic bone ...

Background: Inadequate glucocorticoid (GC) replacement may be associated with overexposure to GC, which can adversely influence metabolic and cardio-vascular state of hypopituitary growth hormone deficient adult patients (A-GHD). In this study we compared metabolic profile of ACTH insufficient and sufficient patients in A-GHD not treated with GH.Patients and methods: A cohort of 260 patients (age 48.6±12 years and BMI 28.7±6.6 kg/m2)...

Introduction: Pituitary apoplexy is both an endocrine and a neurosurgical emergency, and can typically present with sudden onset of headaches, impaired level of consciousness, fever, visual disturbances, nausea or vomiting. Apoplexy ensues when pre-existing pituitary tumour presumably outgrows its blood supply leading to ischaemia, necrosis and haemorrhage or infarction.Case: A 31-year-old man presented to the hospital with 3 months’ history of grad...

Background: Inadequate glucocorticoid (GC) replacement may be associated with overexposure to GC, which can adversely influence metabolic and cardio-vascular state of hypopituitary growth hormone deficient adult patients (A-GHD). In this study we compared metabolic profile of ACTH insufficient and sufficient patients in A-GHD not treated with GH.Patients and methods: A cohort of 260 patients (age 48.6±12 years and BMI 28.7±6.6 kg/m2)...

Ghrelin is able to stimulate HPA axis in both humans and animals. Exaggerated ACTH and cortisol responses to ghrelin have been shown in patients with CD. Here we studied the role of ghrelin alone or in combination with CRH in the diagnosis of CD. In 21 CD patient (18 female, age 49.8±10.2 years, BMI 29.8±0.8 kg/m2, ten macroadenomas 11 microadenomas) we performed: i) ghrelin test (100 μg iv bolus) ii) CRH test (100 μg iv bolus) and iii) ghrelin+C...

Hypopituitarism as deficiency of one or more anterior pituitary hormones, in adults can be consequence of acquired or genetic causes. Only few published studies investigated population-based aetiology of hypopituitarism. In the last 10 years new risks for hypopituitarism have been recognised (traumatic brain injury-TBI, subarachnoid haemorrhage, cranial irradiation).Aim: To present our experiences in the aetiology of hypopituitarism based on data collect...

Background: Pituitary adenoma (PA) is an under-investigated pathology in the elderly.Objective: To review our case records of patients >70 years with PA, in order to evaluate presentation symptoms, hormonal results, and pituitary morphology.Patients: 48 patients aged 70 years or older (21 females/27 males) were identified from the group of 610 patients with PA (7.9%) diagnosed at Neuroendocrine Unit, Clinic for Endocrinology, B...