Endocrine Abstracts

Adrenal incidentalomas (AI) are a common finding in patients studied by abdominal imaging and approximately 9–17% is found bilaterally. So far, the potential role of hypothalomo-pituitary adrenal (HPA) axis dysregulation in the pathogenesis of AI, especially of those found bilaterally, has not been addressed. The DEXA-CRH test has been previously used to detect dysregulation of the HPA axis; herein, it was used to assess ACTH and cortisol responses in a large group of pat...

The aim of the study was to examine the therapeutic trends and the long-term outcome of available therapeutic modalities for acromegaly in a single center over a 40 year period.We retrospectively studied 300 acromegalic patients (131 men, 169 women, 153 macroadenomas and 147 microadenomas) from 1970 until 2010; 154 patients were diagnosed before 1990 (group A) and 146 after 1990 (group B). Outcome was evaluated by IGF1 and GH (random plus post OGTT) meas...

Cushing’s disease (CD) is a rare condition, associated with significant morbidities.The long-term morbidities in a series of patients with CD who presented in two tertiary referral centres between 01/1967-06/2009 were assessed. All information was collected as documented in the records of the patients.224 patients were identified (174 females) with median age at diagnosis 39 years (range 10–76 (females 38 (12–72) &#1...

Aberrant adrenal LH expression is a rare cause of adrenal Cushing’s syndrome (CS) leading to transient hypercortisolism during pregnancies and ACTH-independent macronodular adrenal hyperplasia (AIMAH) after the sustained postmenopausal increase of LH secretion. Subclinical CS due to aberrant LH expression has very rarely been described. Herein, we report a case with aberrant LH/hCG adrenal receptor mediated subclinical CS in a patient with incidentally discovered AIMAH an...

Several alterations of the metabolic processes develop during sepsis. Adiponectin and resistin are amongst the main adipokines that may contribute to the metabolic adaptations observed in the context of critical illness. However, there is scarce data on the circulating pattern of these adipokines in human sepsis. Therefore we aimed to describe the variation in circulating levels of resistin and adiponectin during the course of sepsis and examine whether they are related to the...

Multiple endocrine neoplasia type2A (MEN 2A) is a syndrome of familial cancers characterized by medullary thyroid carcinoma (MTC), pheochromocytoma and hyperplasia of the parathyroid glands. RET protooncogene is the responsible gene for MEN 2A; in more than 96% of MEN 2A families mutations in RET exon 10 or exon 11 are identified. Herein we report a MEN 2A case affected by a mutation (Gly533Cys) in exon 8. A 66-yr-old male patient was referred to our Department due ...

Aberrant hormone receptors have been demonstrated in macronodular adrenal hyperplasia or, rarely, unilateral adenomas causing Cushing’s syndrome but their prevalence in adrenal incidentalomas (AI) remains uncertain. Therefore we evaluated patients with bilateral AI for evidence of abnormal response to physiological stimuli. We also compared their biochemical characteristics with those of patients with unilateral AI.Assessment of adrenal function was...

Although bilateral inferior petrosal sinus sampling (BIPSS) is the most accurate procedure for the differential diagnosis of ACTH-dependent Cushing’s syndrome, a false-negative rate of 4–15% has been reported. An even lower sensitivity has been shown in patients with equivocal responses to CRH and/or high-dose dexamethasone suppression test (HDST). In the present study we investigated whether the administration of CRH plus desmopressin (DDAVP) during BIPPS, which is ...

A 61-year-old woman was admitted to the Emergency Department with generalized seizures. She reported general malaise, anorexia, headache and multiple episodes of vomiting that started about 12 h before admission. She had a history of recent thyroidectomy, and she was on oral calcium carbonate (3 gr/day) and alpha calcidol (3 mg/day). Non-contrast head CT scan was negative for major findings. Laboratory work up revealed hypercalcemia (corrected calcium 14,4 mg/dl), renal impair...

Background: Establishing endocrine diagnoses including pituitary Cushing’s remains challenging with delayed or misdiagnosis being very costly for both patient and the health care system. A key issue is that standard diagnostic tests are typically single time point, single analyte samples, which do not consider dynamic variation intrinsic to endocrine systems. Having previously demonstrated that free tissue hormones correlate strongly with plasma concentrations, we present...