Endocrine Abstracts

Aggressive pituitary tumours (APT) are not controlled by standard therapies. Pituitary carcinomas (PC) share many properties with APT and are defined by the presence of metastases. Temozolomide (TMZ), an oral alkylating with good penetrance into the brain, is the recommended first line chemotherapy. The survival has markedly been improved in patients with APT/PC during the last two decades. Prior to the TMZ-era, 66% of patients with PC were dead within a year after detection o...

Objective: To collect clinical and treatment outcome data in a large patient cohort, and specifically to report experience with temozolomide (TMZ).Design: Cohort study based on an electronic survey open for participation to ESE members Dec 2015-Nov 2016.Results: Reports on 167 patients, 40 pituitary carcinomas, and 127 aggressive pituitary tumours were obtained. Median age at diagnosis was 43 (range 4–79) years. 59% of tumours...

Purpose: We aimed to validate the diagnosis and estimated national incidence of acromegaly reported in the Swedish National Patient Register (NPR), based on clinically reported International Classification of Diseases (ICD-codes), in comparison with the Swedish Pituitary Register (SPR).Methods: All patients in NPR or SPR between 1991-2018 with the ICD-9 or ICD-10 diagnosis of acromegaly and age >18 years at diagnosis were included. The diagnosis was ...

Introduction: Glucocorticoid replacement for adrenal insufficiency (AI) remains inadequate, resulting in high morbidity, premature mortality and quality-of-life (QoL) impairment. This study investigated the long-term safety of dual-release hydrocortisone (DR-HC) in patients with primary AI.Methods: AI patients who completed a randomized, 3-month crossover study of once-daily DR-HC versus thrice-daily conventional immediate-release hydrocortisone plus a 6...

Background: Neuropsychiatric symptoms and cognitive dysfunction are common in Cushing´s disease (CD), and seem only partly reversible after biochemical remission has been achieved.Aim: To investigate prescription of drugs associated with neuropsychiatric morbidity in a large national cohort of CD patients.Methods: Patients in the Swedish Pituitary Registry, diagnosed with CD between July 2006 and January 2018 were included, <e...

Introduction: Cushing’s syndrome is rare, but assessment of patients with clinical suspicion of Cushing’s and/or adrenal incidentaloma is frequently required. Thus, there is a need for biochemical screening methods that with high sensitivity and specificity identifies or rule out hypercortisolism. Analysis of late night salivary cortisol allows an easy sampling procedure performed at home and is independent of variations in plasma CBG levels. Analysis by liquid chrom...

Background & Objective: Late night salivary cortisol (LNSC) and 1 mg overnight dexamethasone suppression test (DST) are two of the three recommended screening tests for Cushing’s syndrome (CS). The classical DST uses serum cortisol, but analysis of salivary cortisol and cortisone has shown high diagnostic accuracy at DST (1). Salivary cortisol can be analysed with immunoassays, which suffer from variable degree of cross reactivity with other steroids, or with LC-MS/MS...

Background: Subtle symptoms such as fatigue, weight gain and depression are commonly present for years in patients with pituitary adenoma (PA) before the diagnosis is made. A delayed diagnosis with risk of increased morbidity and mortality may be due to differences between patient-reported symptoms and symptoms reported in the patient’s medical record.Aim: To estimate diagnostic delay and investigate the concordance between patient-reported symptoms...

Introduction: Patients with acromegaly have an increased mortality, mainly due to cardiovascular and respiratory diseases. Sleep apnea is related to hypertension, stroke and cardiovascular diseases and is reported to occur in 11–30% of acromegaly patients, according to retrospective studies based on diagnostic ICD-codes. However, in smaller prospective studies sleep apnea is found in about 70% of patients with active acromegaly and 40% after biochemical control. This diff...

Introduction: Oral once-daily dual-release hydrocortisone (DR-HC) therapy provides a more physiological cortisol profile than conventional thrice-daily (TID) replacement therapy and has demonstrated improved metabolic profile among patients with adrenal insufficiency (AI). The mechanisms by which this metabolic improvement occurs may be due to less total exposure, changed cortisol time exposure profile, but also modified metabolism of cortisol.Objective:...