Endocrine Abstracts

In the last 20 years, the incidence of thyroid cancer (TC) has more than doubled. Since 50% of the increase is related to papillary microcarcinomas (mPTC, <1 cm), it appears that an increased detection, due to the wide use of neck ultrasound (US), is the major factor driving this dramatic rise. Autoptic and histological studies after thyroidectomy (TX) show that 10 to 30% of adults harbor an undiagnosed mPTC. The disease-specific mortality of patients treated by s...

Small, non-palpable thyroid nodules, detectable by thyroid ultrasound (US) in 30–50% of the general population, are likely to cause no significant health problem, thus deserving the definition of ‘thyroid incidentalomas’. Although clinically overt thyroid cancer is relatively rare, the most relevant issue for thyroid incidentalomas is the exclusion of malignancy by cytological examination of material obtained by fine needle aspiration (FNA). However, in about 30...

In pregnant women with a thyroid disease an increased amount of LT4 may be required for the correction of hypothyroidism or treatment of nodular goiter.Aim of this study was to assess the amount of the variations of LT4 requirement in pregnant women with thyroid diseases.To address this issue, we retrospectively evaluated a cohort of 138 women treated with LT4 divided in two groups: 47 euthyroid (E) (affected by nodular goiter (NG)...

Pregnant women may require treatment of hypo- or hyperthyroidism, L-thyroxine (LT4), propylthiouralcil (PTU) and methimazole (MMI) being the most frequently used drugs. Aim of this study was to verify the consequences of pharmacological treatment during pregnancy. We retrospectively evaluated 379 pregnancies: 124 patients under MMI treatment, 35 of whom still hyperthyroid in spite of treatment (H-MMI) and 89 euthyroid (E-MMI); 52 GD patients under PTU, 20 of whom still hyperth...

Context: Subacute thyroiditis (SAT) is an inflammation of the thyroid, likely caused by a viral infection. IgG Autoantibodies (Ab) to the main thyroid antigens, including thyroglobulin (Tg) (TgAb) have been reported in a few patients with SAT and their appearance is usually transient. We investigated whether IgM TgAb can be detected in sera of patients with SAT.Design: Serum samples were collected from 17 patients with SAT, ten with Graves’ disease ...

Background: Serum calcitonin (CT) is a very sensitive test for the diagnosis of medullary thyroid carcinoma (MTC). However, its routine dosage in patients with nodular thyroid disease is not recommended by all scientific societies. In addition, to optimize costs, it is only suggested in the case of suspicious nodules on ultrasound, indeterminate nodules at cytology or nodular goiter before surgery. The aim of the study is to evaluate the serum CT in a series of consecutive MTC...

Background: CV-PTC is often indolent with excellent long-term response, while TCV-PTC (≥50% of tall cells) have aggressive features and worse clinical behavior. Less is known about the clinical behavior of CV-PTC with tall cells <50% (TC/CV-PTC) that, so far, is considered as low risk tumor.Aim: To evaluate the histological presentation of CV-PTC, TC/CV-PTC, TCV-PTC and their clinical behavior after 6 years of follow up.M...

Berardinelli-Seip congenital lipoatrophy type 1 (BSCL1) is a rare autosomal recessive disease caused by mutations in the AGPAT2 gene. This syndrome is characterized by near total absence of adipose tissue since birth, associated with the progressive development of metabolic complications. The AGPAT2 gene encodes for 1-acylglycerol-3phosphate-O-acyltransferase highly expressed in white adipocytes that catalyzes the acylation of lysophosphatidic acid to form phosphatidic acid, a...

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...