- A challenging coexistence of central diabetes insipidus and cerebral salt wasting syndrome: a case report. [Journal Article]
- JMJ Med Case Rep 2018 Jul 17; 12(1):212
- CONCLUSIONS: We present a rare case of a patient with diabetes insipidus and cerebral salt wasting syndrome, who was successfully treated. Hyponatremia in a patient with diabetes insipidus may erroneously be interpreted as inadequate diabetes insipidus control or as syndrome of inappropriate antidiuretic hormone secretion, leading to therapeutic errors. Thus, all clinical and analytical data should be evaluated together for early and correct diagnosis.
- Isolated adrenocorticotropic hormone deficiency as a form of paraneoplastic syndrome. [Journal Article]
- PPituitary 2018 Jul 14
- CONCLUSIONS: These data indicate that the ectopic ACTH expression in the tumor evoked the autoimmunity to corticotrophs and caused IAD as a form of paraneoplastic syndrome.
- Outcomes following transsphenoidal surgical management of incidental pituitary adenomas: a series of 52 patients over a 17-year period. [Journal Article]
- JNJ Neurosurg 2018 Jun 01; :1-9
- CONCLUSIONS: Transsphenoidal resection of IPAs, when appropriate, can be performed safely at experienced treatment centers. Incidental pituitary adenomas should be evaluated and treated as indicated, especially in younger patients at risk for endocrine or visual dysfunction.
- Complications associated with microscopic and endoscopic transsphenoidal pituitary surgery: experience of 1153 consecutive cases treated at a single tertiary care pituitary center. [Journal Article]
- JNJ Neurosurg 2018 Jun 01; :1-8
- CONCLUSIONS: In this single tertiary center study assessing complications associated with transsphenoidal PA resection, the rate of death or major disability was 0.26%. Risk factors for complications included prior surgical treatment and PA invasion. No differences in complication rates between endoscopic and microscopic surgery were observed. When performed at experienced pituitary centers, transsphenoidal surgery for PAs may be performed with a high degree of safety.
- VCAM-1 upregulation accompanies muscle remodeling following resistance-type exercise in Snell dwarf (Pit1dw/dw ) mice. [Journal Article]
- ACAging Cell 2018 Jul 10; :e12816
- Snell dwarf mice (Pit1dw/dw ) exhibit deficiencies in growth hormone, prolactin, and thyroid stimulating hormone. Besides being an experimental model of hypopituitarism, these mice are long-lived (>4...
Snell dwarf mice (Pit1dw/dw ) exhibit deficiencies in growth hormone, prolactin, and thyroid stimulating hormone. Besides being an experimental model of hypopituitarism, these mice are long-lived (>40% lifespan extension) and utilized as a model of slowed/delayed aging. Whether this longevity is accompanied by a compromised quality of life in terms of muscular performance has not yet been characterized. In this study, we investigated nontrained and trained muscles 1 month following a general validated resistance-type exercise protocol in 3-month-old Snell dwarf mice and control littermates. Nontrained Snell dwarf gastrocnemius muscles exhibited a 1.3-fold greater muscle mass to body weight ratio than control values although muscle quality, maximum isometric torque normalized to muscle mass, and fatigue recovery were compromised. For control mice, training increased isometric torque (17%) without altering muscle mass. For Snell dwarf mice, isometric torque was unaltered by training despite decreased muscle mass that rendered muscle mass to body weight ratio comparable to control values. Muscle quality and fatigue recovery improved twofold and threefold, respectively, for Snell dwarf mice. This accompanied a fourfold increase in levels of vascular cell adhesion molecule-1 (VCAM-1), a mediator of progenitor cell recruitment, and muscle remodeling in the form of increased number of central nuclei, additional muscle fibers per unit area, and altered fiber type distribution. These results reveal a trade-off between muscle quality and longevity in the context of anterior pituitary hormone deficiency and that resistance-type training can diminish this trade-off by improving muscle quality concomitant with VCAM-1 upregulation and muscle remodeling.
- Hypopituitarism and Central Diabetes Insipidus Caused by Central Nervous System Lymphoma. [Journal Article]
- IMIntern Med 2018 Jul 06
- Symptomatic Rathke cleft cyst in paediatric patients - clinical presentations, surgical treatment and postoperative outcomes - an analysis of 38 cases. [Journal Article]
- JPJ Pediatr Endocrinol Metab 2018 Jul 09
- CONCLUSIONS: RCC can present with serious symptoms that significantly deteriorate patients' quality of life. Despite a successful neurosurgical treatment in most of the analysed cases, patients required long-term pharmacological treatment.
- Craniopharyngeal canal, morning glory disc anomaly and hypopituitarism: what do they have in common? [Journal Article]
- OMOxf Med Case Reports 2018; 2018(6):omy018
- A 14-year-old girl with a history of mid-line defects, basal encephalocele and morning glory disc anomaly presented with untreated growth hormone deficiency, pubertal delay and hypothyroidism. She wa...
A 14-year-old girl with a history of mid-line defects, basal encephalocele and morning glory disc anomaly presented with untreated growth hormone deficiency, pubertal delay and hypothyroidism. She was found to have a large craniopharyngeal canal based on MRI scan. Craniopharyngeal canal is an uncommon condition that has not been well described in the pediatric population. Consideration of craniopharyngeal canal in the differential diagnosis for basal encephaloceles and understanding its presentation can impact medical decision making and follow-up for patients.
- DIFFERENTIAL REGULATION OF 11 β -HYDROXYSTEROID DEHYDROGENASE TYPE 1 ACTIVITY IN PATIENTS WITH DIFFERING AETIOLOGIES OF HYPOPITUITARISM. [Journal Article]
- EPEndocr Pract 2018 Jul 05
- Purpose Pituitary patients with different aetiologies of hypopituitarism exhibit differing phenotypes despite similar replacement therapy strategies. We hypothesised that differential regulation of t...
Purpose Pituitary patients with different aetiologies of hypopituitarism exhibit differing phenotypes despite similar replacement therapy strategies. We hypothesised that differential regulation of the isoenzyme 11β-hydroxysteroid dehydrogenase 1 (11β-HSD 1), which mediates the net autocrine conversion of cortisone to cortisol in adipose tissues and liver may play a role. Methods We studied 11β-HSD 1 activity (using urine cortisol/cortisone metabolites ratio), in 36 hypopituitary patients with treated craniopharyngiomas, treated remitted Cushing's disease and treated non-functioning pituitary adenomas+prolactinomas on and off GH (growth hormone) replacement. Results 11β-HSD 1 activity was higher in subjects with craniopharyngioma both on and off GH as evidenced by increased tetrahydrocortisol to tetrahydrocortisone metabolite (THF+5alloTHF/THE) ratios compared to other diagnostic groups, but there was no difference in BMI (body mass index), insulin levels, serum hormone measurements or hydrocortisone dose between groups Conclusions Craniopharyngiomas are associated with enhanced 11β-HSD1 activity compared to other diagnostic hypopituitary groups and this may contribute to the adverse phenotypic and metabolic features seen in this condition.
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- [Opioid Induced Pituitary Dysfunction]. [Journal Article]
- LLaeknabladid 2018 Juli; 104(7):347-349
- A 77-year-old woman with a history of anal squamous cell carcinoma was admitted because of malaise, diarrhea and nausea, in addition to back pain related to a verte- bral compression fracture. During...
A 77-year-old woman with a history of anal squamous cell carcinoma was admitted because of malaise, diarrhea and nausea, in addition to back pain related to a verte- bral compression fracture. During the course of treatment, opioid therapy was initiated, following which the patient became progressively hypotensive and hyponatraemic and respiratory drive progressively decreased. Serum levels of cortisol, TSH and LH were decreased and prolactin slightly elevated, but a Synacthen test and brain MRI turned out normal, suggesting a diagnosis of opioid-induced pituitary dysfunction. The patient was given glucocorticoid replacement therapy with good results. Here we present a case of this serious but less well recognised side-effect of opioids.