Article
Endocrinology & Metabolism
In-Ho Jung, Seonah Choi, Cheol Ryong Ku, Sang-Guk Lee, Eun Jig Lee, Sun Ho Kim, Eui Hyun Kim
Summary: This study evaluated the reliability of IGF-1 levels as an alternative for disease monitoring after surgical treatment of acromegaly. The results showed that IGF-1 levels can serve as a reliable alternative to OGTT and play a valuable role in monitoring acromegaly status.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Review
Medicine, General & Internal
Amit Akirov, Hiba Masri-Iraqi, Idit Dotan, Ilan Shimon
Summary: The diagnosis, management, and treatment of acromegaly heavily rely on the levels of serum IGF-1, basal GH, and nadir GH following OGTT. However, these hormone concentrations can be influenced by various factors, leading to discordant levels that may require additional monitoring and data. New standards for GH and IGF-1 provide more accurate tools, but limitations should be considered along with clinical history and imaging studies when evaluating patients with acromegaly.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Clinical Neurology
Yasuyuki Kinoshita, Akira Taguchi, Atsushi Tominaga, Kazunori Arita, Fumiyuki Yamasaki
Summary: Recovery from AGHD after initial TSS is more likely in younger female patients with higher peak GH levels assessed by preoperative PPT. Patients aged <= 62.2 years and with a peak GH level of >= 0.74 μg/L based on preoperative PPT are likely to recover from AGHD.
JOURNAL OF NEUROSURGERY
(2021)
Article
Oncology
Shun Yao, Wen-Li Chen, Sherwin Tavakol, Farhana Akter, Michael P. Catalino, Xiaopeng Guo, Jie Luo, Ai-Liang Zeng, Leo Zekelman, Zhi-Gang Mao, Yong-Hong Zhu, Qing-Zhi Wu, Edward R. Laws, Wenya Linda Bi, Hai-Jun Wang
Summary: This study investigated the clinical characteristics and predictors of biochemical remission after surgery for acromegaly using the China Acromegaly Patient Association (CAPA) database. The results showed that higher preoperative GH levels, large tumor size, and greater tumor invasiveness are associated with a lower likelihood of biochemical remission at 3 months after surgery, while preoperative medical therapy increases the chance of remission.
JOURNAL OF NEURO-ONCOLOGY
(2021)
Review
Medicine, General & Internal
Nazanin Ershadinia, Nicholas A. Tritos
Summary: Acromegaly is a condition caused by a pituitary adenoma that secretes growth hormone, resulting in various complications. Early diagnosis and appropriate treatment are crucial. Diagnosis is confirmed through biochemical tests and MRI. Pituitary surgery is usually the first-line treatment, while medical therapy and radiation therapy can be used as adjunct options.
MAYO CLINIC PROCEEDINGS
(2022)
Article
Endocrinology & Metabolism
Jiun-Lin Yan, Mao-Yu Chen, Yao-Liang Chen, Chi-Cheng Chuang, Peng-Wei Hsu, Kuo-Chen Wei, Chen-Nen Chang
Summary: This study evaluated the outcomes of the endoscopic transsphenoidal approach as the primary treatment for somatotroph adenomas and investigated patients with suboptimal surgical results. Factors such as tumor size, preoperative GH level, and residual tumors were found to be associated with surgical failure. Octreotide showed good outcomes for treating DGSA patients, while SRS/EXRT generated good results for patients receiving secondary treatments when remission could not be reached after 6 months of TSA operation.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Review
Medicine, General & Internal
Sylvia L. Asa, Shereen Ezzat
Summary: Excess growth hormone causes gigantism and acromegaly, which are characterized by accelerated growth and overgrowth of soft tissue and bone. Pituitary neuroendocrine tumors (PitNETs) that produce GH are primarily derived from PIT1-lineage cells, with various pathologic features. These tumors may vary in hormone production and lineage differentiation, resulting in GH excess.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Clinical Neurology
Sven Berkmann, Joel Brun, Philipp Schuetz, Emanuel Christ, Luigi Mariani, Beat Mueller
Summary: This study evaluated the prevalence and course of hypertension, obesity, diabetes mellitus, obstructive sleep apnea syndrome, carpal tunnel syndrome, and polyposis coli in acromegalic patients. Surgical treatment led to remission in some patients, while drug therapy was more effective, but many comorbidities persisted.
ACTA NEUROCHIRURGICA
(2021)
Review
Endocrinology & Metabolism
Li Li, Liheng Meng, Yuping Liu, Rashi Tamrakar, Xi Yang, Xinghuang Liang, Jia Zhou, Jing Xian, Zhenxing Huang, Yingfen Qin
Summary: Mixed pituitary TSH/GH adenomas are rare adenomas that produce both GH and TSH simultaneously, often associated with acromegaly and thyrotoxicosis. Treatment typically involves somatostatin analogs to regulate hormone levels before surgery.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Endocrinology & Metabolism
Tyler Cardinal, Casey Collet, Michelle Wedemeyer, Peter A. Singer, Martin Weiss, Gabriel Zada, John D. Carmichael
Summary: The study aimed to identify predictive factors for long-term remission of acromegaly after surgical resection of pituitary adenomas. Postoperative GH levels on day 1 and changes in IGF-1 levels postoperatively were found to be useful in predicting hormonal remission. The findings suggest that these factors can help guide clinical follow-up and the need for adjuvant therapy in acromegaly patients.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Ryutaro Makino, Shingo Fujio, Tomoko Hanada, Masanori Yonenaga, Shigeru Kawade, Hiroshi Hashiguchi, Yoshihiko Nishio, Nayuta Higa, Kazunori Arita, Koji Yoshimoto, Ryosuke Hanaya
Summary: This study aims to investigate the incidence and predictors of delayed postoperative hyponatremia (DPH) in acromegaly patients undergoing transsphenoidal surgery. The findings suggest that lower preoperative weight and a postoperative transient gain in body weight are associated with an increased risk of DPH.
Article
Endocrinology & Metabolism
Eva C. Coopmans, Mark R. Postma, Thalijn L. C. Wolters, Sebastiaan W. F. van Meyel, Romana Netea-Maier, Andre P. van Beek, Sebastian J. C. M. M. Neggers
Summary: The study identified that the size of the tumor and random GH concentration at diagnosis are closely related to remission after TSS in acromegaly.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Endocrinology & Metabolism
Xueqing Zheng, He Wang, Wentai Zhang, Shanshan Feng, Yifan Liu, Shuo Li, Xinjie Bao, Lin Lu, Huijuan Zhu, Ming Feng, Renzhi Wang
Summary: This study is the first detailed and systematic comparison between pediatric and adult CD patients. Further exploration of the impact of CD on different genders reveals a more severe and probably an earlier-onset pattern of CD for male patients.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Endocrinology & Metabolism
Mayo Ono, Izumi Fukuda, Akimi Soga, Shigeyuki Tahara, Akio Morita, Hitoshi Sugihara
Summary: Incidental pituitary tumors are generally smaller, found in older patients, have a lower incidence of hormone deficiency, and show better preservation of pituitary function postoperatively. Close observation and appropriate decision-making are important to prevent incidentalomas from progressing into symptomatic tumors.
Article
Cell Biology
Julia Rymuza, Paulina Kober, Natalia Rusetska, Beata J. J. Mossakowska, Maria Maksymowicz, Aleksandra Nyc, Szymon Baluszek, Grzegorz Zielinski, Jacek Kunicki, Mateusz Bujko
Summary: This study identified three transcriptomic groups of somatotroph PitNETs with different gene expression profiles and clinical implications. These subgroups show variations in growth hormone secretion, prognostic gene expression, and potential therapeutic targets.
Review
Endocrinology & Metabolism
Fabienne Langlois, Elena V. Varlamov, Maria Fleseriu
Summary: Hypophysitis is inflammation of the pituitary gland that can be caused by various factors. Diagnosis is challenging and often requires detailed history, clinical examination, and pituitary biopsy. Treatment includes hormone replacement, careful observation, imaging follow-up, and in some cases, surgery, immunosuppressive therapy, and radiation.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Endocrinology & Metabolism
Stefano Frara, Paola Loli, Agnese Allora, Chiara Santini, Luigi di Filippo, Pietro Mortini, Maria Fleseriu, Andrea Giustina
Summary: COVID-19 patients may have pituitary diseases or hypopituitarism, which can worsen the severity of the disease. Hypopituitarism is associated with metabolic complications that contribute to poor outcomes and increased mortality in patients infected by SARS-CoV-2.
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS
(2022)
Article
Endocrinology & Metabolism
Dawn Shao Ting Lim, Maria Fleseriu
Summary: Acromegaly is a condition that requires appropriate treatment to prevent significant morbidity and mortality. The treatment goals include normalization of insulin-like growth factor 1 and growth hormone, tumor shrinkage, symptom relief, complication management, and improvement of quality of life. Surgical resection is the first-line treatment option, and somatostatin receptor ligands (SRLs) are commonly used for medical therapy. However, SRL resistance can be predicted by certain factors, and alternative treatments such as growth hormone receptor antagonists or second-generation SRLs may be considered. Combination therapy can be pursued for patients who are not biochemically controlled or have residual tumor after monotherapy. Personalized management based on individual characteristics and preferences is important for achieving high-quality outcomes.
ENDOCRINE PRACTICE
(2022)
Article
Endocrinology & Metabolism
Eystein S. Husebye, Frederik Castinetti, Sherwin Criseno, Giuseppe Curigliano, Brigitte Decallonne, Maria Fleseriu, Claire E. Higham, Isabella Lupi, Stavroula A. Paschou, Miklos Toth, Monique van der Kooij, Olaf M. Dekkers
Summary: This guideline provides evidence-based recommendations for the treatment and follow-up of patients with immune checkpoint inhibitor (ICI)-induced endocrine side-effects. A systematic approach to diagnosis, treatment, and follow-up is needed, including baseline tests of endocrine function before each treatment cycle. There is no clear evidence for the benefit of high-dose glucocorticoids in treating endocrine toxicities, with the possible exceptions of severe thyroid eye disease and hypophysitis affecting the visual apparatus. Most endocrine dysfunctions appear to be permanent regardless of ICI discontinuation.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2022)
Review
Endocrinology & Metabolism
Filippo Ceccato, Mattia Barbot, Alessandro Mondin, Marco Boscaro, Maria Fleseriu, Carla Scaroni
Summary: This study aimed to evaluate the diagnostic accuracy of the CRH test, desmopressin test, and HDDST for the differential diagnosis of CD and EAS. The CRH test showed the highest sensitivity for detecting CD and the highest specificity for detecting EAS, while the diagnostic accuracy of HDDST and desmopressin test was lower.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Article
Endocrinology & Metabolism
Amit Akirov, Laura Dery, Maria Fleseriu, Yaron Rudman, Ilan Shimon, Yossi Manisterski, Nirit Aviran-Barak, Varda Nadler, Sandra Alboim, Tzipora Shochat, Gloria Tsvetov, Dania Hirsch
Summary: This study aimed to evaluate the clinical presentation, biochemical profile, and etiology of Cushing's syndrome (CS) in women stratified by age. The results showed that adrenal etiology was more common in women over 65 years old, while pituitary etiology was more common in women under 45 years old. The initial presentation of CS also differed between age groups.
Review
Endocrinology & Metabolism
M. Fleseriu, Z. Zhang, K. Hanman, K. Haria, A. Houchard, S. Khawaja, A. Ribeiro-Oliveira, M. Gadelha
Summary: This systematic literature review investigated whether extended dosing intervals (EDIs) of pharmacological acromegaly treatments reduce patient burden and costs compared with standard dosing, while maintaining effectiveness. The results showed that EDIs provided similar clinical efficacy, safety, and health-related quality of life outcomes in adults with acromegaly, while also reducing costs compared to standard regimens. This study has important clinical implications for guiding the treatment of acromegaly.
Article
Endocrinology & Metabolism
Ashley J. J. Han, Maria Fleseriu, Elena V. V. Varlamov
Summary: Hypopituitarism and tumor growth are rare in patients with non-functioning pituitary microadenomas (NFPmA). However, patients often present with non-specific symptoms. This study aims to compare the presenting symptomatology in patients with NFPmA and patients with non-functioning pituitary macroadenomas (NFPMA).
HORMONES-INTERNATIONAL JOURNAL OF ENDOCRINOLOGY AND METABOLISM
(2023)
Article
Endocrinology & Metabolism
Maria Fleseriu, Mark Molitch, Alexander Dreval, Yulia Pokramovich, Irina Bondar, Yury Poteshkin, Djuro Macut, Barbara Obermayer-Pietsch, Yossi Gilgun-Sherki, Asi Haviv, Nienke Biermasz, Christian J. Strasburger
Summary: The study assessed the long-term efficacy and safety of oral octreotide capsules in patients with acromegaly. The results showed that the capsules were noninferior to injectable somatostatin receptor ligands, and transitioning from injectables to oral capsules improved symptoms.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Editorial Material
Endocrinology & Metabolism
Filippo Ceccato, Maria Fleseriu
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2023)
Editorial Material
Endocrinology & Metabolism
Maria Fleseriu, Dawn Shao Ting Lim
Summary: The path to becoming a clinical academic researcher is difficult and complicated, with numerous obstacles. A good mentor is crucial for personal growth and development, serving as a valuable sounding board throughout one's career.
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Correction
Endocrinology & Metabolism
Stephan Petersenn, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M. K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K. Y. Ho, Jurgen Honegger, Adriana G. Ioachimescu, Ursula B. Kaiser, Niki Karavitaki, Laurence Katznelson, Maya Lodish, Dominique Maiter, Hani J. Marcus, Ann McCormack, Mark Molitch, Christopher A. Muir, Sebastian Neggers, Alberto M. Pereira, Rosario Pivonello, Kalmon Post, Gerald Raverot, Roberto Salvatori, Susan L. Samson, Ilan Shimon, Joanna Spencer-Segal, Greisa Vila, John Wass, Shlomo Melmed
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Stephan Petersenn, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M. K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K. Y. Ho, Juergen Honegger, Adriana G. Ioachimescu, Ursula B. Kaiser, Niki Karavitaki, Laurence Katznelson, Maya Lodish, Dominique Maiter, Hani J. Marcus, Ann Mccormack, Mark Molitch, Christopher A. Muir, Sebastian Neggers, Alberto M. Pereira, Rosario Pivonello, Kalmon Post, Gerald Raverot, Roberto Salvatori, Susan L. Samson, Ilan Shimon, Joanna Spencer-Segal, Greisa Vila, John Wass, Shlomo Melmed
Summary: This Consensus Statement provides evidence-based graded consensus recommendations and key summary points for clinical practice on the diagnosis and management of prolactinomas. It covers various aspects including epidemiology, pathogenesis, clinical presentation, assessment, imaging strategies, complications, and treatment in special situations. The workshop emphasizes the need for additional therapeutic options to address clinical challenges in treating these patients.
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Review
Endocrinology & Metabolism
Maria Fleseriu, Elena V. V. Varlamov, Jose M. M. Hinojosa-Amaya, Fabienne Langlois, Shlomo Melmed
Summary: This review discusses the challenges faced in managing Cushing disease in adults and provides valuable information to assist clinicians in devising an integrated and personalized approach for each patient. Cushing disease, caused by an ACTH-secreting pituitary corticotroph adenoma, leads to hypercortisolaemia and is associated with various life-threatening conditions. The complexity of the disease makes it difficult to diagnose, and careful testing is required to evaluate hormone levels in the hypothalamic-pituitary-adrenal axis. Treatment options range from surgical resection to medical therapy and radiation, depending on the persistence or recurrence of the disease. Lifelong surveillance is necessary to monitor for comorbidities and treatment-related side effects. Overall, this review sheds light on the management challenges of Cushing disease in adults and offers guidance for a personalized treatment approach.
NATURE REVIEWS ENDOCRINOLOGY
(2023)
Article
Endocrinology & Metabolism
Elena V. Varlamov, Greisa Vila, Maria Fleseriu
Summary: Patients with Cushing disease may experience various complications before and after transsphenoidal surgery, requiring multidisciplinary care. Preoperative management includes treating electrolyte disturbances, cardiovascular comorbidities, and diabetes, as well as prophylaxis for thromboembolism and infection. Postoperative care involves monitoring for adrenal insufficiency, adjusting medication for hypertension and diabetes, and evaluating recovery of thyroid, gonadal, and growth hormone deficiencies.
JOURNAL OF THE ENDOCRINE SOCIETY
(2022)