ACTA ENDOCRINOLOGICA (BUC)

Background: Hereditary Haemorrhagic Telangiectasia (the Rendu-Osler-Weber syndrome) is a relatively common, underrecognized autosomal dominant disorder that results from multisystem vascular dysplasia. It makes vascular walls vulnerable to trauma and rupture, causing telangiectases and\r\narteriovenous malformations of skin, mucosa and viscera. It is clinically characterized by recurrent epistaxis, telangiectasia lesions on the face, hands and oral cavity, visceral arteriovenous malformations and positive family history. Epistaxis is often the first manifestation associated with haematologic, neurologic, pulmonary, dermatologic and gastrointestinal complications.\r\nCase report: a patient came to our observation presenting recurrent epistaxis with a severe iron deficiency anaemia and hypoparathyroidism. Genetic, laboratory and imaging findings were compatible with the presence of Rendu-Osler-Weber syndrome associated to a form of idiopathic hypoparathyroidism that could find its physiopathological origin in a consequence of an autoimmune process affecting\r\nparathyroids.

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Context. Memory deficits, anxiety and depression are often associated with diabetes, worsening diabetic patients’ prognosis. Caffeine, a worldwide used psychoactive substance, is a candidate for improving these conditions. Objective. The aim of this study was to assess the behaviour in streptozotocin-induced diabetic Wistar rats and to evaluate the behavioural effects of caffeine administration. Materials and methods. Diabetes was induced by a single intraperitoneal injection of 50 mg/kg BW streptozotocin (n=10), while control rats received the vehicle (n=9). After six weeks, behavioural tests for anxiety, memory and depression were performed: elevated plus maze (EPM) test, novel object recognition (NOR) test and forced swimming test (FST), respectively. The tests were repeated after further 2 weeks of continuous caffeine administration (20 mg/kg BW/day in drinking water). Results. Diabetic rats manifested a high anxiety level, showed by a reduced exploratory activity compared to control rats (p<0.05) and long-term memory impairment, spending more time near the old object in NOR test. Caffeine administered for 2 weeks did not modify glycemic values in either group, and attenuated the behavioural changes observed in the EPM test. Also, in NOR test for long-term memory, caffeine administration induced an increased time spent with the novel object than with the old one in both groups. Conclusions. Our data suggest that chronic caffeine administration has an anxiolytic effect in diabetic rats and improves long-term memory in both diabetic and control rats.

Aim: We have undertaken an attempt to compare the application efficacy of the proliferative activity markers in the differential diagnosis of thyroid H?rthle cell tumors using the PCNA and Ki-67 labeling and AgNOR visualization techniques.\r\nMaterials and methods: The present work is a retrospective analysis of proliferative potential in 40 H?rthle cell tumors, on paraffin blocks: 10 H?rthle cell carcinomas (HCC), 16 H?rthle cell adenomas (HCA) and 14 hyperplastic nodules with H?rthle cell metaplasia (HCM). The evaluation of the mean number of nucleolar organizer regions (NORs) per nucleus and the proliferative index (PI-the percentage of PCNA and Ki-67 positive cells) was performed using staining silver impregnation method and antibodies against PCNA (clone PC 10) and Ki-67 (clone MIB-1) in LSAB detection Kit and visualization with DAB (diaminobenzidine). U-Mann-Whitney test was used for statistical analysis. The difference was considered significant for p<0.05.\r\nResults: The values of PI-PCNA, PI-Ki-67 as well as the mean AgNOR counts in nuclei were: 25.5, 12.8, and 5.0 in HCC; 7.6, 4.9, and 3.1 in HCA and respectively 5.1, 4.0 and 2.3 in HCM. Statistically significant differences were found in all the proliferative\r\nactivity markers between malignant and benign tumors: HCM: HCC (p<0.0001) and HCC: HCA (p<0.001). Indifferently of the examined markers and the method of quantification of the reaction, we did not found significant differences between hyperplastic nodules with H?rthle cell metaplasia and oncocytic adenomas (p< 0.07).\r\nConclusions: PI-PCNA, PI Ki-67 and mean AgNOR/ nucleus, used as markers for the appreciation of proliferative activity of oncocytic thyroid tumors (classified as adenomas, carcinomas and hyperplastic nodules with H?rthle cells), reflect differences between the studied thyroid lesions. Our results indicate the utility of these parameters in the differentiation of the benign oncocytic tumors from the malignant ones.

Background. Diabetes mellitus (DM) is considered as an important health confounder in our world, which necessitates its better management by new methods. In this study, we have evaluated the effects of oral Arnebia Euchroma (AE) extract on different stereological parameters of the pancreas as well as blood glucose in Streptozotocin (STZ)-induced diabetes in rats. Methods. We divided 48 Wistar rats into 4 groups: C1 including normal rats, C2 not-treated diabetic rats, E1 with diabetic rats receiving 100 mg/kg AE extract orally, and E2 including diabetic rats treated with 300 mg/kg AE extract. Stereological study was done and the levels of blood glucose were also estimated and compared between experimental and control groups. Results. There were significant differences in volumes of pancreatic islets, β cell populations, blood glucose levels in AE treated groups compared with nottreated diabetic group. Conclusion. Although AE did not completely prevent or heal the pancreatic damage, its oral administration showed promising effects on maintaining the population of beta cells, the main insulin secreting cells, after STZ-induced injury and also lowered blood glucose levels compared to the not-treated diabetic group.

McCune Albright syndrome (MAS) is a rare disease due to a sporadic mutation in Gs protein inducing polyostotic fibrous\r\ndysplasia, pigmented skin patches and hyper functioning endocrinopathies. We aimed to report its association with a hot thyroid nodule and gigantism.\r\nCase report. A man aged 37, with a history of pigmented skin lesions and lameness was referred for acromegaly. He was giant (height = 1.94 m/ target stature = 1.68 m), and had ?caf? au lait? spots. Biological analyses argued for pituitary mixed secretion (random growth hormone = 22 ng/ mL, N<5; prolactin = 27 ng/mL, N<10). Brain CT scan showed a pituitary process of 11x10 mm. Thyroid radioiodine scan revealed a hot nodule. Bone x-ray demonstrated large osteolytic lesions in the right femur and pelvis. He was operated on for endocrine tumours. The thyroid nodule\r\nwas benign and immunohistochemistry pituitary was positive for GH, prolactin and &#945; subunit.\r\nConclusion. Somatolactotrop adenoma causing gigantism associated with MAS is exceptional. It should be known, diagnosed, and treated early to avoid bone deformations\r\nand malignant transformation of osseous lesions under GH and/or IGF1 excess. One should also know that radiotherapy for the pituitary process is contraindicated, because of higher risk of sarcomatous transformation.

Context. Many negative effects of stress regarding cognitive performances and gastrointestinal habits were previously reported in both animal models and human participants. Objective. We aimed to compare perceived stress levels with declared gastrointestinal habits changes in a small cohort of college students during academic acquisition and evaluation periods. Design. College students were recruited and divided into two groups: the control group evaluated during the acquisition period of the academic year and the stressed group evaluated during the examination period. Subject and Methods. The students’ psychological and gastrointestinal status was evaluated using a common stress questionnaire and a gastrointestinal habits survey. Results. Our results showed increased perceived stress in college students during stressful conditions, as compared to lesser demanding periods. Similarly, more than 40%of the participants declared that gastrointestinal habits changes occurred during stressful periods. We observed significant correlations between the perceived stress levels and gastrointestinal habits changes. Conclusion. This small-sized survey study showed that the occurrence of the stressful event in young adults recorded higher perceived stress scores and frequent functional gastrointestinal symptoms, as compared to the lower stressful periods. Also, we showed that functional gastrointestinal symptoms are rather common and could be regarded as a negative response to stress.

Chronic heart failure (CHF) and obesity are two conditions frequently associated and which, despite all the advances made in their management in the recent years, their prevalence continues to rise. Obese patients present unique challenges in the diagnosis of CHF and also therapeutic particularities. The genetic differences may be a possible explanation for the fact that some people, irrespective of their lifestyle and common classical cardiovascular risk factors, are more susceptible to develop heart failure. Moreover, the adipose tissue, a huge endocrine organ which secretes adipokines, is also a well-established source of all renin-angiotensin-aldosterone system components, being strongly involved in the pathogenesis of CHF. That is why this review will explore the possible links between the RAS genetic polymorphisms and leptin secretion in obese HF patients, trying to bring a more precise understanding of this relationship, which will undoubtedly facilitate a more appropriate treatment of HF in obese patients. We also try to explain the possible incriminated mechanisms, and plausible biological explanations for the relationship between RAS genetic polymorphisms and adipokines secretion in obese heart failure patients.

Background. Hidradenitis suppurativa (HS) is a chronic, debilitating disease with a profound impact on the quality of life of patients. Objectives. To describe a rare case of HS with postmenopausal onset, to review the literature data regarding late onset HS and to discuss the current knowledge on the role of endocrine abnormalities in the development of HS. Case report. We report the case of a 68-year-old patient in whom HS occurred 10 years after menopause. She was referred to our clinic for the presence of an open fistula on the left groin, fibrotic scars and visible alteration of the vulvar anatomy due to numerous surgical interventions. The patient shared features of the metabolic syndrome (obesity, arterial hypertension, dyslipidemia, aortic atherosclerosis), but showed no signs of virilism and no hormonal abnormality. HS was controlled using antiseptics, topical retinoids and antibiotics. Conclusions. This case is of particular interest given the late onset of HS, long time after menopause. The development of HS requires a complex interaction between genetic predisposing factors, endocrine dysregulation, metabolic alterations, bacterial overgrowth and an aberrant inflammatory response. Evidence points to an important role of sex-hormones in the emergence and progression of the disease, but the underlying mechanisms are still unclear. A better understanding of HS pathogenesis is needed to elucidate the precise way in which endocrine factors influence the disease onset and course. This would guide the way to novel therapies and a better control of this challenging disease.

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune polymorphous disease that primarily affects women of reproductive age. This gender disparity has suggested the importance of investigating the role of reproductive hormones in the pathogenesis of the disease. Estradiol, the most potent form of estrogen, plays a key role in shaping the immune system including the production of lymphocytes, the peripheral differentiation of regulatory T cells (T-regs), antibody production, and the complement and interferon systems, and has been studied in the pathogenesis of systemic lupus erythematosus (SLE). It operates by binding to estrogen receptors (ERs) α and β, initiating cellular responses including alterations in gene expression. Regulatory T cells are instrumental in preserving immunological self-tolerance and moderating immune responses. Estradiol’s serum levels correlate with the expansion of CD4+CD25+ and FoxP3+ in healthy females. However, this response is reduced in lupus patients. Estradiol also interacts with microRNAs (miRNAs) in gene regulation. Hsa-miR-10b-5p, a miRNA targeting SRSF1, is overexpressed in SLE patients and its levels increase with exposure to estrogens. Other miRNAs also show correlation with plasma Estradiol levels. The precise role of Estradiol in the pathogenesis of SLE remains complex and multifaceted and is a topic for further research.