ACTA ENDOCRINOLOGICA (BUC)

Context. Oxytocin has been investigated as a potential medication for psychiatric disorders. Objective and design. This study prospectively investigates correlations between oxytocin and other neuropeptides plasma levels in patients with autism spectrum disorders (ASD) according to severity and treatment, as compared to controls. Subjects and methods. Thirty-one children (6 neurotypical as control) participated in this study. The patients were classified into mildly and severely-affected, according to Autism Diagnostic Observation Schedule (ADOS) scores. Oxytocin, orexin A and B, α-MSH, β-endorphins, neurotensin and substance P were investigated using a quantitative multiplex assay or a competitive-ELISA method. Results. Plasma oxytocin levels differed between the groups (F (2, 24) =6.48, p=0.006, η2=0.35, observed power=86%): patients with the mild ASD had higher values of plasma oxytocin than those with the severe form (average difference=74.56±20.74pg/mL, p=0.004). Conclusions. These results show a negative correlation between plasma levels of oxytocin and the severity of ASD and support the involvement of oxytocinergic mechanisms in ASD.

Genetics of cancer is a hot topic, an excellent example of translational medicine. Risk stratification, selection of cases for surgery in Bethesda categories 3 &4 FNAB are examples of the high impact of genetic evaluation in thyroid neoplasia.

Diabetes is one of the most prevalent chronic disorders, associating numerous somatic and behavioral modifications. Oxytocin has been widely studied for its involvement in social behavior and psychiatric disorders. This pilot study presents a series of 3 patients with type 1 diabetes and diabetic neuropathy in which the values of plasma oxytocin, neurotensin, β-endorphins, α-MSH, substance P and orexin A were measured in comparison to 3 healthy controls with matching ages. In the diabetic patients group, there was a strong negative correlation between the value of plasma glucose and oxytocin (r=-0.99, p=0.04), respectively neurotensin (r=- 0.99, p=0.03). These values did not correlate in the control group. The results suggest that oxytocin, in conjunction with neurotensin, could be investigated as a potential early detection marker of diabetic neuropathy and, to our knowledge, this is the first report focusing on plasma oxytocin levels in patients with diabetic neuropathy.

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We report the case of a 24 years old male, diagnosed with severe pancytopenia, possibly myelodysplastic syndrome with ringed sideroblasts associated with immune thrombocytopenia, who presented with hyperthyroidism due to Graves’ disease. Standard antithyroid drugs were postponed for fear of exacerbation of cytopenia. Instead, steroid and immunoglobulin therapy gradually induced euthyroidism which was followed by correction of the hematological abnormalities. We review in this paper literature reports that discuss the association of thyrotoxicosis with pancytopenia, with reversibility of both the hematological and endocrine autoimmune picture after immunosuppressive treatment.

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Aims: Prolonged exposure to a glucocorticoid excess leads to cognitive impairment in experimental animals as well as humans. The present study tries to identify the cognitive deficits in patients with Cushing’s syndrome and to evaluate the possible residual deficits in patients after treatment. Materials and methods: 19 patients (women) with a history of chronic endogenous hypercortisolemia were investigated for etiology using clinical and biochemical criteria. Cognitive functions were evaluated using a battery of psychometric tests: the Rey Auditory Verbal Learning Test (RAVLT), the BCR2 battery for general intellectual potential and the Prague test, for divided attention and resistance to psychic fatigue. The patients were divided into two groups (before surgical treatment– Cushing and after surgical treatment – postCushing) without differences in age or duration of studies between groups (p = ns). The controls were considered to belong to the general population for which the psychometric tests were standardized. Results: Both groups showed an altered pattern of incremental learning - scores below standard in the last two trials of the RAVLT (one sample t test, one tailed, p<0.05), and the total score (p<0.05 for PostCushing, p=0.07 for Cushing); both had very low total scores in the battery for intellectual potential. The PostCushing scores were significantly better than those of the Cushing group for only one nonverbal test (complex perceptual analysis), p<0.02. There appears to be no significant effect of cortisol exposure on distributive attention; there is however an alteration in the resistance to psychic fatigue. Daily average cortisol exposure was positively correlated with the number of errors in learning for both groups (r=0.65, p=0.058 for Cushing; r=0.85, p<0.005 for PostCushing) Duration of illness was negatively correlated with the total learning score in the PostCushing group (r=-0.68, p<0.05). For the Cushing group there was a strong negative correlation between the duration of illness, general performance (r=-0.81, p<0.05) and verbal scores (r=-0.77, p<0.07).

Medullary thyroid carcinoma is a neuroendocrine tumour of the parafollicular C cells of the thyroid gland. It is an aggressive tumor that can be cured only by complete resection of the thyroid tumour and any local and regional metastases. Thus, the discovery of novel diagnostic and prognostic markers is very important for early diagnosis and correct management, in order for the survival rates to rise. New research has emphasized the potential role of various genes, serum and immunohistochemical markers, as well as potential targets for therapeutic agents. The calcium stimulated calcitonin test has been recently reintroduced in clinical practice, and current medullary thyroid carcinoma guidelines encourage laboratories to set their own criteria defining reference ranges for elevated serum basal and stimulated calcitonin levels.

Thyroid cancer, the most frequent endocrine malignancy, is in most patients a treatable disease, with excellent outcome and cure rate. However, a few patients present with rapidly progressive metastatic differentiated thyroid cancer which loses the radioiodine uptake capacity. These rare cases are prone to a rapid evolution and poor prognosis. Medullary thyroid cancer is a neuroendocrine tumor occurring sporadically or as part of endocrine tumor syndromes, genetic tests being part of standard clinical evaluation. Current knowledge of tumor biology in thyroid cancer allowed development of a new class of drugs, thyrosine kinase inhibitors (TKI). Their use in clinical trials allowed the development of more specific drugs, increasingly effective and with less adverse reactions, interfering with multiple thyrosine kinase enzymes. Improvement of the progression free survival, decrease of tumor volume and tumor markers, as well as patients with stable disease on TKI are strong arguments for including patients in clinical trials. Currently, only four TKI are approved by FDA: sorafenib and lenvatinib for DTC; vandetanib and cabozantinib for MTC. In this paper we present this new class of drugs used in the treatment of aggressive thyroid cancer.