The International Journal of Romanian Society of Endocrinology / Registered in 1938

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  • Images in Endocrinology

    Lider S, Gheorghiu M, Milos I, Badiu C

    Malignant Paraganglioma Non-Responsive to MIBGIn MEN2A Syndrome

    Acta Endo (Buc) 2022 18(4): 536-537 doi: 10.4183/aeb.2022.536

  • Images in Endocrinology

    Gheorghisan-Galateanu AA, Terzea D, Ioachim D, Carsote M

    Not Just Hashimoto’s Thyroiditis

    Acta Endo (Buc) 2019 15(4): 537-538 doi: 10.4183/aeb.2019.537

  • Perspectives

    Prada GI

    Immunosenescence and Inflamm-Ageing

    Acta Endo (Buc) 2014 10(4): 537-544 doi: 10.4183/aeb.2014.537

    Researches on ageing phenomenon offer significant information regarding the consequences of stressors on immune system that affects longevity in the elderly. Immunosenescence has become the most common immunodeficiency state in humans, occurring in over 30% of community - dwelling elderly, and greater than 90% of elderly who are ill, taking medication, or residing in longterm care facilities. Immunosenescence may reflect tandem changes in neuroendocrine responses. There are several agingrelated changes in cortisol, DHEA and catecholamines, which are considered to set up a “vicious cycle of endocrinosenescence and immuno-senescence”. The low-level, chronic increase in innate, inflammatory response observed in older adults ultimately results in tissue damage and disease; the key inflammatory mediators in this process are CRP, nuclear factor (NF)-kB, IL-1-beta, IL-6, TNF-alpha, cyclooxygenase-2 (COX-2), and inducible nitric oxide (NO) synthase. Further, glucocorticoid inhibition of IL-6 production was observed to be lower in older compared to younger men following psychological stress. There are individual differences that protect aged people from stressors and strains, and it will be important to identify biological mechanisms of protection and those at risk who might benefit from early behavioral interventions.
  • Case Report

    Gupta R, Sharma A, Ksh A, Khadgawat R, Dinda AK

    Phospathuric mesenchymal tumor of the sinonasal tract

    Acta Endo (Buc) 2009 5(4): 537-542 doi: 10.4183/aeb.2009.537

    Background. Phosphaturic mesenchymal tumor (PMT) is a recently described concept\r\nunifying the mesenchymal tumor associated with oncogenic osteomalacia. Most of the cases of\r\nPMT occur in the extremities and appendicular skeleton. PMT occurring in the paranasal\r\nsinuses is extremely rare with only a few cases reported in the available literature.\r\nCase. A 51-year-old man presented with a long history of bone pains. Biochemical\r\nand radiologic investigations, including skeletal survey showed features of osteomalacia.\r\nPositron emission tomography (PET) scan showed a small tumor in the left nasal cavity,\r\nethmoid and sphenoid sinuses. Histopathological examination of the excised tumor showed\r\nfeatures of a phosphaturic mesenchymal tumor- mixed connective tissue variant. Excision\r\nof the tumor was associated with marked improvement in the biochemical parameters and\r\nremarkable clinical relief.\r\nConclusion. Phosphaturic mesenchymal tumor is a rare cause of osteomalacia and is\r\nusually associated with small tumors, which escape detection for long periods. Its occurrence in\r\nthe paranasal sinuses needs to be kept in mind and evaluated to allow for timely detection of the\r\ntumor with subsequent surgical excision and clinico-biochemical relief.
  • Case Series

    Nguyen K, Chen X, Hughes T, Hofflich H, Woods GN, McCowen KC

    Surprisingly Few Women with Severe Osteoporosis by Bone Densitometry Undergo Workup for Secondary Causes - a Retrospective Evaluation

    Acta Endo (Buc) 2021 17(4): 537-542 doi: 10.4183/aeb.2021.537

    We describe clinical features of women with extremely low bone density, and investigate secondary causes of osteoporosis. Our hypothesis was that this population would be enriched in identifiable causes of osteoporosis. We performed a retrospective review of medical records of all women seen at our university over 4 years with T-score on bone densitometry at/below -4 at any site. Historical and fracture details were abstracted. We considered a thorough work up to include Vitamin D, PTH, CBC, chemistry panel, cortisol, transglutaminase, myeloma screen, tryptase and 24-hour urine calcium. Results. 137 women were identified with T-score at/below -4. Percent identified as Asian was 26% (higher than local prevalence of 8%). Average BMI was 21.6 kg/ m2. Clearly identifiable causes of osteoporosis were noted in 57% (inflammatory disorder, glucocorticoid or antacid exposure, prolonged immobilization and alcoholism were most prevalent). Of the remainder, full work up was performed only in 8%. Endocrine consultation and white race predicted thoroughness of secondary work-up. Conclusion. Fragility fractures, leanness and Asian race were common in women with very low T-score. However, few new causes were identified. Underlying etiology was either immediately evident or inadequately studied, especially in minorities.
  • Notes & Comments

    Hekimsoy Z, Eniseler EB, Erdem N, Ozdemir N

    Catamenial Diabetic Ketoacidosis

    Acta Endo (Buc) 2022 18(4): 538-540 doi: 10.4183/aeb.2022.538

    Diabetic ketoacidosis (DKA) is a common medical emergency situation. In rare cases, glycemic changes associated with the menstrual cycle may create a predisposing factor for DKA. In the absence of facilitating factors that may cause DKA, catamenial DKA should be considered. In the patients with catamenial DKA, increasing the insulin dose 1-2 days before menstruation may prevent the development of hyperglycemia or DKA associated with menstrual cycle. In this study, we present a 21-year-old female with type 1 diabetes mellitus (DM) that recurrently applied to our hospital due to DKA a few days prior to menstrual bleeding.
  • Notes & Comments

    Altun Tuzcu S, Cetin FA, Pekkolay Z, Tuzcu AK

    18f-Fluorodeoxyglucose PET/CT Can Be an Alternative Method to Assessment of Insulin Resistance

    Acta Endo (Buc) 2019 15(4): 539-543 doi: 10.4183/aeb.2019.539

    Background. Insulin resistance is routinely measured by homeostasis model assessment of insulin resistance (HOMA-IR).Positron emission tomography of 18F-fluorodeoxyglucose combined with computed tomography (18F-FDG PET/CT) is a valuable assessment tool for patients with cancer or staging tumors. 18F-FDG PET/CT imaging can also be utilised to detect the metabolic activity of glucose in the adipose tissue, liver and muscles. The aim of this study was to determine insulin sensitivity in the liver, muscle visceral adipose and subcutaneous adipose tissue separately via18F-FDG PET/CT. Materials and method. Sixty three adult patients who underwent whole body 18F-FDG PET/CT scanning for clinical purposes (diagnosis or staging of cancer) between July and August of 2016 were included in the study. Patients were divided into two groups according to their BMI (Group 1: BMI<25kg/m2, Group 2: BMI>25kg/ m2). HOMA-IR,fasting glucose,insulin, triglycerides, total cholesterol, HDL levels were measured. We calculated SUV as the tissue activity of the ROI (MBq/g)/(injected dose [MBq]/ body weight [g]) on PET images and measured the maximum SUVs (SUVmax) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT),liver and rectus muscle ROIs (2 cm). SUV corrected by blood glucose level (SUVgluc) was calculated as SUVmax×blood glucose level/100. Student-t test, Chi-square test and Pearson correlation test were used for statistical analysis. Results. Mean glucose,insulin,HOMA-IR levels of the group-2 were statistically higher than of group-1. Muscle SUVmax and liver SUVmax of group-1 were statistically higher than of group-2. Muscle SUVgluc of group-1 was statistically higher than of group-2. HOMA-IR was negatively correlated with both SUVmax(r=-0.340, p=0.01) and muscle SUVmax(r=-0.373, p=0.005) Conclusion. 18F-FDG PET/CT has shown that the muscle tissue maximum FDG uptake was lower in the insulin resistance group. Therefore, 18-FDG PET/CT could be a valuable tool for diagnosing insulin resistance.
  • Case Series

    Dugeroglu H, Karakas A

    Multifaceted Evaluation of 72 Patients with Pituitary Failure

    Acta Endo (Buc) 2018 14(4): 539-548 doi: 10.4183/aeb.2018.539

    Objective. We aimed to reach a diagnosis for patients with pituitary failure (PF) with more detailed multifaceted examination, to obtain new gains in this way and to apply this experience to our future patients. Patients and Method. The study included 72 patients with pituitary failure diagnosis. Patients were divided into two groups of 32 female patients with Sheehan syndrome (SS) and 40 non-Sheehan syndrome patients (20 female and 20 male). Results. The mean age of the 32 patients with Sheehan syndrome was 56.1±11.7 years with mean disease duration 20.3±8.3 years and mean age at disease onset 34.3±7.6 years. For the 40 non-SS pituitary failure patients mean age was 46.5±16.6 years, mean disease duration was 4.7±5.1 years and mean age at disease onset was 41.8±18.2 years. The prolactin response (PRL) on the TRH test was found to be significantly lower in SS patients compared to non-SS patients(p<0.05). Both patient groups had low basal pituitary hormones, with mean PRL level in SS patients 4.9±4.0 ng/mL which was significantly low compared to non-SS patients with 36.8±84.7 ng/mL(p=0.022). Conclusion. Pituitary failure patients may present with a broad range of clinical symptoms and findings. Early diagnosis and timely replacement treatment have vital importance for SS patients.
  • Images in Endocrinology

    Badiu C, Dobrescu M, Ginghina C

    When pericardiotomy becomes compulsory!

    Acta Endo (Buc) 2010 6(4): 539-539 doi: 10.4183/aeb.2010.539

  • General Endocrinology

    Omar NN, Abdel Maksoud S M, Ali OS

    Association of insulin like growth factor 1 (IGF 1) and its binding protein-1 with nephropathy among type 2 diabetes

    Acta Endo (Buc) 2012 8(4): 539-549 doi: 10.4183/aeb.2012.539

    Background. The involvement of IGF 1 in renal pathophysiology has been studied in many details in type 1 diabetes but the role of IGF 1 in early nephropathy in patients with type 2 diabetes is less well characteristic. Objective. To determine whether serum IGF1 and GFBP-1 levels were different between patients with and without diabetic nephropathy and also to investigate the association between them and insulin resistance. Subjects and methods. Insulin resistance (HOMA-IR), IGF 1 and IGFBP-1 were measured in 20 type 2 diabetic patients with nephropathy, 20 type 2 diabetic patients without nephropathy and 15 control subjects. Results. Serum IGF 1 in diabetic nephropathy (333.3 +/-16.44 ng/mL) was significantly higher than in both diabetic patients without nephropathy (133.16 +/- 3.43 ng/mL) and in control subjects (174.33+/-6.23) (P <0.001). A significant negative correlation was observed between IGF 1 and HOMA, (r = -0.72) in diabetic patients without nephropathy and a positive correlation in diabetic nephropathy patients (r = 0.49). Conclusion. High IGF 1 and insulin levels in diabetic nephropathy patients in addition to the significant positive association between IGF 1 and HOMA suggest that both IGF 1 and insulin resistance may play major role in early renal changes in type 2 diabetes.