Clinical Endocrinology最新文献

{"title":"Transient Hyperparathyroidism and Severe Intrauterine Osteopenia Linked to Novel Homozygous TRPV6 Deletion","authors":"Teodora Grigore,&nbsp;Quinty Leusink,&nbsp;Femke Latta,&nbsp;Bram van der Eerden,&nbsp;Paul de Laat,&nbsp;Danielle van der Kaay,&nbsp;Joost Hoenderop","doi":"10.1111/cen.70134","DOIUrl":"10.1111/cen.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Placental calcium (Ca²⁺) transport is essential for foetal bone mineralisation and development, as well as for Ca²⁺ homoeostasis. Rare mutations in transient receptor potential vanilloid (TRPV) 6 of the infant cause insufficient maternal-foetal Ca²⁺ transport through the placenta. Although there is a limited number of cases, phenotype analyses of these patients show skeletal deformities and hyperparathyroidism. In this study, we identified a case with a homozygous mutation in the TRPV6 channel that leads to the deletion of the Ca²⁺ pore.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient measurements</h3>\u0000 \u0000 <p>The neonate was born with skeletal abnormalities, increased umbilical cord PTH levels (75 pmol/L) and normal total Ca²⁺ level (2.06 mmol/L). Skeletal abnormalities improved during the first months of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>⁴⁵Ca²⁺ uptake assays demonstrated loss-of-function, and biotinylation assays demonstrated failure of the channel to reach the cell surface.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicate that the TRPV6-p.Arg492* mutation affects maternal-foetal Ca²⁺ transport and explains the observed phenotype.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 2","pages":"197-204"},"PeriodicalIF":2.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Psychological Adverse Effects of Central Precocious Puberty or Early Normal Puberty, and Its Treatment Among Affected Girls and Their Caregivers","authors":"Kalyarat Wilaiwongsathien,&nbsp;Jariya Chuthapisith,&nbsp;Pat Mahachoklertwattana,&nbsp;Natee Sakornyutthadej,&nbsp;Preamrudee Poomthavorn","doi":"10.1111/cen.70156","DOIUrl":"10.1111/cen.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate psychological adverse effects of idiopathic central precocious puberty and early normal puberty (iCPP/ENP) on Thai girls and their caregivers, and to explore their perceptions of iCPP/ENP and the treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, Patients and Measurements</h3>\u0000 \u0000 <p>Questionnaires were used to assess the perceptions and psychological adverse effects of iCPP/ENP. Newly diagnosed patients were additionally evaluated for bullying, depression, anxiety and low self-esteem.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine hundred and fifty-four participants (340 iCPP, 140 ENP, and 474 caregivers) were included. Mean (SD) age at enrolment was 9.9 (1.1) years. Breast buds, body odour and acne were perceived by the girls as their signs of puberty in 234 (49%), 174 (36%), and 162 (34%) girls, respectively. Two hundred and sixteen (45%) girls believed that certain types of food were the cause of iCPP/ENP. Additionally, the greatest concerns of caregivers were the child's short final adult height and early menarche. On a 10-point anxiety scale, caregivers reported a score of 8.3 (1.7). Among the 38 newly diagnosed girls, 8 (21%) reported being bullied, with experiences of verbal harassment about their breasts and breast grabbing. Additionally, 4 (11%) girls had depression, 9 (24%) had anxiety, and 5 (13%) had low self-esteem. Depression and anxiety were more prevalent in the iCPP group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated that girls and their caregivers lacked adequate knowledge of iCPP/ENP. Given that psychological stress was associated with iCPP/ENP, screening for psychological stress should be considered as part of caring for these patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 2","pages":"220-230"},"PeriodicalIF":2.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Denosumab for Treatment of Pain in Fibrous Dysplasia and McCune-Albright Syndrome: A Systematic Review","authors":"Vicky Yau,&nbsp;David L. Best","doi":"10.1111/cen.70133","DOIUrl":"10.1111/cen.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fibrous dysplasia (FD) skeletal lesions have a range of clinical manifestations including pain, which is a major contributor to reduced quality of life in patients with FD/MAS. Denosumab has been shown to reduce skeletal lesion activity and improve radiographic bone density; however, there is mixed evidence regarding its effect on pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The primary objective was to evaluate the efficacy of denosumab for the treatment of bone pain in FD/MAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted according to PRISMA guidelines utilising electronic databases including PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov. Included studies were those that described patients with a diagnosis of FD, with or without MAS, who were treated with denosumab. The primary outcomes were change in pain score using quantitative pain scales (Visual Analogue Scale, Brief Pain Index, and patient-reported numerical rating scale), proportion of pain responders (≥ 2-point reduction in pain or an overall subjective improvement in pain), and change in analgesic requirement. The secondary outcome was adverse on-treatment and post-treatment events related to denosumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 16 studies included (88 total patients, 86 treated with denosumab). Mean pain score decreased by 3.51 points on a 10-point scale. 81.8% of patients were pain responders, demonstrating a clinically meaningful improvement in pain. Reduction or cessation of analgesic use was reported in 51.7% of patients. Adverse events occurred in 55.8% of patients, most commonly hypocalcemia (11.6%) and hypophosphatemia (8.1%). Rebound hypercalcemia following denosumab discontinuation occurred in 8 patients (9.3%), 4 of which were severe.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients with FD/MAS undergoing treatment with denosumab, pain improved in 81.8% of patients, and analgesic requirement decreased in greater than half of patients. Careful monitoring is required surrounding treatment due the potential for severe adverse events, particularly rebound hypercalcemia following treatment discontinuation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 2","pages":"141-150"},"PeriodicalIF":2.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Clinical Outcomes Between Patients With Incidentally Detected and Clinically Detected Pheochromocytomas and Paragangliomas: A Retrospective Multicenter Study","authors":"Ozden Uzun,&nbsp;Buket Busra Icin,&nbsp;Bekir Cakir,&nbsp;Belma Ozlem Tural Balsak,&nbsp;Narin Nasiroglu Imga,&nbsp;Lala Soltanova,&nbsp;Pinar Kadioglu,&nbsp;Ozge Sahin Kimyon,&nbsp;Sema Ciftci,&nbsp;Ozlem Kandemir Alibakan,&nbsp;Mutlu Niyazioglu,&nbsp;Filiz Mercan,&nbsp;Ozen Oz Gul,&nbsp;Rumeysa Selvinaz Erol,&nbsp;Filiz Eksi Haydardedeoglu,&nbsp;Aysa Hacioglu,&nbsp;Zuleyha Cihan Ozdamar Karaca,&nbsp;Zafer Pekkolay,&nbsp;Esma Merve Arda Ozkan,&nbsp;Mazhar Muslum Tuna,&nbsp;Omercan Topaloglu,&nbsp;Taner Bayraktaroglu,&nbsp;Guzin Fidan Yaylali,&nbsp;Bahri Evren,&nbsp;Nese Cınar,&nbsp;Gulhan Akbaba,&nbsp;Merve Catak,&nbsp;Buket Yilmaz Bulbul,&nbsp;Mehmet Celik,&nbsp;Umit Nur Ozbay,&nbsp;Dilek Tuzun,&nbsp;Ziynet Alphan Uc,&nbsp;Faruk Kilinc,&nbsp;Birol Topcu,&nbsp;Gulsah Elbuken,&nbsp;Sayid Shafi Zuhur","doi":"10.1111/cen.70167","DOIUrl":"10.1111/cen.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>With the increasing use of imaging, a substantial proportion of pheochromocytomas and paragangliomas (PPGLs) are detected incidentally. However, data comparing the clinical outcomes of patients with incidentally and clinically detected PPGLs remain limited. Therefore, we compared them in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter retrospective study included 426 patients. Patients were classified as having incidentally or clinically detected PPGLs. Clinical, laboratory and genetic features; tumour stage; persistent/recurrent disease; disease-free survival (DFS); and overall survival were compared between patients with incidentally and clinically detected PPGLs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the patients, 216 had incidentally detected, and 210 had clinically detected PPGLs. Persistent/recurrent disease was diagnosed in 47 (11%) patients. Patients with incidentally detected PPGLs were older and more normotensive than those with clinically detected PPGLs. Hypertension, hereditary diseases, and persistent/recurrent diseases were more common in patients with clinically detected PPGLs. However, DFS did not differ between the two groups. Only hereditary disease and advanced tumour stage were associated with short DFS and were independent predictors of persistent/recurrent disease. Incidentally detected PPGLs were associated with low overall survival, a fact that could be confounded by the age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The detection method was neither associated with short DFS nor a predictor of persistent/recurrent disease, whereas hereditary disease and tumour stage were associated with short DFS and were independent predictors of persistent/recurrent disease in patients with PPGLs. Therefore, genetic analysis, staging, and close follow-up are necessary to determine persistent/recurrent disease and develop individualised treatment and follow-up plans, irrespective of the detection method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 2","pages":"185-196"},"PeriodicalIF":2.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148041386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mineralocorticoid Receptor Antagonist Discontinuation in Adrenal Venous Sampling for Subtyping Patients With Primary Hyperaldosteronism: A Systematic Review and Meta-Analysis","authors":"Rafael Humberto Pérez-Soto,&nbsp;Ahmed Ghani,&nbsp;Justin Bauzon,&nbsp;Gustavo Romero-Velez,&nbsp;Michael Lui,&nbsp;Guillermo Ponce de León-Ballesteros,&nbsp;Eren Berber","doi":"10.1111/cen.70143","DOIUrl":"10.1111/cen.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Adrenal venous sampling (AVS) interpretation distinguishes unilateral from bilateral primary aldosteronism (PA), which determines surgical versus lifelong medical management. Data is scant regarding the effects of mineralocorticoid receptor antagonist (MRA) use on the risk of AVS misclassification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To review the data in the literature about the effect of uninterrupted MRA use on the success of AVS lateralization and postoperative clinical and biochemical outcomes in patients with PA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of five different databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library) with no time restrictions was performed to identify relevant studies evaluating patients with PA who underwent AVS while on or off concurrent MRA treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four retrospective cohort studies were included, yielding a total of 1116 participants who underwent AVS. Of these, 147 (13.2%) were performed with concurrent MRA therapy. Rates of successful AVS were higher in patients with ongoing (89.1%) versus discontinued (78.0%) MRA treatment, with continuation of MRAs associated with a higher likelihood of lateralization consistent with unilateral disease (OR = 2.1, 95% CI: 1.4–3.1, <i>I</i>² = 0%). Clinical (OR = 0.9, 95% CI: 0.1–10.7, <i>I</i>² = 53%) and biochemical (OR = 0.8, 95% CI: 0.2–3.1, <i>I</i>² = 47%) success rates were comparable between MRA and non-MRA groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Concurrent use of MRA treatment did not adversely affect the diagnostic performance of AVS, rates of PA lateralization or postoperative outcomes. These results suggest that discontinuation of MRAs, despite being recommended by society guidelines, may not be necessary, and instead support a patient-centred approach to management of PA. Given the overall low quality of evidence, future prospective studies are needed to address this dilemma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 2","pages":"163-174"},"PeriodicalIF":2.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147644066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain Metastases in Differentiated Thyroid Carcinoma: Clinical Features, Treatment Outcomes, and the Role of Radioiodine Therapy","authors":"Yogita Khandelwal,&nbsp;Swayamjeet Satapathy,&nbsp;Chandrasekhar Bal","doi":"10.1111/cen.70142","DOIUrl":"10.1111/cen.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Brain metastases (BM) in differentiated thyroid carcinoma (DTC) are rare, with reported incidence of &lt; 1%. They are associated with significant morbidity and poor outcomes, and the role of radioiodine therapy (RAI) in their management remains uncertain. This study aimed to evaluate clinicopathological features, treatment modalities, and outcomes of patients with BM from DTC, with emphasis on RAI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective single-institutional study of 44 patients with histologically confirmed DTC and synchronous/metachronous BM. Clinicopathological, treatment, and survival data were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median age was 52.5 years at BM diagnosis. Papillary carcinoma accounted for 61.4% of cases. Extracranial metastases were present in 79.5%, most commonly in lungs and bones. At BM diagnosis, 61% had solitary and 39% had multiple lesions. Of the evaluated patients, 66% demonstrated RAI-avid BM and received a median of 4 RAI treatments (mean cumulative activity ~23.9 GBq). Three patients achieved complete remission, including two long-term survivors (&gt; 100 months). The disease control rate with RAI was 64%. The median overall survival (OS) in the entire cohort was 61 months (95% CI: 21–101) from DTC diagnosis and 15 months (95% CI: 6–24) from BM diagnosis with significantly improved outcomes in younger patients. While numerically longer median OS was observed for patients having solitary BM, RAI-avid BM, and multimodal treatment approaches, the results were statistically insignificant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BM from DTC are uncommon but confer poor prognosis. Durable responses were observed with RAI in a selected subset, but no statistically significant survival advantage could be demonstrated. Individualised multimodality management is essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 2","pages":"245-251"},"PeriodicalIF":2.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pubertal Dynamics of Sertoli and Leydig Cell Dysfunction in Klinefelter Syndrome.","authors":"Tredez Axelle, Christine Lefevre, Simon Boussion, Cindy Colson, Iva Gueorguieva, Francois Marcelli, Anne Laure Barbotin, Pascal Pigny, Hamza Benderradji, Clara Leroy","doi":"10.1111/cen.70159","DOIUrl":"https://doi.org/10.1111/cen.70159","url":null,"abstract":"<p><strong>Context: </strong>Klinefelter syndrome (KS), defined by a 47, XXY karyotype, is commonly associated with progressive testicular failure. The precise timing of Sertoli and Leydig cell dysfunction during puberty remains unclear.</p><p><strong>Objective: </strong>To determine the onset and progression of testicular insufficiency during puberty in KS, and to assess whether diagnostic timing (prenatal vs postnatal) impacts pubertal phenotype.</p><p><strong>Methods: </strong>We conducted a retrospective, single-centre study of 57 patients with KS aged 9-25 years, followed from the prepubertal period at Lille University Hospital. Longitudinal clinical and hormonal data were analysed according to pubertal stage rather than chronological age.</p><p><strong>Results: </strong>All patients entered puberty spontaneously at a physiological age (mean 12.6 years), but experienced a slow pubertal tempo (mean duration: 4.08 years). Sertoli cell dysfunction appeared within 12 months of pubertal onset, with rising FSH and declining AMH and inhibin B levels. Inhibin B concentrations never reached the reference range for Tanner stage 5 and declined below the adult threshold (92 pg/mL) 2 years after pubertal onset. Leydig cell dysfunction, defined by elevated LH and low-normal testosterone, emerged after 36 months. At puberty completion, 94% had Sertoli cell insufficiency (i.e. FSH level > 7.19 IU/L) and 80% had Leydig cell insufficiency (LH > 5.88 IU/L). Postnatally diagnosed patients exhibited significantly higher LH (p = 0.03) and lower inhibin B (p = 0.01) levels.</p><p><strong>Conclusion: </strong>Testicular insufficiency in KS begins approximately 18 months after pubertal onset, with Sertoli cell failure preceding Leydig cell decline. Early diagnosis and longitudinal monitoring are essential to guide endocrine management and to support individualized counselling regarding fertility preservation strategies, which should be considered according to pubertal stage rather than chronological age.</p>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Radiofrequency Ablation for the Treatment of Primary Hyperparathyroidism in Elderly Patients","authors":"Samet Alkan,&nbsp;Sedat Can Guney,&nbsp;Can Akcura,&nbsp;Busra Sunbul,&nbsp;Aylin Alsac,&nbsp;Serdar Tarhan,&nbsp;Nilufer Ozdemir,&nbsp;Zeliha Hekimsoy","doi":"10.1111/cen.70138","DOIUrl":"10.1111/cen.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) in elderly patients with primary hyperparathyroidism (PHPT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included patients aged ≥ 60 years with PHPT who underwent ultrasound-guided RFA at a single center between May 2021 and May 2025. A total of 36 patients were analyzed. Laboratory parameters, including serum calcium and intact parathyroid hormone (iPTH), were assessed before and after the procedure. All patients were followed for at least 6 months. Cure was defined as normalization of both serum calcium and iPTH levels during follow-up. Procedural outcomes, complications, and factors associated with treatment response were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the cohort was 70.4 (±8.69) years. After a single RFA session, 28 of 36 patients achieved a cure. When repeat procedures were included, the overall cure rate increased to 83.3% (30/36). The key procedure-related adverse events were postoperative mild pain and hoarseness. Hoarseness was transient in most cases; permanent hoarseness occurred in one patient. No major life-threatening complications were observed. Baseline characteristics did not differ significantly between cured and non-cured patients. Patients who developed hoarseness were older and had lower baseline magnesium levels than those without hoarseness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ultrasound-guided RFA appears to be an effective and safe minimally invasive treatment option for selected elderly patients with PHPT, achieving acceptable cure rates with a favorable safety profile. RFA may represent a valuable alternative for elderly or frail patients who are at increased surgical risk. Prospective studies with larger cohorts and longer follow-up are warranted to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"34-41"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Health-Related Quality of Life and Mental Health After Unilateral Adrenalectomy for Primary Aldosteronism","authors":"Sybille Fuld,&nbsp;Christian Adolf,&nbsp;Georgiana Constantinescu,&nbsp;Manuel Schulze,&nbsp;Denise Brüdgam,&nbsp;Carmina T. Fuss,&nbsp;Hanna Remde,&nbsp;Lydia Kürzinger,&nbsp;Sven Gruber,&nbsp;Jun Yang,&nbsp;Amy Kang,&nbsp;Martin Reincke,&nbsp;Felix Beuschlein,&nbsp;Graeme Eisenhofer,&nbsp;Jacques W. M. Lenders,&nbsp;Christina Pamporaki","doi":"10.1111/cen.70106","DOIUrl":"10.1111/cen.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary aldosteronism (PA) has been linked with reduced health-related quality of life (QoL) and increased prevalence of anxiety and depression. While most studies compared patients with PA to healthy subjects, this study focused on comparison with hypertensive patients without PA to identify PA-specific effects. Furthermore, the impact of targeted therapy on QoL and mental health was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mental and physical health-related QoL, anxiety and presence of depressive and panic symptoms were assessed using the SF-12, GAD-7 and PHQ questionnaires in 925 patients with arterial hypertension tested for PA in a prospective, multi-center international prospective cohort study. Questionnaires were assessed at baseline as well as 3−6 months after initiation of targeted therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Amongst 833 of 925 patients who completed the necessary diagnostic procedures, 211 were diagnosed with PA. 98 of 116 patients with unilateral PA received unilateral adrenalectomy. At baseline, QoL, anxiety and mental health scores did not differ in patients with PA vs patients with hypertension without PA. At outcome assessment, SF-12 mental and physical component summaries as well as GAD-7 specifically improved in patients with unilateral PA after adrenalectomy (mean Δ = 4.2, <i>p</i> = 0.018, Δ = 3.6, <i>p</i> = 0.038 and Δ = −1.9, <i>p</i> = 0.006, respectively) in contrast to no improvement in patients with PA on MRA treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was no difference in health-related QoL, anxiety and mental health in patients with hypertension with versus without PA. Unilateral adrenalectomy but not medical therapy improved health-related QoL and decreased anxiety in patients with PA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"24-33"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147375852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hashimoto's Thyroiditis Beyond Thyroid Hormones: A Systematic Review of Autoimmunity, Inflammation, and Multidimensional Burden","authors":"Gaspare Alfì,&nbsp;Valerio Caruso,&nbsp;Giovanna Grenno,&nbsp;Angelo Gemignani,&nbsp;Alessandro Antonelli,&nbsp;Poupak Fallahi,&nbsp;Silvia Martina Ferrari","doi":"10.1111/cen.70114","DOIUrl":"10.1111/cen.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hashimoto's thyroiditis (HT) is the most common autoimmune thyroid disease. Although levothyroxine therapy effectively normalizes thyroid-stimulating hormone (TSH) in most patients, persistent symptoms are frequently reported, suggesting that autoimmunity and inflammation contribute to reduced quality of life (QoL) independently of thyroid hormone levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>According to PRISMA guidelines, we systematically searched for MEDLINE, Scopus, and Web of Science studies that assessed the association of thyroid autoimmunity, inflammatory markers, and QoL in adults with HT. Included designs were observational, interventional, and longitudinal studies that published qualified QoL outcomes and immune/inflammatory markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across diverse study designs, HT patients—typically euthyroid or receiving long-term levothyroxine therapy—consistently reported lower QoL compared with controls, particularly in cognitive, affective, and vitality domains. Elevated anti-thyroid antibodies (anti-TPO, anti-Tg) were negatively correlated with QoL, whereas TSH and thyroid hormone levels showed no consistent association. Interventional studies demonstrated that total thyroidectomy or therapies associated with reduced antibody titers were accompanied by improvements in fatigue and QoL. However, an important caveat must be emphasized. Some studies did not confirm a direct association between antibody levels and symptom severity, likely reflecting methodological variability and heterogeneity in QoL assessment tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is evidence that HT exerts a multidimensional impact beyond endocrine dysfunction, with chronic autoimmunity and low-grade inflammation contributing to impaired QoL. These findings should be taken into account and perhaps challenge a purely TSH-centric model and call for a broader, patient-centered approach that integrates immunological, psychological, and subjective outcomes. Properly designed longitudinal and interventional trials are required to establish causal pathways and support the personalization of therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":"105 1","pages":"3-13"},"PeriodicalIF":2.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}