Endokrynologia Polska最新文献

{"title":"Is [68Ga]Ga-DOTA-TATE PET/CT useful in the diagnosis of patients suspected of ectopic Cushing's syndrome?","authors":"Alain Iskandar, Anna Zemczak, Kacper Pełka, Jolanta Kunikowska","doi":"10.5603/ep.100560","DOIUrl":"https://doi.org/10.5603/ep.100560","url":null,"abstract":"<p><strong>Introduction: </strong>Ectopic Cushing's syndrome (ECS) presents significant diagnostic and management challenges due to its varied clinical presentation and diagnostic uncertainties associated with conventional imaging methods. The aim of this study was to evaluate the effectiveness of [⁶⁸Ga]Ga-DOTA-TATE positron emission tomography/computed tomography (PET/CT) in diagnosing patients suspected of ECS with negative results from conventional imaging techniques.</p><p><strong>Material and methods: </strong>In this retrospective single-institution study, data from January 2010 to August 2023 were analysed. Patients who underwent [⁶⁸Ga]Ga-DOTA-TATE PET/CT (Siemens Biograph 64) scans due to clinical and biochemical indicators of Cushing's syndrome were included, with prior conventional imaging yielding no abnormalities. The PET/CT scans were analysed qualitatively and quantitatively for any pathological foci. The study was conducted in accordance with ethical standards and approved by the Medical University of Warsaw's ethics committee.</p><p><strong>Results: </strong>Of the 56 [68Ga]Ga-DOTA-TATE PET/CT scans performed on 44 patients, pathological accumulations were identified in 6 scans (11%) and 4 (9%) patients. Pathological findings were exclusively located within the thoracic cavity; lung lesions were identified in 3 patients, and 3 independent lesions within the anterior mediastinum and breast were observed in a single patient across 3 distinct scans. Histopathological analysis confirmed neuroendocrine tumours in all patients.</p><p><strong>Conclusions: </strong>[⁶⁸Ga]Ga-DOTA-TATE PET/CT demonstrated limited potential for diagnostic value in patients suspected of ECS with negative outcomes according to conventional imaging. The percentage of patients who achieved positive results (10%) was not high, although other negative tests represented a significant percentage of the patients. This study highlights the need for further research and the development of novel radiotracers to improve ECS diagnosis.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 6","pages":"649-654"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and long-term follow-up after radioligand therapy in aggressive non-functioning pituitary neuroendocrine tumour.","authors":"Dorota Brodowska-Kania, Marek Saracyn, Natalia Osial, Adam Daniel Durma, Maciej Kołodziej, Grzegorz Kamiński","doi":"10.5603/ep.101015","DOIUrl":"https://doi.org/10.5603/ep.101015","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 6","pages":"693-694"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible changes in glucose metabolism induced by radioligand therapy in patients with neuroendocrine neoplasms.","authors":"Marek Saracyn, Adam Daniel Durma, Barbara Bober, Arkadiusz Lubas, Anna Drozd, Gabriela Różańska-Grzelak, Katarzyna Janiak, Dorota Brodowska-Kania, Grzegorz Kamiński","doi":"10.5603/ep.101234","DOIUrl":"https://doi.org/10.5603/ep.101234","url":null,"abstract":"<p><strong>Introductiom: </strong>Neuroendocrine neoplasms (NENs) belong to a heterogeneous group of tumours originating from neuroendocrine cells. Primary tumours most commonly occur in the gastrointestinal tract, although they can arise in any part of the human body. Radioligand therapy (RLT) is recommended for progressive or inoperable cases in subsequent lines of the therapy. Our study aimed to investigate glucose metabolism alterations during and after radioligand therapy in patients with neuroendocrine neoplasms undergoing radioligand therapy.</p><p><strong>Material and methods: </strong>The study was performed on 41 patients with inoperable neuroendocrine tumours, who underwent one cycle (4 courses) of radioligand therapy with [¹⁷⁷Lu]Lu-DOTA-TATE alone or tandem therapy with [¹⁷⁷Lu]Lu-DOTA-TATE and [⁹⁰Y]Y-DOTA-TATE with a standardised nephroprotection protocol. Laboratory parameters were analysed during the first and fourth courses and one year after the last course of treatment.</p><p><strong>Results: </strong>The study showed a statistically insignificant increase in fasting glucose concentration during and after radioligand therapy, accompanied by a parallel increase in insulin concentration. In patients treated with tandem therapy, the increase in fasting glucose was higher, but the results were still statistically insignificant. No glycaemic severe adverse events [Common Terminology Criteria for Adverse Events (CTCAE) G3-G5] were observed.</p><p><strong>Conclusions: </strong>Radioligand therapy potentially increases fasting glucose concentrations, probably due to changes in peripheral glucose metabolism. However, it remains a safe treatment method for patients with neuroendocrine neoplasms and does not cause severe glycaemic adverse events related to glucose metabolism.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 6","pages":"665-671"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The position of monoclonal antibodies and small molecules in the treatment of thyroid orbitopathy.","authors":"Mariusz Nowak, Wojciech Nowak, Bogdan Marek, Beata Kos-Kudła, Lucyna Siemińska, Magdalena Londzin-Olesik, Dariusz Kajdaniuk","doi":"10.5603/ep.98913","DOIUrl":"https://doi.org/10.5603/ep.98913","url":null,"abstract":"<p><p>Since the European Thyroid Association guidelines for the management of thyroid orbitopathy (TO) were published in 2016, a number of randomised clinical trials (RCTs) investigating the use of biologic drugs for the treatment of moderate to severe and active TO have been published. Therefore, new recommendations for its treatment were developed and published in 2021. Treatment of active TO includes 2 types of immunosuppressive agents: non-specific and specific. Specific immunosuppressive agents used to treat TO include adalimumab (ADA), infliximab (IFX), etanercept (ETA), rituximab (RTX), tocilizumab (TCZ), teprotumumab (TEP), and batoclimab (BAT). In the manuscript, we present a review of the literature on RCTs, retrospective studies, and case reports on their use in the treatment of TO. The authors emphasise the beneficial effects of TEP, indicating, however, the lack of data on its long-term efficacy and safety and the lack of head-to-head comparison with i.v. glucocorticosteroids and its huge limitation is also the high price of the drug. TCZ is a therapeutic option for glucocorticosteroid-resistant TO and should be considered for second-line treatment (due to the cost of treatment, among other reasons) or first-line treatment in patients with contraindications to i.v. glucocorticosteroids. Given its side-effect profile, especially some risk of optic nerve neuropathy (DON), RTX is considered by the authors as a second- or even third-line treatment option. The current 2021 European Group on Graves' Orbitopathy (EUGOGO) recommendations include RTX, TCZ, and TEP among the second-line drugs for the treatment of moderate to severe and active TO. BAT is under clinical trials. Given the numerous advantages of biologic drugs over glucocorticosteroids, further RCTs are indicated to confirm their possible place also as first-line treatment in TO.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 6","pages":"604-616"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenging differential diagnosis of recurrent flushing episodes: systemic mastocytosis mimicking carcinoid syndrome.","authors":"Dorota Brodowska-Kania, Marek Saracyn, Adrianna Mróz, Natalia Osial, Beata Dmochowska, Wawrzyniec Żmudzki, Daniel Lisicki, Grzegorz Kamiński","doi":"10.5603/ep.99940","DOIUrl":"10.5603/ep.99940","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 4","pages":"452-453"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standard therapy or additionally radioactive iodine (131I) therapy; which will stop the recurrence of glioblastoma multiforme (GBM)?","authors":"Agata Czarnywojtek, Paweł Gut, Kamil Dyrka, Jerzy Sowiński, Nadia Sawicka-Gutaj, Katarzyna Katulska, Piotr Stajgis, Mateusz Wykrętowicz, Jakub Moskal, Jeremi Kościński, Krzysztof Pietrończyk, Patryk Graczyk, Maciej Robert Krawczyński, Ewa Florek, Ewelina Szczepanek-Parulska, Marek Ruchała, Alfio Ferlito","doi":"10.5603/ep.98240","DOIUrl":"10.5603/ep.98240","url":null,"abstract":"<p><p>Glioblastoma multiforme (GBM) is the most aggressive malignant brain tumour. The average survival time for a patient diagnosed with GBM, using standard treatment methods, is several months. Authors of the article pose a direct question: Is it possible to treat GBM solely with radioactive iodine (¹³¹I) therapy without employing the sodium iodide symporter (NIS) gene? After all, NIS has been detected not only in the thyroid but also in various tumours. The main author of this article (A.C.), with the assistance of her colleagues (physicians and pharmacologists), underwent ¹³¹I therapy after prior iodine inhibition, resulting in approximately 30% reduction in tumour size as revealed by magnetic resonance imaging (MRI). Classical therapy for GBM encompasses neurosurgery, conventional radiotherapy, and chemotherapy (e.g. temozolomide). Currently, tyrosine kinase inhibitors (imatinib, sunitinib, and sorafenib) are being used. Additionally, novel drugs such as crizotinib, entrectinib, or larotrectinib are being applied. Recently, personalised multimodal immunotherapy (IMI) based on anti-tumour vaccines derived from oncolytic viruses has been developed, concomitant with the advancement of cellular and molecular immunology. Thus, ¹³¹I therapy has been successfully employed for the first time in the case of GBM recurrence.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 2","pages":"130-139"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A challenging case of ectopic ACTH-dependent Cushing's syndrome due to medullary thyroid carcinoma.","authors":"Maria Komisarz-Calik, Paulina Sarba, Małgorzata Trofimiuk-Müldner, Grzegorz Sokołowski, Joanna Szpor, Alicja Hubalewska-Dydejczyk","doi":"10.5603/ep.96863","DOIUrl":"10.5603/ep.96863","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 1","pages":"115-116"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between integrin β4 overexpression and lymphovascular invasion in papillary thyroid cancer.","authors":"Busra Tunc Topuz, Sibel Guldiken, Ebru Tastekin, Canberk Topuz, Mehmet Celik, Buket Yılmaz Bulbul, Burak Andac, Ali Cem Yekdes","doi":"10.5603/ep.99050","DOIUrl":"10.5603/ep.99050","url":null,"abstract":"<p><strong>Introduction: </strong>Lymphovascular invasion is an independent prognostic marker in papillary thyroid carcinomas. In addition, integrin β4 is associated with advanced progression and metastasis in many malignancies. We aimed to investigate the relationship between integrin β4 and lymphovascular invasion in papillary thyroid carcinoma.</p><p><strong>Material and methods: </strong>73 patients with papillary thyroid cancer (48 patients with lymphovascular invasion and 25 patients without) were included in our study. The immunohistochemical staining score for integrin b4 was evaluated according to the percentage and intensity of staining. The staining intensity was scored as 0 (no staining), 1 (weak staining - light yellow), 2 (medium staining - yellow-brown), and 3 (strong staining - brown). The staining was scored by multiplying the percentage and intensity of staining.</p><p><strong>Results: </strong>The mean percentage of integrin b4 staining was 63.54 ± 22.26% in the group with lymphovascular invasion and 10.2 ± 22.48% in the group without lymphovascular invasion (p < 0.001). When evaluated in terms of staining score, it was found to be 107.08 ± 45.29 in the group with lymphovascular invasion and 16.2 ± 40.03 in the group without lymphovascular invasion (p < 0.001). There was a linear relationship between the percentage of integrin β4 and the staining scores (r² = 0.881; p < 0.001). In the by receiver-operating characteristic (ROC) curve analysis for the cut-off value of the percentage of integrin b4 staining, the area under the curve was found to be 0.916. The cut-off value for the percentage of integrin b4 was found to be 35 (sensitivity 91.7% and specificity 88%) (odds 80.66%).</p><p><strong>Conclusions: </strong>A significant relationship was found between integrin b4 expression and lymphovascular invasion in papillary thyroid carcinomas. Integrin b4 expression level can be used as a marker to predict the presence of lymphovascular invasion in papillary thyroid carcinomas, especially in large tumours where it may not be possible to sample the entire tumour.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"310-316"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute pancreatitis associated with primary hyperparathyroidism during pregnancy.","authors":"Mateusz Klimek, Martyna Fecko, Tomasz Zieliński, Henryk Koziołek, Jacek Gawrychowski, Mirosława Mackiewicz, Krzysztof Nowosielski","doi":"10.5603/ep.99376","DOIUrl":"10.5603/ep.99376","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"334-335"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Training under normoxia and normobaric hypoxia in patients with type 1 diabetes","authors":"Paula Nowocień, Dominika Rokicka, Marta Wróbel, Artur Gołaś, Sonia Rokicka, Dorota Stołtny, Dariusz Kajdaniuk, Bogdan Marek, Krzysztof Strojek","doi":"10.5603/ep.99346","DOIUrl":"10.5603/ep.99346","url":null,"abstract":"<p><p>Apart from insulin, physical exercise is a crucial component of therapy in patients with type 1 diabetes mellitus (T1DM). The benefits of physical activity in such patients include improved insulin sensitivity, lowered blood glucose, reduced body fat and improved cardiovascular function and physical performance. Hypoglycemia is a crucial issue in the peri-training period in insulin-treated patients. Proper preparation for exercise is the key to reducing the risk of hypoglycemia. The selection of the training type and the patient's knowledge of the effect of such training on glycemia are also significant. Physical exercise under normobaric hypoxia in the training rooms is also available commercially and is becoming increasingly popular. Under such conditions, the air consists of 15.4% oxygen and 84.5% nitrogen, which corresponds to the conditions at an altitude of approximately 2,500 meters above sea level. Hypoxia induces the production of the hypoxia-inducible factor (HIF-1), which regulates the expression of over 100 genes. It modulates key metabolic pathways to optimize glucose utilization by increasing cell sensitivity to insulin, more efficient glucose uptake from the blood and activating effect on glycolytic enzymes. Additionally, HIF-1 shows beneficial effects on the lipid profile, vascular endothelium and performance as measured by the maximal oxygen uptake (VO2max). The aim of this paper was to review and summarize the most recent studies on the effects of exercise on glycemic control and physical performance under normoxia and normobaric hypoxia in patients with T1DM.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"75 4","pages":"403-411"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}