1,721,113 research outputs found
Response to the Letter to the Editor: "Comparison Between Total Thyroidectomy and Medical Therapy for Amiodarone-Induced Thyrotoxicosis".
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Short review: novel concepts in the approach to patients with amiodarone-induced thyrotoxicosis
No full textIntroductionAmiodarone-induced thyrotoxicosis is associated with high morbidity and mortality rates. The approach to this condition is widely variable across different medical specialists and even among expert endocrinologists. As a matter of fact, the approach to amiodarone-induced thyrotoxicosis has always been considered difficult, due to diagnostic uncertainties easily resulting in missteps, and therapeutic challenges easily resulting in unresponsiveness or slow-responsiveness to the administered drugs.PurposeOur purpose is to review novelties emerged during the last years about this condition, with the aim to provide novel insights on the diagnostic and therapeutic management of this challenging condition
Graves' hyperthyroidism and ophthalmopathy associated with pemphigus vulgaris: onset of thyroid autoimmune disease during chronic low-dose glucocorticoid therapy.
No full textA 38-year-old caucasian woman developed typical Graves' hyperthyroidism and ophthalmopathy while being chronically treated for pemphigus vulgaris with low doses of glucocorticoids capable of effectively controlling skin disease. HLA typing showed positivity for DR3 and DR4, suggesting a genetic susceptibility for both Graves' disease and pemphigus vulgaris. The apparent contradiction whereby thyroid autoimmune disease flared up during therapy with glucocorticoids, known for their immunosuppressive effects, may be related to the dose of steroids. It is possible that high doses of glucocorticoids, commonly employed in the treatment of severe Graves' ophthalmopathy, might indeed suppress the disease, whereas the low doses used in this patient might precipitate or aggravate it
Real-life data of Pasireotide LAR in acromegaly: a long-term follow-up
Full text linkObjective Pasireotide LAR (PAS-LAR) was released in Italy in 2017 to treat acromegaly patients resistant to SRLs (Somatostatin Receptors Ligands). The long-term follow-up data of PAS-LAR therapy in Italy are limited. This study aimed to evaluate the efficacy and safety of PAS-LAR in acromegaly.Design Patients with acromegaly in PAS-LAR treatment were enrolled in three tertiary Italian endocrinological centers and evaluated by a retrospective observational real-life multicentre study.Methods Patients have been studied before (baseline) and 1, 6, 12, 24 and > 36 months after PAS-LAR start. Clinical, biochemical, and pituitary magnetic resonance data were collected, along with information on adverse events. Acromegaly disease activity was classified according to the IGF-1 index (normal value < 1.0).Results Fifty patients (female 23) were enrolled. PAS-LAR treatment (mean follow-up 24 +/- 16 months) significantly decreased IGF-1 levels (IGF-1 index baseline vs last visit: 1.9 +/- 0.6 vs 1.2 +/- 0.6, p < 0.0001). At the last visit, 67% of patients had controlled disease, and 44% showed a decrease in tumor volume. Clinical and biochemical efficacy was observed as early as after 1-month of PAS-LAR treatment (IGF-1 index baseline vs 1-month: 1.9 +/- 0.6 vs 1.4 +/- 0.7, p < 0.0001). Also, 50% of patients referred headache improvement or disappearance. Fifteen patients discontinued PAS-LAR due to failure of treatment and poor glycaemic control. The prevalence of diabetes increased from 33% at the baseline to 54% at the last visit (p = 0.0072).Conclusion In real-life settings, PAS-LAR significantly decreases symptoms, IGF-1 levels, and the size of adenoma in patients with acromegaly resistant to SRLs. Beneficial effects may occur early after the first injection
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