Journal of endocrinological investigation
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J. Endocrinol. Invest. · Jun 2006
Case ReportsCarcinoid crisis induced by receptor radionuclide therapy with 90Y-DOTATOC in a case of liver metastases from bronchial neuroendocrine tumor (atypical carcinoid).
SS receptors are overexpressed in many tumors, mainly of neuroendocrine origin, thus enabling the treatment with SS analogs. The clinical experience of receptor radionuclide therapy with the new analog [90Y-DOTA0-Tyr3 ]-octreotide [90Y-DOTATOC] has been developed over the last decade and is gaining a pivotal role in the therapeutic workout of these tumors. It is well known that some procedures performed in diagnostic and therapeutic management of endocrine tumors, such as agobiopsy and hepatic chemoembolization, can be associated with the occurrence of symptoms related to the release of vasoactive amines and/or hormonal peptides from tumor cell lysis. ⋯ These symptoms increased and required new hospitalisation. The patient received iv infusion of octreotide associated with H1 and H2 receptor antagonists and corticosteroid therapy, which induced symptom remission within few days. The case here reported confirms that radionuclide therapy is highly effective in determining early rupture of metastatic tissue and also suggests that pre-medication should be implemented before the radiopeptide administration associated with a close monitoring of the patient in the following days.
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Thyrotoxicosis occurs more frequently during the post-partum period than at other times in women of childbearing age. Graves' disease and post-partum thyroiditis are two major causes of thyrotoxicosis in this period. The major task lies in differentiation of these two diseases in the post-partum period; since throtoxicosis caused by post-partum thyroiditis usually does not require treatment. ⋯ Post-partum thyrotoxicosis due to Graves' disease may be treated with radioiodine but it requires radiation safety measurements for infant and is contraindicated if the mother is breast-feeding. Antithyroid drugs are the mainstay of the treatment of post-partum thyrotoxicosis. Recent investigations conclude that neither propylthiouracil nor methimazole cause any alterations in thyroid function and physical and mental development of infants breast-fed by lactating thyrotoxic mothers, and both can be safely administered in moderately high doses during lactation.
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J. Endocrinol. Invest. · Dec 2005
Case ReportsAcute and persistent iatrogenic Cushing's syndrome after a single dose of triamcinolone acetonide.
Iatrogenic Cushing's syndrome is a well-known adverse effect of glucocorticoids. It usually develops after prolonged exposure to excessive amounts of synthetic glucocorticolds. The development of iatrogenic Cushing's syndrome (ICS) after a single and low dose of synthetic glucocorticoid is an exceptional event. ⋯ Endocrinological evaluation confirmed the hypothalamic-pituitary-adrenal (HPA) axis suppression. Eight months later, cushingoid phenotype had completely disappeared and HPA function had spontaneously recovered. We review clinical features and comment on the possible pathogenic mechanisms of this particular and new form of ICS.
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J. Endocrinol. Invest. · Jun 2005
Attention to the hiding iodine deficiency in pregnant and lactating women after universal salt iodization: A multi-community study in China.
Monitoring of iodine nutrition depends chiefly on the urinary iodine concentration in representative samples from the population. International groups have recommended school-age children as a convenient group for surveys, because of their accessibility and young age, but the relevance of this group to others, especially pregnant women, is not well established. ⋯ An effective iodized salt program has brought iodine sufficiency to most of China, but pregnant women in some areas may still risk deficiency and need further supplements. We suggest other countries and international agencies pay more attention to pregnancy, where iodine deficiency has its worst consequences.
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J. Endocrinol. Invest. · Jan 2005
ReviewPre-clinical and clinical experiences with novel somatostatin ligands: advantages, disadvantages and new prospects.
Since the cloning and characterization of the five human somatostatin receptor (SSTR) subtypes, our understanding of the expression and functional role of the five SSTR subtypes in human (neuro-)endocrine tumors has increased significantly. The majority of human (neuro-)endocrine tumors express multiple SSTR. GH-secreting pituitary adenomas preferentially express SSTR2 and SSTR5, prolactinomas SSTR1 and SSTR5, and corticotroph adenomas express SSTR2 (low number) and predominantly SSTR5s. ⋯ However, every advantage has its disadvantage. Targeting multiple SSTR potentially induces more adverse effects as well. Especially, glucose homeostasis might induce new problems in the long-term use of universal ligands.