ACTA ENDOCRINOLOGICA (BUC)

Pituitary apoplexy (PA) is a life-threatening clinical syndrome. Dopamine receptor agonists are the drugs of choice in the treatment of prolactinomas. The use of cabergoline is reported to cause an increased risk of PA, particularly in macroprolactinomas of cystic nature. In this report, we present a patient with a cystic macroprolactinoma who developed PA on the 16th week of cabergoline treatment.

Idiopathic infantile hypercalcemia (IIH) is a rare, parathyroid hormone (PTH)–independent disorder of calcium metabolism. It is most often caused by mutations in the CYP24A1 gene that impair vitamin D catabolism. We report a 70-year-old male with persistent hypercalcemia (Ca 13.2 mg/dL) and low-normal PTH levels. Extensive evaluation excluded malignancy, granulomatous disease, and vitamin D intoxication. Genetic analysis revealed a homozygous CYP24A1 variant (c.233G>T; p.Gly78Val), consistent with CYP24A1 deficiency. Bisphosphonate therapy with zoledronic acid rapidly and sustainably normalized calcium levels for 10 months. The patient’s daughter was a heterozygous carrier. This confirmed autosomal-recessive inheritance. This case illustrates an atypical late-onset presentation of CYP24A1 deficiency. It emphasizes the importance of considering this diagnosis in adults with PTH-independent hypercalcemia, especially when seasonal variation and family history are present. Recognition of CYP24A1 deficiency at all ages highlights the need for genotype-based terminology rather than the misleading label "infantile" hypercalcemia.

Background. Although cardiovascular risk is increased in patients with subclinical hypothyroidism (SCH), replacement therapy is not recommended in those with TSH levels\r\nbetween 5 and 10 mU/L.\r\nObjective. We aimed to evaluate the effects of levothyroxine (LT4) treatment on cardiovascular risk factors and carotid artery intima media thickness (CIMT) in patients with SCH who had TSH levels between 5 and 10 mU/L.\r\nSubjects and Methods. Sixty SCH patients with TSH levels between 5 and 10 mU/L were included in the study. Patients\r\nwere randomized into two groups as treatment (n=30) and control (n=30) groups. BMI, blood pressure, lipid profile, fibrinogen, homocysteine, hs-CRP and CIMT were measured in all patients at baseline and after six months. LT4 treatment was initiated and the dose was tapered according to TSH levels in treatment.\r\nResults. There was no significant difference between baseline and six month measurements in the control group. However, TSH, LDL-C, fibrinogen and mean CIMT measurements were decreased and HDL-C level was increased in the treatment group.\r\nConclusions. We suggest that LT4 therapy is necessary for the prevention of modifiable cardiovascular risk factors in\r\npatients with TSH levels between 5 and 10 mU/L.

Thyroid carcinomas associated with Graves? ophthalmopathy had been described in the literature, before. The rate of this coincidence is 1.1% - 7.1%. Papillary carcinoma is more common than thyroid cancer in Graves? disease. Herein, we present a 37-year-old male Graves? disease patient with thyroid papillary carcinoma.

A 40-year-old woman has been followed up for 19 years by the\r\nendocrinology clinic with the diagnoses of Addison disease and primary hypothyroidism. During the most recent\r\nvisit of the patient, she complained about fatigue and malaise with pretibial edema. In albumin analysis: 2.2 gr/dL and 5.8 g/day proteinuria were detected. In terms of\r\nnephrotic syndrome etiology, renal biopsy was performed and it was considered as minimal change disease. The dose of 7.5\r\nmg/day methyl prednisolone was potentiated to a dose of 1mg/kg/day. During her control, the proteinuria did not regress and 150 mg/day cyclophosphamide was added to the treatment. During the control, her proteinuria regressed from 5.8 r/day to 1.95 mg/day.