  Clinical Characteristics and Therapeutic Responses in Patients with Germ-Line AIP Mutations and Pituitary Adenomas - An International Collaborative StudyDaly, Adrian  ; ; Petrossians, Patrick et alin Journal of Clinical Endocrinology and Metabolism (2010), 95(11), Context: AIP mutations (AIPmut) give rise to a pituitary adenoma predisposition that occurs in familial isolated pituitary adenomas and less often in sporadic cases. The clinical and therapeutic features ... [more ▼] Context: AIP mutations (AIPmut) give rise to a pituitary adenoma predisposition that occurs in familial isolated pituitary adenomas and less often in sporadic cases. The clinical and therapeutic features of AIPmut-associated pituitary adenomas have not been studied comprehensively. Objective: The objective of the study was to assess clinical/therapeutic characteristics of AIPmut pituitary adenomas. Design: This study was an international, multicenter, retrospective case collection/database analysis. Setting: The study was conducted at 36 tertiary referral endocrine and clinical genetics departments. Patients: Patients included 96 patients with germline AIPmut and pituitary adenomas and 232 matched AIPmut-negative acromegaly controls. Results: The AIPmut population was predominantly young and male (63.5%); first symptoms occurred as children/adolescents in 50%. At diagnosis, most tumors were macroadenomas (93.3%); extension and invasion was common. Somatotropinomas comprised 78.1% of the cohort; there were also prolactinomas (n = 13), nonsecreting adenomas (n = 7), and a TSH-secreting adenoma. AIPmut somatotropinomas were larger (P = 0.00026), with higher GH levels (P = 0.00068), more frequent extension (P = 0.018) and prolactin cosecretion (P = 0.00023), and occurred 2 decades before controls (P < 0.000001). Gigantism was more common in the AIPmut group (P < 0.000001). AIPmut somatotropinoma patients underwent more surgical interventions (P = 0.00069) and had lower decreases in GH (P = 0.00037) and IGF-I (P = 0.028) and less tumor shrinkage with somatostatin analogs (P < 0.00001) vs. controls. AIPmut prolactinomas occurred generally in young males and frequently required surgery or radiotherapy. Conclusions: AIPmut pituitary adenomas have clinical features that may negatively impact treatment efficacy. Predisposition for aggressive disease in young patients, often in a familial setting, suggests that earlier diagnosis of AIPmut pituitary adenomas may have clinical utility. [less ▲] Detailed reference viewed: 66 (33 ULg)An International, Collaborative Study of the Disease Characteristics and Response to Therapy in 60 Pituitary Adenoma Patients with Aryl Hydrocarbon Receptor Interacting Protein (AIP) Gene MutationsDaly, Adrian ; ; et alin ENDO 2008: 90th Annual Meeting of the Endocrine Society - Abstract book (2008) Detailed reference viewed: 10 (2 ULg) Endocrinology of pregnancy and early pregnancy detection by reproductive hormones in reindeer (Rangifer tarandus tarandus); ; et al in Theriogenology (2005), 63(6), 1775-1788 The endocrinology was studied throughout pregnancy in reindeer (Rangifer tarandus tarandus) located in Oulu, Finland (65 degrees N, 25 degrees E) with 13 captive, semi domestic adult females. Blood ... [more ▼] The endocrinology was studied throughout pregnancy in reindeer (Rangifer tarandus tarandus) located in Oulu, Finland (65 degrees N, 25 degrees E) with 13 captive, semi domestic adult females. Blood samples were analyzed for plasma progesterone (P4), estradiol (E,) and estrone sulphate (E1SO4), 15-ketodihydro-PGF(2 alpha) (PG-metabolite) and pregnancy associated glycoproteins (PAG). The mean plasma P4 concentration peaked twice during gestation: at around 24 and three weeks prior to calving. In pregnant females the plasma PAG concentration increased over basal concentrations 21-30 days after the estimated day of conception and peaked at the time of calving. The concentrations of E, and E1SO4 remained low until 60 days before calving when a rapid increase was found for both hormones. The mean plasma concentration of PG-metabolite increased throughout pregnancy to a maximum at parturition. The estimated mean (range) gestation length was 216 (212-220) days. Judged from measures on reproductive organs collected from 86 free-ranging, semi-domestic female reindeer of unknown age presented for slaughter at Roros, Norway (63 degrees N, 11 degrees E) in the second week of December 1999, it was concluded that the breeding season lasted from early September until the end of November. The results also showed that plasma PAG concentration could provide a tool for detection of pregnancy in reindeer [less ▲] Detailed reference viewed: 31 (2 ULg)Ultrasonography in early pregnancy diagnosis and measurements of fetal size in reindeer (Rangifer tarandus tarandus); ; et al in Theriogenology (2004), 61(4), 785-795 Transrectal or transabdominal examinations of 13 pluriparous reindeer (Rangifer tarandus tarandus) by ultrasonography from the start of mating until week 20 of gestation were conducted to find out when ... [more ▼] Transrectal or transabdominal examinations of 13 pluriparous reindeer (Rangifer tarandus tarandus) by ultrasonography from the start of mating until week 20 of gestation were conducted to find out when pregnancy could first be detected and to describe fetal development in early pregnancy. The examinations (n = 35 per animal) were performed with a 5 MHz linear transducer from 7th October until 1st January and with a 3 MHz sector transducer from that time until 24th February. Time of pregnancy diagnosis by ultrasonography, the first fetal heartbeat and measurements of crown-rump length, chest width and chest depth were recorded during the examinations. Pregnancy was diagnosed by transrectal ultrasonography between the weeks 3 and 7 of gestation. The accuracy of the pregnancy diagnosis, defined as the proportion of females correctly detected to be pregnant, was 15% at week 3, 46% at week 4, 77% at week 5, and 92% at week 6 of gestation. Fetal heartbeat was first detected between the weeks 5 and 8 of gestation. The first measurements of crown-rump length were made on week 3 of gestation, of chest width on week 4 and of chest depth on week 5 of gestation. Chest width and depth were detectable until the end of the study at week 20 of gestation. Transrectal ultrasonography is an efficient tool in early pregnancy diagnosis of reindeer. The fetal growth curves obtained by ultrasonography resembled those obtained in previous morphological studies. [less ▲] Detailed reference viewed: 20 (0 ULg) |
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