Publications by authors named "Stefan M Constantinescu"
Article Synopsis
- Pituitary adenomas (PA), or Pit-NETS, are rare in children and especially unusual in those under 10, with the majority of research conducted on adult cases.
- This review addresses the unique clinical considerations, diagnosis, and treatment of PA in young patients, highlighting the importance of involving specialized teams that include both pediatric and adult medical experts.
- Pediatric PAs tend to be larger, more aggressive, and often lead to hormonal imbalances that can affect growth and puberty, with the most common type being prolactinomas; genetic testing is recommended for young patients due to potential hereditary mutations linked to these tumors.
Purpose: In men with prolactinoma treated with dopamine agonists (DA), the extent, timeline, and predictive factors of gonadotropic axis recovery are still unclear.
Methods: We analyzed data of 97 men with a prolactinoma treated with DA (77/97 macroprolactinomas). We excluded patients with primary hypogonadism, surgery < 12 months after DA initiation, and patients with tumors < 5 mm or prolactin < 45 µg/l at diagnosis.
Background: Current guidelines recommend different postpartum approaches for patients started on levothyroxine (LT4) during pregnancy.
Objective: We studied the postpartum management of these patients and determined factors associated with long-term hypothyroidism.
Methods: A retrospective study was conducted at a tertiary center between 2014 and 2020, with LT4 initiation according to 2014 ETA recommendations.
Magnetic resonance imaging (MRI) is the examination of choice for diagnosing and monitoring pituitary adenoma (also known as pituitary neuroendocrine tumor or PitNET), whether treated or not. However, repeating the examination too often (and sometimes unnecessarily) is costly, and worrying data on tissue accumulation (brain, bone, etc.) of gadolinium atoms dissociated from their carrier molecule (chelator) have led European authorities to ban contrast agents based on linear chelators of gadolinium, which are particularly susceptible to rapid dissociation, in favor of chemically more stable macrocyclic chelators.
View Article and Find Full Text PDFBackground: Thyroperoxidase (TPOAb) and thyroglobulin (TgAb) antibodies are highly prevalent in Graves' disease (GD), but their significance is controversial.
Methods: We retrospectively analyzed TPOAb and TgAb levels and evolution in 136 patients with newly diagnosed GD between 2000 and 2022, treated with anti-thyroid drugs (ATD) in a block-and-replace (B+R) regimen for at least 12 months and followed up for at least 1 year after ATD discontinuation or until disease relapse.
Results: At diagnosis, 98 out of 136 (72%) patients were TPOAb positive and 73 out of 136 (54%) patients were TgAb positive.
Objectives: The incidental diagnosis of nonfunctioning pituitary macroadenomas (NFPMAs) is becoming more prevalent with the spread of modern brain imaging techniques. We sought to uncover new data about their natural history and surgical outcome.
Design: This is a retrospective single-center observational study.
Pituitary incidentalomas (PI) are lesions of the pituitary region discovered fortuitously by imaging for reasons unrelated to pituitary disease. They range from small cysts to large invasive adenomas. All over the world, improvements in the quality and availability of radiological examinations are leading to an increase in the discovery of PI.
View Article and Find Full Text PDFIntroduction: Intravenous etomidate infusion is effective to rapidly lower cortisol levels in severe Cushing's syndrome (CS) in the intensive care unit (ICU). Recently, etomidate treatment has also been proposed at lower doses in non-ICU wards, but it is not yet clear how this approach compares to ICU treatment.
Methods: We compared data from patients with severe CS treated with high starting doses of etomidate (median: 0.
Background: Isoniazid is the most widely used anti-tuberculosis agent, yet it may lead to life-threatening complications.
Case Presentation: Here we report the case of a chronic hemodialysis patient who developed severe encephalopathy after the start of isoniazid. Blood levels of isoniazid were elevated, and acetyl-isoniazid over isoniazid ratio was decreased 3 h after intake of the medication, suggesting that a slow acetylator phenotype may have contributed to drug toxicity, in addition to pyridoxal phosphate removal by dialysis.