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Neuroendocrine and Pituitary
Tumor Clinical Center (NEPTCC) Bulletin

Winter 2017/2018 | Volume 24, Issue 1

Cushing’s Disease in Pregnancy

Case presentation

A 28-year-old woman was referred to the Neuroendocrine and Pituitary Tumor Clinical Center for management of Cushing’s disease (CD). Four years prior to referral, she had a full-term uncomplicated pregnancy and delivered a baby girl. Post-partum, she experienced depression, fatigue, hirsutism, and easy bruising, as well as inability to lose weight and secondary amenorrhea. Three years prior to referral, an outside endocrinologist suspected Cushing’s syndrome (CS), and checked 24-hour urine free cortisols (UFC), which were 10x the upper limit of normal (ULN), and late night salivary cortisols (LNSC), which were also elevated. Serum adrenocorticotropic hormone (ACTH) was elevated, suggesting ACTH-dependent CS. A pituitary MRI revealed a 12 x 9 x 6 mm right sellar lesion. The patient then underwent transsphenoidal surgery at an outside hospital, and pathology was consistent with an ACTH-producing pituitary adenoma. Post-operatively, UFC normalized, but she did not become adrenally insufficient, suggesting she was not in remission and was at a high risk of recurrent hypercortisolemia. Post-operative MRI did not show clear residual tumor.

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Effects of Growth Hormone on Thyroid Function in Patients with Growth Hormone Deficiency – A Potential Effect of GH on Type 2 Iodothyronine Deiodinase

Janet LoThe growth hormone (GH)-insulin-like growth factor-1 (IGF-I) axis has notable effects on thyroid function and thyroid hormone metabolism.  In the literature, concern had been raised that GH replacement may unmask undiagnosed central hypothyroidism1, 2.  GH treatment was shown in several studies to lower levels of thyroxine (T4) and free thyroxine (free T4) in adults and children with growth hormone deficiency (GHD)1-6.  Some studies have shown that GH and IGF-I can increase levels of triiodothyronine (T3)7, 8, while others have shown no change in free T3 levels with GH replacement3.  In healthy men, Grunfeld et al. demonstrated that recombinant human GH (rhGH) at a dose of 0.125mg/day subcutaneously for four days acutely reduced serum total T4 and free T4, increased total T3 and markedly decreased serum TSH, considered likely to be compensatory9.

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NEPTCC moved!

The Neuroendocrine and Pituitary Tumor Clinical Center is now located on the MGH Main Campus directly across the street from our previous location.

 

100 Blossom Street, Cox 140
Boston, MA 02114

Phone: 617-726-7948
Fax: 617-726-1241

 

Announcement on Zervas Lectureship

SAVE THE DATE

SPECIAL LECTURE

19th Annual Nicholas T. Zervas, M.D. Lectureship

Massachusetts General Hospital

Historic Ether Dome

Tuesday, May 15, 2018 at 12pm

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Register now for Clinical Endocrinology 2018

MASSACHUSETTS GENERAL HOSPITAL AND
HARVARD MEDICAL SCHOOL CME PRESENT
CLINICAL ENDOCRINOLOGY: 2018

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Research Studies Available

Patients may qualify for research studies in the Neuroendocrine and Pituitary Tumor Clinical Center.  We are currently accepting the following categories of patients for screening to determine study eligibility.  Depending on the study, subjects may receive free testing, medication and/or stipends.

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Welcoming Dr. Pamela Jones

Pamela JonesPamela S. Jones, MD MS MPH

Pamela Jones, MD MS MPH, is a neurosurgeon who cares for people with all types of brain tumors, including glioblastoma, low and high-grade gliomas, metastatic brain tumors, and skull base tumors such as meningiomas, acoustic neuromas, and pituitary tumors. Her expertise includes performing minimally-invasive endoscopic neurosurgery for treating tumors in the skull base and pituitary.

Dr. Jones completed residency training in neurosurgery at the Massachusetts General Hospital. Her fellowship training in pituitary and endoscopic skull base was also performed at the Massachusetts General Hospital and the Massachusetts Eye and Ear Infirmary under Dr. Brooke Swearingen and Dr. William Curry. Dr. Jones earned her medical degree from Tulane University School of Medicine, where she graduated with Alpha Omega Alpha honors. She attended Stanford University for her undergraduate degree in biology. She also holds a master’s degree in public health from Harvard School of Public Health and a master’s degree in biomedical journalism from New York University.  Dr. Jones’ research focuses on neurosurgical outcomes and clinical trials, particularly within brain tumor and pituitary tumor, as well as quality and safety improvement initiatives.

Dr. Jones is thrilled to return to the MGH after being an assistant professor at UCSD.  In her free time, Dr. Jones has a passion for ballet, both as a dancer and as a patron, and enjoys running, writing, traveling with friends and family, and watching Patriots and Stanford football.