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Aim: Acromegaly is a rare chronic disease, caused by the over-secretion of growth hormone (GH), that creates a pro-inflammatory state, but the exact mechanisms by which GH or insulin-like growth factor 1 (IGF-1) act on inflammatory cells are not fully understood. Aim of the study was to evaluate Interleukin-33 (IL33) and the skin perfusion of hands in patients with acromegaly (AP) and healthy controls (HC). Methods: IL33 have been assessed in 40 AP and 40 HC. IL 33 was determined and skin perfusion of hands was assessed by laser speckle contrast analysis (LASCA) in both populations. Results: IL33 was significantly higher in AP compared to HC [45.72 pg/ml (IQR 28.74–60.86) vs 14 pg/ml (IQR 6.5535); p< 0.05]. At LASCA, peripheral blood perfusion (PBP) was significantly lower in AP compared to HC [53.39 pU (IQR 40.94–65.44) vs 87 pU (IQR 80–98) p< 0.001]. The median values of ROI1, ROI2 and ROI3 were significantly lower in AP compared to HC [97.32 pU (IQR 50.89–121.69) vs 131 pU (IQR 108–135); p< 0.001], [58.68 pU (IQR 37.72–84.92) vs 83 pU (IQR 70–89), p< 0.05] and HC [52.16 (34.47–73.78) vs 85 (78–98), p< 0.001], respectively. The proximal–distal gradient (PDG) was observed in 18 of 40 (45%) AP. Conclusion: Serum IL33 is higher in AP compared to HC; conversely a reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction, strictly dependent on acromegaly and are not influenced by the choice of treatment.

In multiple sclerosis (MS), contrast-enhancing lesions (CELs) in T1-weighted postcontrast MRI are considered markers of blood–brain barrier breakdown. It remains unknown if re-enhancement can be considered a radiologic indicator of different pathology in CELs. We investigated 1) the incidence of re-enhancing lesions (re-CELs) from chronic lesions; 2) differences in size, magnetization transfer ratio (MTR), and likelihood to appear as acute black holes (aBHs) between new lesions (n-CELs) and re-CELs; and 3) associations between re-CELs and features indicating more advanced disease.

Tako-tsubo cardiomyopathy (TTC), also known as “stress induced cardiomyopathy”, is an acute cardiac condition characterized by transient myocardial dysfunction associated with a peculiar pattern of reversibile left ventricular ballooning that mimics myocardial infarction, but with normal coronary arteries. Tako-tsubo cardiomyopathy typically occurs in postmenopausal women and it is often triggered by physical or emotional stressful events. We report on a patient with Alzheimer’s disease, who presented with TTC and an ischemic stroke.