Endocrine Abstracts

Transsphenoidal surgery is the treatment of choice in acromegaly. However, some patients do not achieve postoperative remission. The aim of our study was to identify factors that predictive of a poor surgical outcome in patients with acromegaly. In our study we included 39 acromegalic patients, who underwent transsphenoidal surgery as initial treatment. We evaluated clinical, hormonal and radiological predictors based on magnetic resonance imaging (MRI). Also we examined immun...

Patients with craniopharyngioma are frequently obese with a high prevalence of vascular morbidity. Many patients with treated craniopharyngioma have severe GH deficiency (GHD), which independently results in abnormal body composition and increased cardiovascular risk. This study investigated how GH treatment influences body composition in adults with treated craniopharyngioma and GHD.Using the electronic database Diabeta3® we identified 50 patients ...

Background: Self-management is essential for patients with adrenal insufficiency (AI) to achieve optimal outcomes of glucocorticoid (GC) replacement therapy by minimising adverse effects from over- or under-replacement and appropriately adjusting the dose in intercurrent illness to prevent adrenal crisis. Evidence suggests that many patients report deficits in self-management especially concerning ‘sick day rules’, prevention and management of adrenal crisis and have...

Introduction: Endocrine deficiency as a result of glandular infiltration by metastatic cancer is considered rare. Metastases to the adrenal cortex are relatively common and we present the clinical presentation and radiological appearances of cases involving pituitary and adrenal metastases.Case histories: Case 1: An 84 year old male with bronchogenic carcinoma presented with lethargy, polyuria and dehydration. The serum Na+ was 156 mmol...

A 44-year-old woman presented to an emergency department with ear pain and worsening of longstanding headache. There was no history of menstrual disturbance, galactorrhoea, tiredness or weight gain and physical examination demonstrated only a left homonymous hemianopia. CT head scan revealed a brightly enhancing, enormous, lobulated mass arising from the pituitary fossa and causing obstructive hydrocephalus through compression of the fourth ventricle. Following collection of b...

Objective: To determine whether transdermal oestrogen (E2) preparations alter total cortisol and cortisol binding globulin (CBG) concentration similarly to oral E2 treatment.Methods: This cross-sectional, observational study compared levels of total serum cortisol, CBG, the free cortisol index (FCI) and salivary cortisol levels (as a measure of free cortisol) in oestrogen naïve women (n=15), women taking oral oestrogen (...

Familial glucocorticoid deficiency (FGD) is a rare autosomal recessive disease resulting from adrenal unresponsiveness to ACTH. Patients present in early childhood with hyperpigmentation, hypoglycaemic episodes and seizures secondary to glucocorticoid deficiency. If left untreated this condition is fatal. Mineralocorticoid production is normal. Mutations in the ACTH receptor have been well described and account for approximately 25% of cases. We describe 3 additional novel mut...

BDNF, a neurotrophin involved in brain development and plasticity, is implicated in the melanocortin regulation of obesity onset. Mice deficient in the orphan nuclear receptor SF-1 have a poorly developed VMH and consequent absence of BDNF in this region. Our studies reveal a role for SF-1 in BDNF expression, and its' implications for hypothalamic obesity. Real-time RT-PCR indicated expression of BDNF exons I, III and IV were dramatically reduced in the VMH of SF-1 heterozygou...

Introduction: Pembrolizumab is an immune checkpoint inhibitor (ICI) used to treat advanced cancers. While improving survival rates, ICIs also cause immune-related adverse events (IRAEs). The endocrine system remains the most vulnerable to IRAEs: thyroid involvement is the commonest while pancreatic involvement is rare, affecting less than 1% of individuals. Risk factors for IRAEs include, personal or family history of autoimmune conditions, presence of another...

The thyroid hormone receptors (TRs) are ligand-dependent transcription factors regulating growth, development, and differentiation. That TRs are cellular homologs of the retroviral v-erbA oncogene suggests their possible involvement in carcinogenesis. Recent studies showed altered expression of TRs at both the mRNA and protein levels and identified somatic mutations of TRs in several human cancers, including thyroid carcinomas. We have created a knockin mutant mouse by targeti...