Endocrine Abstracts

Hyponatraemia is the commonest electrolyte disturbance in hospital patients. It may be observed in up to 30% of cases and it has been clearly associated with an increased morbidity and mortality in a diverse array of clinical scenarios. Despite the frequency of the problem, robust evidence examining its importance and comparing treatment options has traditionally been lacking. However, recent years have seen the publication of high-quality prospective studies evaluating the ep...

Background: The transition period is a challenging time for adolescents and is frequently associated with deterioration of HbA1c, decreased attendance, and disengagement from services. Two London hospitals both have existing transition programs to facilitate the movement of patients with diabetes from paediatric to adult care services.Aim: This audit aimed to assess mean HbA1c values, HbA1c monitoring frequency, and appointments offered and attended in t...

A 36-year-old, previously healthy, man presented with several weeks’ history of gradually worsening headache. He attended A&E after he was woken by sudden worsening of the headache, associated with vomiting and pre-syncopal symptoms. Investigations revealed severe hyponatraemia - serum Na 109 mmol/L. He was also severely hypocortisolaemic – serum cortisol (random) 16 nmol/L, ACTH 19 ng/L. Cranial imaging revealed a 17 mm suprasellar, complex cystic pituitary lesi...

Recent literature suggests anterior pituitary hormone deficiency (APHD) is common in paediatric patients with idiopathic cranial diabetes insipidus (CDI); this has been attributed to autoimmune panhypopituitarism.1 We therefore determined the frequency of coexisting APHD and autoimmune disease in our cohort of patients with idiopathic adult CDI.Eight patients with idiopathic CDI were reviewed (6 females mean age at diagnosis 30 years, range 7&...

Introduction: Patients with craniopharyngioma are characterised by a high incidence of hypopituitarism, visual failure and hypothalamic dysfunction. Standardised mortality is markedly elevated and controversy exists about optimal treatment.Aim: We aimed to examine the temporal trends in the treatment of craniopharyngioma at our centre. Also, we sought to examine treatment needs and long-term morbidity in this patient group.Methods:...

Increased life expectancy in patients with CF has brought about novel challenges in their care. Osteoporosis in CF is associated with significant morbidity and is an exclusion criterion for lung transplantation. Recent evidence suggests an association between dysglycaemia and low bone mineral density (BMD). We aimed to determine predictors of bone loss in a cohort of CF patients attending a tertiary referral centre and, in particular, if dysglycaemia is linked with low BMD.</p...

Differentiation between non functioning pituitary macroadenomas (NFPA) and prolactinomas may be difficult as hyperprolactinaemia can also be present at diagnosis in NFPA cases due to pituitary stalk compression (disconnection hyperprolactinaemia). Some authors suggested that prolactin >2,000 mIU/l is almost diagnostic of a prolactinoma, while others use a higher cut-off of >5000 mIU/l. Our aim was to identify the level of prolactin above which a prolactinoma was more l...

Studies on the probability of recurrence of surgically treated but radiotherapy (RT) naïve non-functioning pituitary adenomas (NFPA) are inconsistent and selective as cases deemed to be at high risk of recurrence were prophylactically irradiated. We traditionally used very low rate of post-operative RT leaving us with a largely unselected cohort.We identified 223 surgically resected, histology-proven NFPA cases. Only 9% received post-operative RT an...

Introduction: Patients with hypopituitarism often report poor quality of life (QoL) despite adequate hormonal replacement therapy. Oxytocin, a peptide hormone produced in the hypothalamus and released by the posterior pituitary, has been known for its role in social and emotional behaviour. Our aim was to investigate the relationship between oxytocin and QoL domains in patients with hypopituitarism under optimal hormonal replacement therapy.<p class="abste...

Neck ultrasound (US) can facilitate minimally invasive parathyroidectomy by providing fine anatomical detail of enlarged parathyroid adenomas in patients with primary hyperparathyroidism (PHPT). The role of neck MRI in US negative/equivocal cases remains unclear. We aimed to evaluate the performance of neck MRI in parathyroid tumour localisation in the setting of negative or equivocal neck US.We performed a retrospective review of a consecutive series of...