Endocrine Abstracts

Clinically non-functioning pituitary adenomas (NFA) are common anterior pituitary tumours, arising from a variety of pituitary cell types, but little is known of their pathogenesis. The vast majority of NFA are benign tumours; some of which may remain intrasellar, while others may exhibit expansive extrasellar growth and/or become invasive and infiltrate dura and bone. Pituitary carcinoma, defined as a tumour with subarachnoid, brain or systemic metastases is very rare. Determ...

VA Thornton-Jones, JAH Wass and HE Turner, OBJECTIVE: Despite a recommended injection frequency of 4 weekly(4w), prolonged duration of GH suppression has been observed in some patients following treatment with long-acting somatostatin analogues. The aim of our study was to perform a prospective systematic study to determine whether extending the interval between doses of Octreotide LAR (LAR) allows maintenance of 'safe' GH in selected patients with acromegaly.<p class="abs...

Background: Octreotide LAR is used in the treatment of Acromegaly and is effective in reducing growth hormone levels in the majority of patients. With the introduction of the Endocrine Specialist Nurse it has been possible to take their care into the community.Method: A questionnaire was administered for both patients and practice nurses, to enable us to highlight the benefits and identify any problems. It was sent to 27 patients who receive Octreotide LAR and 27 GP Surger...

IntroductionTestosterone replacement for hypogonadism comes in a variety of galenical forms. Side effects include prostatic enlargement and polycythaemia. Furthermore careful scrutiny for prostatic carcinoma is essential. We audited 205 male patients from one clinical centre to assess dose, frequency and complications profile and the effectiveness of biochemical and haematological monitoring. Data of this type in a group of this size has not been previously published.M...

Background & Methods: Occasional case reports of individual patients with scalp hairloss while receiving somatostatin analogues for acromegaly led us to audit similar patients in our departments.Results: Ten patients (four men, mean age at diagnosis 44.7years [range 26-65years]) who have received somatostatin analogues either initially as primary therapy (50%) or as post-surgical treatment (50%) for uncured acromegaly reported significant scalp hair...

Patients with Cushing's disease are well known to develop easy bruising due to cortisol excess but are also predisposed to thrombembolism.We present four patients who developed thromboembolism during active Cushing's disease.Case 1- Four year history of hypertension, osteoporosis and central obesity. A DVT developed prior to referral. Initial urinary free cortisol(UFC)was 524nmol/24hrs. Inferior petrosal sinus sampling indicated ...

Background: Acromegaly has until now been managed almost entirely in tertiary care. Introduction of nurses specialising in endocrinology has enabled us to take their care into the community.Method: 39 patients (P) mean age 57y(29-82) with active acromegaly, required Octreotide LAR treatment, and lived 5-173(median 38) miles from the endocrine unit. A shared care (SC) protocol was approved whereby the patient's first injection was given at the hospital, ...

Aim: To assess the relationship between clinical symptoms, growth hormone (GH) and IGF-1 during medical treatment for acromegaly.Methods and Patients: 6 patients, mean age 52y, (range 43-68), 4 males, were treated with Lanreotide SR (LAN). A growth hormone day curve (GHDC) and IGF-1 were assessed at week 0, pre LAN. All patients received LAN 30mg, 2weekly. GHDC was repeated at week 8, aiming for mean growth hormone (MGH) <5mu\/l. LAN was increased t...

Background: Anecdotal reports have suggested that silent ACTH tumours behave in an aggressive fashion, however, clear comparative data are lacking.Methods: 28 patients (16 men, mean age 51.3years [range 30-80years]) who underwent trans-sphenoidal surgery in Oxford between 1975 and 2001 for clinically non-functioning adenomas where the subsequent immunostaining was positive for ACTH were identified from the patient database. The mean follow-up period was...

Introduction: In cancer patients treated with immune checkpoint-inhibitors (ICI) that target CTLA-4, PD-1 and/or PD-L-1, thyroid dysfunction represents the commonest associated endocrinopathy (1). Patients receiving ICI should be monitored for thyroid dysfunction. A case of PD-1 inhibitor-induced thyroid function test (TFT) interference has been reported (2) and having noted discordant results, we undertook a preliminary assessment of the extent of such ICI-related TFT interfe...