Endocrine Abstracts

Metastasis to the pituitary gland is a rare occurrence. Here we discuss our experience managing a patient with pituitary neuroendocrine metastasis who first presented with ocular symptoms. A 65-year-old lady presented in July 2015 with progressive diplopia. An MRI scan revealed a pituitary mass lesion with aggressive features and two abnormal enhancing nodules within the brain white matter, raising suspicion of metastatic disease. Radiotherapy was commenced on the basis that t...

All those involved in delivery of health care are obliged to deliver safe and effective management for patients. Effectiveness is often achieved where specialists for the condition are involved. In contrast, patient-safety depends of recognition of the condition in question and then use of appropriate treatment and management, regardless of who is seeing the patient. This is particularly the case where there may be a rare disease confused for a common one, and where the treatm...

Polycystic ovary syndrome (PCOS) is the most common reproductive problem in women of childbearing age attending an endocrine clinic with a reported prevalence of between 4-8 %. The classical symptoms result from excess ovarian androgen production and chronic anovulation. Ovarian ultrasound shows more than 10 follicles, 2-10mm in diameter. A common presentation in the clinic can be menstrual dysfunction but the most characteristic feature of the syndrome is the hirsutism which ...

Thyroid cancer is the most common endocrine malignancy, and accounts for between 5 and 10% of thyroid nodules biopsied in endocrine services. As per the Global Cancer Observatory, the incidence of thyroid cancer in Bahrain is 2.12 cases per 100 000 people, which is less than the neighbouring countries of Saudi Arabia and Kuwait. The purpose of the study is to investigate the relationship between thyroid cancer and obesity in Bahrain, where 28.9% of males and 38.2% of females a...

There are 126 departments of adult endocrinology in England. We will be producing a national report towards the end of the year joint with the Society for Endocrinology. Endocrinology is not properly coded in hospital data systems. This is because of misattribution to general medicine or diabetes. Commonly accepted clinical standards are not being applied uniformly (e.g., steroid sick day provision). We have looked at surgical volumes. There are a large number of places where ...

Mitochondrial disorders are the result of mitochondrial respiratory chain dysfunction and caused by mutations of genes encoded by the nuclear or the mitochondrial DNA. They affect approximately 1 in 5000 of the population and are the most common group of inborn errors of metabolism. Most of them involve multiple organ systems with predominant central nervous system features including ptosis, external ophthalmoplegia and sensorineural hearing loss.Introdu...

There are several regulatory systems the body that keep body functions, like body temperature and blood glucose, constant. In this study we have added and removed weight loads from experimental animals and measured the effects on biological body weight. The results of these experiments indicate that there is a novel regulatory mechanism to keep the body weight constant, mostly by adjusting the body fat mass. The mechanism was dependent on intact bone cells. We hypothesize that...

Adrenal incidentalomas (AI) found on axial imaging are common. In ages <20 y the prevalence is <1%, but this increases around 10% of the population aged 70 y. Depending on definitions anything between 10–40% of these tumours exhibit low-grade cortisol excess, but patients are without the classic features of Cushing’s syndrome. This equates to 1–4% of the ageing population.Independent studies from our own group and others have demon...

Pancreatic neuroendocrine tumours (pNET) in patients with MEN1 pose a particular and challenging clinical problem. Whilst patients with a pNET and clear clinical and biochemical evidence of hormonal hypersecretion are usually candidates for some form of surgical or medical therapy, the decision-making is far harder for those who are found to have a non-functioning tumour on surveillance imaging. There is a lack of knowledge of the differing biological behaviour between pNETs i...

Pituitary radiotherapy plays an important role in the overall management of pituitary disease, but needs discussion at an expert regional pituitary MDT. Repeat surgical exploration is increasingly performed either as an alternative to radiotherapy or to further reduce tumour bulk ahead of radiotherapy. Careful discussion with the patient on the risks and benefits of radiotherapy, and all the other options, is essential. It is best to consider the control of tumour growth and a...