Endocrine Abstracts

In 2011 is the 40th anniversary of prolactin (PRL) characterisation as a distinct hormone. Only 30 years ago most patients with large pituitary tumours received primary surgery (often transcranial) followed by routine radiotherapy – treatments associated with significant morbidity and hypopituitarism. Much therapeutic progress has been made; effective medical treatments now exist for many pituitary tumour subtypes, particularly the use of long-acting dopamine agonists (DA...

Background: Adrenal incidentalomas are becoming increasingly common due to the improvements in imaging techniques, increasing numbers of radiological investigations and an aging population. The current follow-up protocols are designed to avoid missing clinically relevant lesions (e.g. malignancy or hormone hypersecretion) by recommending repeated radiological and biochemical investigations. Large amounts of money are spent on patients who as it seems mostly have benign and non...

The human adrenal gland develops from around 4 weeks gestation and undergoes distinct changes throughout pre- and post-natal life. Defects in these processes can cause adrenal hypoplasia and result in adrenal insufficiency. Adrenal hypoplasia can be: i) secondary to abnormal pituitary function, ACTH synthesis or splicing; ii) the result of ACTH resistance (familial glucocorticoid deficiency; triple A syndrome); or iii) due to a primary defect in adrenal development itself (pri...

Hypocalcaemia following thyroidectomy may be temporary or permanent, usually occurring within 14–72 h. The British Association of Endocrine Surgeons 2009 audit reported long-term hypocalcaemia rates of 7%. Total thyroidectomy for Graves’s disease carries the greatest risk (reported in 6–30% of cases) and currently there is no national consensus on management of this complication.We present three healthy young women who underwent total thyr...

Following seminal observations published nearly 20 years ago, it is apparent, increasingly, that patients with pituitary disease have excess mortality due to cardiovascular, cerebrovascular and respiratory causes; with women having a worse outcome than men. Patients with craniopharygioma have the greatest risk. There does not appear to be an overall excess of death due to malignancy. Despite large retrospective and prospective database cohort analyses, the precise reasons for ...

Cushing’s disease (CD) is often severe and debilitating and is caused by a POMC-expressing corticotrope tumour autonomously secreting ACTH to cause chronic hypercortisolism. Untreated CD is associated with excess mortality. The mainstay of management remains transsphenoidal surgery, but the overall long-term remission rate is a disappointing 55–60%. Compared to surgery for other states of pituitary hormone hypersecretion, there is an excess of new hypopituitarism, it...

We present an unusual case of painful gynaecomastia due to a large adrenocortical tumour secreting oestradiol and other steroid hormones.A 46 years old man presented with a 6 months history of progressive, painful gynaecomastia. He had no other specific symptoms and had previously been well. Alcohol intake was not excessive. Interestingly, his sister had presented with a phaeochromocytoma 2 years previously.Examination demonstrated...

Introduction: Systemic steroids have an established role in the management of numerous medical conditions across all specialities. Osteoporosis predisposing to osteoporotic fracture is a well known adverse effect of long term steroid treatment, which can affect at an early stage of the treatment. Established steroid induced osteoporosis is associated with significant co-morbidity and is difficult to reverse.Aim: To determine the frequency of osteoporosis...

Hyperandrogenism in PCOS often manifests itself with the cosmetically disfiguring problems of acne, androgenetic alopecia and hirsutism. These conditions cause considerable psychological morbidity in women with PCOS.Specific treatments for these cosmetic problems should be considered in addition to hormonal or other therapy.Topical retinoids are an appropriate first line therapy for most cases of acne particularly when comedones pr...

Background: As thyrotoxicosis is associated with significant morbidity, treatment and ultimately cure is essential. Along with anti-thyroid medication and surgery, the use of radioactive Iodine (I-131) has long been established. However, opinion still varies as to when to use I-131, in which patients and whether to give a fixed or tailored dose. To see if our practice was consistent with published data, we conducted an audit of patients treated with I-131 for benign thyroid di...