Endocrine Abstracts

Adrenal venous sampling (AVS) is regarded as the gold-standard for the study of lateralisation of primary aldosteronism (PA) after its biochemical diagnosis. After catheterisation of both adrenal veins, confirmed by ratio of cortisol concentration in each adrenal vein and peripheral vein (selectivity index (SI)), lateralization is accepted if aldosterone/cortisol (A/C) ratio between both adrenal veins is over 3–4 (lateralization index (LI)), particularly if non-dominant v...

Background: The overnight dexamethasone (DEX) suppression test is useful for the investigation of hypercortisolism, however several factors may influence its performance. Intestinal uptake of DEX, inactivation by conversion by CYP3A4 in the liver and renal clearance can all affect test variability. It is also known that several drugs can either reduce or accelerate CYP3A4 activity, thereby affecting blood DEX concentrations. Interpretation of the test would be greatly enhanced...

Primary hyperparathyroidism (PHP) is a common endocrine disorder. It is due to a single parathyroid adenoma in 80% of cases, most of the remainder due to hyperplasia of all four parathyroid glands. The only curative procedure is parathyroidectomy, but preoperative localization can be difficult. Isotope scanning with sestaMIBI is considered to be useful in localizing any parathyroid adenoma to help guided surgery. The aim of this study is demonstrated the influence of biochemic...

Aims/hypothesis: Bone turnover markers mainly reflect three processes: bone remodelling, linear growth, and bone modelling. These occur at different rates depending on age. Oestradiol levels, a mediator of all processes of bone turnover, vary according to sex and age whereas, parathyroid hormone levels, an important regulator of bone remodelling, vary with age. We hypothesised that gender and age differences in the bone formation marker, serum amino terminal propeptide of type...

Objective: The diagnosis of subclinical Cushing’s syndrome in patients with incidentalomas is not always straight forward and a number of different criteria have been used. The 1 mg overnight dexamethasone suppression test has been recommended as a screening test, followed up by other tests of the hypothalomo–pituitary–adrenal axis to confirm the diagnosis. In this study we investigate whether the low-dose dexamethasone suppression test offers additional informa...

Introduction: Single adenoma is the most frequent cause of Primary hyperparathyroidism (HPT1). Surgical excision has a high success rate, particularly when associated with a fast intraoperative intact parathyroid hormone assay (PTHi).Aim: Evaluate the success rate of primary hyperparathyroidism surgery in our unit.Methods: Descriptive study of the last 33 consecutive HPT1 patients who undertook surgery, 27 of which with PTHi. The P...

In postmenopausal women with clinical hyperandrogenism Cushing’s syndrome and adrenal/ovarian neoplasms must be excluded, but radiological and biochemical studies are not always useful for localizing the source of androgens.Case 1: A 75-year-old woman developed alopecia and progressive hair growth on the chest and abdomen over 4 months. Five years before a successful parathyroidectomy had been carried out. Hormonal evaluation: Testosterone (T): 5.84...

Introduction: Cyclic Cushing syndrome (CCS) involves rhythmic fluctuations in ACTH secretion resulting in a cyclic variation of adrenal steroid production.Case presentation: A 37-year-old woman was referred to our Pituitary Clinic in 1999, for evaluation of galactorrhea and irregular menses that had started four months ago. She also complained of depression, facial hirsutism, alopecia and progressive obesity. Blood pressure was normal. Endocrinological e...

Introduction: There are limited data on the incidence and prevalence of pituitary adenomas (PA). Although classically considered rare, systematic assessments from autopsy and radiological studies have shown a prevalence of 17% in the general population.Objective: We describe the epidemiologic of PA in Braga, the third most populous district of Portugal (860 000 inhabitants, 2673 km2), over the last 20 years.Methods: We r...

Background: Prolactinomas are usually highly sensitive to dopamine agonists. We report the use of temozolomide in a 47-year-old gentleman with MEN 1 and a highly dopamine agonist-resistant, and aggressive prolactinoma.Case summary: He presented in 2001 with a 3rd nerve palsy and recurrent headaches. MRI revealed a pituitary tumour extending into the left cavernous sinus. Prolactin levels were 29 000 mU/l. (NR<360). Primary hyperparathyroidism, a lesi...