Endocrine Abstracts

InroductionDue to persistent qualitative abnormalities in GH secretion following treatment, it is extremely difficult to diagnose GHD in treated acromegalic patients. We aimed to study the response of successfully treated acromegalic patients to the combined growth hormone releasing hormone and arginine test and compare it with the insulin tolerance test.Patients and MethodsTwelve acromegalic patients, in whom mean serum GH level off medical treatment was below 5mU...

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...

AIMS: The Pituitary Foundation (a national UK Support Group)undertook a questionnaire of its members to solicit patients' views on their experience of growth hormone replacement (GHR). This resulted in a lay submission to NICE regarding GHR in adults.METHOD: A questionnaire was mailed to members known to be receiving GHR. 78% of these (303) were returned. In addition, a further 86 completed questionnaires were received following a...

Background: The symptom triad of ’headaches, palpitations and sweating’ along with elevated urinary catecholamine levels are commonly used to diagnose phaeochromocytoma. We wanted to assess how often patients with histologically verified phaeochromocytoma did not have this triad or had normal urinary catecholamine excretion on one occasion or more.Methods: Retrospective analysis of clinical presentation and urinary catecholamine levels in 75 pa...

Aim: Serum TSH is the target value by which adequate thyroid hormone supply can easily be monitored in patients with primary hypothyroidism. It is controversial when TSH should be measured before thyroxine dose adjustments are made, 4–8 weeks are recommended. To define the time when dose adjustments of thyroxine are feasible more clearly, we looked at the time required to reach stable TSH levels.Methods: We prospectively studied a case series of pat...