Searchable abstracts of presentations at key conferences in endocrinology
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Society for Endocrinology BES 2012

ea0028p236 | Pituitary | SFEBES2012

Evaluation of the expression of vesicular protein (SNARE) isoforms in human pituitary adenomas

Garcia Edwin , Trivellin Giampaolo , Michael Powell , Grieve Joan , Sabin Ian , Alusi Ghassan , Louis Pobereskin , Shariati Babak , Roncaroli Federico , Mendoza Nigel , Grossman Ashley , Harper Elaine , Korbonits Marta

Background: Botulinum neurotoxin inhibits muscle function by interfering with neurotransmitter release from secretory vesicles. The mechanism underlying this effect involves cleavage of SNARE proteins which are required for vesicle docking at the plasma membrane. The ability of botulinum neurotoxin serotypes to cleave SNARE proteins and inhibit secretion is being exploited for therapeutic purposes by Syntaxin Ltd with their ‘targeted secretion inhibitor technology’ (...

ea0028p237 | Pituitary | SFEBES2012

Management of prolactinomas during pregnancy - A survey of four canadian provinces

Almalki Mussa , Johnson Michelle , Ur Ehud , Clarke David , Imran Syed Ali

The guidelines for management of prolactinomas (PRLoma) during pregnancy are mostly based on retrospective evidence or expert opinion. We conducted a survey of four Canadian provinces (NS, NB, PEI and BC) to assess the current trends in management of PRLoma during pregnancy. A case-based electronic questionnaire was sent to all practicing endocrinologists, with 3 cases of varying severity ranging from a micro PRLoma to a large macroPRLoma compressing the optic chiasm. A total ...

ea0028p238 | Pituitary | SFEBES2012

Ultrastructural changes in somatotrophs and gonadotrophs in TPit null mice

Yick Lok , Khetchoumian Konstantin , Drouin Jacques , Christian Helen

Tpit is a pituitary-specific transcription factor that is important for corticotroph terminal differentiation. In TPit null mice corticotroph cells do not differentiate and cells immunopositive for SF1, LH and FSH are observed in the intermediate lobe (Pulichino et al. 2003 Genes Dev). As the anterior lobe in TPit null mice showed a 50% decrease in cell number compared to wild-type (WT), and corticotrophs comprise only 5–7% of anterior lobe cells, we investigated c...

ea0028p239 | Pituitary | SFEBES2012

Mechanisms underlying termination of acute gonadotrophin-releasing hormone (GnRH)-stimulated ERK activation.

Finch Ann , Caunt Christopher , Perrett Rebecca , McArdle Craig

GnRH acts via G-protein coupled receptors to stimulate phospholipase C. This activates protein kinases C, driving the activation of extracellular signal regulated kinases (ERKs) that mediates transcriptional effects of GnRH. GnRH is secreted in pulses that cause rapid, transient and reproducible ERK activation (1). ERK response kinetics dictate biological consequences in many systems and, although GnRH-mediated ERK activation has been thoroughly explored, little is known about...

ea0028p240 | Pituitary | SFEBES2012

Transcriptional regulation of prolactin in the rat oestrous cycle

Patist Amanda , Featherstone Karen , Spiller David , Semprini Sabrina , McNeilly Judith , McNeilly Alan , Mullins John , White Michael , Davis Julian

Circulating levels of prolactin are subject to acute and long-term regulation by many factors including oestrogen and dopamine. We have studied the regulation of prolactin promoter activity in living pituitary cells using transgenic Fischer rats in which reporter gene expression is regulated by the human prolactin gene locus (hPRL-d2EGFP). We have previously identified pulsatile prolactin transcription patterns in living lactotroph cells in fetal tissue, that became stabilised...

ea0028p241 | Pituitary | SFEBES2012

Can the stability of variant aryl hydrocarbon receptor interacting protein (AIP) be a marker for pathogenicity in FIPA (familial isolated pituitary adenoma)?

Martucci Federico , Trivellin Giampaolo , Garcia Edwin , Dalantaeva Nadezhda , Chapple Paul , Pecori Giraldi Francesca , Grossman Ashley , Korbonits Marta

Background: 20% of the familial isolated pituitary adenoma (FIPA) population harbour an aryl hydrocarbon receptor-interacting protein (AIP) gene mutation. The recognition of whether a variant is pathogenic can be difficult, in cases where the observed change does not lead to a truncated protein. Segregation with disease in a family, in silico predictions, loss of heterozigosity in the tumour, in vitro functional studies and screening of the variant in controls may help in asce...

ea0028p242 | Pituitary | SFEBES2012

Development of a platform technology to generate long-acting protein therapeutics

Parry Heather , Thorpe Alice , Wilkinson Ian , Pradnanhanga Sarbendra , Sayers Jon , Artymiuk Peter , Ross Richard

Background: The development of recombinant biologics such as interferon, insulin and Growth Hormone (GH) has had a major impact on the management of diseases including hepatitis, diabetes and GH-deficiency. However, most biologics undergo rapid renal filtration and proteolytic degradation, necessitating frequent dosing regimens. Pegylation can successfully delay clearance but has several drawbacks including potential toxicity, expense and reduced activity. There is therefore n...

ea0028p243 | Pituitary | SFEBES2012

Acute Management of Pituitary Apoplexy: Experience in 70 consecutive cases

Jose Biju , Pelluri Lavanya , Mitchell Rosalind , Gittoes Neil , Ayuk John

Introduction: Pituitary apoplexy is an uncommon medical emergency with a reported incidence in pituitary adenomas of 2–7%. UK guidelines on the management of pituitary apoplexy have recently been published. On this background we analysed the management of pituitary apoplexy at a single tertiary centre.Methods: A retrospective analysis was performed to evaluate clinical presentation, management and clinical outcomes in a cohort of patients, who prese...

ea0028p244 | Pituitary | SFEBES2012

Maximising the accuracy of IPSS: Validation of the use of Prolactin as a marker of pituitary venous effluent in the diagnosis of Cushing’s disease

Grant Paul , Carroll Paul

Background: Although early studies with IPSS reported a diagnostic sensitivity and specificity approaching 100%, additional experience has revealed a false negative rate of 1–10%. Previous studies have suggested that the measurement of other anterior pituitary hormones may be useful as a guide to the effectiveness of cannulation and to improve diagnostic accuracy.Method: In this retrospective cohort study, we reviewed all patients who had undergone ...

ea0028p245 | Pituitary | SFEBES2012

Results and challenges of genetic testing in a large familial isolated pituitary adenoma (FIPA) kindred with an R304X AIP mutation

Williams Fred , Hunter Steven , Bradley Lisa , Morrison Patrick , Chahal Harvinder , Korbonits Marta , Atkinson A

20% of cases of FIPA have AIP gene mutations. These adenomas are often large and invasive. Our index case presented aged 13 with pituitary apoplexy. Histology showed necrotic tissue. He continued to grow and was 195 cm 4 y later. GH excess was confirmed. After treatment with octreotide and radiotherapy remission was achieved. His first cousin had also been successfully treated for acromegaly. This led to the original familial diagnosis. Subsequently, the c.910C>T, p.R304X ...

ea0028p246 | Pituitary | SFEBES2012

High prevalence of pituitary adenomas in patients with Macroprolactinaemia and oligo-/amenorrhoea

Gasior-Perczak Danuta , Lewandowski Krzysztof , Kowalska Aldona , Lewinski Andrzej

Background: The so called “big-big” prolactin, also known as macroprolactin is formed by prolactin-immunoglobulin complexes, and is considered to be biologically inactive. Nevertheless, macroprolactin may cause elevation of serum prolactin (Prl) concentrations measured by standard assays. In women presenting with oligo- and/or amenorrhoea the cause of menstrual irregularity needs to be explained even in the setting of concomitant macroprolactinaemia. We have therefor...

ea0028p247 | Pituitary | SFEBES2012

A case series of corticotroph macroadenomas and Cushing’s: clinical characteristics and management

O'Toole Sam , Metcalfe Karl , Plowman Piers , Evanson Jane , Carpenter Robert , Drake Will

Background: Pituitary macroadenomas are an uncommon cause of Cushing’s disease. They present with a higher cortisol burden, are more aggressive and harder to cure and manage than microadenomas.Aims: To review the demographics, clinical features, biochemistry, radiology and required treatment modalities of a single-centre case series of corticotroph macroadenomas.Methods: Retrospective analysis and review of the case records of...

ea0028p248 | Pituitary | SFEBES2012

‘Isolated acquired secondary hypogonadism’ in men referred to an adult endocrine clinic

Kandasamy Narayanan , Baxter Mark , Skittrall Jordan , Annamalai Anand Kumar , Antoun Nagui , Simpson Helen , Halsall David , Gurnell Mark

Background: Acquired male secondary hypogonadism is a relatively common cause of referral to the endocrine clinic. However, the extent to which further investigation is required, and the indications for a trial of testosterone therapy, remain unclear. Aim To review the clinical/biochemical/radiological findings in men presenting with this condition.Methods: We performed a retrospective case analysis of 41 consecutive patients referred to our clinic over ...

ea0028p249 | Pituitary | SFEBES2012

Observational analysis of local protocol for screening for hypoadrenalism post pituitary surgery

Smith Christopher , Kernohan Andrew

Background: Adrenal insufficiency is a common complication of pituitary surgery. We screen for hypoadrenalism with a day 4 morning cortisol. If < 400 nmol/l the patient is prescribed steroid replacement. Patients have a follow up short synacthen test at 6 weeks to assess the hypothalamic-pituitary-adrenal axis. We wanted to ensure the threshold of 400 nmol/l stopped patients with/or developing hypoadrenalism being discharged without glucocorticoid replacement. We also want...

ea0028p250 | Pituitary | SFEBES2012

Factors affecting growth hormone (GH) replacement during transition in patients with childhood-onset GH deficiency

Thankamony Ajay , Capalbo Donatella , Rachel Williams , Heywood James , Ong Ken , Dunger David , Simpson Helen

Background: GH therapy during the transition period is important for somatic maturation. Identification of factors associated with low IGF-I levels may be useful in optimising GH replacement therapy.Objectives: To explore the prevalence and determinants of insufficient GH replacement during transitionMethods: Childhood-onset GH deficient (CO-GHD) patients (n=65) who stopped therapy, and were started on adult GH dose during t...

ea0028p251 | Pituitary | SFEBES2012

The characterisation of growth hormone-related cardiac disease with magnetic resonance imaging

Thomas Julia , Dattani Abhishek , Burchell Thomas , Zemrak Filip , Khoo Bernard , Chew Shern , Kaplan Felicity , Drake William , Aylwin Simon , Gurnell Mark , Akker Scott , Petersen Steffen , Davies Ceri , Grossman Ashley , Korbonits Marta

Acromegaly causes a distinct cardiomyopathy. Growth hormone deficiency (GHD) limits cardiac response to exercise and increases cardiac mortality. Cardiac magnetic resonance imaging (CMR) is considered the gold standard for assessment of cardiac mass and provides data on function, fibrosis, valves and ischaemia. Twenty-three patients with abnormal GH levels (acromegaly, n=13; adult-onset GHD, n=10) and 23 matched controls underwent CMR. Patients had repeat CMR at ...

ea0028p252 | Pituitary | SFEBES2012

Discordance between growth hormone and IGF1 in patients with acromegaly following recent guidelines

Scally Niamh , Swords Francesca , Gorick Sondra , Chipchase Alison , Temple Rosemary

Introduction: Discordance between growth hormone (GH) and insulin-like growth factor 1 (IGF1) is observed in up to 30% patients with acromegaly, with the most common finding being high IGF1 with normal GH levels. Recently published guidelines recommended a nadir GH of 0.4 μg/L rather than 1.0 during growth hormone suppression test as being indicative of controlled disease. This may lead to reduced discordance between GH and IGF1. Methods We measured nadir GH (Beckman Coul...

ea0028p253 | Pituitary | SFEBES2012

Sleep apnoea in acromegaly: a meta-analysis

Begum Fauzia , Prague Julia , Lyall Rebecca , Ayis Salma , Aylwin Simon

Objective: To conduct a systematic review and meta-analysis of observational, cross sectional and longitudinal studies of sleep apnoea syndrome in acromegalic subjects to determine a) prevalence b) effect of treatment and c) relationship to GH and/or IGF-1.Method: A PubMed search using ‘(acromegaly) AND (sleep apnoea)’ as search terms was performed with subsequent hand searching of relevant papers. Cross sectional and longitudinal studies were ...

ea0028p254 | Pituitary | SFEBES2012

The Pituitary Apoplexy Score (PAS) in the evaluation and management of acute pituitary apoplexy: a single centre experience from the United Kingdom

Thondam Sravan , Bujawansa Sumudu , Noonan Carmel , MacFarlane Ian , Javadpour Mohsen , Daousi Christina

Aims: The United Kingdom (UK) guidelines for management of acute pituitary apoplexy recommend the Pituitary Apoplexy Score (PAS) to objectively assess clinical severity of this rare neuro-endocrine emergency. We aimed to apply retrospectively this scoring tool to a large, single centre series of patients with acute pituitary apoplexy, and to determine its applicability in the management of these patients in the acute setting.Methods: Retrospective study ...

ea0028p255 | Pituitary | SFEBES2012

Ipilimumab induced hypophysitis - an evolving clinical entity

Juszczak Agata , Karavitaki Niki , Grossman Ashley

Introduction: Ipilimumab (Yervoy, BMS) is a human monoclonal antibody increasingly used in oncology. It targets cytotoxic T lymphocytes antigen 4 (CTLA-4) promoting their proliferation and augmenting an anti-tumour response. It is licensed for the treatment of unresectable or metastatic melanoma and multiple clinical trials using this medication for other malignancies are ongoing. Ipilimumab related adverse reactions are mainly autoimmune and occur in 61% of patients, of which...

ea0028p256 | Pituitary | SFEBES2012

Pituitary regrowth following growth hormone replacement therapy.

Evans Nicholas , Saada Janak , Swords Francesca , Temple Rosemary

Introduction: Growth hormone (GH)-deficiency in adults is associated with a range of adverse outcomes that improve with GH replacement. Pituitary adenomas and their treatment account for a large proportion of patients with adult GH-deficiency. However, safety fears have arisen due to the mitogenic effect of excess GH on pre-malignant colonic polyp formation in individuals with acromegaly. This, along with anecdotal suggestions of pituitary tumour recurrence, has prompted furth...

ea0028p257 | Pituitary | SFEBES2012

Distinct signalling cascades mediate GnRH pulse frequency-dependent differential regulation of FSHβ transcription via CREB and ICER activation

Thompson Iain , Ciccone Nick , Xu Shuyun , Carroll Rona , Kaiser Ursula

GnRH is released from the hypothalamus in a pulsatile manner and binds to specific receptors (GnRHR) in the anterior pituitary gland to stimulate follicle-stimulating hormone (FSH) and luteinizing hormone (LH) subunit gene expression and subsequent FSHβ and LHsecretion. The FSH and LH subunits are preferentially stimulated by pulsatile GnRH at low and high pulse frequencies, respectively. The transcription factors, cAMP response element binding protein (CREB) and inducibl...

ea0028p258 | Pituitary | SFEBES2012

Prolactin and ACTH secreting pituitary macroadenoma and cabergoline responsive Cushing’s disease: a case report

Srinivas V , Sampson M , Swords F , Jeanes C , Gorrick S , Krishnan L

A 33 year old male presented with a two year history of fatigue, headaches, loss of libido, insomnia, depression and hypertension. On examination, he was floridly Cushingoid with central obesity, proximal muscle weakness and purple striae. A bilateral temporal, superior quadrantanopia was noted on formal perimetry. Investigations revealed markedly elevated prolactin levels at 56560mIU/L, hypogonadotropic hypogonadism and secondary hypothyroidism. He also had elevated urinary c...

ea0028p259 | Pituitary | SFEBES2012

A case of post-radiation encephalopathy following radiotherapy for pituitary adenoma

Bujanova Jana , Armitage Mary , Richardson Tristan

We report a case of severe postradiation encephalitis presenting 6 months following pituitary radiotherapy for pituitary adenoma. Our patient (78 years old female) was diagnosed with non-functioning pituitary ademona compromising the optic chiasm in 1999 at the age of 66 years. She underwent transphenoideal decompression in 2000. Over the next 8 years there was slow re-growth of the pituitary adenoma and by 2008 it was causing optic chiasm compression. At this stage, the patie...

ea0028p260 | Pituitary | SFEBES2012

Ipilimumab Induced Hypophysitis presenting as SIADH

Abdulla Haitham

This is a case of forty six year old lady who is known to have resected stage 3 malignant melanoma diagnosed in 2008. She has recently she was started on Ipilimumab, an anti cytotoxic T cell antigen 4(CTLA-4), a monoclonal antibody as part of clinical trial. After two cycles she developed headaches and an MRI scan showed bulky piruitary with an enhacement in keeping with pituitary hypophysisits. She received Dexamethasone 8 mg twice daily with good symptomatic effect. The head...

ea0028p261 | Pituitary | SFEBES2012

Improving local services: using objective measures to determine levels of psychosocial need in pituitary patients

Jackson Sue , Pay Charlotte , Crown Anna

Introduction: In 2005, an explorative study was undertaken on behalf of the Pituitary Foundation (PF) to assess the psychosocial impact of living with a pituitary condition. The study found high levels of psychosocial distress among patients resulting in reduced quality of life (QoL). Improving QoL is central to the National Institute for Clinical Excellence guidance on improving outcomes for pituitary patients. The aim of this study was to utilise the same measures of psychos...

ea0028p262 | Pituitary | SFEBES2012

Quality of life in patients with non-functioning pituitary adenoma: the Oxford experience

Capatina Cristina , Christodoulides Constantinos , Fernandez Alberto , Grossmann Ashley , Wass John , Karavitaki Niki

Data on the quality of life (QoL) of patients with non-functioning pituitary adenoma (NFA) are sparse and conflicting. We have therefore evaluated the QoL in patients with NFAs followed-up in a tertiary UK referral centre and explored the impact of various factors. Three validated questionnaires (Short Form 36-SF36, Nottingham Health Profile-NHP and European Quality of Life Scale-EuroQoL) were offered to consecutive NFA subjects attending outpatient clinics over a 6-month peri...

ea0028p263 | Pituitary | SFEBES2012

Autoimmune hypothyroidism coexisting with a TSH secreting pituitary adenoma

Manjunatha Rashmi , Warner Darren

Case: A 62-year old man with a previous diagnosis of asymptomatic subclinical hypothyroidism (TSH: 13.6 mU/L, FT4: 23 pmol/L) and elevated TPO antibody titres (>600 IU/ml) was referred with persistently elevated TSH levels despite increments in the dose of thyroxine. Thyroid function test (TFT) on 200 mcg of thyroxine showed an elevated TSH (13.0 mu/L) and FT4 (31.1 pmol/L). Thyroxine was gradually reduced and stopped. Following this, although FT4 levels normalised (20.7 p...

ea0028p264 | Pituitary | SFEBES2012

Neurosarcoidosis presenting with anterior hypopituitarism and hypothalamic syndrome

Bejinariu Emanuela , Mathews Anitha

Introduction: We present a case of neurosarcoidosis presenting with anterior hypopituitarism and hypothalamic syndrome.Case Report: A 38-years old Caucasian woman presented from primary care with six-month history of secondary amenorrhoea. Additionally she reported non-specific tiredness, postural dizziness, nausea and abdominal pains. Over the same period she noticed progressive weight gain of three stones, increased somnolence, lethargy and excessive s...

ea0028p265 | Pituitary | SFEBES2012

Cushing’s disease associated with pituitary carcinoma

MacEwen Alison , McLellan Alastair

History: A 50-year-old lady presented in March-08 with clinical features consistent with Cushings syndrome and was diagnosed with pituitary driven ACTH-dependent Cushings disease on the basis of the following investigations; elevated 24 hours urinary free cortisol 1660 nmol/l; baseline cortisol 1230 nmol/l; serum cortisol levels post low dose and subsequent high dose dexamethasone suppression tests 722 nmol/l and 1032 nmol/l respectively; serum cortisol post 100 mcg CRH 979 nm...

ea0028p266 | Pituitary | SFEBES2012

Audit of mri imaging in growth hormone deficient children

Lucas-Herald Angela , Yeap Phey , Donaldson Malcolm , Ahmed Syed , Shaikh Mohammed

Background: All children with Growth Hormone Deficiency (GHD) should have a Magnetic Resonance Imaging (MRI) scan performed as standard (GH Research Society, 2000).Aims: To determine whether all patients diagnosed with GHD as determined by stimulation testing had an MRI scan performed; and to examine the relationship between the results of endocrine investigations and MRI scans.Methods: Retrospective review of all children who had ...

ea0028p267 | Pituitary | SFEBES2012

Potential pitfalls in the management of thyrotropinoma

Koulouri Olympia , Kandasamy Narayanan , Moran Carla , Melvin Alison , Donnelly Neil , Mannion Richard , Pickard John , Halsall David , Chatterjee Krishna , Gurnell Mark

Case Report: A 49-year-old man presented with a two-year history of thyrotoxic symptoms for which he had been investigated on several occasions. He had a past medical history of dilated cardiomyopathy, which had been attributed to excess alcohol consumption, and had also suffered episodes of non-sustained ventricular tachycardia. His family history was strongly positive for autoimmune thyroid disease. Eventually, he was found to have an elevated fT4 (53 pmol/L, RR 12–22) ...

ea0028p268 | Pituitary | SFEBES2012

Local v National - comparing results of a 2010 local survey on pituitary patients’ satisfaction with information and support from healthcare professionals to 2008 nationwide survey data

Jackson Sue , Baker Daniel , Crown Anna

Introduction: Pituitary conditions are rare and diagnosis may be slow because symptoms are ambiguous. The treatment may be a combination of surgery, radiotherapy and medication so patients see many healthcare professionals. This survey sought to assess patient satisfaction with the information and support they receive from GPs, endocrinologists, neurosurgeons, radiotherapists, specialist nurses, and other agencies (e.g. Pituitary Foundation (PF)).Method:...

ea0028p269 | Pituitary | SFEBES2012

A case report of hypopituitarism following recovery from cardiac arrest - a poorly recognised sequelae?

Joseph Stonny , Fenton Mark , Kearney Edward

Hypopituitarism is a recognised complication of pituitary and hypothalamic pathology. It can also be a consequence, less commonly, of traumatic brain injury. It has never been described in patients following recovery from a cardiac arrest. We present a case history of hypopituitarism following successful cardiopulmonary resuscitation for a ventricular tachycardia (VT) cardiac arrest. A 51 year old patient with known prolonged QT (Romano ward) syndrome and chronic obstructive a...

ea0028p270 | Pituitary | SFEBES2012

Recurrent hypoglycaemia in a young lady with type 1 diabetes - an unusual cause

Manjunatha Rashmi , Tan Hiang , Barton David

Introduction: Hypoglycaemia is a common event encountered in patients with type 1 diabetes usually due to an imbalance between diabetic therapy, activity level and dietary intake.Case: We report a case of a 31-year old lady with 20-year history of type 1 diabetes on basal-bolus regimen of insulin, who presented with a 2 month history of secondary amenorrhoea and recurrent disabling hypoglycaemia despite significant reduction in insulin doses. Clinical ex...

ea0028p271 | Pituitary | SFEBES2012

An extraventricular neurocytoma in the pituitary region

Kaimal Nisha , Gnanalingham Kanna , Kearney Tara

Case history: A 50-year-old lady presented with blurred vision in her left eye. She was clinically eupituitary. Visual field testing confirmed a bitemporal field deficit. MRI pituitary showed a pituitary macroadenoma occupying part of the sphenoid fossa and causing significant optic chiasmal compression. The lesion was extending across the left carotid loop, with a part of the lesion extending and compressing the medial aspect of the left temporal lobe. She was found to be hyp...

ea0028p272 | Pituitary | SFEBES2012

Late onset isolated cortisol insufficiency after pituitary haemorrhage following traumatic brain injury

Kalathil Dhanya , Rajeev Surya , Chattington Paula

Introduction: Pituitary dysfunction is a recognised complication of traumatic brain injury; it usually involves multiple hormones and can be transient. We present a case of traumatic pituitary haemorrhage resulting in late onset persistent isolated cortisol insufficiency. Case report: A 40 year old man sustained head injury following a road traffic collision. CT brain scan soon after the event was unremarkable. He then developed drowsiness and confusion. MRI scan of the brain ...

ea0028p273 | Pituitary | SFEBES2012

Hyperprolactinemia: A DGH experience

Rajeev Surya , Kalathil Dhanya , Ooi Cheong , Saunders Simon , Chattington Paula

Background: Raised prolactin is a frequent reason for referral to endocrine clinics. Prolactinomas are the most common functioning pituitary tumours. Medical management with dopamine agonists remains the treatment of choice. MHRA advises baseline echocardiograms within 3–6 months and then 6–12 monthly in patients taking dopamine agonists due to a potential risk of cardiac valvular fibrosis though the evidence for fibrosis at endocrine doses remains limited. Aim: The ...

ea0028p274 | Pituitary | SFEBES2012

Pregnancy as a cure for a macroprolactinoma?

Koko Thet , Pernicova Ida , Ward Emma

Our patient presented at the age of 29 years with headaches and galactorrhoea and was found to have a prolactin level of more than 3000 mu/L. Her other pituitary function was normal. MRI pituitary showed 2×2 cm lesion with suprasellar extension and some distortion of the optic chiasm. She was started on Cabergoline 0.5 mg twice weekly for a presumed macroprolactinoma. Visual testing was normal. The repeat MRI four months after initiation of dopamine agonist therapy showed...

ea0028p275 | Pituitary | SFEBES2012

Aggressive prolactinoma treated with a large dose of dopamine agonist and radiotherapy

Kenz Sami , Trainer Peter

Introduction: Prolactinomas account for approximately 40% of all pituitary adenomas, with an estimated prevalence of 100 prolactinomas per million adults. Dopamine agonists currently represent the mainstay of treatment. Nevertheless, increasing dopamine-agonist dosage, surgery, and radiotherapy may be necessary in some cases, such as aggressive, dopamine-agonist resistant or atypical prolactinomas.Case: We report the case of a 55 year old man who was inc...

ea0028p276 | Pituitary | SFEBES2012

A case of hypopituitarism secondary to metastatic colonic adenocarcinoma

Adam Safwaan , Zengeni Causemore , Sissons Mark , El-Khateeb Mohamed , Mackay Jonathon , Elrishi Mohammed

Introduction: Cancers that metastasise to the pituitary gland are unusual. The clinical manifestations of these can be varied making the diagnosis challenging. The most common cancers that metastasise to the pituitary are breast and lung which together account for more than two-thirds of cases. There have been reports of other types of cancers metastasising to the pituitary but these are rare. Case An 86 year old female with a previous history of a laparotomy for Duke’s C...

ea0028p277 | Pituitary | SFEBES2012

Recurrent neutropenia associated with the use of dopamine agonists

Butt Muhammad , Waheed Najeeb , Kalk John

A 38 year lady was referred with a five month history of secondary amenorrhea, galactorrhoea, failure to conceive and elevated prolactin levels of 2023 miu/L (reference 102–496 miu/L). She could not undertake an MRI scan of the pituitary gland as she was claustrophobic and hence a CT scan was performed which did not show and gross pituitary lesion. Microprolactinoma was diagnosed and she commenced bromocriptine. She had normal white blood cells and neutrophil count prior ...

ea0028p278 | Pituitary | SFEBES2012

Abstract withdrawn....