Pituitary

Calcium mobilization from intracellular stores represents an important cell signalling process that is regulated, in mammalian cells, by inositol-1,4,5-triphosphate (IP3), cyclic ADP ribose (cADPR) and nicotinic acid adenine dinucleotide phosphate (NAADP). Intracellular calcium is important for mobilization of secretory granules to the plasma membrane in preparation for exocytosis. NAADP mobilizes calcium from lysosome-related acidic compartments and it has been sho...

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ea0031p245 | Pituitary | SFEBES2013

Transport features of pituitary folliculostellate cells increase in pregnancy

Maurer Typhanie , Morris John , Christian Helen

Folliculo-stellate (FS) cells exert a paracrine regulation on their neighbouring endocrine cells in the anterior pituitary gland. FS cells are non-granular cells characterized by long cytoplasmic processes and form follicles with microvilli on their luminal cavity, suggesting a transport function. Moreover, FS cells form monolayers in primary culture and develop domes after reaching confluence, characteristics of polarized transport epithelia. However little is known about tra...

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ea0031p246 | Pituitary | SFEBES2013

Chronic glucocorticoid exposure causes de-novo methylation of genes key to the regulation of the hypothalamic–pituitary–adrenal axis

Bakirtzi Georgia , Newell-Price John

Introduction:: The HPA axis is essential for mammalian life. Proopiomelanocortin (POMC), expressed in corticotroph cells of the pituitary, is the master activator of the axis, and a classical negative feedback loop exists whereby glucocorticoids from the adrenals repress its expression. Glucocorticoids are commonly prescribed medicines (10 million prescriptions in UK per year), but when used long-term, suppression of the HPA axis is a major side effect, with risk of life-threa...

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ea0031p247 | Pituitary | SFEBES2013

Polymersomes-mediated siRNA delivery for states of hormone excess

Bakirtzi Georgia , Battaglia Giuseppe , Battaglia Giuseppe , Newell-Price John

Introduction: Cushings disease is a devastating condition associated with a fivefold excess mortality. It is usually due to a small (few mm) benign corticotroph tumour in the pituitary expressing excess pro-opiomelanocortin (POMC), the peptide product of which, ACTH, drives excess secretion of cortisol from the adrenal. There is a clear clinical need for better treatment options.Background: We have designed, optimized and validated unique siRNAs to...

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ea0031p248 | Pituitary | SFEBES2013

Transcriptional regulation of C-type natriuretic peptide (CNP/Nppc) and its receptor guanylyl cyclase-B (GC-B/Npr2) in gonadotroph and somatolactotroph cell lines

Mirczuk Samantha , Jones Alexander , McGonnell Imelda , Fowkes Robert

C-type natriuretic peptide (CNP) has recently been implicated as a key meiotic arrest factor in oocytes, and mechanistic studies suggest that the transcriptional regulation of the CNP gene (Nppc) and of its receptor, GC-B (Npr2) is sensitive to gonadotrophin-dependent cAMP accumulation. We have shown CNP to be a major regulator of gonadotrophs in the pituitary, but have yet to establish how either Nppc or Npr2 are transcriptionally controlled locally. In the current study, the...

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ea0031p249 | Pituitary | SFEBES2013

‘Invasion signature’ revealed by the analysis of AIP positive and AIP mutation negative human pituitary adenomas

Barry Sayka , Gadaleta Emanuela , Chelala Claude , Korbonits Marta

Background: Familial isolated pituitary adenoma (FIPA) is an autosomal dominant condition with incomplete penetrance. Heterozygote mutations have been identified in the aryl-hydrocarbon receptor interacting protein (AIP) gene in 20% of FIPA families causing young-onset aggressive tumours.Aims: The aim of this study was to perform comparative gene expression microarray analysis of familial AIP positive and AIP negative adenomas and compare them to sporadi...

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ea0031p250 | Pituitary | SFEBES2013

Maternal vocalisation as an effective priming method for oxytocin in young adults

Daughters Katie , Jensen Keith , Hinson Joy

The neuropeptide oxytocin is the most recent peptide to have emerged from a new field of research investigating the physiological underpinnings of human social behaviour. Whilst previous studies have focused on the role of touch as an effective method of priming, this study investigated the role of social vocalisation as a potential priming method of endogenous oxytocin release. 40 female participants, aged between 18 and 21 years of age, were randomly allocated into either a ...

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ea0031p251 | Pituitary | SFEBES2013

Altitude acclimatization: plasma AVP response and physiological changes

Sachidhanandam Meenakshi , Kumar Salthan Ashok , Singh Som Nath , Ray UdaySankar

Background: Arginine vasopressin (AVP) changes during altitude acclimatization is of clinical interest as increases in their plasma levels (with reference to sea-level (SL)) have been associated with fluid retention accompanied by elevated plasma cortisol levels. Studies have reported no change/ decrease in plasma AVP during normal acclimatization. This study was conducted to evaluate plasma AVP changes and the associated physiological changes during chronic exposu...

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ea0031p252 | Pituitary | SFEBES2013

Craniopharyngiomas and Wnt signalling pathways

Preda Veronica , Larkin Sarah , Karavitaki Niki , Robinson Bruce , Clifton-Bligh Roderick , Grossman Ashley , Ansorge Olaf

Craniopharyngiomas are tumours which grow in the region of the sella, with adamantinomatous (ACP) and papillary (PCP) subtypes. While usually benign, They can have devastating long term sequelae, both from the mass effects of the tumour itself on the visual, pituitary or hypothalamic pathways, but also from the neurosurgical challenge to achieve tumour control with preservation of the surrounding pituitary and hypothalamic pathways. To date there is no satisfactory...

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ea0031p253 | Pituitary | SFEBES2013

In vivo characterisation of skeletal muscle metabolism in GH deficient adults using phosphorus-31 magnetic resonance spectroscopy

Sinha Akash , Hollingsworth Kieren , Ball Steve , Cheetham Tim

Context: GH deficient (GHD) adults can experience fatigue which resolves with GH replacement. The precise basis of this is unclear. Suboptimal mitochondrial function has been demonstrated in several conditions in which fatigue is a prominent symptom. Phosphorus-31 magnetic resonance spectroscopy (31P-MRS) can measure maximal mitochondrial oxidative phosphorylation, an important parameter of mitochondrial function. We have adapted this technique to enable non-invasive measureme...

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ea0031p254 | Pituitary | SFEBES2013

Creation of a locus-specific database for AIP mutations

Begum Fauzia , Trivellin Giampaolo , Gabrovska Plamena , Wertheim-Tysarowska Katarzyna , Jones Michael , Stals Karen , Ellard Sian , Radian Serban , Korbonits Marta

Locus-specific databases (LSDBs) have been recently developed in response to the increasing number of genetic changes reported in the human genome. LSDBs have been created for several genes implicated in endocrine syndromes, for example MEN1, VHL, RET, GNAS, PRKAR1A and the SDH subunits. Mutations in AIP are found in about 20% of familial isolated pituitary adenoma (FIPA) patients.The aim of this proj...

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ea0031p255 | Pituitary | SFEBES2013

High prevalence of pituitary dysfunction following blast traumatic brain injury: results from the UK Blast Injury Outcome Study of Armed Forces Personnel (BIOSAP)

Feeney Claire , Baxter David , Sharp David , Peters Debbie , Ham Timothy , Midwinter Mark , Bennett Alex , Mistlin Alan , Goldstone Anthony

Background: Pituitary dysfunction is a recognised consequence of traumatic brain injury (TBI) causing significant cognitive, psychological and metabolic impairment. Hormone replacement offers an important therapeutic opportunity. Blast traumatic brain injury (bTBI) from improvised explosive devices (IEDs) is commonly seen in soldiers returning from recent conflicts. We investigated: i) the prevalence and consequences of pituitary dysfunction following moderate-severe bTBI, and...

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ea0031p256 | Pituitary | SFEBES2013

Correlation of clinical smell test and magnetic resonance imaging of olfactory system in idiopathig hypogonadotropic hypogonadism

Kota Sunil Kumar , Meher Lalit Kumar , Jammula Sruti , Modi Kirtikumar D

Objectives: i) To measure olfactory bulbs and sulci using dedicated magnetic resonance imaging (MRI) sequences in idiopathic isolated hypogonadotropic hypogonadism (IHH) patients with a well detailed phenotype characterization and ii) to correlate MRI findings with a clinical smell test.Methods: MRI was performed in 20 patients (all male, aged between 11 and 45 years, mean age of 26) with IHH and olfactory dysfunction was assessed using the smell identif...

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ea0031p257 | Pituitary | SFEBES2013

Endocrine remission of Cushing's disease after endoscopic trans-sphenoidal surgery: Retrospective review of a single centre experience

Kennard Devon , Whitelaw Ben , Dworakowska Dorota , Thomas Nick , Barazi Sinan , Bullock Peter , King Andrew , Hampton Tim , Sherwood Roy , Buchanan Charles , Gilbert Jackie , McGregor Alan , Aylwin Simon

Background: Cushings disease is caused by corticotroph tumours of the pituitary gland and the standard first-line treatment is trans-sphenoidal surgery. Published data from other centres describes post-operative endocrine remission achieved in 5090% of cases.Table 1 Remission (cortisol <50)Cortisol (50150 nmol/l)<td alig...

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ea0031p258 | Pituitary | SFEBES2013

Prevalence of familial isolated pituitary adenomas

Herincs M , Owusu-Antwi S , Chahal H S , Kumar S R , Ozfirat Z , Grossman A B , Druce M R , Akker S A , Drake W M , Korbonits M

While pituitary adenomas (PA) usually occur as a sporadic disease, an increasing number of patients are recognised with a family member also suffering from a PA. If no other syndromic features are present, these families are categorised as FIPA. In published studies, 20% of the FIPA families, 20% of sporadic childhood and 13% of sporadic young-onset (≤30 years) acromegaly patients carry a germline AIP mutation. As familial disease is more aggressive, family scre...

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ea0031p259 | Pituitary | SFEBES2013

Short-term (3 months) compared to long-term response to somatostatin analogues in acromegaly

Gheorghiu Monica Livia , Vintila Madalina , Purice Mariana , Poiana Catalina , Coculescu Mihai

Objective: To evaluate whether serum GH and IGF1 levels achieved after 3 months treatment with somatostatin analogues (SSA) are concordant with the efficacy of SSA after longer treatment with the same dose.Patients and methods: From 71 patients with acromegaly treated with SSA in our clinic, in 38 of them (28 women, 10 men, aged 2262 years) data on serum GH and IGF1 were available at baseline, after 3 months and at the last evaluation on the same S...

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ea0031p260 | Pituitary | SFEBES2013

Incidental pituitary haemorrhage is common in prolactin-secreting macroadenoma especially in women

Sarwar Komil , Huda Bobby , Van de Velde Vanessa , Hopkins Laura , Luck Sara , Preston Rebecca , McGowan Barbara , Carroll Paul , Powrie Jake

Background: Incidental pituitary haemorrhage, not associated with pituitary apoplexy, is a common clinical and radiological finding. Little information exists on the clinical behaviour of incidental haemorrhage with most reports describing surgically treated macroprolactinoma and non-functioning adenoma, and there are few data in a clinic prolactinoma population.Aims: To characterise the prevalence, natural history and risk factors associated with pituit...

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ea0031p261 | Pituitary | SFEBES2013

Ophtalmological, endocrine, and neurological complications in giant male prolactinomas.

Chentli Farida , Daffeur Katia , Akkache Lina , Haddad Meriem , kalafate Nadia

Introduction: Prolactinomas are more invasive in males. Giant ones (height ≥4 cm) are relatively rare in literature.Our aim is to analyze their frequency, their radiological aspects, and their neurological, endocrine and ophthalmological complications.Methods: All of them had clinical exam, hormonal, ophthalmological, and radiological assessment based on cerebral MRI. Mixed adenomas were excluded. Positive diagnosis was based...

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ea0031p262 | Pituitary | SFEBES2013

Endocrine and radiological abnormalities in empty sella syndrome

Westland Sophie , Mason Helen , Bano Gul , Rich Philip

Background: Primary or idiopathic empty sella syndrome (ESS) is the herniation of the meninges through an incompetent diaphragma sellae into the sella turcica which pushes the pituitary gland aside so giving the appearance of an empty sella. Secondary ESS is caused by damage to pituitary tissue which results in an empty sella turcica. There is significant lack of agreement in the literature regarding the number of patients with empty sella syndrome (ESS) who suffer from pituit...

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ea0031p263 | Pituitary | SFEBES2013

¹¹C-methionine PET–CT co-registered with volume MRI identifies residual functioning tumour in acromegaly

Koulouri Olympia , Kandasamy Narayanan , Moran Carla , Chatterjee Krish , Halsall David , Cheow HK , Antoun Nagui , Hoole Andrew , Burnet Neil , Donnelly Neil , Mannion Richard , Pickard John , Gurnell Mark

Although MRI remains the investigation of choice for pituitary imaging, it does not reliably identify all secretory microadenomas, and cannot always discriminate residual tumour from post-surgical change following hypophysectomy. We hypothesised that i) imaging with the PET ligand 11C-methionine, which is taken up at sites of peptide/protein synthesis, would permit more reliable identification of functioning pituitary adenoma, and ii) co-registration of PETCT ...

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ea0031p264 | Pituitary | SFEBES2013

A retrospective cohort study of patients with hyperprolactinaemia

Banner Alexandra , Hazlehurst Jonathan , Ayuk John

Hyperprolactinaemia is the most common endocrine disorder of the hypothalamic-pituitary axis and represents a significant referral volume to secondary care. It is therefore necessary to employ a timely, structured management pathway.This retrospective cohort study at University Hospitals Birmingham, included 450 patients with serum hyperprolactinaemia, measured between 2011 and 2012. Patients with a known hyperprolactinaemia were excluded. 71 patients re...

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ea0031p265 | Pituitary | SFEBES2013

Examining the distribution of abdominal fat in GH deficiency using magnetic resonance imaging

Sinha Akash , Hollingsworth Kieren , Ball Steve , Cheetham Tim

Background: Adults with GH deficiency (GHD) have altered body composition with an increase in abdominal fat when compared with healthy matched controls. However, most studies have not compared GHD adults with GHD adults on GH replacement.Abdominal fat is composed of subcutaneous abdominal tissue (SAT) and visceral abdominal tissue (VAT). Increased VAT is associated with poor metabolic outcomes. Magnetic Resonance Imaging (MRI) is a reliable and reproduci...

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ea0031p266 | Pituitary | SFEBES2013

Long-term results after treatment of craniopharyngioma: experience with 46 adult patients

Capatina Cristina , Preda Maria , Dumitrascu Anda , Hortopan Dan , Caragheorgheopol Andra , Alexandrescu Daniela , Ciubotaru Vasile , Coculescu Mihail , Poiana Catalina

Background: Craniopharyngioma is a rare, mostly benign tumor of the central nervous system, generally associated with important morbidity.Aim: To study the clinical characteristics and treatment outcome in adult patients.Methods:: Adult patients diagnosed with craniopharyngioma between 1980 and 2012, followed-up in the Pituitary and Neuroendocrine Department of the C.I.Parhon National Institute of Endocrinology in Bucha...

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ea0031p267 | Pituitary | SFEBES2013

Syndrome of inappropriate antidiuretic hormone secretion and treatment with tolvaptan: a case series

Jude Edward , Vere Joanne

Background: Hyponatraemia is the most common electrolyte abnormality, encountered in up to 30% of inpatients. Plasma sodium levels <125 mmol/l are classed as severe and can be associated with drowsiness, confusion, ataxia and personality change. In mild hyponatraemia, the patient is usually asymptomatic, although studies have shown chronic low sodium of any level may be associated with increased mortality and longer hospital stays. Vasopressin receptor antagonist (tolvapta...

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ea0031p268 | Pituitary | SFEBES2013

Hyponatraemia assessment and outcomes in acute medically ill patients

Jude Edward , Hughes Anna , Taha Omer , Tetlow Tony

Background: Hyponatraemia is the most common electrolyte abnormality, encountered in up to 30% of inpatients. Inappropriate management can have serious implications for patients; including demyelinating disease, coma, and death.Methods: Patients (n=122) admitted to the medical admission unit of a district general hospital with a serum sodium (Na) <130 were selected for the study. All details including patient demographics, blood bio...

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ea0031p269 | Pituitary | SFEBES2013

Inside acromegaly: a pilot study for recruiting focus groups using social media

Idowu Oluwasomidotun , Levy Andy

Background: The exponential growth of social media over the last decade has provided new, diverse and accessible ways in which people can share and receive information. Its rapid rise has attracted researchers and professionals of various disciplines, aiming to capitalise on this relatively new phenomenon. In this qualitative study we utilised social media to conduct research on psychosocial aspect of acromegaly. Facebook currently has 845 million users. Acromegaly, with a pre...

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ea0031p270 | Pituitary | SFEBES2013

Pituitary apoplexy: a case series

Dimitropoulos Ioannis , Pobereskin Louis , Flanagan Daniel

Pituitary apoplexy whether due to haemorrhage or infarction remains a rare endocrine diagnosis. Recent UK guidelines have emphasised the lack of published evidence in the management of this condition. We present our experience of 12 current cases (nine males, three females).Eleven cases were managed conservatively (91.6%), one patient required urgent pituitary surgery. None of the above cases required pituitary radiotherapy.Present...

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ea0031p271 | Pituitary | SFEBES2013

An unusual cause of testosterone deficiency

Eboh Cecil , Price Paul , Moorhouse Louise

36-year-old gentleman referred by his GP with poor libido and erectile dysfunction associated with hypogonadotrophic hypogonadism. 0900 h testosterone 0.3 nmol/l (1035), LH <0.2 IU/l, FSH 0.1 IU/l, prolactin 71 mIU/l (50500).Symptoms started at time of break up of his marriage in 2011. No other symptoms of hypogonadism or of pituitary disease. Previously fit and well. Teetotal. On no medication. Patient an avid fitness fanatic. He had nev...

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ea0031p272 | Pituitary | SFEBES2013

Rare case of round blue cell pituitary tumour with probable hypothalamic involvement

Zhyzhneuskaya Sviatlana , Mitchell Anna , Abbas Jehangir , Ganguri Murali , Biswas Swethajit , Perros Petros , Kane Philip , Arutchelvam Vijayaraman

Introduction: We submit a rare presentation of round blue cell pituitary tumour complicated by cranial diabetes insipidus following transphenoidal surgery.Case history: 47-year-old lady with severe headache was diagnosed with a 10 mm non functioning pituitary macro adenoma. Initial plan for conservative management was revised as she developed sixth cranial nerve palsy, bi temporal hemianopia and rapidly enlarging pituitary tumour to 20×18×19 mm...

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ea0031p273 | Pituitary | SFEBES2013

Pituitary abscess: a rare cause of pituitary mass lesion

Kummaraganti Srinivasa , Bachuwar Ravi , Hundia Vikram

Pituitary abscess is very rare accounting for 0.2 0.6% of all pituitary lesions. Only around 210 case reports have been described so far. We report a case of pituitary abscess presented as pituitary mass lesion with hypopituitarism.A 51 year old man was admitted with headache and found to have severe hyponatraemia. Past medical history included paranoid schizophrenia. Clinical examination was normal.Relevant investigations: ...

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ea0031p274 | Pituitary | SFEBES2013

Hypopituitarism presenting with features of stiff person syndrome

Mudaliar R N , Wilson S , Howell S J , Shaunak S , Kaushal K

Introduction: Stiff person syndrome (SPS) is a progressive neurological disorder characterized by fluctuating stiffness and rigidity in both axial and limb muscles. Stiff leg syndrome, an SPS variant mainly affecting limb muscles, is emerging as a distinct identity. The cause of SPS is unknown but an autoimmune pathogenesis is suspected. There are a few reported cases of hypopituitarism presenting with features suggestive of SPS.Case: A 66-year-old woman...

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ea0031p275 | Pituitary | SFEBES2013

Snake bite and hypopituitarism: ignorance or incompetence?

Kamath Akshatha Taranath , Kumar Sampath Satish

Hypopituitarism as a consequence of snake bite is rare. However, there are a few case reports from India and adjacent South-East Asian countries. We present a case of hypopituitarism secondary to snake bite where the diagnosis was significantly delayed. A 42-year-old gentleman presented as out-patient with a 10 years history of generalized weakness, lethargy, coarse facial features, reduced libido, reduced socialization and depression. He had an acute illness following a snake...

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ea0031p276 | Pituitary | SFEBES2013

TSH-secreting pituitary adenoma identified in pregnancy: management of an unusual case

Triay Jessica , Wynick David , Thorogood Natasha , Bradley Karin

A 35-year-old woman was referred with biochemical hyperthyroidism (T4 30 pmol/l; T3 7 pmol/l) without TSH suppression (5.4 mIU/l). She was 7 weeks pregnant following natural conception, and reported no symptoms of hyperthyroidism. Migraines had been a feature in very early pregnancy, but her medical history was otherwise unremarkable and there was no significant family history. Examination findings were entirely normal.Investigation...

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ea0031p277 | Pituitary | SFEBES2013

A rising TSH in a patient with known TSHoma does not necessarily indicate recurrence

Laheru Dhruvkumar , Armitage Mary , Richardson Tristan

In 2003, a 60-year-old man presented to our unit non-specifically unwell. Thyroid function tests (TFTs) demonstrated an elevated fT4 of 50 pmol/l (reference range 1022 pmol/l)), T3 8.8 pmol/l (reference range 3.16.8 pmol/l) and TSH of 10.3 mU/l (reference range 0.54.5 mU/l)). Following appropriate investigations, a TSHoma was confirmed. MRI of the Pituitary confirmed the finding of a macroadenoma and the patient underwent pituitary decom...

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ea0031p278 | Pituitary | SFEBES2013

Unusual presentation of acromegaly and functioning pituitary gonadotrophinoma (FSHoma)

Pan Shwe Zin Chit , Bevan-Jones Richard , Mathews Anitha

Background: Gonadotroph adenomas are the most common non-functioning pituitary adenomas in adult1, 2. However, functioning gonadotrophinomas are rare. Here, we describe an unusual presentation of concurrent acromegaly and functioning FSHoma (FSH-secreting pituitary adenoma).A 39-year-old man presented with a vague visual disturbance to the optometrist and a bitemporal hemianopia was detected.Further questioning elicited ...

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ea0031p279 | Pituitary | SFEBES2013

Pituitary apoplexy and aortic dissection

Mudaliar R N , Golash A , Kaushal K , Howell S J

Introduction: Pituitary apoplexy is a rare but life threatening clinical syndrome characterised by acute neuro-ophthalmological features caused by haemorrhage and/or infarction of the pituitary gland. Although many precipitating factors are known, most apoplectic episodes occur spontaneously.Case: A 59-year-old gentleman presented in 2005 with a 12-month history of bitemporal hemianopia. An MR scan revealed a pituitary macroadenoma. When he was reviewed ...

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ea0031p280 | Pituitary | SFEBES2013

Isolated central hypoadrenalism as the sole manifestation of presumed neurosarcoidosis

Zhyzhneuskaya Sviatlana , Ganguri Murali , Abbas Jehangir , Nag Sath

Introduction: Hypothalamicpituitary sarcoidosis is uncommon and affects <10% of patients with neurosarcoidosis. It presents a diagnostic challenge. We present a case of isolated central hypoadrenalism presenting as the sole manifestation of neurosarcoidosis.Case history: A 76-year-old man with recently diagnosed primary hypothyroidism presented with weight loss, increasing lethargy and fatigue. Physical exam revealed inguinal lymhadenopathy. St...

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ea0031p281 | Pituitary | SFEBES2013

Etiology and outcome of hyponatremia due to pituitary insufficiency in a tertiary endocrine center

Trifanescu Raluca-Alexandra , Badiu Corin , Caragheorgheopol Andra , Coculescu Mihail , Poiana Catalina

Background: Hyponatremia is a common electrolyte abnormality, especially in elderly, hospitalized patients, with a prevalence of severe hyponatremia (<125 mmol/l) up to 68%. Pituitary insufficiency (TSH+ACTH) may be difficult to diagnose, but it is important to differentiate it from SIADH and cerebral salt wasting syndrome.Aim: To describe the aetiology and outcome of patients with hyponatremia due to pituitary insufficiency in a tertiary endoc...

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ea0031p282 | Pituitary | SFEBES2013

Spontaneous resolution of pituitary Cushing's

Humayun Malik

A 32-year-old male was referred by his GP with a 6-month history of lethargy, erectile dysfunction, weight gain, acne and hypertension. He denied exogenous steroid usage and had no other past medical history. On examination, he had classical features of Cushings including moon face, central adiposity, proximal muscle weakness and purple striae.Investigations confirmed Cushings from a pituitary source as shown in the table below. MRI pituitary...

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ea0031p283 | Pituitary | SFEBES2013

A case of complex neurodevelopmental abnormality causing asymptomatic SIADH

Gondhalekar Anjali , Grubb Anthony , Herbert Angharad , Tong Wing Hong , Rao Ranganatha , Jenkins David

Case: A 25-year-old lady was incidentally found to have hyponatremia while she was investigated for painful left ankle and hand swelling. At the time of review in endocrine clinic, she was completely asymptomatic. Her menstrual period was normal. On examination she was found to be hypertensive with consistent blood pressure of 188/110. Rest of the systemic examination was unremarkable. Investigations revealed biochemical findings consistent wi...

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ea0031p284 | Pituitary | SFEBES2013

Hypopituitarism with visual field loss is not always an adenoma

Farooq Umar , Raja Umar , Basu Ansu

Introduction: A biochemical profile of an underactive pituitary gland allied to visual field loss is commonly due to an underlying adenoma. We report a case where such a clinical picture was found but imaging/biopsy revealed a different cause.Case report: A 52-year-old Indian male was referred by his GP to an endocrine outpatient department with reduced visual acuity, balance problems and a biochemical profile of an underactive pituitary gland. Past hist...

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ea0031p285 | Pituitary | SFEBES2013

Rapidly progressive pituitary carcinoma in a young female

Giritharan Sumithra , Kearney Tara , Gnanalingham Kanna

A 32-year-old female presented with a 6-week history of worsening headaches associated with bitemporal visual field defects. An urgent MR scan demonstrated a sizeable pituitary lesion with chiasmal compression and suprasellar extension. Endocrine tests revealed hyperprolactinaemia (2550 mU/l) with hypocortisolaemia (<37 nmol/l). Cabergoline and hydrocortisone replacement were initiated. Unfortunately, 24 h later her visual fields deteriorated further and the patient underw...

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ea0031p286 | Pituitary | SFEBES2013

Growth of a meningioma in a female patient with uncontrolled congenital adrenal hyperplasia

O'Shea Triona , Crowley Rachel , Farrell Michael , Hunter Steven , Gibney James , Sherlock Mark

Context: Growth of meningiomas has been previously described in patients receiving oestrogen/progestogen therapy.Methods: Case history, laboratory findings, imaging and histology are discussed.Case history: A 45-year-old woman with a known history of 21-hydroxyase deficiency (of the non-salt wasting variety) and long-standing non-adherence with corticosteroid therapy presented to the Endocrine Clinic for follow-up care. She complai...

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ea0031p287 | Pituitary | SFEBES2013

Finally we know! ‘It comes from your pituitary'

Rashid Nazia , Baldeweg Stephanie E

Introduction: Cushings syndrome is broadly categorized into ACTH dependent (pituitary and ectopic source) and ACTH independent (adrenal source). Localizing source of Cushings can sometimes be a cumbersome diagnostic process.Case history: A 25-year-old male patient presented with sudden rapid onset weight gain, muscle weakness and occasional headaches.as well as severe dyspnoea, orthopnea and PND. There was no significant past medical or famil...

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ea0031p288 | Pituitary | SFEBES2013

Inflammatory markers in polycystic ovarian syndrome and their association with cardiovascular risk factors

Kota Sunil Kumar , Meher Lalit Kumar , Jammula Sruti , Modi Kirtikumar D

Objectives: To determine and compare inflammatory markers including adiponectin, visfatin and IL18 in patients with polycystic ovarian syndrome (PCOS) 2. To find out whether adiponectin and interleukin 18 (IL18) is associated with markers of insulin resistance, hyperandrogenism and carotid intima-media wall thickness (CIMT) as a cardiovascular risk factor.Methods: This is a prospective controlled study involving 60 consecutive euglycemic patients with PC...

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ea0031p289 | Pituitary | SFEBES2013

Maternal corticosterone regulates amino acid allocation to fetal growth in mice

Vaughan Owen , Sferruzzi-Perri Amanda , Fowden Abigail

Synthetic glucocorticoid administration during pregnancy reduces birth weight and increases disease risk in the offspring. This study investigated whether increasing maternal natural corticosterone levels, by endogenous stress or exogenous administration, alters fetal amino acid supply in the mouse.C57BL6/J dams (n=82) were exposed to daily restraint and subcutaneous saline injection (stress) or given corticosterone (cort, 82±11 &#...

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ea0031p290 | Pituitary | SFEBES2013

BMP4 induces terminal differentiation of primary trophoblast cells and increases chorionic gonadotrophin secretion

Cabrera-Shaarp Victoria , Richardson Stephanie , Kowalski Alycia , Antczak Doug , Mukherjee Abir , Mestre Amanda de

Objective: Chorionic gonadotrophin (CG) is a hormone induced during terminal differentiation of trophoblast cells that significantly influences pregnancy outcome. The TGFβ superfamily SMAD2/3 pathway regulates placental function but the activity of the alternative pathway through SMAD1/5/8 in the placenta is unknown. This study investigated the role of BMP4 signalling through SMAD1/5 in terminal differentiation of primary chorionic gonadotrophin-secreting trophoblast cell...

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ea0031p291 | Pituitary | SFEBES2013

Is diethylstilboestrol an endocrine disruptor in the developing human fetal testis? Effects of DES exposure using a xenograft approach

Mitchell R T , Anderson R A , van den Driesche S , McKinnell C , MacPherson S , Wallace W H B , Kelnar C J H , Sharpe R M

Context: In rodents, in-utero exposure to the exogenous oestrogen diethylstilboestrol (DES) results in reproductive abnormalities in male offspring. It has been proposed that similar anti-androgenic effects also occur in the human fetal testis following oestrogen exposure.Objective: Determine effects of DES exposure on testosterone production by normally growing human fetal testis xenografts.Design: Human fetal testes (15&...

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ea0031p292 | Pituitary | SFEBES2013

Perinatal origins of adult Leydig cells and function: role of developmental androgens

Kilcoyne Karen , Atanossova Nina , Franca Luiz Renato de , Lara Nathalia , Gendt Karel De , Verhoeven Guido , McKinnell Chris , Macpherson Sheila , Driesche Sander van den , Smith Lee , Sharpe Richard M

Fetal events can affect adult testosterone levels but how this occurs is unknown, as adult Leydig cells (ALC) do not differentiate until puberty. Qin et al. 2008 (PLos ONE) identified that chicken ovalbumin upstream promoter-transcription factor II (COUP-TFII) is essential postnatally for ALC development. We hypothesized that: i) COUP-TFII+ non-Leydig interstitial cells are progenitors for ALC and are present in the fetal testis, ii) these pr...

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ea0031p293 | Pituitary | SFEBES2013

Pulsatile GnRH signaling to ERK: relevance of pulse duration and frequency

Perrett Rebecca , Armstrong Stephen , Fowkes Rob , McArdle Craig

GnRH is secreted in pulses and its effects on pituitary gonadotropes depend on pulse frequency. This is crucial for physiological control and therapeutic manipulation of the system (in IVF and treatment of hormone-dependent cancers) but GnRH pulse frequency decoding mechanisms are unknown. The simplest form of frequency dependence is a linear relationship between integrated inputs and outputs but such integrative tracking cannot explain the bell-shaped frequency-re...

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ea0031p294 | Pituitary | SFEBES2013

Intrahepatic cholestasis of pregnancy levels of sulfated progesterone metabolites downregulate hepatic LXRα

Nikolova Vanya , Abu-Hayyeh Shadi , Papacleovoulou Georgia , Parker Malcolm , Williamson Catherine

Introduction: Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder which is associated with higher incidence of gallstone disease. ICP symptoms are usually presented in the third trimester of gestation and their severity advances in parallel with the increase in serum sulphated progesterone metabolites (P4-S) in the mother. Liver X receptor α (LXRα) actively participates in the regulation of lipid metabolism functioning as a cholesterol ...

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ea0031p295 | Pituitary | SFEBES2013

DNA methyltransferase 3a, 3b and 3L expression in fetal germ cells and its modulation

Chambers Thomas , Dean Afshan , Driesche Sander van den , Mitchell Rod , MacPherson Sheila , Anderson Richard , Drake Mandy , Sharpe Richard

Background: 5-Cytosine methylation of DNA is a means of encoding epigenetic information. In the testis, the generation of de novo methylation is conducted by the enzymes DNMT3a and 3b and the co-enzyme DNMT3L. Epigenetic marks made to the DNA of germ cells are important as a potential means of trans-generational carriage of environmental information. In fetal life, germ cell demethylation and remethylation are important physiological events and these overlap with key ...

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ea0031p296 | Pituitary | SFEBES2013

Dissecting the prokineticin receptor dimerization interface: a role in kallmann sindrome?

Sposini Silvia , Hanyaloglu Aylin , Miele Rossella

Prokineticin receptors (PKR1 and PKR2) are GPCRs that belong to neuropeptide Y receptor class. They exert their biological functions binding two structurally related peptides (Bv8 or PK2 and EG-VEGF orr PK1). Intensive research over the past few years has shown that PKs/PKRs signalling modulates neuronal survival and neurogenesis, hypothalamic hormone secretion, nociception, circadian rhythm and complex behaviours, such as feeding and drinking. It also promotes angiogenesis in...

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ea0031p297 | Pituitary | SFEBES2013

Tocopherol interacts with β-mimetic effect in reproductive and respiratory tracts in the rat

Hodi Agnes , Hajagos-Toth Judit , Klukovits Anna , Seres Adrienn , Gaspar Robert

Background: It is known that reactive oxygen species (ROS) production is necessary for the signal transduction mechanism of β-adrenergic receptors.Aim: Our aim was to investigate whether antioxidant agent (α)-tocopherol-acid-succinate may reduce the effect of β-mimetic action on β(2)-adrenergic receptor regulated tissues.Methods: Tissue samples were collected from non-pregnant (trachea) and 22-day pregnant (myom...

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ea0031p298 | Pituitary | SFEBES2013

Steroid regulation of gene and protein expression of osteopontin and αvβ3 integrin in ovine endometrium

Tremaine Tina , Fouladi-Nashta Ali , Khalid Mohammed , Wathes Claire

At implantation, the ability of an embryo to successfully attach to the luminal epithelium is dependent on the receptive phenotype the endometrium must acquire. This spatially and temporally restricted period of uterine receptivity is defined by endometrial molecular adaptations, highly regulated by embryonic-derived signals and ovarian steroids. Critical to this isthe expression of adhesivemoleculesintegrins and osteopontin (OPN) at the foetal-maternal interface which facilit...

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ea0031p299 | Pituitary | SFEBES2013

The effect of mTOR blockers on japanese quail ovarian granulosa cell functions

Kadasi Attila , Maruniakova Nora , Kolesarova Adriana , Balazi Andrej , Hanusova Emilia , Kotwica Jan , Mai Antonello , Sirotkin Alexander V

The aim of our study was to elucidated the role of mTOR-dependent intracellular signalling pathway in control of ovarian functions. For this purpose, we have examine the effect of three mTOR inhibitors (resveratrol, curcumin and synthetic mTOR blocker MC 2183 Mai et al. 20051, at the doses 0, 1, 10, 100 μg/ml) on apoptosis and steroidogenesis by cultured Japanese quail ovarian granulosa cells. The release of steroid hormones (progesterone and te...

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ea0031p300 | Pituitary | SFEBES2013

K_ATP channels are involved in the tocolytic effect of β₂ agonists in pregnant rat

Lovasz Norbert , Koncz Andrea , Ducza Eszter , Falkay George

Preterm birth defined is a major determinant of neonatal mortality and morbidity. The incidence of preterm birth has not decreased over the years despite major improvements in medical research. In the view to decreasing the potentially maternal and foetal adverse events it is a pharmacological challenge to find new therapeutic strategies. In the clinical practice the most frequently used tocolytic agents are the β2-adrenoceptor agonist (terbutaline, fenoterol, ...

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ea0031p301 | Pituitary | SFEBES2013

Possible role of fetuin-B in the preterm delivery in the rat

Ducza Eszter , Seres Adrienn , Gaspar Robert

Fetuin-B is an inhibitor of basic calcium phosphate, preventing unwanted calcification. The low level of fetuin could be associated with an increased risk of atherosclerosis and ectopic microcalcifications in soft tissues and the rupture of the membranes leading to preterm delivery. Our aims were i) to examine the alterations of mRNA expression of the fetuin-B in the late pregnant rat uterus, furthermore ii) to investigate the fetuin-B expression in hormonally- and lipopolysac...

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ea0031p302 | Pituitary | SFEBES2013

Effect of t-2 toxin and combination of t-2 toxin with resveratrol and mc2183 on ovarian cells of japanese quails

Maruniakova Nora , Kadasi Attila , Medvedova Marina , Halenar Marek , Bulla Jozef , Sirotkin Alexander V , Grossmann Roland , Kolesarova Adriana

Occurence of mycotoxins in various food and feed commodities is a worldwide problem. T-2 toxin is one of the most toxic trichothecene mycotoxin, produced mainly by Fusarium species. Poultry belongs to very sensitive species which are very often explored to toxic effects of mycotoxins. The aim of our in vitro studies was to examine secretion activity of ovarian granulossa cells to produce progesterone P4 after T-2 toxin and its combinations with res...

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ea0031p303 | Pituitary | SFEBES2013

In vitro effect of 4-nonylphenol and 17β-estradiol on bovine spermatozoa

Lukacova Jana , Knazicka Zuzana , Tvrda Eva , Lukac Norbert

Nonylphenol (NP) is an endocrine disruptor that is capable of interfering with the hormonal system of numerous organisms. Estrogens play a central role in female reproduction, but also affect the male reproductive system. In males, they stimulate sperm capacitation, acrosome reaction and fertilizing ability. The aim of the present study was to investigate the effect of 4-nonylphenol (4-NP) and the effect of 17β-estradiol (E2) on bovine spermatozoa motility. We ...

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ea0031p304 | Pituitary | SFEBES2013

Effects of iron on the steroidogenesis of human adrenocarcinoma (nci-h295r) cell line in vitro

Knazicka Zuzana , Forgacs Zsolt , Lukacova Jana , Gren Agnieszka , Lukac Norbert

Currently, there is increasing evidence that various chemicals introduced in the environment have the potential to cause damage to endocrine system, which regulates reproductive processes. Iron has various effects on reproductive endocrinology and it can also cause or contribute to hormonal disruption and to interfere with the key enzymes involved in steroid synthesis. The target of this in vitro study was to determine the effects of iron (FeSO4·7H<sub...

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ea0031p305 | Pituitary | SFEBES2013

Gaining a better understanding of individual experiences of weight regulation in polycystic ovary syndrome

Cooper Gill

Polycystic ovary syndrome (PCOS) is an endocrinopathy affecting 510% of women. The PCOS symptomatology spectrum includes compromised fertility, dermatological conditions and metabolic dysregulation, the predominant cause of which is excess androgen production. PCOS is associated with increased risk of developing features of the metabolic syndrome which is exacerbated by the fact between 40 and 80% of PCOS diagnosed women are estimated to be obese. Achieving modest weight...

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ea0031p306 | Pituitary | SFEBES2013

Regulation of LH/CG receptor signaling in human endometrium and perturbations in recurrent pregnancy loss

West Camilla , Hanyaloglu Aylin , Brosens Jan

G-protein coupled receptors (GPCRs) represent the largest family of signaling receptors in nature. Their diversity means they play key physiological roles and their dysfunction underlies many pathological conditions, thus they are the focus of many drug design programs due to their primary biological and clinical importance. Our objective is to understand the fundamental mechanisms regulating hormone signaling via GPCRs. Disruption of GPCRs regulation in humans underlies many ...

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ea0031p307 | Pituitary | SFEBES2013

Kisspeptin-54 administration stimulates LH pulsatility in women with hypothalamic amenorrhoea

Abbara Ali , Jayasena Channa , Ratnasabapathy Risheka , Comninos Alexander , Nijher Monica , Ganiyu-Dada Zainab , Mehta Amrish , Todd Catriona , Ghatei Mohammad , Bloom Stephen , Dhillo Waljit

Introduction: Kisspeptin-54 is a recently identified hormone, which potently stimulates GnRH secretion within the hypothalamus. Women with hypothalamic amenorrhoea (HA, hypogonadotrophic hypogonadism associated with low body weight) have reduced LH pulsatility causing amenorrhea and infertility. We have previously demonstrated that exogenous administration of kisspeptin-54 acutely stimulates gonadotrophin secretion in women with HA. However, it is not known whether exogenous k...

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ea0031p308 | Pituitary | SFEBES2013

Effect of ethnicity on the clinical presentations of women with polycystic ovary syndrome: a 20-year retrospective cohort study

Mani Hamidreza , Levy Miles , Davies Melanie , Morris Danielle , Gray Laura , Khunti Kamlesh , Howlett Trevor

Methodology: Polycystic ovary syndrome (PCOS) has a variety of signs and symptoms compromising different phenotypic presentations. Insulin resistance is a known association of PCOS. Despite the documented effect of ethnicity on insulin resistance, there is little known about the effect of ethnicity on the clinical presentations of PCOS. We compared the clinical presentations of white and South Asian (SA) women with PCOS.Methodology: Retrospective analysi...

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ea0031p309 | Pituitary | SFEBES2013

A case of persistent Mullerian duct syndrome

Graham Una , McCracken Emma , Mullan Karen

A 45-year-old man who works as a psychotherapist was referred with an incidental finding of a rudimentary uterus and bilateral pelvic gonads on pelvic computerized tomogram and magnetic resonance imaging. This was performed for investigation of abdominal pain which has since settled. As far as he is aware he was born without complications and developed normally through childhood. He progressed through puberty uneventfully with voice changes by 13 years and shaving by 16 years....

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ea0031p310 | Pituitary | SFEBES2013

Pubertal induction in males with hypogonadotropic hypogonadism using long-acting intramuscular testosterone undecanoate 1g depot (Nebido)

Santhakumar Anjali , Miller Margaret , Quinton Richard

Background: Hypogonadotropic hypogonadism in apubertal males is commonly due to constitutional delay; permanent gonadotropin deficiency becomes more likely with older age at presentation, cryptorchidism and non-reproductive defect, e.g. anosmia. All forms of testosterone induce pubertal development, though short-acting IM preparations are associated with extraphysiological excursions of serum testosterone and are increasingly unavailable. Long-acting testosterone undecanoate I...

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ea0031p311 | Pituitary | SFEBES2013

White matter changes on magnetic resonance imaging in Klinefelter syndrome

Beeharry Deepa , Iqbal Amena , Overend Louise , Srinivas-Shankar Upendram

Introduction: Klinefelter syndrome may involve multiple organ systems. The CNS, magnetic resonance brain imaging (MRI) findings (white matter changes, reduction in ventricular volume and brain size) are under recognised.We present the case report of a 47-year-old man with schizophrenia who presented with a 4-month history of lethargy, self-neglect and decline in cognitive function. Brain MRI revealed abnormal white matter changes in left frontal and temp...

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ea0031p312 | Pituitary | SFEBES2013

Metformin treatment of PCOS: St George's Hospital Endocrine Unit Clinical Experience

Walton Hannah , Mason Helen , Bano Gul

Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting women and is associated with hyperinsulinaemia and hyperandrogenism. Obesity is present in at least 30% of cases and plays a vital role in the development and maintenance of PCOS as well as affecting the severity of the clinical and endocrine features. Significant improvements in symptoms of androgen excess and ovulatory function are seen with even a modest weight loss of 5% in women with PCOS. M...

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ea0031p313 | Pituitary | SFEBES2013

Myotonic dystrophy: a rare cause of primary hypogonadism

Thorne Alison , Iqbal C M , Beeharry Deepa , Mayes Tom , Srinivas-Shankar Upendram

Male hypogonadism is usually considered in the presence of classical symptoms like reduced libido, erectile dysfunction and reduced bone mineral density.We present the case history of a 43-year-old man with learning difficulties who presented with long-standing lethargy. Clinical examination revealed bilateral ptosis, muscle weakness and slow relaxation of handgrip. He had abdominal obesity, pseudo-gynaecomastia, frontal balding, reduced facial, chest, a...

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ea0031p314 | Pituitary | SFEBES2013

Abstract withdrawn....

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Society for Endocrinology BES 2013

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