Endocrine Abstracts

Anorexia nervosa is a common psychiatric disease, with a prevalence of 1–2% of college-aged women, characterized by chronic starvation. Nutritional deprivation is complicated by serious and multi-axis endocrine dysregulation. This includes abnormalities in GnRH secretion resulting in hypothalamic amenorrhea, with resultant estrogen and androgen deficiency, which is usually but not always reversible with weight and psychiatric recovery. GH resistance at the level of the li...

The treatment of growth hormone deficiency (GHD) with growth hormone (GH) leads to increased bone turnover, new bone formations and increased bone mineral density (BMD). This response is paralleled by an increased demand for bone substrate. We present a case in which the increased turnover induced by GH treatment revealed previously occult metabolic bone disease.The patient a 56-year-old male with panhypopituitarism following treatment for acromegaly, co...

Background: Quantification of 1,25-dihydroxyvitamin D (1,25(OH)2D) remains challenging because of low circulating concentrations and potent cross-reactivities with steroid-like structures. The most frequent assays for 1,25(OH)2D testing are still based on RIA format with preliminary extraction. The analytical performances and the turnaround time of analysis (TAT) for these assays are limited. Several novel assays for 1,25(OH)2D testing are emer...

Malignant neoplasm of the Adrenal gland is rare and carries a poor prognosis. Presentation is with either symptoms of hormone excess; Cushings Syndrome (Steroids), Conns Syndrome (Aldosterone), Virilisation (Androgens), Feminisation (Oestrogens), Phaeochromocytoma (Catecholamines) or abdominal mass, and patients often present with hypertension. Laboratory investigations confirm clinical suspicion of isolated hormone excess. Surgical resection offers the best chance for long-te...

GnRH neurons are vital for reproductive competence. These neurons originate mainly in the nasal epithelium and migrate to the preoptic region of the hypothalamus during foetal development. Defective migration may result in Hypogonadotropic Hypogonadism (HH), a condition in which puberty is never or only partially achieved.Little is known about the molecular ontogeny and regulation of GnRH neurons. Their anatomical localisation and small numbers (about 10...

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...

Nebido (testosterone undecanoate 1000 mg injection) was used to induce pubertal development in 2 apubertal men with Kallmann’s syndrome, in their 6th decade.Case 1: Originally diagnosed with Kallmann’s syndrome aged 21, but then discontinued treatment for the next 25 years. Now aged 50, he was markedly eunuchoid: G3-4, P3, A1.Investigations: Testosterone 1.0 nmol/l, LH and FSH <0.5IU/l.Normal fe...

A 50 year old lady undergoing elective surgery for pyloric stenosis secondary to chronic ulceration, was diagnosed with primary hyperparathyroidism (calcium 3 mmol/l), elevated parathyroid hormone (PTH). Following exploratory parathyroidectomy, left and right superior parathyroid adenomas were removed. 2 years later she re-presented with hypercalcaemia (Calcium 2.74 mmol/l, PTH 26.5 pmol/l (1.1–6.8 pmol/l)) and appeared Cushingoid. Investigations confirmed Cushing’s ...

The most effective means of treating macroprolactinomas, including those associated with significant visual loss at presentation, is with dopamine agonist (DA) therapy. Improvement in visual function often occurs within days of commencing DA therapy, and usually precedes significant reductions in prolactin (PRL) concentrations and may predate significant evidence of tumour volume reduction by months or years. The temporal association between PRL concentration reductions and tu...

Growth Hormone (GH) deficiency in the adult is associated with sub-optimal bone mineral density (BMD) and reduced bone turnover. GH replacement therapy results in increased bone turnover and new bone formation with biphasic changes in BMD: We report a case in which the anabolic effects of GH on bone precipitated profound Vitamin D (Vit D) deficiency.The patient 56-year-old man with panhypopituitarism following treatment for acromegaly commenced adult GH ...