Endocrine Abstracts

The diagnosis of Cushing’s syndrome firstly involves making or excluding the diagnosis. If the diagnosis is confirmed then an accurate diagnosis is needed as treatment modalities are in general specific to the aetiology. The diagnosis can be straightforward when symptoms and signs are classical and advanced. In these patients 24 h urinary free cortisol levels are markedly raised, late evening serum and salivary cortisol levels are raised and there is failure to suppress s...

A 53-year-old man was referred for assessment of diabetes insipidus. He had been treated with intranasal desmopressin from18 months of age on the basis of an extensive family history but without confirmatory testing. The current referral was because of hyponatraemia in a similarly affected relative, which had raised uncertainty about diagnosis and treatment.The family history included 11 affected individuals across four generations and suggested autosoma...

Primary hyperaldosteronism secondary to bilateral adrenal hyperplasia (BAH) bears striking similarities pathophysiologically to essential hypertension. During stimulation studies to elucidate possible aberrant aldosterone responses in BAH we measured the aldosterone response to 250mcg iv synacthen after 30 and 60 minutes in 7 patients with BAH and in 20 healthy controls. Patients had diuretics withheld for at least 4 weeks and betablockers and calcium channel blockers withheld...

Radioiodine is the treatment of choice for relapsed hyperthyroidism although the optimum protocol is uncertain. We assessed the outcome of therapy with 131I in relapsed hyperthyroidism using a fixed dose regimen.We retrospectively studied 449 patients (M: F 82: 367; age range 13–89 y, median 42 y) treated between 2003 and 2007 with a fixed dose of 550 MBq 131I for relapsed hyperthyroidism. Patients were classified as either Gra...

Dopamine agonist therapy is an effective long-term treatment in >90% of patients with hyperprolactinaemia, controlling both prolactin secretion and tumour growth. We describe the unusual late emergence of resistance to high-dose dopamine agonist treatment in two recent female patients. Both women presented with secondary amenorrhoea, were shown to have high prolactin levels and a pituitary microadenoma. Each had an excellent initial response to bromocriptine but years late...