Endocrine Abstracts

There is little information on the effects on pituitary function of cranial irradiation for non-pituitary tumours. We have studied anterior and posterior pituitary function in 17 patients (6 males), with a median age 19 years (range 5-48) at the time of radiotherapy. 16 patients had primary brain tumours and one had acute lymphocytic leukaemia. The patients were selected by the radiotherapists for investigation . Pituitary functions were assessed at a median of 60 months (rang...

Recent evidence suggests a high prevalence of neuroendocrine dysfunction in patients following traumatic brain injury (TBI), but dynamic anterior pituitary assessment were performed in relatively small number of patients and posterior pituitary function remains poorly investigated.We studied 102 consecutive patients (84 males) who had survived severe or moderate TBI [initial Glasgow Coma Scale (GCS) score 3-13] at a mean (+/- standard deviation) of 19 +/...

Acromegalic patients have increased morbidity and mortality, which correlate with post-treatment growth hormone (GH) level. Target post-treatment plasma GH level should be less than 2.5 nanograms per millilitre, which predicts normal life expectancy.We evaluated the prevalence of complications and treatment outcome in 76 acromegalic subjects who attended our unit for surgery between 1978-2002. 60 patients are followed up in a specialised pituitary clinic in Beaumont Hospit...

Subarachnoid haemorrhage (SAH) is a well reported cause of hypopituitarism but the precise incidence is controversial. We aimed to prospectively determine the incidence of acute and long term hypopituitarism in SAH.We prospectively recruited 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium, urea, osmolality, glucose, and 0900 h cortisol (PC) measured on days 1, 2, 3, 4, 6, 8, 10...

Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH). Retrospective data suggests that the Syndrome of Inappropriate Antidiuresis (SIAD) is the most common cause, although glucocorticoid deficiency and rarely cerebral salt wasting may also cause hyponatraemia.We prospectively studied 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (p...

Microprolactinomas are considered not to cause pituitary hormone dysfunction, but there is little data available on the prevalence of hormone deficiencies. We aimed to establish the frequency of pituitary hormone dysfunction in patients with hyperprolactinaemia.We examined the casenotes of 124 consecutive patients (85 females) with documented hyperprolactinemia from our pituitary data-base. 52 patients had macroadenomas (tumour > 1cm diameter), 64 mic...

The insulin tolerance test (ITT) is the gold standard for assessing growth hormone (GH) and cortisol production in pituitary disease, However it is potentially hazardous, requires medical supervision and adequate hypoglycemia may not be achieved. We retrospectively examined the records of 185 consecutive patients aged 14-76 years with pituitary disease who underwent the ITT over 18 months. Testing was performed in the endocrine day ward by an experienced endocrine nurse. Absol...

Hypopituitarism is associated with premature vascular mortality. Growth hormone (GH) deficiency, over-replacement with glucocorticoid, cranial irradiation and traditional vascular risk factors are possible contributing factors to the excess mortality.We studied 200 consecutive adult hypopituitary age (mean standard deviation) 51.7 plus/minus 15.3 years, who attended our pituitary clinic between July and December 2002. Hypertension was defined as blood pr...

Pituitary hormone abnormalities have been reported in up to 50% of survivors of traumatic brain injury (TBI), tested several months or longer after the event. No information is available on the frequency of hypopituitarism in the immediate post-TBI period.We studied 50 consecutive patients who were admitted to the neurosurgical unit with severe or moderate TBI [initial Glasgow Coma Scale (GCS) score 3-13]. Testing was performed at a median of 12 days pos...

Published data has demonstrated that low 0900 h plasma total cortisol (PTC) immediately following traumatic brain injury (TBI) predicts mortality. However, potential discrepancies exist between PTC and plasma free cortisol (PFC). We hypothesised that low PTC would correlate closely with PFC and predict mortality and long-term hypopituitarism.One hundred patients (84 men, median age 33, range 18–75) with TBI (mean GCS±S.D.=8.59&#1...