Endocrine Abstracts

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The current indication for TRT is hypogonadism, a syndrome complex combining hypogonadal symptoms and low testosterone concentrations. The optimal formulation for the treatment of hypogonadism is one that generates a physiological testosterone concentration in the age adjusted reference range, as well as the concentration of its metabolites oestradiol and dihydrotestosterone, while ideally mimicking the circadian rhythm in younger subjects. Optimal treatment should lead to cor...

Introduction: Hyponatraemia is the most common electrolyte abnormality encountered in hospitalised patients.Methods: This retrospective study included all inpatients with serum sodium ≤128 mmol/l at any point during their hospital stay between 1st March 2013 and 31st May 2013. Full review of medical case notes and laboratory results was undertaken in order to determine the comorbidities, drug history and aetiology of inpatients with hyponatraemia.<...

Introduction: Hyponatraemia is associated with increased inpatient mortality, but there is debate about whether hyponatraemia per se contributes to mortality or is merely an epiphenomenon of severe illness.Methods: This retrospective review of medical records included all inpatients with serum sodium (sNa)≤128 mmol/l who died at a teaching hospital over a 3-month period. The aim of this study was to examine the clinical course and the pote...

A 45-year-old man was found wandering in the streets by the Ambulance Service. He complained of productive cough with haemoptysis. On examination he was cachectic with clubbing, and he was confused (abbreviated mental test score 1/10). Chest XR showed left hilar and perihilar air space shadowing. He was treated for a community acquired pneumonia. A CT scan of the head showed a mass lesion in the pituitary fossa, confirmed on an MRI scan.Assessment of his...

History: A 63 year old female presented with nausea, vomiting and loss of balance. She had no other symptoms. An MRI of the brain revealed a large incidental pituitary lesion occupying both the sella and suprasellar region, causing distortion of the optic chiasm and tracts. She had no headache, visual disturbance, tiredness, thirst or daytime frequency although she had long standing nocturia.Examination: Visual fields showed mild bitemporal desaturation ...

Background: Endoscopic endonasal transsphenoidal hypophysectomy is an alternative to microscopic transsphenoidal hypophysectomy. The technique may provide a safer, quicker and more effective treatment.Objectives: To assess preliminary results of this technique when introduced at a single centre with a single surgeon.Methods: A retrospective analysis of 62 patients who underwent transsphenoidal surgery, 33 microscopic and 29 endosco...

Introduction: Loss of anosmin-1 function underlies the pathogenesis of X-linked Kallmann's syndrome (X-KS), a disorder characterized by anosmia (loss of smell) and hypogonadotrophic hypogonadism, due to olfactory bulb (OB) dysgenesis and failed migration of gonadotrophin releasing hormone (GnRH) neurons. Additional phenotypic features include bimanual synkinesis and unilateral renal agenesis. Anosmin-1 contains a whey acidic protein-like (WAP) domain and four contiguous fibron...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...

Case summary: A 55 year-old lady was referred by ophthalmology following diagnosis of bilateral central serous retinopathy, an accumulation of sub-retinal fluid at the fundus associated with Cushing’s syndrome. She also had proximal myopathy, bruising, centripetal weight gain and hypertension. Cushing’s was confirmed by 1 mg overnight DST (cortisol 581 nmol/L) and 48 hr-LDDST (407 nmol/L). 24 hr UFC was raised at 2666 nmol/L (12...