Endocrine Abstracts

Cortisol metabolism is modulated by inhibition of 11 beta-hydroxysteroid dehydrogenase type 1 (11 beta HSD1) during GH replacement (Weaver et al, Clin Endocrinol, 1994, 41, 639; Gelding et al, Clin Endocrinol, 1998, 48, 153) and in active acromegaly (Moore et al, J Clin Endocrinol Metab, 1999, 84, 4172). 11 beta HSD1 activity is also influenced by both fat mass and insulin. To determine the relative contribution of GH/IGF-I to alteration in cortisol metabolism we have examined...

Ergot derived dopamine agonist therapy (EDDAT) has recently been associated with fibrotic cardiac valvulopathy in patients with Parkinson’s disease. These patients received a cumulative dose of 2800–6700 mg of cabergoline for an average duration of two years. This has raised concerns about the use of these agents in patients with prolactinomas and has led to the recent EMEA/MHRA guidance that all patient being treated with EDDA should undergo surveillance echocardiog...

Background: Withdrawal of dopamine agonist (DA) therapy in the management of microprolactinoma is common practice. It is unclear however which patients are likely to attain long term remission.Aims: The aim of this prospective study was to identify clinical factors that might predict long term remission.Subjects: Fourty subjects (39 female, aged 24–60 years) with microprolactinoma; all had been normoprolactinaemic on DA therap...

The route of oestrogen replacement has an important influence on growth hormone (GH) sensitivity, but it remains unclear whether the route of testosterone treatment in hypopituitarism influences the response to GH replacement. We have compared IGF-I levels, body composition and BMD in hypopituitary male patients with severe GH-deficiency receiving either oral testosterone undecanoate (T.U.)(80-160 milligrams per day) or intramuscular testosterone (I.M.) (250-500 milligrams per...

Background: Auto-immune Addison’s disease (AAD) is the most prevalent cause of primary adrenal insufficiency in the UK. Co-morbidities are commonly associated with AAD and can manifest years after the initial diagnosis. There is no clear consensus on the optimal surveillance and management of this condition.Objectives: To establish the prevalence of co-morbidities, assess bone health and review clinical surveillance practice of patients attending an...

A 32 year old man with a history of epilepsy since childhood presented in 1992 with a grand mal seizure and clinical features of tuberous sclerosis (TSC). One year later he was referred with classical Cushingoid features. His serum Na was 140 mmol/l, K 3.4 mmol/l, 9 AM cortisol 1018 nmol/l with lack of diurnal variation and ACTH 42-50 ng/l. Urinary cortisol: 797 nmol/24 h. After overnight, low and high dose dexamethasone suppression, cortisol was 1018, 1154, and 62 nmol/l resp...

Aim: To assess usage of newly available rapid-acting insulin analogues in the antenatal diabetes clinic, and to determine whether introduction of these agents has influenced glycaemic control.Methods: We analysed our diabetes antenatal clinic attendances from April 2002 to June 2003 using the DIABETA 3 database. 290 pregnant women were seen over this period which was divided into three groups: Group I (April to September 2002), Group II (October 2002 to ...

Aim: To assess usage of newly available rapid-acting insulin analogues in the antenatal diabetes clinic, and to determine whether introduction of these agents has influenced glycaemic control.Methods: We analysed our diabetes antenatal clinic attendances from April 2002 to June 2003 using the DIABETA 3 database. 290 pregnant women were seen over this period which was divided into three groups: Group I (April to September 2002), Group II (October 2002 to ...

Parathyroidectomy is the only definitive cure for primary hyperparathyroidism (PHPT). The standard for pre-operative localisation of parathyroid pathology at our institution is both a (99m)Tc-sestamibi SPECT/CT (sestamibi) and neck ultrasound scan (USS). The aim of this audit was to assess the accuracy of this standard pre-operative imaging.Methods: Retrospective data was gathered from all parathyroidectomies performed at St Thomas’ Hospital between...

CaHASE is a multicentre cross-sectional study of the health status of adults with congenital adrenal hyperplasia (CAH). Although fertility is considered to be reduced in both sexes, few published series report the proportion that has actively sought pregnancy. About 203 patients were recruited from 17 centres. Four patients (3, 11-hydroxylase, 1 HSD3B2 deficient) were excluded from analysis. Demographics are shown in Table 1.<table boarder="1" cellpadding="3" cellspacing="...