Endocrine Abstracts

Dexamethasone is frequently used in diagnostic work-up of patients suspected of having Cushing's syndrome. We report the case of a young woman whose cortisol production paradoxically increased following dexamethasone administration. A 27 years old woman presented with intermittent facial rounding (see photos), weight gain (6 kg), hirsuitism, spontaneous bruising, menstrual irregularity. On examination the only feature to suggest Cushing's syndrome was very thin skin on the bac...

We report a 61year old female who presented with severe Cushing's disease 13 years after diagnosed as non-functioning adenoma. First presented in 1992 with visual field defect. MRI showed macroadenoma, suprasellar, and lateral extension. Gonadotrophin and GH were low. At this time there was no clinical suspicion of Cushing's syndrome. Treated with transphenoidal pituitary surgery resulting in improved vision. Immunohistochemistry showed 50% cells positive for ACTH and negative...

Objective: Surgical outcome in acute acromegaly has been studied nationally and internationally with conflicting and variable results. Definition of cure varies from centre to centre.Rrecent studies have shown increased mortality in acromegalic patients with GH level >5mu/l. We studied the out come of transphenoidal surgery by a single surgeon at 6 and 12 moths after surgery to compare the results with other national and international published studies.Patients and methods...

Introduction. We have reported a family with atypical Laron syndrome with no obvious defect in the growth hormone receptor but with an apparent defect in growth hormone (GH) signaling. We aimed to assess how this signaling defect alters GH-dependent gene expression.Methods. Atypical Laron fibroblasts (Lfib) and normal fibroblasts (Nfib) were exposed to 200ng/ml of recombinant GH for 24 hours. mRNA was extracted and reverse transcribed using...

Aim: This study was aimed to assess the need for multiple cortisol samples in ruling out adrenal insufficiency by standard dose Short Synacthen Tests (SST) and Low Dose Short Synacthen Tests (LDSST).Method: We assessed the lab results of 767 patients who attended Metabolic Unit of a University Hospital in the UK from 1999 to 2006 for assessment of adrenal reserve. In LDSST, serum cortisol was measured at 0, 30 and 40 min after administration of 1 mcg of ...

Increased mortality in patients with acromegaly has been confirmed in a number of retrospective studies, but causative factors and relationship to serum IGF1 remain uncertain. The West Midlands Acromegaly database contains details of 419 patients (178 males). Serum IGF1 data from the Regional Endocrine Laboratory was available for 338 patients (81%). At diagnosis mean age was 47 years (range 12-84) and mean GH was 70plus/minus5.4 milliunits per litre. 61% were treated by surge...

In numerous tumour types, including those of pituitary origin, gene silencing is frequently mediated through inappropriate methylation of CpG islands. In studies designed to identify novel methylated sequences we used a technique termed arbitrarily primed methylation sensitive PCR (MsAP-PCR) to identify DNA in its hypermethylated forms. The technique relies on cutting the DNA, with methylation sensitive restriction enzymes, prior to PCR amplification. In a similar way in which...

Background: Amongst hospitalised patients, hyponatraemia is the commonest electrolyte abnormality with reported prevalence of about 25%. Its association with mortality, morbidity and increased length of stay is well recognised, including adverse fracture risk and falls with mild hyponatraemia in elderly. We audited the management of hyponatraemia in inpatients in a University hospital setting.Methods: Over a 3-month period, amongst all in-patients, we id...

Candidate gene approaches have identified loss of heterozygosity (LOH) at putative tumour suppressor gene (TSG) loci in sporadic pituitary tumours. This study reports a high-resolution genome wide allelotyping in a large cohort of somatotrophinomas and non-functioning pituitary adenomas (NFA). Samples were first subjected to whole genome amplification by primer extension amplification (PEP) to circumvent limitation imposed by insufficient DNA for the whole genome analysis with...

In severe CHI which is unresponsive to medical therapy, pancreatic resection is undertaken to prevent further hypoglycaemia from dysregulated beta-cell insulin secretion. Traditionally, 95% subtotal pancreatectomy has been the surgery of choice (Lovvorn et al. 1999), with associated risks of post-operative complications such as lifelong diabetes and malabsorption. Since the introduction of 18F-DOPA PET-CT imaging, clinicians have been able to effectively differentia...