Endocrine Abstracts

Aim: The aim of the study was to assess the differences between patients in remission in acromegaly and those with active ongoing disease, using cumulative GH measurement as risk factor for various complications.Methods: A retrospective observational analysis of all patients with acromegaly treated at a tertiary referral centre since the initiation of service (~50 years) was conducted. Cumulative GH exposure was calculated as a sum of averages of GH leve...

Aim: Acromegaly is associated with higher mortality and morbidity, and achieving disease control can be challenging. The aim of this study was to assess the morbidity and mortality associated with active acromegaly compared to patients in whom disease control was achieved.Methods: Retrospective analysis of all patients treated with acromegaly at a university hospital between 1948 and 2014 was performed. Mortality rates and development of new cardiovascul...

A 51-year-old Afro-Caribbean lady with a history of primary hyperparathyroidism, type 2 diabetes and hypertension was admitted with confusion. Her medication at the time included five anti-hypertensives.She was treated for an infection but despite a long course of antibiotics she remained confused with visual hallucinations and aggression.She was noted to have resistant hypertension with systolic blood pressures over 220 mmHg and p...

Introduction: Bariatric surgery is an important treatment option for morbid obesity. The current guidelines recommend testing and supplementation of vitamin D postoperatively. The aim of our study was to assess the need for preoperative proactive supplementation of vitamin D. Methods All patients who had restrictive bariatric surgery (laparoscopic gastric bypass or sleeve gastrectomy) between January 2010 and June 2011 were included. Data was collected retrospectively from com...

Aim: An increasing proportion of patients are referred to endocrine clinics for assessment of an endocrine reason for obesity. The aim of our study was to assess the hormone profiles of patients referred for bariatric surgery.Methods: Patients referred to bariatric surgery clinic were investigated for hypothyroidism (TSH, T4), Cushing’s disease (2 mg-overnight dexamethasone suppression test), acromegaly (IGF1) and Vitamin D deficiency (PT...

There are very limited data on long-term mortality in pituitary ACTH dependent Cushing’s disease (CD).We report on our data from Stoke-on-Trent, UK, spanning 50 years and provide a meta-analysis of six other reports which addressed mortality of CD. Case records of 60 CD patients from 1958-31 Dec 2009 from Stoke-on-Trent were reviewed. The standardised mortality ratio (SMR) overall and separately for patients in remission and having persistent diseas...

Introduction: Pituitary tumors account for 15% of all intracranial neoplasms and could remain asymptomatic for a significant period. We conducted a retrospective analysis to assess pattern of referrals and management of non-functioning pituitary adenomas at our tertiary referral centre.Methods: Data was collected on referrals for NFA received at our university hospital from 2005 to 2008. Medical records, radiology reports and endocrine department data we...

We report a 47-year old lady who was initially diagnosed to have primary hypothyroidism nearly four years ago; on treatment with levothyroxine sodium (LT4) 150 μcg daily. Despite reasonable doses of LT4, and being fully compliant with her therapy, at no stage her TSH was less than 20 mU/L (Table-1). Malabsorption was ruled out and there were no clinical features to suggest this. When she was reviewed...

The aim of treatment in patients with acromegaly is to achieve serum GH/ IGF-I concentrations associated with cure or normalisation of mortality. Using the West Midlands acromegaly database (n=501) we assessed a number of parameters in the follow up of patients with acromegaly including the reliability of basal fasting GH in predicting nadir or mean GH during oral glucose tolerance test (OGTT) or growth hormone day curve (GHDC) respectively, the degree of discordance be...

Acromegaly is associated with increased morbidity and mortality. Surgery, radiotherapy (RT) and medical therapy are the treatment options to decrease GH and IGF-I concentrations to levels associated with cure or normalisation of mortality. We examined the response to dopamine agonists (DA) and somatostatin analogues (SSA) in 276 patients with acromegaly who received medical therapy during follow up (198 DA, 143 SSA). One hundred and seventy two had surgery and 73 RT prior to m...