Endocrine Abstracts

Growth hormone (GH) excess is extremely rare in children. It can be associated with endocrine syndromes including MEN1, Carney complex and Mc Cune Albright syndrome. We describe two cases of GH excess and their management. Patient A (15yr M) presented with fibrous dysplasia affecting his cranium and a large café-au-lait spot covering his right scapula. His height was 193cm (2.6 SDS) and BMI 29.6kg/m2(2.3SDS). His IGF1 was 84.1nmol/L (22.5 – 65.9) and GH did not suppr...

Background: Obesity is a common sequel to tumours of the hypothalamic region and their treatment. Weight gain occurs at a rate faster than any expected age-related increase and despite treated hormone deficiencies.Methods: Retrospective review of patients with hypothalamic-pituitary tumours attending a large neuroendocrine clinic in UK.Results: Initial review in 2002 had identified 42 adults with tumours causing hypothalamic damage...

Case history: A 61 year old male with a background of diabetes mellitus Type 2 and congestive cardiac failure (CCF) was diagnosed with Cushing’s disease in 2014 following identification of severe osteoporosis through investigations for non-traumatic vertebral fractures causing paraplegia.Investigations: He had high ACTH and cortisol levels which failed to suppress on low and high dose dexamethasone suppression tests, hypogonadotrophic hypogonadism a...

Background: The management of Cushing’s disease can be challenging especially when patients can present with sepsis and severely immunocompromised with limited oral medications to achieve cortisol control. We review a case of Cushing’s disease and the medical management of Cushing’s disease.Case Report: A 54 year old female presented with symptomatic hyperglycaemia with truncal obesity, proximal muscle weakness, right posterior thorax haem...

Aims: To ascertain the incidence of hypo- and hyper-natraemia in patients admitted to a tertiary neurosurgical centre with confirmed spontaneous aneurysmal subarachnoid haemorrhage (SAH), and to determine their impact on length of hospital stay and mortality.Methods: Retrospective case note review of patients admitted between January 2008 and April 2011.Results: 402 patients with SAH were identified [mean (±sd</sma...

Aims: The United Kingdom (UK) guidelines for management of acute pituitary apoplexy recommend the Pituitary Apoplexy Score (PAS) to objectively assess clinical severity of this rare neuro-endocrine emergency. We aimed to apply retrospectively this scoring tool to a large, single centre series of patients with acute pituitary apoplexy, and to determine its applicability in the management of these patients in the acute setting.Methods: Retrospective study ...

Background: Non-alcoholic fatty liver disease (NAFLD) is reported to be more prevalent in patients with GH deficiency (GHD) than in the general population. Case control studies have not however been undertaken. Recognition of NAFLD is important due to its association with cardiovascular disease and chronic liver disease.Aims: To determine i) the prevalence of NAFLD in patients with severe GHD compared to age and BMI-matched controls, and, ii) the effect ...

Introduction: Pituitary adenomas are uncommon in childhood and adolescence and knowledge of long-term outcomes is sparse. We describe a large cohort of patients, now attending our adult clinic.Patients and methods: Retrospective review of patients aged ≤18 years at diagnosis of a pituitary adenoma.Results: There were 24 patients (18 female), mean age at diagnosis 15.6 (range 11–18) years, current age 25.5 (14–47). O...

Background: Pituitary apoplexy is rare resulting from acute haemorrhagic infarction of a pituitary adenoma. Optimal management in the acute stage still remains a matter of debate.Methods: Retrospective analysis of casenotes of patients presenting with acute apoplexy at a single neurosurgical centre between 1984 and 2009 in the United Kingdom.Results: Fifty-five patients (35 males, mean age 52.4 (range 14–78) years, mean years ...

Aims: Although rare, craniopharyngiomas are the commonest suprasellar tumour in childhood. Despite high overall survival, children and young people <19 years with craniopharyngiomas are at risk of multiple relapses and long-term tumour- and treatment-related morbidity. We sought to provide, for the first time, a national standard for best practice based on currently available evidence for the assessment, treatment and follow-up of paediatric craniopharyngiomas under the au...