Endocrine Abstracts

Introduction: Cushing’s disease (CD) is very rare in children and is invariably caused by a corticotroph adenoma. However, corticotroph cell hyperplasia has only been convincingly shown in two previous cases of paediatric Cushing’s disease. We report the case of a 7-year-old boy with Cushing’s disease caused by coticotroph cell hyperplasia.Case report: Our patient presented with a 10-month history of obesity, hirsutism and growth retardati...

Cyclophosphamide is an alkylating agent used in the treatment of malignant and autoimmune diseases. Severe hyponatraemia is a serious electrolyte disorder with life threatening neurological sequelae. We report a case of recurrent severe, symptomatic hyponatraemia that developed in a 61 year old female with systemic vasculitis and Sjogrens syndrome following low-dose cyclophosphamide.Case report: A 61 year old lady, with ANA positive systemic vasculitis p...

Introduction: The natural history of adipsic diabetes insipidus (ADI) is not completely understood. Isolated case reports suggest occasional recovery of adipsia. We present the follow up of a cohort of 12 patients with ADI.Setting: National pituitary unit with interest in diabetes insipidus.Methods: ADI was identified by demonstrating absent thirst and AVP responses to hypertonic saline infusion. Results 12 patients with ADI were i...

Background: Adrenal insufficiency remains a potentially life-threatening condition, necessitating adequate glucocorticoid replacement and appropriate stress-related adjustment to avoid crisis. Flu-like illness is a key precipitant of adrenal crisis. While some authorities recommend annual influenza vaccination for such patients, uptake rates in this population are unknown. Additionally, while seasonal vaccines may lead to minor symptoms in the general population, there are no ...

Acute hyponatraemia is a medical emergency with high mortality. Recent expert guidelines advocate treatment with intravenous boluses of 3% saline with the aim to reduce cerebral oedema more rapidly than traditional slow intravenous infusion, but there is a poor evidence base for this policy change. We retrospectively audited treatment of symptomatic hyponatraemia due to SIAD (n=57, age 22–76 year), comparing low dose (20 ml/h) and bolus infusion of 3% saline. Bol...

Lithium is used in psychiatric practice as maintenance therapy in bipolar disorder. It has a narrow therapeutic index with serious toxic potential. Lithium is associated with multiple endocrine and metabolic disturbances but data regarding the rates of these in individual patients is lacking. In a tertiary referral centre, all patients on lithium therapy from 2000 to 2014 were identified. The aim of this study was to assess the impact of lithium therapy on the development of e...

Acromegaly is a rare disease characterised by excessive Growth hormone (GH) production from a pituitary adenoma. Subfertility is common in acromegaly and has various aetiologies, therefore pregnancy in acromegaly is rare. We present a case series of 19 pregnancies in 13 women with acromegaly from the newly formed Irish National Pituitary Registry. Twelve women had pituitary macroadenomas, one woman had a microadenoma. The age of the women ranged from 28 to 40 years with a medi...

Non-functioning pituitary adenomas (NFPAs) are the commonest subtype of pituitary tumour. Surgical resection, accompanied by radiotherapy (RTX) in selected cases, is the treatment of choice for compressive tumours. Long-term health consequences of treatment for NFPAs are unclear. In this retrospective study, we assessed long-term pituitary function and mortality rates in a large NFPA cohort across two tertiary centres in the UK and Ireland.Case-note revi...

Fluid restriction (FR) is the recommended first-line treatment for chronic hyponatraemia due to syndrome of inappropriate antidiuresis (SIAD) in expert guidelines, despite the lack of prospective data to support its efficacy. We aimed to test the hypothesis that FR was more effective than no treatment. 46 patients with chronic SIAD were randomised to either fluid restriction (1 litre/day, FR) or no specific hyponatraemia treatment (NoTx) for one month. Inclusion criteria were ...