Endocrine Abstracts

Introduction: Von Hippel-Lindau (VHL) syndrome is a complex multi-organ disorder with significant associated morbidity and mortality. Patients see multiple specialities and have many clinic appointments which can significantly disrupt their lives. In 2012 the St Bartholomew’s VHL multi-disciplinary clinic was set up. It consists of an amalgamated one-stop clinic for patients and their families when all relevant specialities are seen in one sitting. The major aims were to:...

Bromocriptine (BC) and cabergoline (CAB) are ergot-derived dopamine agonists (DAs) used for the treatment of hyperprolactinaemia. Recently, concern has been raised about a possible association between long-term DA use and cardiac valvular abnormalities. These concerns are largely derived from studies in patients with Parkinson’s disease receiving higher doses (typically CAB 3 mg/day vs 0.5–1 mg/week for hyperprolactinaemic patients). Studies in hyperprolactinaemic pa...

Etomidate, an imidazole derived anaesthetic agent, potently inhibits adrenocortical 11-beta-hydroxylase at non-hypnotic doses in Cushing's syndrome. We report its use in controlling hypercortisolism in a patient with aggressive Cushing's disease requiring pelvic surgery for endometrial carcinoma.IJ, a 42-year old female was diagnosed with Cushing's disease in 1998 in Malaysia. 8am cortisol was 800nmol/l, midnight cortisol 659nmol/l and ACTH 103ng/l. MRI ...

We present the case of a 44-year-old woman from Afghanistan who had lived in the UK for 2 years. She was admitted to hospital with headache. She gave an 8 months history of generalised headache, secondary amenorrhoea and weight gain. There was no history of polyuria or polydypsia. Examination revealed a bitemporal hemianopia to red pin confrontation. Investigations confirmed that she was panhypopituitary. In addition, she was vitamin D deficient. Imaging of the pituitary gland...

A high prevalence of rickets in the Gbagyi tribe around Kaduna, Northern Nigeria, has been noted. Multiple affected children born to one wife, but not others, of polygamous men suggests a genetic aetiology.With ethical approval, children with deformities characteristic of rickets (genu varum/valgum, rachitic rosary) were identified, clinical histories obtained and examination points documented included genu valgus/varus distances and other limb deformiti...

Introduction: Growth hormone (GH) replacement is widely used in the management of patients with adult-onset (AO) GH deficiency (GHD). In most cases, AO-GHD arises as a result of pituitary/peri-pituitary tumours and/or their treatment. The aim of this study was to examine the effect of GH replacement on growth/recurrence of non-anterior pituitary parasellar tumours.Methods: Fifty consecutive patients (21 males; mean age 45.9) with severe AO-GHD (peak seru...

Selective Parathyroid Venous Sampling in Patients with Complicated Primary HyperparathyroidismCM Ogilvie, PL Brown, M Matson, R Carpenter, WM Drake, PJ Jenkins, SL Chew, JP MonsonCentre for Endocrinology and Departments of Surgery and Radiology, St Bartholomew's Hospital, QMUL, London EC1A 7BEThe role of pre-operative localisation of abnormal parathyroid glands remains controversial but is particularly releva...

We report the efficacy, safety, and effects on glucose homeostasis of converting patients with acromegaly from slow release octreotide (OT, treated for >3 months) to pegvisomant (Peg), a GH receptor antagonist. 52 patients (median age 49, range 23-81, 13 with diabetes) who had previously participated in a Peg clinical trial and subsequently treated with OT were enrolled in a 32-week, open-label, multicentre study. Peg 10 mg/d was started 4 weeks after the last dose of OT (w...

Carpal tunnel syndrome (CTS) in acromegaly is caused, in part, by median nerve (MN) swelling. Pegvisomant (Peg), a growth hormone receptor (GHR) antagonist, lowers serum insulin-like growth factor-I (IGF-I) concentrations in patients with acromegaly, but serum GH levels rise and Peg is detected by most GH assays. Demonstrating that normalisation of serum IGF-I by Peg is associated with improvement/reversal of the consequences of GH excess is desirable. We documented changes in...

Vascular endothelial growth factor (VEGF) is involved in the activation of the matrix metalloproteinase system (MMP) which in turn degrades the extracellular matrix involved in development, morphogenesis and tissue remodelling. Increased activity of MMPs has been implicated in atherosclerosis and cardiovascular disease. This study assessed plasma MMP and VEGF levels in patients with active acromegaly (IGF-I >130%ULN), and on treatment with pegvisomant.<p class="abstext"...