Endocrine Abstracts

The anti-natriuretic properties of growth hormone (GH) are well established. GH deficiency (GHD) results in salt and water depletion and studies confirm that replacement leads to sodium and vasopressin-mediated water retention, in patients with intact posterior pituitary function.We report the case of a 20-year-old male patient with septo-optic dysplasia, fixed cranial diabetes insipidus (DI) and an abnormal thirst threshold. He first presented after bir...

Cabergoline is a dopamine agonist that may be used as primary or adjunctive therapy for acromegaly. Although one study suggested biochemical control may be achieved in a substantial proportion of patients (Abs et al, JCEM 1998), it is still commonly perceived to be a relatively ineffective treatment, possibly on account of inadequate dosing.We performed a retrospective case notes review of 9 consecutive acromegalic patients to determine the effectiveness...

We report the use of Gamma knife radiosurgery (GK) to 15 somatotroph adenomas. Eight patients had refractory acromegaly despite maximal conventional treatments: all had undergone conventional radiotherapy (CRT), mean interval between CRT and GK 15.6 years. Six had undergone surgery, two on more than one occasion. Five were receiving somatostatin analog therapy, one was receiving dopamine agonist therapy, one was on pegvisomant alone. All had radiologically defined disease, wel...

Introduction: We present the outcome for the first 80 patients undergoing neuronavigation–guided, endoscopic transphenoidal surgery in our centre since August 2001. All operations were undertaken by the same neurosurgeon and endoscopic nasal surgeon.Indications for treatment: Indications for treatment may be divided into: Functioning microadenomas, with the aim of surgical cure while protecting residual pituitary function. Functioning macroadenomas,...

Introduction: Diagnosis of pancreatic neuroendocrine tumours (NETs) is often a challenge and involves biochemical characterisation and anatomic localisation of the tumour. Wherever feasible, curative surgical excision is the treatment of choice.Materials and Methods: Twenty four consecutive patients with pancreatic NETs were referred for consideration of surgery over a six-year period (1999–2005). Following use of multi imaging modalities to localis...

The effect of growth hormone (GH) replacement on thyroid function in hypopituitary patients has only been studied in small groups of children and adults with conflicting results.We aimed to define the effect and clinical significance of adult GH replacement on thyroid status in a large cohort of 243 patients with hypopituitarism due to various causes. 84 patients were considered euthyroid before GH treatment and 159 patients had central hypothyroidism an...

Objective: Variability in growth hormone (GH) responsiveness is evident in adult hypopituitary patients receiving recombinant GH (rhGH). Doses vary up to 4-fold for unexplained reasons. Deletion of exon 3 in the GH receptor (d3-GHR) has been linked to an increased response to GH treatment in children, although data are conflicting. We investigated the role of the d3-GHR polymorphism in determining GH responsiveness in adult GH deficient patients.Methods:...

Sporadic somatostatinomas are rare neuroendocrine tumours (NETs), classically presenting with hyperglycaemia, cholelithiasis and steatorrhoea. The mainstay of treatment is surgical resection; other aspects of management remain uncertain. We report 3 cases. Case 1: A 55 year-old female presented with abdominal discomfort and steatorrhoea. Computed tomography (CT) demonstrated a 9 cm pancreatic mass. Biopsy suggested a NET. Somatostatin (SMS) was 160 pmol/l (normal 0-150)...

Introduction: Patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps; however the frequency of colonoscopic screening remains unclear.Aims: To determine optimum frequency for repeated colonoscopy of acromegalic patients.Methods: Since 1992, 254 patients (mean age 56.6 years) at our centre have undergone at least one fibre-optic colonoscopic surveillance; 156, 60 and 15 patients hav...

Differentiating aldosterone-producing adenomas (APA) from bilateral adrenal hyperplasia (BAH) as a cause of Conn’s syndrome (CS) is crucial for appropriate management. We have prospectively evaluated the relative contributions of PST, adrenal imaging by Computed Tomography (CT) and AVS in the differential diagnosis of CS.We investigated 25 consecutive patients with CS referred to our unit with an identical protocol. Every patient underwent PST, CT a...