Endocrine Abstracts

Introduction: Bilateral 3rd nerve palsy is known in conditions such as diabetes mellitus, neurosarcoidosis, Guillain-Barre syndrome, multiple sclerosis, anterior or posterior communicating artery aneurysm or mesencephalic bleed/trauma. There are only single cases reported in association with pituitary adenoma or carcinoma, usually in the context of apoplexy. We describe a patient with Cushing’s disease and bilateral 3rd nerve palsy secondary to apoplexy in pituitary macro...

Introduction/Background: Patients with NETs and acromegaly are commonly treated with somatostatin analogues (SSAs), such as octreotide and lanreotide depot formulations. The Pharmathen syringe is now available in several European countries and the USA for lanreotide depot injection. When using SSAs, confidence in and ease of use with syringes is important for decision-making in long-term therapy.Aims: PRESTO 3 compared nurses’ preference for the Som...

Introduction: Phaeochromocytomas and paragangliomas (PPGLs) are rare tumours with high morbidity. The majority are benign and surgically curable, but genetic testing suggests that many are associated with germline mutations, and careful long-term follow-up of patients and their family members is important. Regular biochemical screening with plasma or urinary metanephrines (uMetanephrines) is essential, but currently 24-h collections of uMetanephrines is cumbersome and inconven...

Context: Disease processes that affect the pituitary stalk are broad, ranging from indolent lesions requiring simple observation to severe lesions with significant implications. Diagnosis and management of these lesions remains unclear.Objective: The aim of this study was to assess the clinical presentation, biochemical and pathology characteristics of pituitary stalk thickening lesions and their association with specific MRI features in order to provide...

Introduction: Adenosine monophosphate-activated protein kinase (AMPK) is a regulator of cellular and systemic energy homeostasis. Many of the changes seen in glucocorticoid excess correspond to the metabolic steps regulated by AMPK. In the hypothalamus and adipose tissues, glucocorticoids and cannabiniods share the same tissue specific effects on AMPK activity. Cannabinoids have central orexigenic and peripheral metabolic effects via the cannabinoid receptor type 1 (CB1). The ...

Background: Pituitary adenomas are relatively common in the general population, but the pathogenesis of these tumours remains largely unknown. Recently, germline mutations have been described in the AIP (aryl hydrocarbon receptor interacting protein) gene in several patients with familial isolated pituitary adenomas (FIPA). This gene is located on chromosome 11q13 and loss of heterozygosity at this locus as well as functional data from our group demonstrates a tumour suppresso...

Background: Pituitary adenomas usually occur as sporadic tumours, but familial cases are increasingly identified. Patients of 15–40% with familial-isolated-pituitary-adenoma (FIPA) harbour germline mutations in the aryl-hydrocarbon receptor interacting gene (AIP). AIP is thought to act as a tumour suppressor gene, with loss of heterozygosity shown in pituitary tumour samples at the 11q13 locus, where AIP is located. Previously we have shown AIP has properties consistent w...

Background: AMPK is a metabolic enzyme regulating the energy supply of the cell but it has antiproliferative effects as well via the up-regulation of the p53-p21 axis and inhibition of the mTOR-pathway. Somatostatin (SST) analogues reduce hormone secretion from somatotroph adenomas and tumour growth inhibition can also be achieved. SST affect several signalling pathways including the mTOR-pathway. mTOR is a mediator of a pro-proliferative pathway that can be inhibited by activ...

A 47 year old Macedonian Personal Trainer presented with 4 days of vomiting, abdominal pain and profuse sweating. He admitted abusing anabolic steroids 20 years previously but never insulin. The presenting capillary blood glucose (CBG) was 1.7 mmol/L, blood pressure (BP) 182/106 mmHg, pulse 62 bpm. On examination, he was sweaty, pale and cold. Blood was drawn for measurement of insulin, C-peptide, glucose, cortisol and thyroid function tests. He was treated with 50% dextrose a...

Background: Cushing’s syndrome results from chronic exposure to excessive levels of glucocorticoids (GC). The clinical manifestations associated with hypercortisolaemia are variable and differ widely in severity, including hypertension, apparent obesity and metabolic aberrations such as diabetes, dyslipidaemia, ultimately leading to changes similar to the metabolic syndrome. We hypothesised that GC might influence the expression of the genes involved in lipogenesis and gl...