Endocrine Abstracts

Teenagers and young adult survivors of congenital and acquired brain injury caused by developmental defects (e.g. septooptic dysplasias), brain tumours and their treatment, or intracerebral and systemic disease (e.g. histiocytoses and meningitis), are often both learning disabled and requiring lifesaving (cortisol and desmopressin) and life-enhancing (sex steroid, thyroxine, and growth) hormone replacement due to panhypopituitarism.Managing the parental ...

Craniopharyngiomas are paradoxically considered ‘benign’ and hence curable by complete excision. Despite a high survival rate, however, this notion belies a high morbidity and propensity for premature mortality from neuroendocrine disease and treatment complications in those diagnosed in childhood, whose disease differs from that in adulthood. These result from a proximity to, and invasion of, vital ophthalmic, neurometabolic, neurocognitive and neuroendocrine pathwa...

Background: Children with brain tumours are known to be at risk of late neuroendocrinopathies due to anatomical and treatment disturbances to central pituitary function.Aims: To provide a descriptive analysis of a cohort of children with such tumours, referred to the late-effects neuroendocrine service at UCLH. It aims to describe the types of tumour, treatment and current endocrine morbidity of this cohort.Methods: Cases were iden...

A 10-year old boy presented with 12-months history of headache, vomiting, declining school performance and change in behavior. There was no visual disturbance. Neurological examination was normal. Weight and height were between 50th−75th centile. CT head showed a large, partly calcified mass in the sellar region with acute hydrocephalus. Dexamethasone was immediately commenced and care was transferred to the neurosurgical centre.<p class="abstex...

Introduction: Low-grade gliomas (LGGs) are the commonest benign childhood brain tumour and typically affect the optic tracts, chiasm and suprasellar diencephalon, thus potentially causing serious neuroendocrine deficits from tumour mass or treatment effects. In the absence of any major studies, we sought to comprehensively evaluate patient-, disease- and treatment-related risk factors for neuroendocrine morbidity in a large single-centre survivor cohort treated by varied, prim...

Introduction: The debate surrounding the most suitable pituitary provocation test in children is controversial. There is a perception that the gold standard insulin tolerance test (ITT) is ‘dangerous’ and that the glucagon stimulation test (GST) is ‘safer’ and a more tolerable alternative, particularly in younger children. There have been no reports in the literature comparing patient experiences of these tests.Aim: To examine the tol...

Introduction: ACTH deficiency is life-threatening, but difficult to differentiate from ACTH suppression especially in children and young people (CYP) receiving perioperative corticosteroids for pituitary tumour surgery. In our experience, ACTH is the most, and GH the least robust anterior pituitary hormone, with LH/FSH and TSH intermediate in hierarchical loss.Aims: To assess potential misdiagnosis of ACTH suppression versus deficiency and time to adrena...

Background: Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) is a well-recognized complication of intracranial tumours (ICT). Fluid restriction as treatment for SIADH is challenging in infants since it is coupled with calorie restriction. Moreover, it may conflict with chemotherapy-associated hyperhydration protocols. Existing evidence on the use of the type-2 vasopressin receptor antagonist (Tolvaptan) for refractory SIADH in infants and young children is limi...

Introduction: Children with TPS and/or ICDI represent a diagnostic and management conundrum. Agreed radiological criteria for TPS are lacking.Aims: To longitudinally characterize the neuroradiological features of children presenting with TPS and/or ICDI due to different aetiologies (oncological, inflammatory, idiopathic).Methods: We searched the terms ‘thickened pituitary stalk’ or ‘idiopathic diabetes insipidus&#146...

Introduction: We wanted to assess whether our report of better adherence to GH therapy using jet (ZomaJet) rather than needle delivery in a large nationwide cohort, translated into better growth outcomes.Aims and hypothesis: To retrospectively audit growth markers in our local split-site (GOSH/UCLH) cohort of children, starting GH using Zomajet between 01.01.2010 and 31.12.2012, for whom we had previous adherence (PDC) scores.Metho...