Endocrine Abstracts

Fulvestrant (faslodex) is currently the only available new pure antioestrogen. It has a long side chain in the 7 alpha position which impedes receptor dimerisation and function and results in increased turnover and reduced numbers of receptor molecules. Faslodex is active against tamoxifen resistant human tumour cells both in vitro[1] and in the clinic[2]. Given for 2-3 weeks preoperative Faslodex causes downregulation of both oestrogen and progesterone receptors[3].Faslodex w...

A 55-year-old lady presented with visual deterioration of 2 years duration affecting both eyes. Initial examination demonstrated reduced visual acuity in the LE at finger perception and RE 6/9 with right temporal superior quadrantopia. Rest of the systemic examination was unremarkable. Relevant endocrine tests revealed a FSH-146.9 U/l and FT4-14 pmol/l. MRI pituitary demonstrated a pituitary adenoma with significant suprasellar component compressing the optic nerves...

Turner’s syndrome is one of the most common chromosomal abnormalities affecting 1 in 2500 live births. Short stature and gonadal dysgenesis are known as the hallmarks of the syndrome since Henry Turner described the original cases in the late 1930s. Although the majority of these patients have streak ovaries as a result of stromal fibrosis, the uterus is intact, albeit with atrophic endometrium due to the hypoestrogenic state. We report a case of ...

A 55-year-old lady was admitted with sudden onset headache, diplopia, photophobia and confusion. CT brain showed SAH with hydrocephalus. Coiling of the aneurysm with EVD insertion was done on the same day. On day 5 post-operatively she developed hyponatremia and dropped her GCS to 10/15.On examination she was volume depleted with dry mucous membranes and loss of skin turgor. Urine output over the previous 4 days had been 2.5–4 l/day, urinary sodium ...

Hypogonadism is a common finding in men with metabolic syndrome (MS) and/or type 2 diabetes (T2D) which adversely affects quality of life, is associated with several cardiovascular (CV) risk factors and a greater risk of mortality. Testosterone replacement therapy (TRT) in pilot studies has beneficial effects on waist circumference (WC), insulin resistance, glycaemic control, lipid and inflammatory profiles.Testosterone replacement in hypogonadal metabol...

Pituitary metastases are uncommon, with breast and lung carcinomas being the most common primary sites. Of the minority that are symptomatic, diabetes insipidus (DI) is frequently present. We report two cases, one presenting with DI and the other with hypopituitarism and DI, who deteriorated rapidly and died within 3 months.Case 1: A previously fit 53-year-old lady presented in December 2008 with a one month history of polyuria and polydipsia. Investigat...

A 62-year-old man presented with 1 month history of lethargy, nocturia, thirst and diplopia. On examination he had left 3rd nerve palsy with complete ptosis. MRI pituitary demonstrated a 1.3×1.1 cm enhancing mass on the left side of the pituitary gland, with invasion of the left cavernous sinus. Endocrine work up revealed partial DI, TSH and gonadotrophin deficiency. Because of unusual appearance of the pituitary lesions, a biopsy was arranged but initial histology was in...

Annexin 1 (ANXA1) externalised from folliculostellate cells is known to be an essential intermediate in the early delayed (30 min- 3 h) negative feedback of glucocorticoids on the release of ACTH and other pituitary hormones. We have used a well-characterised folliculostellate cell line (TtT/GF cells) to investigate the mechanism by which ANXA1, a cytoplasmic protein, is externalised by cells. Externalisation is stimulated by dexamethasone (Dex) and inhibited by inhibitors of ...

Cytotoxic chemotherapy is a well recognised cause of premature ovarian failure (POF). A proportion of women with biochemical evidence of POF following treatment recover ovarian function with a return of normal menses and fertility, but there are no indicators that allow the identification of this subgroup of patients. In addition, we have previously reported only minor reductions in BMD in a cohort of women with POF following cytotoxic chemotherapy and had postulated that this...

Primary aldosteronism (PA) uncommonly presents during pregnancy. Uncontrolled blood pressure may result in adverse maternal and fetal outcomes. We report a case presenting in pregnancy whose management proved particularly challenging, due to variable compliance with therapy, frequent non-attendance at clinic, a subsequent pregnancy and negative imaging.A 24 year old woman presented at 26 weeks gestation with severe pre-eclampsi...