Endocrine Abstracts

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Craniopharyngioma (CP) is associated with considerably higher mortality and morbidity than pituitary adenomas. The tumours are rare, but present a considerable management challenge. In addition to the endocrine and mass effects which are common to all tumours arising from the region of the pituitary fossa, the site, size, and sometimes the treatment of CP, dictate that the endocrinologist must also manage hypothalamic complications. Endocrinologists are aware of the high frequ...

Hyponatraemia is the commonest electrolyte abnormality in clinical practice; epidemiological data would suggest that SIAD is the commonest cause of hyponatraemia, and it is particularly important in patients undergoing neurosurgery, in whom SIAD is common. Recent data has shown that even mild hyponatraemia (plasma sodium 125–135 mmol/l) is associated with gait instability, falls, fractures, osteoporosis and increased mortality. This has led to the recognition that correct...

Clinical features associated with PCOS include obesity, hirsutism or acne, cycle abnormalities and infertility. Therefore, depending on the primary complaint these patients visit different medical specialists such as general practitioner, pediatrician, dermatologist, medical endocrinologist and gynecologist. The variability in primary complaint asks for different approaches in the work-up of these patients. Hence, doctors usually see just a proportion of the overall spectrum o...

Case history: A 28 year old male presented following his first generalised tonic clonic seizure in the context of a headache with mild photophobia, nausea and vomiting. He was haemodynamically stable, euvolaemic and had no focal neurological deficit, but was mildly disoriented. He had reported cannabis and MDMA use 8 days prior to his presentation. The patient was profoundly hyponatraemic with a serum sodium of 108.Investigations: Serum osmolality was 22...

Introduction: Non-alcoholic steatohepatitis (NASH) is part of the spectrum of non-alcoholic fatty liver disease (NAFLD). NASH commonly occurs in patients with type 2 DM and is less recognised in type 1 DM. The natural history of NASH in adult patients suggests potential development of progressive fibrosis and cirrhosis. However, secondary glycogenosis, commonly occurs in type 1 DM, is reversible when good glycaemic control is achieved, but may be misidentified as NASH b...

Background: Placental signalling has been postulated to drive inflammation, endothelial dysfunction and insulin resistance in gestational diabetes mellitus (GDM).Objectives: To determine if placental signalling contributes to systemic insulin resistance in GDM.Methods: Adiponectin, leptin, adipsin and resistin in placental and omental explant culture supernatants (n=10 GDM and n=10 control) and maternal plasma (n=20 GDM and n=20 co...

Background: SIADH is the most frequent underlying cause of hyponatraemia but is frequently ignored and suboptimally treated.Aim: To identify the treatment applied in clinical practice for hyponatraemia due to SIADH and to evaluate the effect of fluid deprivation.Method: A prospective, non-intervention observational study of a sequentially evaluated cohort of hyponatraemic patients during first 48 h after hospitalization from Januar...

Context: The post-surgical follow-up of malignant insulinomas is often marked by recurrence after initial remission. However, the criteria for the diagnosis of recurrence of these malignant endocrine tumors are not well defined in the literature, unlike diagnostic of criteria for hyperinsulinemic hypoglycaemia (Cryer 2009). We retrospectively reviewed the criteria that allowed the diagnosis of recurrence in four patients with malignant insulinoma after initial post-operative r...

In 1984 an 18-year-old girl was operated because of primary hyperpara-thyroidism (PHPT). Recurrence was seen 13 years later and another neck exploration was performed. Histological examination was consistent with both adenoma and hyperplasia.She had a history of urticaria pigmentosa since the age of one year. In 1991–94 she complained of syncope, weight loss, diarrhoea, abdominal pain and alcohol intolerance. Typical skin lesions were found. Total 2...