Endocrine Abstracts

Transsphenoidal surgery results in biochemical cure of approximately 50% of all acromegalic patients, depending on tumour size and surgical expertise. It is uncertain whether prior treatment with somatostatin analogues would result in tumour shrinkage and therefore improve the efficacy of subsequent surgery. Aims: To determine whether 6 months de novo treatment with Sandostatin LAR results in tumour shrinkage. Methods: 6 patients (mean age 53 yr; range 42-...

We have reported that serum DHEAS increases in growth hormone deficient (GHD) adults with intact ACTH reserve during GH replacement (GHR) in contrast with persisting low levels in ACTH-deficient GHD patients (Isidori et al. Clin Endo 2003:58:601). This was associated with a lower GH dose requirement in ACTH sufficient patients suggesting that DHEA may augment IGF-I generation. We have examined this hypothesis in a double blind placebo controlled trial of 30 hypopituitary femal...

Objective: To identify a range of IGF-I values representative of growth hormone deficiency (GHD), which could be utilised to reduce the risk of 'functional' GHD in Pegvisomant treated acromegaly.Method: We analysed centrally measured IGF-I data from the KIMS European GHD database. We stratified this cohort into six gender based, age ranges and assessed IGF-I and IGF-I standard deviation scores (SDS).Results: Baseline measurements f...

Etomidate, an imidazole derived anaesthetic agent, potently inhibits adrenocortical 11-beta-hydroxylase at non-hypnotic doses in Cushing's syndrome. We report its use in controlling hypercortisolism in a patient with aggressive Cushing's disease requiring pelvic surgery for endometrial carcinoma.IJ, a 42-year old female was diagnosed with Cushing's disease in 1998 in Malaysia. 8am cortisol was 800nmol/l, midnight cortisol 659nmol/l and ACTH 103ng/l. MRI ...

The contribution of conventional hormone replacement to the clinical features attributed to adult growth hormone deficiency (GHD) is poorly defined. We measured baseline bone mineral density (BMD/DXA) at the lumbar spine and femoral neck in patients with isolated GHD (IGHD, 16 patients, 14 female, 4 childhood onset, mean age 39, range 19- 63 years) and patients with multiple pituitary hormone deficiencies (MPD, 135 patients, 94 female, 14 childhood onset, mean age 44, range 19...

Background: Although the negative impact of GHD in adults on quality of life (QoL) is well recognized and it has become routinely measured in clinical practice, there is still limited information about the extent of the differential between adults with GHD and their age/sex-matched peers within the general population.Objectives: The study was designed to test the discriminatory power of QoL-AGHDA by determining normative reference values in the general p...

The contribution to adult growth hormone deficiency (GHD) of hormone replacement and other aspects of hypopituitarism are poorly defined. We compared baseline characteristics and response to GH treatment of patients with isolated GHD (IGHD, 16 patients) to patients with multiple pituitary hormone deficiencies (MPD, 135 patients). At baseline, MPD patients showed significantly greater waist-hip ratios (0.87 plus/minus 0.007 vs. 0.82 plus/minus 0.02, mean plus/minus SD; P < 0...

The route of oestrogen replacement has an important influence on growth hormone (GH) sensitivity, but it remains unclear whether the route of testosterone treatment in hypopituitarism influences the response to GH replacement. We have compared IGF-I levels, body composition and BMD in hypopituitary male patients with severe GH-deficiency receiving either oral testosterone undecanoate (T.U.)(80-160 milligrams per day) or intramuscular testosterone (I.M.) (250-500 milligrams per...

INTRODUCTION: Brittleness is a well-known phenomenon in patients with type 1 diabetes mellitus (DM). The possibility of a similar theme in the context of Addison's disease is not well established. CASE STUDY: We describe a 22-year-old woman who has had Addison's disease since the age of 9 years and type 1 DM since the age of 18 years. She was admitted with acute medical problems 47 times and attended OPD clinics on 17 occasions in 5 years (1996-2000). Of these, 29 inpatient an...

Non-islet cell tumour hypoglycaemia (NICTH) is a syndrome associated with overproduction of pro-IGF-II, a 14-18 kDa product of incomplete proteolytic cleavage of IGF-II pro-hormone, usually secreted by large mesenchymal tumours. The excess of pro-IGF-II in NICTH leads to a reduction in circulating insulin, GH, IGF-I, IGFBP-3 and acid-labile subunit (ALS) levels and to an increase in IGF binding protein-2 (IGFBP-2). IGFs and IGFBP-3 are found primarily in binary complexes of ap...