Endocrine Abstracts

Introduction: It is known that growth hormone secretion is affected by age and patient’s sex. We have assessed pre-treatment IGF-1 levels and responses to a standard dose of exogenous growth hormone (0.4 mg daily) in males and females arbitrarily categorised into young (20–40 yrs), middle-aged (40–60 yrs) and elderly (over 60 yrs). All patients were growth hormone deficient on either an insulin tolerance test or a glucagon test, peak growth hormone did not rise ...

The optimal post-operative management of patients undergoing trans-sphenoidal adenomectomy for non-functioning pituitary adenoma is uncertain. Since 1994, in our centre, patients receiving immediate post-operative radiotherapy have been monitored with annual visual field assessment. Annual MRI is undertaken for 5 years if radiotherapy has not been given, followed by 2-yearly MRI continued indefinitely.We aimed to examine the efficacy of our follow-up MRI...

Autoimmune hypoadrenalism (Addison’s disease) is a relatively rare condition; recent research has found the European prevalence to be up to 140 per million [Lovas & Husebye 2002]. It frequently occurs in association with other organ-specific autoimmune diseases, both endocrine and non-endocrine. Previous studies identified a considerable range in the prevalence of associated conditions and, because of the rarity of the disease, were often drawn from relatively small s...

Bone loss in treated Addison’s disease (autoimmune hypoadrenalism) is often attributed to supraphysiological doses of glucocorticoid. The largest international survey to date (N=613) suggests that other factors are also likely to be associated with bone loss in these patients and that an intrinsic risk of bone loss in autoimmune hypoadrenalism cannot be ruled out. This survey also found significant rates of osteoarthritis among autoimmune hypoadrenalism patients. 1...

Addison’s disease is notoriously difficult to diagnose and has been labelled ‘the master of unforgiving disguise’. In the largest international survey of autoimmune Addison’s disease to date (N=613), we asked patients to recall their symptoms at diagnosis. The results confirm the challenges of diagnosis, in that no patients recalled all the standard symptoms.Hyperpigmentation with dizziness on standing/blackouts and weight loss...

Introduction: The diagnosis of Cushing’s syndrome (CS) requires a screening test of high sensitivity, followed by biochemical evaluation aiming to identify the aetiology of hypercortisolism. The high-dose dexamethasone suppression test (HDDST) with the corticotropin-releasing hormone (CRH) test is commonly used for the differential diagnosis of ACTH-depended Cushing’s syndrome. However, the diagnostic utility of the HDDST has been questioned.Ai...

Turner syndrome results from the complete or partial lack of one X chromosome and occurs in approximately 1:2500 female live births. The incidence of spontaneous puberty in the 45, X karyotype is about 9%. Spontaneous pregnancy has been reported in less than 5% of the cases, the majority of which have been described in subjects with mosaicism; these are often associated with high rates of miscarriage and stillbirth.A 51-year-old check-out supervisor was ...

Background: Surgery is indicated for patients with prolactinomas if intolerant of or resistant to medical therapy with dopamine agonists. The transphenoidal route offers fast relief from symptoms in the hands of an experienced surgeon, with remission achieved in up to 87% of microprolactinomas and 56% in macroprolactinomas.1Aim: To evaluate the outcome of transsphenoidal adenectomy for non-responsive prolactinomas in a single centre in the UK....

Background: Turner syndrome (TS) affects 1:2500 live births. Mean age of death is reported 27.9±25.5 years due to cardiovascular complications. Expert care is required for better outcome.Aim: To review data on presentation and follow-up of a large series of patients with TS attending our Adult TS clinic.Patients and methods: The records of 64 out of 72 patients were available for review.Results: About 56...

Since July 2005 our centre has offered an e-mail enquiry service to General Practitioners. This service was established for two reasons, firstly to create a more efficient way of dealing with clinical enquiries from primary care and secondly with a long term objective to reduce GP referral rates. The service is manned by Endocrine/Diabetes Specialist Registrars and is part of their training commitment. Compared to telephone calls it gives the registrar more chance to think thr...