Endocrine Abstracts

Multiple endocrine neoplasia (MEN) syndromes are rare autosomal-dominant disorders that predispose affected individuals to benign and malignant tumours involving two or more endocrine glands. Four major forms of MEN are recognised, each associated with the occurrence of specific tumours. MEN1 is due to germline-inactivating mutations of the MEN1 tumour-suppressor gene, and is associated with the occurrence of parathyroid, pancreatic islet and anterior pituitary tumours. MEN2 (...

ATL1103 is a second generation antisense 20mer intended to inhibit expression of the GH receptor (GHR) gene. Phosphorothioate and 2′-O-methoxyethyl modifications to nucleotides increase its plasma half-life and affinity for the target RNA to allow post-hybridization RNaseH degradation. We previously reported a phase 2, randomised, open-label, parallel group study of ATL1103 in 26 patients with acromegaly which demonstrated a fall in serum IGF-I of 26% with 200 mg twice w...

ATL1103 is a second generation antisense oligomer directed at the GH receptor. It is a 20mer with a phosphorothioate backbone and 2′-O-methoxyethyl modifications of the five nucleotides at either end intended to increase its plasma half-life and affinity for the target RNA to allow post-hybridization RNaseH degradation. We report a phase 2 randomised, open-label, parallel group study of subcutaneously administered ATL1103 in patients with active acromegaly. Appr...

Serum magnesium concentration is regulated by the balance between intestinal absorption and renal excretion. Hypomagnesaemia is relatively common, with an estimated prevalence in the general population ranging from 2.5 to 15%. It may result from inadequate magnesium intake, increased gastrointestinal or renal loss, or redistribution from extracellular to intracellular space. Drug-induced hypomagnesaemia, particularly related to proton-pump inhibitor (PPI) therapy, is being inc...

Contemporary management of pituitary tumours is based on a multidisciplinary approach involving surgery, radiotherapy (RT) and medical therapy. External beam RT significantly reduces the likelihood of tumour re-growth following surgery for non-functioning pituitary adenomas and suppresses hypersecretion in hormonally-active tumours. However, over the years, a number of potentially significant complications of pituitary RT have been described.Radiation ma...

Metastasis to the pituitary gland is a rare occurrence. Here we discuss our experience managing a patient with pituitary neuroendocrine metastasis who first presented with ocular symptoms. A 65-year-old lady presented in July 2015 with progressive diplopia. An MRI scan revealed a pituitary mass lesion with aggressive features and two abnormal enhancing nodules within the brain white matter, raising suspicion of metastatic disease. Radiotherapy was commenced on the basis that t...

Background: Most phaeochromocytomas are unilateral and are not associated with a neuroendocrine syndrome. Although these tumours are often histologically benign, they tend to have potentially lethal presentations.Case: A 51-year-old female presented in 2016 with headache, vomiting, palpitations, and a cardiac-sounding chest pain for 16 hours. Her ECG showed a junctional rhythm with generalised ST-segment depression. Acute coronary syndrome treatment was ...

Background: An 88 year old gentleman was referred to the endocrine team as an inpatient with recurrent episodes of spontaneous hypoglycaemia. These occurred in the early hours of the morning when he was found to be unrousable from sleep. There was no background history of diabetes. He was under the oncology team on this admission with pyrexia post-palliative chemotherapy with trabecitidine. Significant past medical history include metastatic solitar...

Background: An 88 year old gentleman was referred to the endocrine team as an inpatient with recurrent episodes of spontaneous hypoglycaemia. These occurred in the early hours of the morning when he was found to be unrousable from sleep. There was no background history of diabetes. He was under the oncology team on this admission with pyrexia post-palliative chemotherapy with trabecitidine. Significant past medical history include metastatic solitar...

A 61-year-old man presented to his primary care service with complains of frequent hot flushes, dizziness and headache. Following initial screening, an incidental pituitary lesion was diagnosed on computed tomography (CT) scan and hence was referred to specialist review. Further detailed history revealed similar presentation with dizziness and hot flushes two and a half years ago. He was then diagnosed with essential hypertension after a negative work-up for Cushing disease. H...