Endocrine Abstracts

Introduction: We present a case of probable cyclical Cushing’s syndrome (CS) masquerading as polycystic ovarian syndrome (PCOS) which went undetected for almost a decade. Our case highlights the subtleties and complexities of interpreting diagnostic tests in patients with cyclical endogenous hypercorticolism.Case: A 33-year old female with presumed PCOS presented with a seven year history of persistent hirsutism and acne. However there was no menstr...

Introduction: Giant prolactinomas are uncommon tumours and typically exceed 40 mm. These tumours are locally invasive but still respond to dopamine agonist therapy. The medical management of cystic giant prolactinomas with dopamine agonists is controversial as the non-solid components of these aggressive tumours are believed to respond poorly to drug therapy. We present a case of a giant cystic invasive prolactinoma masquerading as a multilobular schwannoma that was successful...

IntroductionIsolated TSH (thyroid stimulating hormone) deficiency has been reported in the literature as a rare condition. Only 60 cases have been reported so far since 1960. It has been defined as central hypothyroidism without evidence of any other pituitary hormonal deficiencies or evidence of any structural pituitary abnormality. We report 3 cases of suspected isolated TSH deficiency, 2 of which presented in a year to one endocrine centre.<p clas...

IntroductionPituitary macroadenoma requires extensive endocrine investigations to diagnose any evidence of hormone excess or deficiency. As a part of routine investigation, IGF-1 is frequently used to exclude growth hormone excess. Here we report 3 cases of pituitary macroadenoma, who had a normal pre-operative IGF-1 but post-operatively developed biochemical evidence of growth hormone excess.CasesWe report 3...

Clinic based studies have shown that patients with Addison's disease have relatively high rates of depression and anxiety symptoms compared with population-based reference samples. Addison's disease results in deficiency of dehydroepiandrosterone (DHEA) and DHEA-sulphate in addition to glucocorticoids and mineralocorticoids. DHEA is thought to have beneficial effects on energy level and mood, independent of circulating testosterone levels. Thus there may be a direct link betwe...

We examined the results of treatment of adult Cushing's disease by transphenoidal surgery by a single neurosurgeon (MP). Patients with Nelson's syndrome and those who previously had received treatment for Cushing's by a different surgeon were excluded. We reviewed the pituitary database and patient records for all patients operated between 1988 and 2000 with clear pre-operative evidence of Cushing's disease. 117 patients had clear evidence of a pituitary source of excess ACTH....

Metyrapone is a potent inhibitor of the conversion of 11-deoxycortisol (11-DOC) to cortisol and is used in the treatment of Cushing's syndrome. This study has assessed the clinical significance of 11-DOC cross-reaction in five serum cortisol assays provided on automated immunoassay analysers. Cross-reaction was determined from the linear regression of increase in measured cortisol against increasing levels of 11-DOC (0, 1590, 4310, 6490, 7040 nmol/L) added to a serum pool. In ...