Endocrine Abstracts

Case notes of 150 consecutive patients (58% male) who underwent pituitary surgery by a single surgeon for non-functioning pituitary adenoma and endocrine follow up at our centre between July 2005 and February 2015 were reviewed. All patients underwent endoscopic transsphenoidal surgery as the first approach. Post-operative pituitary function was assessed by measurement of baseline pituitary hormonal profile and a glucagon stimulation test to assess ACTH and GH axis. Mean age a...

Introduction: Current literature suggests that the incidence of GH deficiency (GHD) post subarachnoid haemorrhage (SAH) ranges from 0 to 37%. We present the results from a large single centre study and discuss factors that should be considered when testing for GHD in this population.Method: One hundred survivors of SAH were screened with a glucagon stimulation test (GST) for pituitary hormone deficiency. Participants with isolated GHD were required to un...

A 32-year-old female presented with a 6-week history of worsening headaches associated with bitemporal visual field defects. An urgent MR scan demonstrated a sizeable pituitary lesion with chiasmal compression and suprasellar extension. Endocrine tests revealed hyperprolactinaemia (2550 mU/l) with hypocortisolaemia (<37 nmol/l). Cabergoline and hydrocortisone replacement were initiated. Unfortunately, 24 h later her visual fields deteriorated further and the patient underw...

Case history: A 50-year-old lady presented with blurred vision in her left eye. She was clinically eupituitary. Visual field testing confirmed a bitemporal field deficit. MRI pituitary showed a pituitary macroadenoma occupying part of the sphenoid fossa and causing significant optic chiasmal compression. The lesion was extending across the left carotid loop, with a part of the lesion extending and compressing the medial aspect of the left temporal lobe. She was found to be hyp...

We present a 35-year-old male who was incidentally found to have a large macroadenoma when he presented with left sided weakness three months ago. He had no headaches or visual disturbances. His prolactin at presentation was >100 000 mU/l (86–324 mU/l). Magnetic resonance imaging confirmed an invasive macroadenoma. His Humphrey’s visual field tests were normal.Rest of the endocrine profile revealed a normal T4 of 14.3 (12–22...

Objective: To describe the experience of pituitary apoplexy from a single-centre modern series.Methods: We retrospectively reviewed the case notes of patients presenting to Salford Royal NHS Foundation Trust between February 2005 and April 2014 with pituitary apoplexy.Results: A total of 32 cases (20 males) presenting with classical apoplexy were identified, with a mean age at presentation of 54 years (range 22–88 years). 11 p...

A 60-year-old female was referred to the department in October 2010 after a CT thorax revealed an incidental finding of a right adrenal nodule. On questioning, the patient reported some sweats but otherwise no other symptoms of hormonal excess. Adrenal functional studies were normal and it was therefore decided that the patient should have a repeat CT scan in 6 months. Repeat CT adrenal glands in April 2011 did not show any changes to the size of the nodule but gave indetermin...

A 22-year-old pregnant lady presented to the Emergency Department (ED) at 36 weeks of gestation with sudden onset of severe headache and blurring of vision. On examination, she was alert, conscious (GCS: 15/15) and had bitemporal hemianopia, confirmed on formal visual field assessment. MRI brain scan (limited views due to pregnancy) showed a pituitary mass extending into the suprasellar region and reaching the optic chiasm. Serum prolactin (PRL) was elevated at 3876 μ/l (...

A 51 year old lady presented with a 3 week history of persistent headache, sweating, increase in shoe and ring size and prognathism. Imaging confirmed an 18×19 mm pituitary macroadenoma indenting the optic chiasma. Visual fields were normal.Bloods: IGF1-181 nmol/l (11.3–30.9 nmol/l), prolactin 76 mU/l (102–496 mU/l), LH 22 U/l (2–13 U/l), FSH 46.6 U/l (4–13 U/l), TSH 0.63 mU/l (0.27–4.2 mU/l), FT4- 25.9 pmol/l (12–22 pm...

Sixty seven year old gentleman presented to eye clinic with blurring of vision in the left eye for 2 weeks. Patient was seen by Ophthalmologist and discharged home. Presented 3 weeks later with headache and blurring of vision. On examination no perception to light in the left eye and bitemporal hemianopia.His past history includes carcinoma prostate, diagnosed a year ago and had surgery and Radiotherapy. His recent PSA was normal. Bones scan showed no ev...