Endocrine Abstracts

During starvation, ketone bodies acetoacetate and 3-D-hydroxybutyrate are freely soluble energy substrates made by the liver. Their major role is to supply an alternative glucose substrate for the brain under conditions of medium- and long-term energy restriction. The most common cause of pathological ketoacidosis is poorly controlled type 1 diabetic mellitus triggering uncontrolled hyperglycaemia. Other common causes are alcoholic ketoacidosis and fasting ketosis. In non-diab...

A 71 year old man presented with 6 months history of pain over the nipples, weight loss of ½ stone over the previous month and nausea. Initial investigations carried out by the breast surgeons including ultrasound scan of the breast and testes were normal. He was then referred to the Endocrine department for further investigations. There was no significant past medical history, he was taking over the counter vitamins and ...

A 42 year old male was referred to the endocrine clinic with accelerated hypertension (190/110) and an elevated aldosterone renin ratio (59). CT adrenal scan revealed a 16 mm diameter mass in the posterior limb of the right adrenal gland which was confirmed to be hyperfunctioning through adrenal vein sampling. Laparoscopic adrenalectomy was performed and histology confirmed cortical adenoma of the right adrenal gland consistent with Conn’s syndr...

A 71 year old man presented with 6 months history of pain over the nipples, weight loss of ½ stone over the previous month and nausea. Initial investigations carried out by the breast surgeons including ultrasound scan of the breast and testes were normal. He was then referred to the Endocrine department for further investigations. There was no significant past medical history, he was taking over the counter vitamins and ...

A 42 year old male was referred to the endocrine clinic with accelerated hypertension (190/110) and an elevated aldosterone renin ratio (59). CT adrenal scan revealed a 16 mm diameter mass in the posterior limb of the right adrenal gland which was confirmed to be hyperfunctioning through adrenal vein sampling. Laparoscopic adrenalectomy was performed and histology confirmed cortical adenoma of the right adrenal gland consistent with Conn’s syndr...

A 24 year old gentleman presented following an episode where he became ‘sleepy’ and disorientated whilst driving and had to pull over. He was confused and lethargic and paramedics found blood glucose of 2 mmol/l. He gave a 3-week history of extreme lethargy, nausea, epigastric discomfort, blurring of vision and constant hunger. He denied recent weight changes and had no significant past medical/family history. Biochemical evaluation was as follows; Laboratory glucose...

Pituitary apoplexy is a rare but life threatening condition if not diagnosed and treated promptly. Common causes include hypertension, head trauma, major surgery, dynamic pituitary tests, anticoagulant use and pregnancy. In pregnancy, hyperplasia and hypertrophy of the lactotroph cells increase pituitary volume by 45% returning to original size at 6 months post-partum. Pituitary apoplexy is uncommon in pregnancy and an underlying adenoma is usually the cause. Very few...

Introduction: To assess outcome for patients with acromegaly treated at Royal Preston Hospital since 1st of January 2000.Results: Out of 22 patients (12 presenting in the last 2 years) 20 had endoscopic transsphenoidal hypophysectomy and two were managed medically. Headaches, visual disturbance and characteristic morphological features were the main presenting problems. 4 were microadenomas and 18 macroadenomas\. Exact dimensions were only available in 1...

Background: Transsphenoidal surgery is the primary therapy in majority of Acromegaly patients with GH-secreting somatotroph adenomas. Reported outcomes of surgery show an initial remission rate of 40–50% for macroadenomas and >85% for microadenomas. Rates of hypopituitarism following endoscopic pituitary decompression vary between 5 and 25%. Invasion of cavernous sinus indicates the tumour is unlikely to be resectable.Methods: We audited the res...

Transphenoidal surgery is an effective treatment option in patients with pituitary tumours associated with compression of the optic chiasm or hormone hypersecretion. Surgery carries with it a risk of the development of new pituitary hormone deficits but also the potential for recovery of existing pituitary hormone deficits. We have examined data concerning pituitary function in 80 patients who underwent endoscopic transphenoidal pituitary surgery at Royal Preston Hospital....