Endocrine Abstracts

Hypopituitarism is associated with profound androgen deficiency, even in patients who are adrenocorticotrophic hormone (ACTH) replete. DHEA has been shown to have a beneficial effect on well-being in patients with adrenal failure. We hypothesised that DHEA may be additive to the known effects of GH on psychological well-being in patients with hypopituitarism. In a double blind placebo controlled trial 50 mg DHEA or placebo was added to standard replacement, including growth ho...

Hyperparathyroidism occurs in most patients with MEN Type 1 but the association of MEN type-1 with parathyroid carcinoma has only been described previously in one patient. In this report, we describe two further cases of parathyroid carcinoma presenting in association of MEN type 1 syndrome.The first patient was a 69-year-old woman who presented with severe hyperparathyroidism and tracheal compression by a mediastinal mass which was shown histologically ...

A provisional diagnosis of paroxysmal atrial fibrillation with normal blood pressure and echocardiogram was made in a 58 years old man. He described ‘funny turns’ on standing during which he would become sweaty, tremulous with palpitations and headache and facial flushing preceded by pallor. The patient was otherwise fit and healthy with a BMI of 27.3 kg/m2; he used to drink about 15 pints of beer per week and smoke 11 cigarettes daily for the last 40 year...

We report the use of Gamma knife radiosurgery (GK) to 15 somatotroph adenomas. Eight patients had refractory acromegaly despite maximal conventional treatments: all had undergone conventional radiotherapy (CRT), mean interval between CRT and GK 15.6 years. Six had undergone surgery, two on more than one occasion. Five were receiving somatostatin analog therapy, one was receiving dopamine agonist therapy, one was on pegvisomant alone. All had radiologically defined disease, wel...

Introduction: We present the outcome for the first 80 patients undergoing neuronavigation–guided, endoscopic transphenoidal surgery in our centre since August 2001. All operations were undertaken by the same neurosurgeon and endoscopic nasal surgeon.Indications for treatment: Indications for treatment may be divided into: Functioning microadenomas, with the aim of surgical cure while protecting residual pituitary function. Functioning macroadenomas,...

We report two cases of MIBG avid secretory phaeochromocytoma in 2 middle-aged ladies. Adrenalectomy, after standard preparation, was performed successfully and histology confirmed complete excision of a phaeochromocytoma in both cases; however, there was capsular infiltration and metastasis to a neighboring lymph node in the first case. In this case, surveillance CT scans 3 and 6 months later showed left adrenal bed recurrence and rapidly growing lesions in the right lobe of t...

Introduction: Diagnosis of pancreatic neuroendocrine tumours (NETs) is often a challenge and involves biochemical characterisation and anatomic localisation of the tumour. Wherever feasible, curative surgical excision is the treatment of choice.Materials and Methods: Twenty four consecutive patients with pancreatic NETs were referred for consideration of surgery over a six-year period (1999–2005). Following use of multi imaging modalities to localis...

The effect of growth hormone (GH) replacement on thyroid function in hypopituitary patients has only been studied in small groups of children and adults with conflicting results.We aimed to define the effect and clinical significance of adult GH replacement on thyroid status in a large cohort of 243 patients with hypopituitarism due to various causes. 84 patients were considered euthyroid before GH treatment and 159 patients had central hypothyroidism an...

Objective: Variability in growth hormone (GH) responsiveness is evident in adult hypopituitary patients receiving recombinant GH (rhGH). Doses vary up to 4-fold for unexplained reasons. Deletion of exon 3 in the GH receptor (d3-GHR) has been linked to an increased response to GH treatment in children, although data are conflicting. We investigated the role of the d3-GHR polymorphism in determining GH responsiveness in adult GH deficient patients.Methods:...

Sporadic somatostatinomas are rare neuroendocrine tumours (NETs), classically presenting with hyperglycaemia, cholelithiasis and steatorrhoea. The mainstay of treatment is surgical resection; other aspects of management remain uncertain. We report 3 cases. Case 1: A 55 year-old female presented with abdominal discomfort and steatorrhoea. Computed tomography (CT) demonstrated a 9 cm pancreatic mass. Biopsy suggested a NET. Somatostatin (SMS) was 160 pmol/l (normal 0-150)...