Endocrine Abstracts

A 33-year-old lady reported a 6 months history of sweating and worsening palpitations especially after taking sotalol. She had a history of congenital heart disease (double inlet left ventricle, pulmonary valvular stenosis, ventricular septal defect, and Fontan connection surgery at 18 years); Blue Bleb Syndrome with chronic gastrointestinal blood loss, and recurrent pulmonary emboli. She required long-term warfarin treatment and regular blood transfusions. She was found to ha...

Cyclical Cushing’s syndrome is typically detected by collecting sequential daily early morning urine (EMU) samples for cortisol to creatinine ratio over a 28 day period. More recently nocturnal salivary cortisol (NSC) measurement has been shown to be a sensitive means of screening for Cushing’s syndrome. The Endocrine Society have suggested that NSC may be used to assess patients for cyclical Cushing’s however there is limited evidence that it correlates with th...

Aberrant and upregulated eutopic receptors have been identified in vitro in patients with primary aldosteronism (PA). We previously identified an exaggerated aldosterone response to synacthen in patients with PA versus healthy controls. In this study we aimed to evaluate whether the synacthen test differentiates between patients with PA and essential hypertension (EH).The 250mcg intramuscular synacthen test was performed after 30 minutes recumbenc...

There is limited evidence on the effect of potassium (K+) supplementation on endothelial function. Three studies suggest a beneficial effect in healthy volunteers and mild hypertensives. However potassium increases aldosterone due to a direct effect on the adrenal gland and there is evidence that aldosterone excess is detrimental to cardiovascular health. We therefore aimed to determine the effect of potassium supplementation on endothelial function in patients with >10% c...

Primary hyperaldosteronism secondary to bilateral adrenal hyperplasia (BAH) bears striking similarities pathophysiologically to essential hypertension. During stimulation studies to elucidate possible aberrant aldosterone responses in BAH we measured the aldosterone response to 250mcg iv synacthen after 30 and 60 minutes in 7 patients with BAH and in 20 healthy controls. Patients had diuretics withheld for at least 4 weeks and betablockers and calcium channel blockers withheld...

A 14 year old girl was referred with a diagnosis, made at birth, of congenital adrenal hyperplasia. She had undergone clitoral reduction and vulvovaginoplasty at age 2. Her height had been on 10th-25 th centile, and, at presentation to us, she was taking prednisolone (7.5milligrams in divided doses) and fludrocortisone 0.05 milligrams. At age 14 her height dropped to the 3 rd centile. She was hirsute, obese and had abdominal striae. A variety of steroid regimes only led to an ...

Radioiodine is the treatment of choice for relapsed hyperthyroidism although the optimum protocol is uncertain. We assessed the outcome of therapy with 131I in relapsed hyperthyroidism using a fixed dose regimen.We retrospectively studied 449 patients (M: F 82: 367; age range 13–89 y, median 42 y) treated between 2003 and 2007 with a fixed dose of 550 MBq 131I for relapsed hyperthyroidism. Patients were classified as either Gra...

It is well established that external pituitary irradiation (EPI) effectively reduces serum growth hormone levels in acromegaly. However the effect of EPI in normalising serum insulin like growth factor-1 levels (IGF-1) remains disputed. We studied 60 patients between 1964 and 2004 who received EPI for acromegaly: 22 women, 38 men; mean age at diagnosis 38.5 years (range 14-68). Pituitary surgery was carried out in 50/60 patients; in 47 patients EPI was given after their last s...