Endocrine Abstracts

Serum GH and IGF-I levels are closely correlated but discordance between GH and IGF-I levels can occur in patients with acromegaly either as a consequence of biological factors or as an artefact of the means of assessment or definitions of normality.Pegvisomant as a GH receptor antagonist lowers serum IGF-I but, due to negative feedback, increases GH levels. Raloxifene has been shown to lower IGF-I in men and women with acromegaly and oestrogen has been ...

The McCune–Albright syndrome is a rare condition of variable severity that typically presents in childhood and is characterized by the triad of fibrous dysplasia (FDP), endocrinopathy and café-au-lait spots. The syndrome was independently described by Donovan McCune (1902–1976) and Fuller Albright (1900–1969) approximately 70 years ago and is now recognized to be the result of post-zygotic somatic constituently activating mutations of the alpha subunit of t...

Introduction: Prolactinomas account for approximately 40% of all pituitary adenomas, with an estimated prevalence of 100 prolactinomas per million adults. Dopamine agonists currently represent the mainstay of treatment. Nevertheless, increasing dopamine-agonist dosage, surgery, and radiotherapy may be necessary in some cases, such as aggressive, dopamine-agonist resistant or atypical prolactinomas.Case: We report the case of a 55 year old man who was inc...

: In community-dwelling men, salivary testosterone (Sal-T) concentrations are thought to represent tissue hormone levels and correlate strongly with serum free-T levels. Measurement of salivary glucocorticoid concentrations is a non-invasive and objective means of assessing cortisol exposure in users and non-users of hydrocortisone therapy. We assessed relationships of Sal-T with transdermal testosterone replacement therapy (TD-TRT) and with markers of testosterone exposure. I...

Ipilimumab, a monoclonal antibody against CTLA-4, is licenced for the treatment of metastatic melanoma (dose of 3 mg/kg for four cycles intravenously). It can cause immune-related adverse reactions (IRAEs) in multiple organs, with hypophysitis the most common endocrine IRAE. We carried out a retrospective analysis of 171 ipilimumab-treated patients in one centre for endocrinopathies.Results: Nine cases (six female, mean age 64 years, range 42–76) of...

Tolvaptan (a V2 receptor antagonist) is licensed for correction of hyponatraemia in patients with SIADH at an initial dose of 15 mg od. Data in oncology patients with SIADH suggest 7.5 mg can safely and effectively increase sodium levels where 15 mg can on occasion lead to too rapid a correction. Recommendations suggest a repeat sodium taken at 4–6 h. We retrospectively assessed the safety and efficacy of intermittent out-patient dosing with 7.5 mg tolv...

A decrease in insulin sensitivity (IS) is associated with increasing visceral adiposity. An inverse correlation has been demonstrated between Intramyo-(IMTG) and intrahepatocellular triglyceride (HCTG) concentrations and IS. Patients with AA have reduced IS but IMTG and HCTG content has not been studied.Eight patients with AA (IGF-I >ULN, median 1.83×ULN (range1.16–4.38) ((6 M), median age 39.5 (range 23–66) years, median BMI 30.6(23.5...

Aggressive angiomyxoma (AA) is a rare mesenchymal tumor which is more common in females, occurring predominantly in the pelvi-perineal region. It tends to be locally aggressive with high recurrence after primary excision. The majority of these tumors are positive for oestrogen and progesterone receptors. Hence hormonal manipulation provides the possibility of effective treatment.Since 2005, we have been treating two female patients with AA medically (see...

Initial clinical trials with pegvisomant at doses of up to 80 mg once weekly led to a 30% fall in IGF-I. Subsequently, daily administration of up to 40 mg/day (280 mg/week) achieved an IGF-I within reference range in 97% of patients. Pegvisomant’s half-life is >70 h suggesting weekly dosing may be possible using higher doses than in the original trials.We performed a two-centre, open-label prospective study in seven patients (4M, 3F, mean age 57...

Pituitary infarctions are not unknown in patients with pituitary tumours. We describe here a 39-year-old lady, who presented with a history of sudden onset severe headache without any restriction of her visual fields. She had features of acromegaly with enlarged hand and feet size, progressive deepening of her voice and coarsening of facial features over the preceding year. She also had a euthyroid multinodular goitre. CT scan and MRI of the pituitary gland suggested cystic de...