Endocrine Abstracts

A 34 weeks pregnant woman was reviewed in the joint antenatal clinic with over a month history of neck swelling. Her thyroid function tests showed TSH of 1.39 mU/l and a free T4 of 11 pmol/l. An initial ultrasound of the neck revealed a solitary heterogeneous nodule in the right lobe of the thyroid consistent with U3 morphology (indeterminate). She was reviewed by ENT consultant and had a fine needle aspiration (FNAC). Cytology was consistent with features of papill...

Context: Acromegaly is chronic insidious disease caused by excessive GH secretion by pituitary adenoma. This leads to overproduction of IGF1 and serious disseminated concequences.Material: 14 acromegalic subjects with diagnosed insulin dependent diabetes on stable octreotide LAR) treatment. Patients did not meet recent criteria of biochemical controlled disease (mean GH 4.6 ng/ml, mean IGF1 2.2-fold upper normal limit).Methods: Pat...

A 61-year-old ex-smoker with a background of chronic obstructive pulmonary disease, bilateral cataracts and advanced retinitis pigmentosa presented in April 2014 with a 5 months history of feeling generally unwell and weight loss. He was found thyrotoxic with TSH suppressed to less than 0.01 mU/l, free T4 of 38 pmol/l and free T3 of 26 pmol/l. On examination there was tunnel vision bilaterally and diplopia in all directions with no evidence of thyroid eye...

Background: Neurosurgery is treatment of choice in patients with GH-secreting pituitary adenoma. However, in about 50% of cases surgery is ineffective or contraindicated. Long-acting somatostatin analogues are possible, although expensive therapeutic alternative. Generally, 60–70% of patients with active disease responds to such medical treatment.Aim: Aim of this study was to identify factors influencing medical treatment outcome and to determine if...

Background: Insulin resistance leading to glucose intolerance and even diabetes mellitus is common in acromegaly and is partially caused by pathological high concentrations of growth hormone (GH) and somatomedin C (IGF-1). On the other hand, somatostatin analogues, common treatment option, can cause inhibition of insulin secretion and glucose tolerance disturbances.Aim: Of the study was to determine impact of prolonged somatostatin analogues administrati...

Background: Bilateral total adrenalectomy (TA), despite causing persistent adrenal insufficiency with lifetime replacement of corticosteroids, is the method of choice in patients with bilateral pheochromocytoma. Partial adrenalectomy (PA) is an alternative approach that aims to balance tumor removal while maintaining adrenal function, although the oncological completeness of the procedure is questionable.Objective: The aim of this systematic review and m...

Introduction: Generously supported by IPSEN)-->Impaired glucose tolerance and insulin resistance are frequently associated with acromegaly. The aim of this study was to assess the effect of octreotide-LAR treatment on glucose homeostasis in acromegalic patients.Patients and methods: In this prospective study 16 naïve acromegalic patients were studied before and after 3-month therapy of octreotide-LAR (20 m...

Background: Acromegaly is characterized by disabling symptoms and relevant comorbidities. Insulin resistance, leading to glucose intolerance is one of the most important contributory factor to the cardiovascular mortality in acromegaly.Aim: To assess the impairments of glucose homeostasis in acromegalic patients and find association between activity of the disease and the severity of glucose intolerance.Patients and methods: In thi...

Introduction: Acromegaly is a rare disease of the pituitary gland. Both GH and IGF-1 levels are of key importance for monitoring of treatment effects in patients with acromegaly. In some patients, divergent results of measurements of these hormones are observed. Purpose: The purpose of the study was to estimate frequency of GH and IGF-1 inconsistencies in the population of patients with acromegaly included in the Polish Register of Acromegaly Patients, a...

We describe a case of a male who presented to a rheumatologist with hypercalceamia at the age of 22 in 1995. Investigations were incomplete and he was lost to follow up. He was referred to a general surgeon in 2002 as another blood test had showed hypercalcaemia of 2.8 mmol/l (2.2–2.6), parathyroid hormone 9.5 pmol/l (1.6–6.9). A spot urine calcium/creatinine excretion ratio was 0.014. It was felt he probably had primary hyperparathyroidism and he was managed conserv...