Endocrine Abstracts

The adverse effect of childhood cancer and treatment thereof on growth was firmly established in the mid-1970’s. The impact on growth is multifactorial, however, cranial irradiation was quickly established as one of the most important contributors. Exposure of the hypothalamo-pituitary (HP) region to radiation in childhood cancer survivors is now a well-established risk factor for the development of anterior hypopituitarism. The degree of hypopituitarism can vary between ...

A 54 year old gentleman presented to the eye services with reduced vision on the right attributed to a cataract. Following cataract surgery there was no improvement and his vision declined further with reducing vision also on the left. He was reviewed in Neuro-ophthalmology clinic 29/10/21 and clinical suspicion of a pituitary lesion based on binasal retinal ganglion cell layer loss and bilateral optic atrophy prompted urgent imaging. His right eye visual acuity was to hand mo...

Case history: A 27 years old lady having presented with a neck mass, underwent a total thyroidectomy for thyroid malignancy in 1967. Histology confirmed papillary carcinoma of the thyroid. In 1968, she complained of tiredness and mild neck swelling despite TSH suppressive therapy. Her thyroid uptake study showed a residuum of thyroid tissue within the neck. She went on to have radioiodine ablation therapy on two separate occasions. She responded well with no evidence of residu...

Introduction: Within the setting of putative or established pituitary disease the primary disease process (i.e. Cushing’s disease), hormone deficits (i.e. sex steroids, GH), and inappropriate replacement therapy (i.e. glucocorticoids) are reputed to predispose to low bone mass.Patients and Methods: We examined bone mass at the lumbar spine (LS) and total hip (TH) using DXA in 259 patients with an insult to the hypothalamo–pituitary axis (51.6&#...

We look into total 67 patients with non-functioning pituitary adenoma and review their bone mineral density in association with age and gender, effect of radiotherapy and hormonal replacement.Age range: 5.97% (4 patients) are between 18 and 40 years, 43.28% (29 patient) between 41 and 60 years and 50.74% (34 patients) are between 61 and 86 years.Gender: 61.19% (41 patients) are male and 38.8% (26 patients) are female.<p class="...

Background: Graves’ disease is widely treated with anti-thyroid medication. After an initial course of treatment, remission is achieved in around 50% of patients. Definitive treatment is generally offered in relapsed cases, based on the assumption that remission rates following a second course of anti-thyroid medication are significantly lower.Method: A database of patients with Graves’ disease has been kept from 2004. 150 patients were suitabl...

Background: Acute adrenal insufficiency leads to potentially life threatening crises if increases in steroids are delayed or insufficient. The patient is central to early increases in dosage and informing Healthcare Professionals of their steroid-dependency.Methods: To assess adequacy of information given to cortisol deficient patients we performed an audit of case notes documentation. The audit was performed over four weeks, involving 32 patients from t...

Case history: A 30-year old female presented with a 10-month history of enlarging neck mass, fatigue and weight gain. Assessment by her GP found her to have a large smooth goitre and biochemical hypothyroidism. The patient had a history of intestinal failure secondary to mitochondrial disorder. As a result of intestinal failure she was entirely dependent on parenteral nutrition and was intolerant of any oral intake, with venting of her stomach to reduce pain. She was referred ...

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder. However, a familial hyperparathyroid syndrome is diagnosed in less than 5% of cases. We present two related cases of CDC73-related familial hyperparathyroidism due to a rarely described germline Leu63Pro missense mutation in CDC73 exon 2.Case report: The index patient, a 24-year-old female, presented acutely unwell with symptoms of hypercalcaemia. Her blood...

Aim: The insulin tolerance test (ITT) is considered the gold standard test in assessing the integrity of the hypothalamic–pituitary–adrenal (HPA) axis. The aim of this study is to evaluate if the 0900 h cortisol levels can be predictive of the patient’s response to hypoglycaemia, minimizing the use of the ITT as it is labour, intensive and unpleasant for the patient.Methods: This is a retrospective study of 110 ITTs performed at the Endocr...