Endocrine Abstracts

Case history: Our patient is a 64 year old lady who had bilateral adrenalectomy in 1978 for Cushing”s disease. This was followed by radiotherapy in late 1978. To get further reduction of the ACTH producing pituitary adenoma she had transsphenoidal surgery in 1979 and then transfrontal craniotomy in 1982. This was followed by further radiotherapy in 1985. It left her with panhypopituitarism and she was on full hormone replacement. She presented to our hospital in late 2008...

Background: Testosterone replacement therapy has been shown to produce a wide range of benefits for men with hypogonadism with studies showing improvement in libido, bone density, muscle mass, body composition, mood, cognition, and erythopoiesis. The risks associated with testosterone replacement therapy are less well characterised and there is a lack of larger randomised trials. One recognised risk is polycythaemia. The aim of this study is to assess the frequency of polycyth...

Context: Prolactinomas are the most common functioning pituitary adenomas & it is recognised that gender has an influence on presentation and management of this condition.Objective: To examine the effects of gender on presentation and response to treatment in a large cohort of adults with confirmed prolactinoma (MRI performed and macroprolactin excluded).Design & patients: This retrospective cohort study design used an elec...

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

Recently updated international guidelines recommend specialist surveillance of adults with Turner Syndrome (TS). In 2005, we established a dedicated TS clinic, attracting referrals from our general endocrine service and other specialities including primary care.Twenty-three patients currently attend of whom 9 were previously under endocrinology review. Karyotypes include 45XO (8/23), 45XO/46XrX (4/23), and 45XO/46XiXq (3/23). Mean (±S.D.</sma...

Case history: A 26-year-old lady presented with a two-week history of weakness associated with pins and needles affecting the lateral calf and dorsomedial aspect of her left foot. The patient denied any trauma or symptoms including weight loss. She had no drug allergies and was taking no regular medications. She had a vegan diet supplemented with multivitamins. Her past medical and family history was unremarkable. On examination, she had a narrow-based high-steppage-gait. Lowe...

Background: The route of oestrogen replacement has an influence on GH sensitivity in hypopituitary women, although the practical relevance of this effect remains unclear.Objectives: To compare the effects of oral and transdermal oestrogen replacement on GH requirement in adult females with hypopituitarism receiving GH replacement.Methods: This cross-sectional, observational study included 69 GH-deficient women each receiving a stab...

Controversy exists as to the role of adrenal venous sampling in the assessment of primary aldosteronism (PA). There is no consensus as to how best to define successful outcome post resection of aldosterone producing adenoma (APA). We performed a retrospective analysis of the outcome of patients following unilateral adrenalectomy without pre-operative venous sampling. The study included 14 patients (9 males; mean age 47 yrs (r: 38–59 yrs) with PA and CT identified u...

No guidelines exist for the management of Congenital Adrenal Hyperplasia (CAH) in adults. With no ideal glucocorticoid regimen to replicate normal physiology, best practice remains unclear. Concerns have been raised regarding overtreatment, particularly with longer acting steroids, and potential adverse effects on body composition and bone mineral density (BMD).We examined the case records of all 35 patients currently under review in our unit. Mean±...

Background: It is recognised that there is ‘cross-talk’ between the thyroid and hypothalamo-pituitary–adrenal (HPA) axes. The few available studies suggest that cortisol levels may be low and cortisol metabolism altered in some patients with thyrotoxicosis.Aim: To compare HPA axis variables in the thyrotoxic state (TT) and euthyroid state (EU).Materials and methods: Short synacthen testing (250 μg tetracosactide...