Endocrine Abstracts

We report the management of 16 predominately elderly patients (12 female: 2 male; mean age at presentation 73.8 years, range 48 to 85 years) presenting with massive goitres. Seventy-five percent had significant co-morbidities. Fifteen had multinodular goitres and 1 Reidel’s thyroiditis. Four goitres were confined to the neck; 6 were intra-thoracic and 6 had both neck and intra-thoracic goitres. Five had symptoms of compression; 9 were thyrotoxic and 2 hypothyroid. Mean fo...

A 21-year-old man presented with tonic–clonic seizures and two-week history of nocturnal headaches, sweatiness, hot flushes and abdominal pain. Blood pressure was 220/110 mmHg and pulse 120–160 bpm. A GTN infusion was commenced and the blood pressure improved to 150/90 mmHg. Examination revealed a large, hard mass in the left hypochondrium. There was no palpable lymphadenopathy and no papilloedema. A 2 cm hard, irregular mass was present on the left testis. CT showed...

Turner syndrome (TS) affects over 15,000 females in the UK and is defined by the loss of X chromosome material. In the setting of an adult clinic we can observe adverse outcomes and determine their risk factors. For instance women with TS have an excess risk of hypertension, diabetes, fatty liver and osteoporosis. The Turner Syndrome Life Course Project at UCLH has collected data from over 750 women with TS over 20 years. Here we report the influence of weight on these outcome...

Introduction: Endocrine deficiency as a result of glandular infiltration by metastatic cancer is considered rare. Metastases to the adrenal cortex are relatively common and we present the clinical presentation and radiological appearances of cases involving pituitary and adrenal metastases.Case histories: Case 1: An 84 year old male with bronchogenic carcinoma presented with lethargy, polyuria and dehydration. The serum Na+ was 156 mmol...

BACKGROUND: AGHD is associated with increased prevalence of osteoporosis. Alterations in both parathyroid gland sensitivity to changes in calcium concentration and end-organ response to the effects of PTH play a role in the development of osteoporosis.OBJECTIVES: To investigate the effects of PTH (1-34) infusion on end-organ and parathyroid gland responsiveness.METHODS: 6 patients with severe AGHD were recruited. All patients were admitted, prior to commencement of GH ...

BACKGROUND: AGHD is associated with osteoporosis. Alterations in parathyroid gland responsiveness to changes in calcium concentration play a role in the genesis of osteoporosis.OBJECTIVES: To investigate PTH response to hypo- and hypercalcaemic stimuli in AGHD.METHODS: 12 patients with untreated AGHD were consented to the study. Venous cannulae were inserted in each arm and half-hourly blood samples collected between 0900-1800hours for PTH, calcium and albumin. After 5...

BACKGROUND: Adult growth hormone deficiency (AGHD) is associated with osteoporosis. Growth Hormone replacement (GHR) results in increased bone mineral density (BMD), with greater benefit derived in men. PTH plays an important role in bone metabolism and reports suggest that bone and renal insensitivity to PTH may contribute to changes in bone turnover in AGHD.OBJECTIVES: To determine the gender difference in PTH, phosphocalcium metabolism and bone turnov...

BACKGROUND: Healthy and Adult Growth Hormone Deficient (AGHD) women exhibit elevated leptin concentrations compared with men. AGHD is characterised by obesity and associated with increased leptin concentration and decreased leptin pulsatility, however the gender variation in rhythm and pulse parameters is yet to be defined. Following growth hormone replacement (GHR), leptin concentration decreases and pulsatility increases preceding a reduction in body fat mass (BFM).<p cl...

Background: Low energy availability (LEA) in female athletes can result in HPG axis suppression. Basic military training (BMT) is physically arduous and associated with amenorrhoea and low-trauma fractures. We hypothesised that women undergoing BMT would demonstrate evidence of LEA and suppressed HPG function.Design: Prospective study of 61 women undertaking 11-month BMT. Subjects acted as their own controls at baseline (all measures). Body composition m...

BACKGROUND: Adult Growth Hormone Deficiency (AGHD) is associated with reduced bone mineral density (BMD). PTH plays an important role in bone metabolism and reports have suggested target cell insensitivity to PTH as a contributor to the changes in bone turnover seen in AGHD. Although growth hormone replacement (GHR) increases BMD, the underlying mechanisms remain unclear.OBJECTIVES: To determine the effect of GHR on 24-hour PTH profiles, phosphocalcium ...