Endocrine Abstracts

A 29 year old woman was admitted to her local hospital with haematemesis, and found to be hypercalcaemic. A peptic ulcer was confirmed and she was commenced on omeprazole. There was biochemical evidence of primary hyperparathyroidism and a single-gland parathyroidectomy was performed. During her admission, a diagnosis of gastrinoma was suspected, but an attempt at measuring fasting gut hormone concentrations off omeprazole therapy resulted in gastro-intestinal perforation. She...

Autoimmune thyroid diseases (AITD), such as Graves' disease (GD) and autoimmune thyroiditis (AT), cluster within families and within individuals and exhibit a strong female preponderance. The type 1 diabetes Warren Repository was established between 1989 and 1996 and contains 505 families of British white Caucasian origin. Each family consists of both parents and at least two siblings with type 1 diabetes. We have examined the clinical data collected to establish the frequency...

Graves' disease (GD) is caused by genetic and environmental factors. To date only the HLA class II region on chromosome 6p21 and the CTLA-4 gene on chromosome 2q33 have been consistently associated with disease. A recent study has indicated the most likely position of the aetiological variant in the CTLA-4 locus to be in a 6.1kb region of the 3' untranslated region of the gene. However the same degree of mapping resolution has not been achieved for the HLA class II region due ...

Medullary thyroid carcinoma (MTC) is hereditary in 25 per cent of cases. This may be in association with Multiple Endocrine Neoplasia (MEN) Type 2 (A and B) or as familial MTC (FMTC) alone. The mutations causing hereditary forms of MTC arise in the RET-proto-oncogene.A 40 yr old asymptomatic gentleman presenting with a mass in his neck. Fine needle aspiration of the mass revealed a probable medullary thyroid carcinoma. Total thyroidectomy and neck dissec...

A 65 year old lady presented to her GP in 1997 with an extensive rash. She was referred to a dermatologist but the rash which failed to settle with topical treatments. A plasma glucagon level was elevated at 275 pmol/l (NR 0-50). CTscan revealed a mass in the pancreatic tail and hepatic metastases consistent with malignant glucagonoma. She was commenced on octreotide and the rash resolved. She underwent a distal pancreatectomy, partial left hepatic lobectomy and intraoperative...

Langerhans cell histiocytosis is a disease caused by clonal proliferation of a group of antigen-presenting cells known as Langerhans cells. Its manifestations range from isolated lesions to multisystem disease usually involving bone, skin and the pituitary stalk. Thyroid involvement is rare.A 44-year old woman presented to the joint thyroid clinic with a short history of neck swelling, confirmed to be a smooth goitre on clinical examination. Initial bloo...

A 37-year old gentleman with MEN 1 was referred to our Centre for further assessment. MEN 1 had manifested as recurrent primary hyperparathyroidism and multiple pancreatic gastrinomas. He complained of reduced libido, with absent early morning erections for the preceding 18 months. Biochemistry confirmed hyperprolactinaemia (prolactin 1494, NR 0–625 mU/l, testosterone 12 NR 10–28 nmol/l, LH 2.6 NR 2–12 IU/l, FSH 3.7 NR 1.7–8 IU/l). During investigation of h...

Background: Controversy exists over the prevalence of colonic neoplasia in individuals with acromegaly. Some previous studies have demonstrated an increased prevalence of colorectal neoplasia compared to controls, however others have shown no such association. Furthermore, colonoscopy in acromegalic individuals has an increased rate of complications and even death....

Background: Yttrium-90 (90Y) pituitary implants have previously been used to treat patients with growth hormone (GH) secreting pituitary adenoma. This study reports the long-term effect of 90Y implants on growth hormone levels and pituitary function in a group of acromegalic patients....

BackgroundPrevious studies suggest that patients with acromegaly should have regular colonoscopic examinations due to their increased risk of colorectal neoplasia. However, acromegalic patients have significantly enlarged colon and increased rate of complications due to colonoscopy have been reported.AimTo assess the difficulty of performing colonoscopy in acromegalic patients by comparing large bowel length,...