Endocrine Abstracts

Up to 90% of patients treated with radioactive iodine treatment for hyperthyroidism develop hypothyroidism, in some cases many years after treatment. The majority of patients receiving RI in our clinic were referred from clinics throughout the northwest of England and attend on one occasion for RI treatment with follow-up by the referring physician. The Royal College of Physicians guidelines recommend centres administering RI have a system for regular patient monitoring to ide...

In many centres a test dose (TD) of octreotide is administered prior to commencing LAR. The value of the TD as a predictor of subsequent response to therapy remains uncertain. We have studied the relationship of the GH response to a TD to the subsequent response to LAR in 26 patients (median age 59 years, range 20- 84). After baseline GH sampling, 50mcg subcutaneous octreotide was administered and sampling continued for six hours. Results of the TD were compared to the lowest ...

Serum IGF-I is increasingly used, and IGFBP-3 has been proposed, as a marker of treatment efficacy in patients with acromegaly. IGF-I bioactivity and half-life are dependent on the degree of IGF-I incorporation into 150kDa ternary complexes with IGFBP-3 and ALS. When serum GH is lowered in patients with acromegaly all three ternary complex components decline, but effects on ternary complex formation have not been described. We investigated GH action on ternary complex formatio...

Cardiovascular outcomes are better predicted by 24 hour ambulatory BP monitoring than random clinic BP (mmHg). In acromegaly, hypertension is common and cardiovascular disease is the principal cause of death. We investigated prevalence and characteristics of hypertension in 44 patients (26 male, mean age 53.1 ± 14.2), 17 of whom were receiving treatment for hypertension. A random clinic BP (normal <140/90) and IGF-I were measured prior to 24 hr ABPM assessment (Astra...

There is increasing reliance on published consensus criteria for clinical decision-making in states of GH excess and deficiency. NICE eligibility criteria for GH treatment include a peak GH response <9 mU/L during an ITT. To determine the adequacy of GH assay performance for diagnosing GH deficiency (GHD), we have assessed the variability in 101 UKNEQAS reported results from a single sample with a value close to 9.0 mU/L. For all laboratories (n=101) median GH was 11.1 mU/L...

Objective: To identify a range of IGF-I values representative of growth hormone deficiency (GHD), which could be utilised to reduce the risk of 'functional' GHD in Pegvisomant treated acromegaly.Method: We analysed centrally measured IGF-I data from the KIMS European GHD database. We stratified this cohort into six gender based, age ranges and assessed IGF-I and IGF-I standard deviation scores (SDS).Results: Baseline measurements f...

Cabergoline (CB) is a potent, long-acting dopamine agonist licensed for the treatment of hyperprolactinaemia and, although unlicensed, is extensively used to treat acromegaly. There is a dearth of data on the use of CB in the treatment of acromegaly. We have performed a retrospective analysis of CB therapy in 34 [19 male, mean age 46 years (range 14-82)22 macroadenomas] patients with acromegaly treated since 1975. The patients were divided into two groups, those on CB as sole ...

Radioiodine(RI) is an effective treament for thyrotoxicosis, being used with increasing frequency. Since 1998 an initial dose of 400 MBq has been used in the treatment of thyrotoxicosis, with a standard second dose of 550 and third dose of 799 MBq. The efficacy of this dosing regimen in controlling hyperthyroidism was studied by a questionnaire survey of the GPs of 259 patients treated between November 1998 and January 1999. RI was deemed a success if patients were rendered eu...

Salivary cortisol is an increasingly popular tool in endocrine, psychological and sports studies. Immunoassays used for its measurement are limited by cross-reactivity from related steroids, mainly cortisone, which is abundant in saliva.A method was developed for the simultaneous measurement of cortisol and cortisone (SalF and SalE respectively) in saliva using LC-MS/MS. 40 μl of extract was injected onto a C8 4×2 mm guard cartridge attached to...

We have previously reported comparisons of ACROQOL, a disease-specific questionnaire for QOL in patients with acromegaly, with the non-disease-specific generic tools Psychological General Well-Being Schedule (PGWBS) and EUROQOL and disease-specific signs and symptoms score (SSS). ACROQOL comprises 22 questions (subdivided into physical and psychological classes, total score out of 110 quoted as percentage, higher scores = better QOL). SSS rates 5 features of acromegaly each ra...