Endocrine Abstracts

Adrenocortical carcinoma (ACC) is a rare and highly malignant tumour with a poor prognosis with an incidence of 1 – 2 per million population per year. We report 2 cases of functioning ACC.Case 1: An 80 yr old with a history of hypertension, paroxysmal atrial fibrillation and cerebrovascular disease presented with leg ulcers, peripheral oedema, tiredness, weight gain, plethora and proximal myopathy. ACTH-independent Cushing’s syndrome was confir...

Background: Long-acting depot somatostatin analogues injections are useful drugs in the medical treatment of acromegaly. No previous study has assessed the value of acute octreotide suppression test in predicting responses to depot injections.Objective: The aim of this study was to investigate the value of the acute octreotide suppression test (100 micrograms subcutaneously, GH measurements hourly for 8 hours) in predicting the long-term response to long...

Introduction: Studies have reported a rising incidence of congenital hypothyroidism (CHT) although the pathophysiology of most cases is unknown. A rising incidence is not simply a reflection of changing assay methodology and environmental factors may have an aetiological role. If so, then cases may exhibit space-time clustering, where cases occur at similar times and close proximities to other cases.Methods: We investigated whether there is evidence of s...

INTRODUCTION: Although IGF-I is considered to reflect the daily GH secretion, its value in establishing the diagnosis of adult growth hormone deficiency (GHD) and in predicting the presence of further anterior pituitary deficits has not been elucidated in a large series.AIM: To evaluate the diagnostic utility of a subnormal IGF-I in patients with GHD and to investigate whether a low IGF-I is associated with the presence of further anterior pituitary defi...

Background: Military training has been associated with changes in the hypothalamic–pituitary–testicular axis that are consistent with central hypogonadism (fall in testosterone, LH and FSH concentrations). The effects on the hypothalamic–pituitary–testicular axis of deployment to a combat zone are not known. The aim of this study was to clarify this situation.Methods: Military personnel were investigated pre-deployment (Pre-) and foll...

A 69-year-old woman was admitted with new uncontrolled diabetes, severe hypertension and bilateral leg oedema. Cushing’s syndrome was suspected when she developed resistant hypokalemic alkalosis on diuretic therapy. Detailed questioning also revealed a history of episodic sweating, palpitation and tremor.Investigation & management: ACTH-dependant Cushing’s syndrome was confirmed: Serum ACTH 516 ng/l; urine free cortisol 20 045 nmol/24 h; 09...

Case report: A 56-year old man presented with a 3 month history of painful bilateral gynaecomastia and sexual dysfunction. Investigations revealed hypogonadotrophic hypogonadism with markedly elevated serum E2, but otherwise normal baseline anterior pituitary function. Tumour markers were negative and adrenal androgens and LFTs were normal. Imaging identified a ∼6 cm right adrenal mass. Preoperative workup excluded phaechromocytoma, but identified low-grade, ACTH-indepen...

Introduction: Cardiovascular disease is the commonest cause of death (absolute-excess-risk:41%) in Turner Syndrome (TS). Hypertension is a major risk for circulatory-disease (up to 60%) and a key modifiable-risk factor of aortopathy, ischemic heart disease and stroke in TS. There is no current consensus for hypertension diagnosis/management in TS.Methods: Retrospective multi-centre observational study of patients aged &#...