Endocrine Abstracts

Background: Alongside various physical symptoms, patients with high levels of cortisol, such as typically found in Cushing’s disease, often display a wide variety of neuropsychiatric symptoms such as depression, psychosis, mania and cognitive impairments. This indicates involvement of the central nervous system in hypercortisolism.Methods: Various neuroimaging approaches can be used to examine the effects of hypercortisolism on the brain. The freque...

Use of therapeutic plasmapheresis in hyperthyroidism is mainly described in thyroid storm when traditional measures fail. Patients with hyperthyroidism who respond poorly or suffer adverse effects to conventional antithyroid therapies, which then need to be stopped, can have persistently high levels of thyroxine and at risk of a full blown thyroid storm. Hence an alternative treatment to achieve euthyroidism followed by thyroidectomy as definitive therapy is vital. We report h...

We present 2 patients who developed severe thyrotoxic exacerbation following radioiodine. The first treated by conventional antithyroid therapy, the second was plasma exchanged.Patient A aged 39 male with FT3=28.2 pmol/l (2.5–5.3) FT4=49.0 pmol/l (9.1–23.8) TSH=<0.01 mU/l (0.32–5.0),a large diffuse goitre, thyroid eye disease and asthmatic on inhaled ventolin. He received 3.5 years of carbimazole 40 mg and thyroxine 100 mcg. Thyroxine ...

Background: Dopamine agonist (DA) withdrawal is common in the management of microprolactinoma. Guidelines in 19971 and 20062 suggest that DA should be withdrawn after normoprolactinaemia for 3 years.Aims: To assess DA withdrawal and adherence to guidelines.Methods: We retrospectively examined casenotes from 1997 to 2008. Patients were included with clinical and biochemical evidence of hyperprolactinaemia, and ...

Background: Patients with long-term remission of Cushing’s disease (CD) demonstrate residual psychological complaints. At present, it is not known how previous exposure to hypercortisolism affects psychological functioning in the long-term. In foregoing Magnetic Resonance Imaging (MRI) studies, abnormalities of brain structure and resting-state connectivity were demonstrated in patients with long-term remission of CD. However, no data are available on functional alteratio...

Background: Patients with Cushing’s Syndrome (CS) suffer from a variety of neuropsychiatric and cognitive problems. Following remission, some, but not all of these symptoms resolve. Recent cross-sectional studies in patients with CS show persistent structural and functional brain abnormalities. However, longitudinal studies using magnetic resonance imaging, and a detailed neurocognitive assessment, performed before and after treatment, are not available.<p class="abs...