Endocrine Abstracts

Concern exists in the literature that the long-term use of ergot-derived dopamine agonists (DAs) may be associated with the development of clinically-significant cardiac valvulopathy. This has arisen largely by extrapolation from experience with high doses of these drugs given to patients with degenerative neurological conditions and it has led to regulatory authority recommendations to arrange regular screening echocardiograms for patients receiving much lower doses of these ...

Epidemiological studies have demonstrated an association between low birth weight and an increased prevalence of cardio-metabolic disorders in later life. Both human and animal studies suggest that this phenomenon of ‘early life programming’ is not limited to the first generation offspring. Epidemiological studies in humans have shown intergenerational effects on birth weight, cardiovascular risk factors and type 2 diabetes. Transgenerational effects on birth weight,...

Lactotroph pituitary adenomas (prolactinomas, PRLomas) are the most common form of functioning pituitary tumour. The vast majority can be managed successfully by means of medical (dopamine agonist) therapy; only a small minority require second-line therapy of surgical resection with or without adjunctive radiation. PRLomas occur in adolescent patients, but are unusual. Using a combination of illustrative case presentations and selective reference to informative publications, t...

Lactotroph pituitary adenomas (prolactinomas, PRLomas) are the most common form of functioning pituitary tumour. The vast majority can be managed successfully by means of medical (dopamine agonist) therapy; only a small minority require second-line therapy of surgical resection with or without adjunctive radiation. PRLomas occur in adolescent patients, but are unusual. Using a combination of illustrative case presentations and selective reference to informative publications, t...

What does a clinical endocrinologist actually do? There are no angiogram, pacemaker, bronchoscopy, ERCP, kidney biopsy or joint injection lists to be done. Our only practical procedure is venepuncture, albeit multiple times and occasionally at odd times of day. Within a single clinic an endocrine physician will have to ‘key in’ very quickly to a variety of symptomatic issues that often go to the core of human identity. There may be two successive patients with second...

Although development is a highly organised and tightly regulated process, the developing embryo is sensitive to environmental influences, resulting in pathophysiological changes which may increase the risk of later cardio-metabolic, neurobehavioural and reproductive disorders. We have shown that prenatal overexposure to the synthetic glucocorticoid dexamethasone (Dex) in rats reduces birthweight in the first generation (F1) and leads to hypertension and insulin resistance in t...

Several reports indicate that hypopituitarism is associated with decreased life expectancy compared to age-matched healthy controls and that this mortality penalty exists despite ‘adequate’ or ‘satisfactory’ replacement with glucocorticoids, thyroid hormone and sex steroids. Almost coincident with these studies came a series of randomised, placebo-controlled trials, in which it was convincingly demonstrated that treatment of growth hormone deficient (GHD) a...

An 18 year old gentleman was first reviewed in our endocrine adolescent transition clinic. He had been under the care of the paediatricians since birth, where he initially presented with developmental delay. This triggered investigations which led to the diagnosis of septo-optic dysplasia. At aged 12 he developed cranial diabetes insipidus (DI) and secondary hypothyroidism. This was managed with intranasal DDAVP (20 ug BD) and thyroxine 125 μg. Due to an abnormal thirst t...

A 31 year-old lady presented to clinic with an acute, three-week history of rapidly worsening polyuria and polydipsia. She described an eighteen month history of dysmenorrhoea with no galactorrhoea and reported no change in her vision. Her past medical history included alopecia areata one year previously from which she made a full recovery. Clinical examination was normal including full visual fields to red-pin confrontation. Biochemistry identified serum sodium of 141 mmol/l,...

We would like to present the case of a twenty-six year old gentleman whose first presentation to hospital was aged 4 days old. At that time he was thought to be generally unwell with poor feeding and excessively somnolent. During his resuscitation he was found to have extremely deranged serum electrolytes with sodium 122 mmol/l and potassium 14 mmol/l. His electrocardiogram (ECG) was initially noted to be bizarre, with no clear rhythm. After resuscitation with IV fluid, glucos...