Endocrine Abstracts

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...

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...

Case history: An 11 year old girl was diagnosed with von Hippel-Lindau disease (VHL) on cascade genetic screening due to a positive family history and was enrolled in a VHL surveillance programme. She developed bilateral phaeochromocytomas and underwent staged bilateral adrenalectomies at the age of 12 and 14. At the age of 16, she was discovered to have a 2.5 cm tail of pancreas pancreatic neuroendocrine tumour (pNET) on routine surveillance imaging. This enlarged during foll...

A 36 year old lady presented to the endocrine clinic with a 4 month history of secondary infertility, amenorrhea, galactorrhoea and headaches. She had stopped breast-feeding her 5th child 18 months previously and was not taking any antidopaminergic drugs. She had a normal neuro-ophthalmic examination, including full visual fields to confrontation with a red pin. Her prolactin was elevated at 5690 mU/l and MRI pituitary confirmed a 17 mm partially cystic macroadenoma which was ...

A 37-year-old lady with complete androgen insensitivity syndrome (AIS, 46,XY) presented with the desire to breastfeed her first child during the pregnancy of a surrogate mother. Her past medical history included thyrotoxicosis initially treated with block-and-replace regime, followed by multiple relapses, and definitive treatment with radioactive iodine ablation. There was a family history of complete androgen insensitivity syndrome (two sister out of four) and one sister had ...