Endocrine Abstracts

Hypopituitarism is associated with premature vascular mortality. Growth hormone (GH) deficiency, over-replacement with glucocorticoid, cranial irradiation and traditional vascular risk factors are possible contributing factors to the excess mortality.We studied 200 consecutive adult hypopituitary age (mean standard deviation) 51.7 plus/minus 15.3 years, who attended our pituitary clinic between July and December 2002. Hypertension was defined as blood pr...

Pituitary hormone abnormalities have been reported in up to 50% of survivors of traumatic brain injury (TBI), tested several months or longer after the event. No information is available on the frequency of hypopituitarism in the immediate post-TBI period.We studied 50 consecutive patients who were admitted to the neurosurgical unit with severe or moderate TBI [initial Glasgow Coma Scale (GCS) score 3-13]. Testing was performed at a median of 12 days pos...

Corticosteroid therapy is associated with potentially serious side effects, but there is no information available regarding glucocorticoid requirements in adult hypopituitary patients with partial adreno-corticotrophin hormone (ACTH) deficiency.10 male adult hypopituitary patients with partial ACTH deficiency, baseline plasma cortisol > 200 nanomole/ litre but a peak stimulated cortisol < 550 nanomole/ litre, were randomised to a cross-over protoco...

The diagnosis of Cushing’s Syndrome (CS) requires demonstration of excess circulating cortisol. Measurement of late night salivary cortisol (LNSF) has been advocated as a simple, non-invasive and reliable outpatient diagnostic tool for patients with suspected CS but the usefulness of its metabolite cortisone (LNSE) remains unclear. LNSE levels are approximately six times higher than LNSF in saliva due to the rapid action of 11β-hydroxysteroid dehydrogenase type 2 (11...

Introduction: Chordomas are rare slowly growing locally aggressive neoplasms of the bone arising from embryonic remnants of notochord. These tumours typically occur in the axial skeleton and have a proclivity for the spheno-occipital region of the skull base. Parasellar/clivus chordomas account for one third of all chordomas.Methods: We conducted a retrospective chart review of 4 patients with chordomas of the clivus treated in Beaumont Hospital between ...

BackgroundThyrotoxicosis with Graves’ Disease is treated with thionamide, radio-iodine treatment and thyroidectomy. Surgery is an important choice, especially when Graves’ Disease is complicated by thyroid orbitopathy. Pre- and post-operative protocols for thyroidectomy are imperative.Aims1) To assess pre-operative preparation of patients, with potassium iodide, vitamin D, beta blockade, and the pre...

Section 1: Case history: A 50-year-old woman presented to the HIV clinic after suspecting adverse effects following two intra-articular triamcinolone injections to her left hip, administered three and seven months prior. She complained of ongoing leg pain, generalised weakness and lethargy. Her past medical history included HIV infection, mild asthma for which she took inhalers only and had never required oral steroids. Her antiretroviral medications included dolutegravir, dar...

Transsphenoidal surgery is the first-line treatment for non-functioning pituitary macroadenomas (NFPAs) causing pressure symptoms. However, the approach to asymptomatic NFPAs is unclear due to the limited data on their natural progression. This study retrospectively analysed data from patients with NFPAs who underwent conservative management for at least six months. The study screened 175 individuals treated at the National Neurosurgery/Pituitary Centre at Beaumont Hospital be...

Intravenous Immunoglobin (IVIG) therapy is used in recurrent miscarriage, despite its efficacy being limited to specific sub-groups such as those with underlying immune conditions. The indications, efficacy and side effect profile of IVIG when used in pregnant women are not established. We present the case of a 41-year-old pregnant woman with one previous miscarriage, who had received IVIG as part of her fertility treatment and subsequently developed profound symptoms and bioc...

Introduction: Selenium supplementation is recommended for all patients with mild Graves’ orbitopathy (GO). The thyroid gland contains high levels of selenium, which has an anti-oxidant effect and a role in the metabolism of thyroid hormones. The study on which this recommendation is based was conducted in countries of a selenium-deficient region and did not measure subjects’ selenium concentrations. There is therefore no consensus on optimum dose, duration, or safety...