Endocrine Abstracts

Introduction: Bilateral 3rd nerve palsy is known in conditions such as diabetes mellitus, neurosarcoidosis, Guillain-Barre syndrome, multiple sclerosis, anterior or posterior communicating artery aneurysm or mesencephalic bleed/trauma. There are only single cases reported in association with pituitary adenoma or carcinoma, usually in the context of apoplexy. We describe a patient with Cushing’s disease and bilateral 3rd nerve palsy secondary to apoplexy in pituitary macro...

Hyperprolactinaemia in association with a large sellar lesion could represent either tumoural secretion of prolactin (PRL) or stalk disruption by a non-prolactinoma: the differentiation has important therapeutic consequences. We have previously shown that based on currently used assays disconnection hyperprolactinaemia associated with non-functioning adenoma (NFA) practically never exceeds levels above 2000 mU/l. We aimed to verify our proposed disconnection hyperprolactinaemi...

A relapse rate of more than 50% is quoted for patients with Graves’ Disease (GD) treated with anti-thyroid drugs. Our aim was to audit the outcome/relapse rate and possible predictive factors in a series of patients managed in our Nurse-led Thyroid Clinic (NLTC). The notes of patients with newly-diagnosed GD seen in the NLTC between 2005–2011 who had completed 18 months of anti-thyroid drug were reviewed: 60 patients (48 females) were identified. After 18 months of t...

GH influences multiple metabolic pathways. Excess GH (acromegaly) causes a distinct form of cardiomyopathy, which may progress to fulminant heart failure. AMPK is an energy conservation enzyme that modulates multiple areas of the cell stress response, inhibiting anabolism and promoting catabolism. AMPK is activated by phosphorylation at Thr172 and measurement of Thr172 phosphorylation is thought to correlate with enzyme activity. We investigated the influence of GH on cardiac ...

Pituitary adenomas are benign tumours, which do not involve mutations in tumour suppressor genes or oncogenes. We have shown that the canonical Raf/MAPK and PI(3)K/Akt pathways are over-activated in these tumours, but their downstream effectors are modified to a much lesser extent. It is probable that the oncogenic mutations responsible for the initiation of these tumours therefore lies proximal to the convergence of these pathways, at or even upstream to the growth factor rec...

Introduction: Neuroendocrine tumours (NET) are a diverse group of neoplasms originating from cells within the diffuse endocrine system. Urine 5-HIAA is commonly used in the diagnosis and monitoring of patients with NET in particular small intestinal neuroendocrine tumour with carcinoid syndrome. Urine 5-HIAA collection over a 24 hour period and the potential exposure to acid preservative in the sample container, limit the use of urine 5-HIAA.Methods: Sam...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

This 22 year old lady presented with Haemophilus Influenza meningitis. Given an unusual organism, she had an MRI which revealed an incidental pituitary macroadenoma extending into the right cavernous sinus and breaching the anterioinferior wall of the pituitary fossa. Thyroid function showed raised T4 (24.7 pmol/L) and T3 (8.3 pmol/L) with unsuppressed TSH (1.75 munit/L). IGF-1 was also raised at 56.7 nmol/L (12–50.1 nmol/L).<p c...

Olfactory neuroblastoma (ONB) is a rare neuroendocrine tumour with a slow onset of symptoms, and classically a propensity for recurrence and a poor prognosis. Due to its rarity, there is no agreed standard therapy, but treatment will usually include surgical resection, adjuvant radiotherapy and/or chemotherapy. However, such tumours very often show positive uptake on somatostatin receptor radionuclide scanning, and selective use of peptide receptor radionuclide therapy (PRRT) ...

Introduction/Background: Patients with NETs and acromegaly are commonly treated with somatostatin analogues (SSAs), such as octreotide and lanreotide depot formulations. The Pharmathen syringe is now available in several European countries and the USA for lanreotide depot injection. When using SSAs, confidence in and ease of use with syringes is important for decision-making in long-term therapy.Aims: PRESTO 3 compared nurses’ preference for the Som...