Endocrine Abstracts

A 63-year-old Caucasian female was admitted with a 12-month history of exertional breathlessness, anxiety attacks, syncopal episodes, diarrhoea, fatigue, reduced appetite, two stones weight loss, and dry facial and truncal flushing. Investigations revealed raised Urine 5-HIAA of 116 (RR <50 μmol/24 h) and raised Chromogranin A of 48 (RR <6 nmol/l). CT scan revealed an extensive soft tissue mass encasing the upper abdominal aorta, compressing the inferior vena cava...

Introduction: Non-functioning pituitary macroadenoma (NFMA) can cause considerable morbidity due to pituitary dysfunction and pressure effects. We present recent experience in managing cases diagnosed with NFMA at a single tertiary centre between January 2009 and October 2013.Results: Of the 63 patients with NFMA, 28 (44%) were females. Age ranged from 22 to 91 (mean 63). Visual disturbance symptoms (35/63; 57%) were the commonest presentation. Headache ...

A 34-year-old male with no significant past medical history presented with severe abdominal pain. On detailed questioning his symptoms included tremors, headache, sweating, and agitation. Despite recent weight gain he had obvious muscle wasting. On admission blood pressure was 166/107 mmHg. Abdominal examination revealed a palpable left upper quadrant mass.CT scan demonstrated a 15 cm mass in the left supernal region with extensive signs of haemorrhage i...

Management of newly-diagnosed non-functioning pituitary adenomas (NFPAs) has evolved over the last decade. Whilst surgical debulking remains the mainstay of treatment for patients presenting with compressive disease, the use of pituitary irradiation has declined, with greater emphasis on observation or further surgical debulking. We aimed to compare outcomes of treatment for NFPAs at our institution since 2004 with older management strategies.We reviewed...

Background: The UK Acromegaly Register contains data for 2700 patients. IGF-1 and random growth hormone (GH) measurements are used for disease monitoring. The registry reference laboratory (RRL) uses the Immunodiagnostic systems (IDS)-iSYS immunoassay platform for GH and IGF-1. The RRL uses age- and sex-specific reference ranges for IGF-1. We compared IGF-1 and GH results fromlocal laboratories to those of the RRL (pre-defined as the Gold standard) to determine the extent of d...

Glycogen storage diseases (GSD) are autosomal recessive inborn errors of carbohydrate metabolism. With current dietary therapy, life expectancy in patients with GSD has improved considerably and almost all children reach adulthood. Notwithstanding intensive therapy, patients with GSD have an increased risk of osteoporosis. We followed 20 patients aged 22–62 (mean age of 37) years with GSD type I, III and IX, for up to 5 years with serial measurements of bone turnover mark...

Pituitary carcinoma is rare and diagnosis requires demonstration of cerebrospinal and/or systemic metastasis. We present case of a 64-year-old lady who presented with widespread spinal metastasis from a pituitary adenoma diagnosed 36 years ago. Our patient presented in 1971 with visual failure, headache and oligomenorrhoea. Imaging confirmed pituitary macroadenoma and she underwent transcranial hypophysectomy. Histology revealed chromophobe adenoma. Post operatively her vision...

Introduction: Although acromegaly and pituitary gigantism have the same pathological cause, they have different disease characteristics.Aim: To study tumour size, treatment course and the most common comorbidities in a population with young-onset acromegaly.Materials and Methods: UK Acromegaly Register (UKAR, 22 centres, 1997-2017) retrospective analysis, enriched with patients from the FIPA-consortium. We defined gigantism as diag...

Background: Dopamine agonists (DA) are included in the management algorithm of acromegaly. Studies on cabergoline monotherapy report IGF-1 normalisation in between 0% and 100% of the patients during treatment periods ranging between 2.6 and 24 months. However, in many of these studies, previous radiotherapy is a confounding factor. Furthermore, real world data applying the current disease control criteria (normal IGF-1 and GH<1 mg/l) are not available. The aim of this stud...

Background: The detection of phaeochromocytomas evolved from autopsy finding to presentation in symptomatic/hypertensive, and genetically-predisposed individuals. Increasingly, phaeochromocytomas are diagnosed in incidental adrenal masses and the impact on the clinical, biochemical, and radiological features is unclear.Methods: Retrospective review of patients with phaeochromocytomas seen at a large tertiary referral centre between January 2010 and May 2...