Endocrine Abstracts

Background: BIPSS is considered the gold-standard procedure for differentiating autonomous pituitary [Cushing’s Disease (CD)] and ectopic ACTH syndrome (EAS) sources of ACTH hypersecretion. A basal (i.e. unstimulated) pituitary:peripheral ACTH ratio >2, and/or a CRH stimulated pituitary:peripheral ACTH ratio >3, have been proposed as indicative of CD, with a range of sensitivities and specificities cited in the literature. Ad...

Background: Existing biomarkers have limited ability to discriminate indolent non-functioning pituitary adenomas (NFPAs) from those with a propensity to recur following primary surgery. Radiomics, the extraction of quantitative data from medical imaging, is increasingly recognised as a tool to augment clinical decision making.Methods: 39 patients who underwent primary trans-sphenoidal surgery for an NFPA between January 2007 and April 2017, were enrolled...

Background and aims: We have previously reported an increased prevalence of gallbladder polyps in treatment-naive acromegaly when compared with the general population (29 vs 4.6%), with potential implications for future malignant transformation and screening. However, little is known about biochemical markers of liver function in active acromegaly, or in response to treatment. Furthermore, somatostatin analogue (SSA) therapy is associated with the development of gallstones. He...

Endometriosis is a chronic hormone-dependent disorder, characterised by growth of ‘ectopic’ endometrial tissue outside the uterus. It has been reported that 30–40% of women who are sub/infertile have endometriosis. Infertility in women with severe endometriosis may be the result of either scarring or pelvic distortion, but in women with mild/moderate disease it is believed subfertility may result from disturbances in endometrial tissue function. Transformation o...

Endometriosis is a hormone-dependent disorder, characterised by growth of endometrial tissue outside the uterus. It has been reported that 30–40% of women with infertility have endometriosis. Transformation of human endometrial stromal fibroblasts (hESC) (termed decidualisation) is accompanied by increased steroid synthesis and is fundamental to the establishment of a receptive endometrial microenvironment, which can support and maintain pregnancy. Evidence suggests that ...

The establishment of pregnancy requires dynamic remodelling of the endometrium. Decidualization, a key part of this process, is characterised by differentiation of endometrial stromal fibroblasts (ESF) which secrete factors that regulate implantation and placental development. We recently discovered that ESF synthesise androgens which modulate the expression of endometrial receptivity and decidualization markers. Utilisation of the circulating androgen precursor DHEA within ta...

The uterus is an androgen-responsive tissue and AR is expressed in cells within the endometrium and myometrium. We have demonstrated that treatment of ovariectomised mice with the potent androgen dihydrosterone (DHT) induces a uterotrophic response with changes in expression of genes involved in cell-cycle progression, Wnt signalling and an expansion of the glandular epithelium. Selective androgen receptors modulators (SARMs) are AR ligands in development as potential therapeu...

Background: Although, the diagnostic accuracy of magnetic resonance imaging (MRI) has increased in recent years, it may fail to detect secretory adenoma in a few patients with GH excess. Managing such patients with acromegaly can be challenging. We present a case where 11C-methionine PET/CT co-registered with SPGR/volume MRI proved to be helpful in identifying GH secreting pituitary adenoma.Case history: A 42-year-old male was referred by surg...

Introduction: Inflammatory bowel disease (IBD) has been associated with various disorders of thyroid function. Many of these patients are now treated with biological agents targeting on TNF-a.Aim: To investigate thyroid function in patients with IBD and the potential effect of anti-TNF therapy.Patients and methods: We studied 41 patients with IBD (25M/16F, 36.4±11 years), without any known thyroid disorder. Eighteen patients (...

Background: Thyrotropinomas (TSHomas) are traditionally considered a rare albeit important cause of thyrotoxicosis, accounting for ∼1% of all pituitary adenomas. Although early case series reported a preponderance of macroadenomas, emerging evidence suggests microadenomas are being increasingly diagnosed. In addition, the clinical/biochemical phenotype appears to be more variable than previously suspected. We therefore examined the clinical, metabolic, biochemical and ra...