Endocrine Abstracts

We report the use of Gamma knife radiosurgery (GK) to 15 somatotroph adenomas. Eight patients had refractory acromegaly despite maximal conventional treatments: all had undergone conventional radiotherapy (CRT), mean interval between CRT and GK 15.6 years. Six had undergone surgery, two on more than one occasion. Five were receiving somatostatin analog therapy, one was receiving dopamine agonist therapy, one was on pegvisomant alone. All had radiologically defined disease, wel...

Introduction: We present the outcome for the first 21 patients undergoing neuronavigation–guided, endoscopic transphenoidal surgery for pituitary dependent Cushing’s disease in our centre since August 2001. All operations were consecutive, and undertaken by the same neurosurgeon and endoscopic nasal surgeon.Methods: Records are available for 20 cases. Pre and post operative management of cases was led by the endocrine team with standard assessm...

A 47 year old Macedonian Personal Trainer presented with 4 days of vomiting, abdominal pain and profuse sweating. He admitted abusing anabolic steroids 20 years previously but never insulin. The presenting capillary blood glucose (CBG) was 1.7 mmol/L, blood pressure (BP) 182/106 mmHg, pulse 62 bpm. On examination, he was sweaty, pale and cold. Blood was drawn for measurement of insulin, C-peptide, glucose, cortisol and thyroid function tests. He was treated with 50% dextrose a...

A high prevalence of rickets in the Gbagyi tribe around Kaduna, Northern Nigeria, has been noted. Multiple affected children born to one wife, but not others, of polygamous men suggests a genetic aetiology.With ethical approval, children with deformities characteristic of rickets (genu varum/valgum, rachitic rosary) were identified, clinical histories obtained and examination points documented included genu valgus/varus distances and other limb deformiti...

Introduction: We present the outcome for the first 80 patients undergoing neuronavigation–guided, endoscopic transphenoidal surgery in our centre since August 2001. All operations were undertaken by the same neurosurgeon and endoscopic nasal surgeon.Indications for treatment: Indications for treatment may be divided into: Functioning microadenomas, with the aim of surgical cure while protecting residual pituitary function. Functioning macroadenomas,...

Introduction: Diagnosis of pancreatic neuroendocrine tumours (NETs) is often a challenge and involves biochemical characterisation and anatomic localisation of the tumour. Wherever feasible, curative surgical excision is the treatment of choice.Materials and Methods: Twenty four consecutive patients with pancreatic NETs were referred for consideration of surgery over a six-year period (1999–2005). Following use of multi imaging modalities to localis...

The effect of growth hormone (GH) replacement on thyroid function in hypopituitary patients has only been studied in small groups of children and adults with conflicting results.We aimed to define the effect and clinical significance of adult GH replacement on thyroid status in a large cohort of 243 patients with hypopituitarism due to various causes. 84 patients were considered euthyroid before GH treatment and 159 patients had central hypothyroidism an...

Introduction: Growth hormone (GH) replacement is widely used in the management of patients with adult-onset (AO) GH deficiency (GHD). In most cases, AO-GHD arises as a result of pituitary/peri-pituitary tumours and/or their treatment. The aim of this study was to examine the effect of GH replacement on growth/recurrence of non-anterior pituitary parasellar tumours.Methods: Fifty consecutive patients (21 males; mean age 45.9) with severe AO-GHD (peak seru...

Selective Parathyroid Venous Sampling in Patients with Complicated Primary HyperparathyroidismCM Ogilvie, PL Brown, M Matson, R Carpenter, WM Drake, PJ Jenkins, SL Chew, JP MonsonCentre for Endocrinology and Departments of Surgery and Radiology, St Bartholomew's Hospital, QMUL, London EC1A 7BEThe role of pre-operative localisation of abnormal parathyroid glands remains controversial but is particularly releva...

We report the efficacy, safety, and effects on glucose homeostasis of converting patients with acromegaly from slow release octreotide (OT, treated for >3 months) to pegvisomant (Peg), a GH receptor antagonist. 52 patients (median age 49, range 23-81, 13 with diabetes) who had previously participated in a Peg clinical trial and subsequently treated with OT were enrolled in a 32-week, open-label, multicentre study. Peg 10 mg/d was started 4 weeks after the last dose of OT (w...