Endocrine Abstracts

Selective transsphenoidal adenomectomy remains the accepted first line treatment for Cushing’s disease (CD), until recently by microscopic (sublabial) transsphenoidal pituitary surgery. Endonasal transsphenoidal endoscopic surgery is emerging as a novel, less invasive treatment for pituitary adenomas with lower postoperative complications and morbidity. The safety of endoscopic surgery has been extensively reviewed in adult patients and is now considered best practice for...

Introduction: 131I-MIBG is a well-established treatment modality for patients with neuroendocrine tumours (NETs). Our centre has now accumulated over 10 years of experience with 131I-MIBG therapy, with long term data to evaluate effects on disease progress and other long term outcomes following therapy. Bone marrow effects of radionuclide therapy may include prolonged suppression, myelodysplasia or even frank leukaemia. Incidence is thought to be low, but...

Introduction: Bone mineral density (BMD) and fracture tendency are influenced by diet, activity, drugs, and hormones. Recent studies highlight an inverse relationship between serotonin and BMD, of uncertain mechanism.Purpose: We investigated the relationship between serotonin metabolites and BMD in patients with sporadic neuroendocrine tumours (NETs), with and without the carcinoid syndrome.Materials and methods: One-year prospecti...

Objective: Variability in growth hormone (GH) responsiveness is evident in adult hypopituitary patients receiving recombinant GH (rhGH). Doses vary up to 4-fold for unexplained reasons. Deletion of exon 3 in the GH receptor (d3-GHR) has been linked to an increased response to GH treatment in children, although data are conflicting. We investigated the role of the d3-GHR polymorphism in determining GH responsiveness in adult GH deficient patients.Methods:...

Background: Glucocorticoids play a key role in determining body fat distribution. Excess circulating glucocorticoids lead to intrahepatic fat accumulation. Obesity is associated with enhanced glucocorticoid production but this is offset by enhanced degradation such that circulating steroid concentrations are normal. However, tissue-specific pathways may lead to different degrees of cortisol exposure in different organs. Local steroid exposure in the liver is determined by the ...

Background/objective: Published data suggest that growth hormone replacement (GHR) may be safely given to patients with hypopituitarism consequent upon a pituitary/peri-pituitary tumour. However, to date, these series have included a preponderance of patients treated with external pituitary irradiation. We have performed a retrospective study to evaluate the recurrence rate in a group of patients with pituitary/peripituitary tumours treated with GHR.Meth...

Sporadic somatostatinomas are rare neuroendocrine tumours (NETs), classically presenting with hyperglycaemia, cholelithiasis and steatorrhoea. The mainstay of treatment is surgical resection; other aspects of management remain uncertain. We report 3 cases. Case 1: A 55 year-old female presented with abdominal discomfort and steatorrhoea. Computed tomography (CT) demonstrated a 9 cm pancreatic mass. Biopsy suggested a NET. Somatostatin (SMS) was 160 pmol/l (normal 0-150)...

THE SENSITIVITY OF 123I-MIBG IN THE DETECTION OF HISTOLOGICALLY CONFIRMED CATECHOLAMINE-PRODUCING TUMOURS.M Ismail, R Foley, WM Drake, AB Grossman, PJ Jenkins, SL Chew, GMBesser, R Reznek, K Britton, JP MonsonDepartments of Endocrinology, Nuclear Medicine and Radiology, StBartholomew's Hospital (QMUL), London EC1A 7BERadionuclide imaging is widely used for the loc...

Continuation of GH at final height in hypopituitary adolescents with severe GH-deficiency results in accrual of bone mass over 12 months. We report body composition and BMD in 7 of these patients who discontinued GH but continued to have observations over 24 months. Five males and 2 females were included (17.4plus/minus0.3, years, meanplus/minusSE), in this Ethics Commitee approved study. All had severe GH-deficiency with multiple pituitary hormone deficits on appropriate repl...

ObjectiveActive acromegaly is associated with increased mortality. While surgery is the mainstay of treatment, it is not always curative. In selected cases, CyberKnife stereotactic radiosurgery (CK SRS) can be used as adjuvant treatment in patients with persistent disease.DesignThis is a retrospective review of the biochemical and imaging characteristics for patients with active acromegaly treated with CK SRS...