Endocrine Abstracts

Introduction: Regimens for pre-operative α and β-blockade for patients with secretory phaeochromocytomas/paragangliomas vary widely between centres. The worldwide lack of availability of intravenous phenoxybenzamine (Goldshield) has removed a useful tool in the management of phaeochromocytoma crisis and has necessitated a change in our institution’s routine pre-operative strategy. We compare pre, peri and post-operative surrogate measures of blockade in a cohort...

A 42-year-old woman presented to her GP with episodes of feeling ‘shaky’ exacerbated by physical exercise and prolonged fast. She was previously diagnosed with an insulinoma in 2006 (serum glucose 1.6 mmol/l, serum insulin 3.1 mIU/l and serum C-peptide <165 pmol/l). CT abdomen /transabdominal ultrasound revealed a 1 cm insulinoma in the uncinate process of the pancreas and the patient later underwent pancreatic enucleation in 2006. Post pancreatic enucleation, 72...

Objective: (1) To review normative data for catecholamines using our cohort of hyperaldosteronism patients undergoing adrenal vein sampling. This adds to the previously published data of normative values in a cohort of patients with cortisol-producing adenoma. (2) To demonstrate the usefulness of the noradrenaline to adrenaline ratio in the interpretation of adrenal venous sampling results.Design: 38 patients underwent successful, bilateral adrenal venou...

Introduction: We describe two patients admitted to our institution with severe hypercalcaemia, resistant to conventional treatment, requiring haemofiltration. Patient 1 was admitted to hospital with profound hypercalcaemia (5.8 mmol/L) secondary to primary hyperparathyroidism (PTH >263 Pmol/L). The hypercalcaemia had been discovered on a surgical admission 3 months previously and was being managed with 0.9% normal saline and pamidronate infusions at an outside hospital. On...

Background: Maternal obesity during pregnancy is associated with adverse effects on fetal growth and development. As the placenta is a key organ regulating fetal growth, we hypothesized that maternal obesity is associated with altered placental expression and DNA methylation of genes regulating fetal growth and glucocorticoid metabolism and aimed to investigate this in first trimester (F; <12 weeks gestation) and term (T;>37 weeks gestation) placental tissues.<p cl...

Background: Pituitary macroadenomas are an uncommon cause of Cushing’s disease. They present with a higher cortisol burden, are more aggressive and harder to cure and manage than microadenomas.Aims: To review the demographics, clinical features, biochemistry, radiology and required treatment modalities of a single-centre case series of corticotroph macroadenomas.Methods: Retrospective analysis and review of the case records of...

Objectives: To determine the prevalence/aetiology/clinical significance of pituitary dysfunction following moderate/severe childhood traumatic brain injury (TBI).Subjects: Twenty-six survivors of childhood TBI (20 males). Age at study: 5.4–18.9 year (median 13 year). Median time since TBI: 4.5y (2.3–6.7 year). King’s outcome scale for childhood head injury (KOSCHI) rating: 11 good recovery, 15 moderate disability, two severe disability.</p...

Objectives: To determine the prevalence and clinical significance of pituitary dysfunction following moderate/severe childhood traumatic brain injury (TBI).Subjects and methods: We recruited 25 survivors of childhood TBI (19 males). Age at study was 5.4–18.9y (median 13.0y). Median time since TBI: 4.4y (2.3–6.7y). Subjects provided an early morning urine sample for osmolality and underwent basal hormone evaluation at 0800–1000h, followed b...

We present the case of a 44-year-old woman from Afghanistan who had lived in the UK for 2 years. She was admitted to hospital with headache. She gave an 8 months history of generalised headache, secondary amenorrhoea and weight gain. There was no history of polyuria or polydypsia. Examination revealed a bitemporal hemianopia to red pin confrontation. Investigations confirmed that she was panhypopituitary. In addition, she was vitamin D deficient. Imaging of the pituitary gland...

The potential for primary tumour relapse is an important consideration during GH replacement therapy (GHR). We report 3 cases of relapse of intra cranial germ cell tumour (GCT) during GHR.Patient 1: An 11 year-old female presenting with visual loss and short stature due to a suprasellar malignant teratoma. She was successfully treated with bleomycin, etoposide and cisplatinum (BEP) and intrathecal chemotherapy. She suffered a first relapse two years late...