Endocrine Abstracts

A 61 year old female, without significant medical history, presented to her optometrist in Feb 2018 with clouding of vision and left sided proptosis. Opthalmic examination showed vision 6/7.5 right and 6/9 left eye, 3 mm proptosis on the left and diplopia on upward and right lateral gaze. Brain MRI demonstrated 6.3×5.6×5.8 cm lesion centered in the clivus and pituitary fossa, expanding in all directions; the bulk of the lesion was in the left parasellar region, encas...

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...

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...

BackgroundChronic hypoparathyroidism (hypoPT) predisposes patients to comorbidities such as cardiovascular/cerebrovascular disease, infection, mental illness, and renal impairment often associated with an increased burden to healthcare systems. Suboptimal disease control is common with standard therapy. The objective of this study was to quantify and assess differences in the clinical and economic burden on secondary care among patients with post-surgica...

A 65-year-old gentleman was referred by his GP because of acute kidney injury and hypercalcaemia, which was associated with low levels of parathyroid hormone. He had been fit and well and was on no regular medications. Whilst his hypercalcaemia was partly correctible with saline rehydration, cautious use of bisphosphonates and cinacalcet were not effective in preventing rebound, and his nephropathy persisted. Curiously, he had longstanding low plasma alkaline phosphatase, but had normal denti...

Background: In the UK, 1 to 4 per 1000 people have primary hyperparathyroidism (PHPT) and are at risk of hypercalcaemia and its complications. Whilst surgery is the only curative option in the management of PHPT, several patients are managed conservatively or medically. Cinacalcet (a calcimimetic) has a role in PHPT management, in those who have declined or are unable to progress to surgery. It is important that the use of Cinacalcet in these cases adheres to ...

Introduction: In the UK, most adult patients with growth hormone deficiency (GHD) continue with growth hormone (GH) treatment indefinitely, even when they do not report any benefits from treatment. To date, the optimal duration of GH treatment in adults has not been established. We conducted a survey of UK endocrine clinicians between 01/06/2022 and 31/08/2022 to understand current practices regarding GH treatment discontinuation in adults with GHD.<p clas...

Background: Endocrinology is well-established as an outpatient specialty. However, virtually no data exist on the volume, nature, management and disposal of inpatient referrals to inform the design and delivery of a quality-assured service.Methods: We undertook an audit of all activity of the Inpatient Endocrine Service at University Hospitals Birmingham NHSFT (IES@UHB) between January 2010 and December 2015. Referrals received electronically via the Pat...

Introduction: Osteogenesis imperfecta (OI) is a genetic, heterogeneous, connective tissue disorder most commonly caused by mutations in type I collagen genes. A hallmark of disease is frequent fractures that are precipitated by minimal trauma. There are limited data on the impact of OI on non-skeletal outcomes across the lifecourse. We present cross-sectional data of one of the largest single centre patient cohorts of OI in adulthood (n=186).The aim of this study was ...