Endocrine Abstracts

Most authorities recognise adult growth hormone deficiency (AGHD) as a distinct endocrine disorder, although determining an appropriate strategy for optimising replacement remains controversial.We reviewed the outcome of a cohort of patients treated with a fixed graded initiation phase followed by an individualised titration phase. Patients were initiated on a starting dose of 0.3 mg recombinant human growth hormone (rhGH) for one month, with increases t...

Case history: An 18-year-old Caucasian female presented with primary amenorrhoea after her younger sister aged 16 years old started menstruating. She had a normal childhood and progressed through puberty normally, with no past medical history or family history. BMI was 22.6 with a normal examination including secondary sexual characteristics (Tanner Stage 5) and no signs of hyperandrogenism.Investigations and Results: Bloods showed an elevated LH:FSH rat...

Background: Lack of expression of MGMT (O-6-methylguanine-DNA methyltransferase) is associated with a better tumour response to temozolomide. There are no systematic studies of MGMT expression in pituitary tumour series.Aim: We introduced MGMT immunohistochemistry for all pituitary adenoma specimens in 2011. In this study we investigated the immunohistochemical expression of MGMT in a large series of pituitary adenomas, in order to determine (1) the over...

Background: Kisspeptin stimulates hypothalamic GnRH secretion resulting in gonadotrophin release and has the potential as a future therapeutic for infertility. Previous studies have observed that kisspeptin increases LH and to a lesser degree FSH when administered to healthy women, which may limit its therapeutic potential. However, studies in women with hypothalamic amenorrhoea show that i.v. infusions of kisspeptin-54 stimulated both LH and FSH equally. Chronic s.c. infusion...

Background: The initial management of hypercalcaemia is well described: aggressive intravenous rehydration and subsequent intravenous bisphosphonates if required. Isolated case reports document the use of haemo/peritoneal dialysis and haemofiltration in the management of severe hypercalcaemia. We report three cases that required renal replacement therapy to treat severe hypercalcaemia.Case series: A 21-year-old male presented with abdominal pain and vomi...

Background: Successful reproduction relies on integration of sensory cues of attraction with corresponding emotions and behaviours. However, the intrinsic factors integrating these fundamental aspects of human attraction with limbic and reproductive pathways have not been fully identified. Kisspeptin is a crucial activator of the reproductive axis and together with its receptor is widely expressed throughout the limbic and olfactory systems in humans suggesting a potential rol...

Background: Mitotane is an adrenolytic chemotherapy, currently accepted as first line adjuvant therapy in adrenocortical carcinoma. Mitotane has a narrow therapeutic window. Serum levels of >14 mg/l are required to achieve a cytotoxic effect and levels of >20 mg/l are potentially toxic. There are two strategies for mitotane initiation: a low-dose regimen (3 g) and a high-dose regimen (increase to 6g/day over 4 days and reduce to 4.5 g/day after 10 days).<p class="...

Background: Kopetschke et al. (2009) suggested that nearly thirty per-cent of adrenal/extra-adrenal phaeochromocytoma were found incidentally1. However, they included cases from 1973 to 2007, whereas in the modern era CT and MR investigations are requested more frequently and earlier in the diagnostic algorithm.Methods: We report a pilot series of consecutive referrals to a tertiary centre for adrenal and extra-adrenal phaeochromocytoma from July ...

Clinical Endocrinology 2016 84 939–945. DOI: 10.1111/cen.12603...

Background: Hot flushes (HF) affect 70% of menopausal women and can be debilitating. Oestrogen administration is effective but not without risk. Neurokinin B signalling is increased in menopausal women, and is likely critical in the aetiology of their HF. We therefore hypothesised that a neurokinin 3 receptor (NK3R) antagonist could attenuate menopausal flushing.Design: This single-centre, phase 2, randomised, double-blind, placebo-controlled, crossover ...