Endocrine Abstracts

Cinacalcet, a calcimimetic, is licensed for the management of primary hyperparathyroidism (PHP) where surgery is deemed inappropriate. It is unclear when patients might be deemed more appropriately managed by medical treatment rather than surgery. We report two cases in which cinacalcet has been used to predict the effect of parathyroidectomy and a choice to be made between surgery and conservative management.A 43-year-old woman had a parathyroid adenoma...

In 2006, responding to the Government White Paper, ‘Our future, our inheritance’, a project commenced promoting genetics in mainstream medicine.By 2008, the original project framework has evolved to address logistical constraints, patient preference and cost effectiveness, offering a streamlined service for clients with inherited endocrine disorders. Recognised patient pathways and a dedicated endocrine genetic clinical nurse specialist (EGCNS)...

We studied 5 female patients, aged 54–79 years old (mean 70.6 years), on PPI therapy for 2–13 years (mean 8.2 years), who were symptomatic from chronic and sometimes severe hypomagnesaemia (lowest readings 0.36, 0.29, & <0.21 mmol/l in 3 patients) for 7–45 months (mean 29.2 months). Oral magnesium (Mg) supplements were either poorly tolerated or ineffective; and repeated magnesium sulphate infusions (total doses per patient 120–1200 mmol Mg, mean 44...

Exposure to stressful events during development is known to have significant effects on a range of phenotypic traits in later life. Several mammalian studies have linked early post-natal stress to later changes in the hypothalamic pituitary adrenal (HPA) axis, underlying the physiological response to stress. However, the physiological link (lactational hormonal transfer) between mother and offspring during post-natal development limits our ability to determine the direct effec...

Recent data suggests that oestrogen(E)-responsive somatostatin neurones are involved in the generation of the ovine GnRH surge. Specifically, somatostatin neurones in the hypothalamus are activated (as assessed by nuclear fos) and mRNA levels are elevated in the early stages of the surge induction process. In addition, somatostatin fibres have been visualised in close apposition to hypothalamic GnRH neurones, which may indicate direct neural connection between GnRH and somatos...

A 38-year-old lady was referred to our endocrinology department with headache, elevated prolactin concentration and intolerance to cabergoline by the gynaecologist. She was found to have elevated prolactin whilst investigating for secondary amenorrhoea. She described her headaches to be worse on cough, sneezing and laughing. There was no evidence for raised intracranial pressure clinically and no visual field defect was identified. Prolactin was 3194 miu/l, however there was n...

Pituitary gland has an influence on erythropoiesis. Anaemia is thought to be due to loss of thyrotrophic and adrenotrophic hormones. Testosterone is also known to stimulate erythropoiesis. Here we present a patient with long standing iron deficiency anaemia, which corrected with management of hypopituitarism.A 72-year-old gentleman was under regular review at the diabetic clinic with type 2 diabetes mellitus. He had a background medical history of COPD, ...

Background: A variety of preparations for testosterone replacement therapy are currently available. Testogel, a transdermal gel, is widely used and considered one of the most convenient. However, a wide variation in the increment of serum testosterone two hours after its application has been reported.Aim: To investigate whether skin thickness affects the absorption of testogel.Subjects and methods: Fourteen patients (mean age 55.4 ...

Aim: Thyroidectomy is a common surgical procedure done in adults. However, thyroid surgery in children is infrequently undertaken. But due to genetic screening of families with multiple endocrine neoplasia (MEN) syndromes, more paediatric thyroidectomies are being performed. It is suggested that general and endocrine specific complications in children after thyroid surgery are higher than in adults. In this study we explored the indications for thyroidectomy and the post opera...

Radio-iodine is a safe and effective treatment of thyrotoxicosis, but carries a risk of the late development of hypothyroidism several years after therapy. Patients treated with radio-iodine require long-term follow-up to ensure that late hypothyroidism is detected and treated. Current changes in health care commissioning propose an increasing reliance on primary care for the long term follow-up of patients with thyroid disease. We report a study of the 8 year follow-up of 100...