Endocrine Abstracts

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...

TSH producing pituitary adenomas are a rare cause of thyrotoxicosis. These tumors account for only 1–2% of the pituitary adenomas. Co-secretion occurs in 30% of thyrotropinomas and requires careful investigation and subsequent follow up.A 43-year-old male presented with hand tremor and tachycardia. He was found to have elevated TSH, free T4 (FT4) and free T3 (FT3), but did not get treatment for years. In 2019 he developed atrial fibrillation. TSH wa...

Case history: A 38-year-old woman presented with blepharospasm, cramping of the hands, and paraesthesia primarily affecting the face and hands. Symptoms had been present for 10 years but had been progressive over the previous 12 months. Symptoms were consistent with neuromuscular instability. Hypocalcaemia and elevated Parathyroid hormone (PTH) were confirmed. Past medical history was notable for anorexia nervosa in remission. Family history was non-contributary. Hypocalcaemia...

Case history: A 57-year-old male with well controlled primary hypertension presented with acute onset severe headache while exercising, associated with nausea and vomiting. He had no visual or other neurological symptoms. The pain settled with analgesics in ED. He reported four transient similar episodes during the preceding 18 months. There were no symptoms suggestive of pituitary or other endocrine dysfunction, including hyperprolactinaemia. Clinical examination was unremark...

Background: Growth hormone (GH) and Insulin like growth factor 1 (IGF-1) discordance in patients with acromegaly is a well-recognised phenomenon. It is unclear whether this is associated with increased mortality and morbidity compared to patients with concordant normal results.Methodology: A retrospective study was conducted on the United Kingdom Acromegaly Registry (UKAR). A comparison of mortality and morbidity was performed among four groups categoris...

Background: In our previous works the interdependence of DNA demethylation with proliferation and differentiation of pituitary neuroendocrine tumours (PitNET) and the inhibitory effect of Aspirin on pituitary cell proliferation were demonstrated. Although the role of Aspirin in epigenetic regulation was described in other malignancies, its correlation with pituitary tumorigenesis is currently unknown.Our objective: was to investigate the genomic and epig...

Background: Cabergoline monotherapy or in combination with somatostatin analogue (SSA) has been reported in few studies with IGF-1-normalization-rates 0%-100%(monotherapy) and 42%-60%(combination therapy). However, in these studies, inclusion of irradiated patients is a potential confounder and currently proposed disease control criteria (normal IGF-1, GH<1 mg/l) have not been applied.Aim: Investigate the efficacy of cabergoline monotherapy or as add...

We present the case of a 54-year-old woman with known metastatic non-functional pancreatic NET since 2004 that developed new debilitating recurrent hypoglycemia in 2013. The patient presented in 2004 with disseminated malignancy. Radiology revealed a large pancreatic mass associated with multiple liver lesions and abdominal lymphadenopathy. Liver biopsy confirmed well differentiated NET. Initial treatment with cisplatin etoposide chemotherapy was poorly tolerated and discontin...

Primary hyperparathyroidism (PHP), usually due to multigland hyperplasia, occurs in >90% of patients with multiple endocrine neoplasia type 1 (MEN1). The literature is divided on the optimal surgical management for such patients. We report a retrospective cohort study on the long-term outcomes associated with limited, subtotal, or total parathyroidectomy as initial surgery for PHP in MEN1. The primary endpoint was recurrent PHP defined as an adjusted serum calcium >2.6 mmol/l ...

Endocrine Society guidelines recommend random growth hormone (RGH) <1 mcg/l as indicative of biochemical control of acromegaly. Growth hormone (GH) control may also be determined using the mean GH (MGH) of a growth hormone day curve (GHDC). We report a retrospective analysis of 461 consecutive GHDCs, from 121 patients with treated acromegaly, performed in a single centre between 2009 and 2019. Each GHDC contained 7–9 GH measurements (mean 8.9) taken at regular interva...