Endocrine Abstracts

Introduction: Increased cardiovascular risk in hypopituitary patients was first documented by Rosen in 1990. Subsequent studies confirmed increased prevalence of cardiovascular and cerebrovascular disease in these patients. The exact mechanism for this is unclear. There is no clear consensus on how best to quantify or predict cardiac risk in hypopituitarism. QRISK2 cardiovascular disease risk algorithm provides estimates of 10-year cardiovascular disease (CVD) risk in patients...

Introduction: Patients with craniopharyngioma are characterised by a high incidence of hypopituitarism, visual failure and hypothalamic dysfunction. Standardised mortality is markedly elevated and controversy exists about optimal treatment.Aim: We aimed to examine the temporal trends in the treatment of craniopharyngioma at our centre. Also, we sought to examine treatment needs and long-term morbidity in this patient group.Methods:...

Background: The glands most commonly affected in MEN1 are parathyroid, pituitary and pancreas. Pancreatic neuroendocrine tumours (pNETs) are of foregut origin, but a number of other so-called ’foregut carcinoid tumours’ may also occur in MEN1, including tumours of bronchial, thymic, and gastrointestinal origin. Reported rates of prevalence of these latter tumours vary from 2% for thymic and bronchial carcinoids, to 10% for gastric carcinoids. Thymic carcinoids have b...

A 35 year-old lady presented to her local hospital with a 3 year history of fatigue, weight gain, recurrent tonsillitis and oligomenorrhoea. Examination revealed facial plethora, round facies and thin skin on the dorsum of the hand. She appeared tanned, with evidence of spontaneous bruising and difficulty standing up from a chair unaided. No striae were present. Blood pressure was 152/91 mmHg. Investigations revealed a 0900 h cortisol of 632 nmol/l (ACTH 59 ng/l) and an elevat...

A 21-year-old woman with homozygous sickle cell disease, presented to A&E with vomiting and diarrhoea, and was noted to be hypercalcaemic (corrected calcium 3.00 mmol/l [ref. 2.2–2.6]; phosphate 0.48 mmol/l [ref. 0.8–1.5]). She reported polyuria and polydipsia, but no other symptoms of hypercalcaemia. There was no history of renal stones, renal impairment, or fragility fracture. A maternal aunt required parathyroidectomy in middle age. Bloods revealed PTH 138.4 pmo...

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...

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...

Thalassaemia patients are transfusion dependent and at risk of iron overload with end organ damage. Iron deposition is reduced by chelation treatment. We present the data on endocrinopathy and bone density in the adult patients under our care with thalassaemia. In addition, we will discuss therapeutic approaches to these problems including the use of newer chelation agents and possible reversal of endocrine end organ damage. We will also review the correlation in our patients ...

A 37-year-old woman, 30 weeks pregnant, presented with palpitations and abdominal cramps. Ultrasound demonstrated a supra-renal abnormality and MRI showed a 10 cm heterogeneous left adrenal mass. For five years she had experienced episodes of palpitations, shaking, sweating and chest tightness. She was investigated by a neurologist and diagnosed with temporal lobe epilepsy. During pregnancy the frequency of episodes increased. Lamotrigine was started, but at each dose increase...

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...