Endocrine Abstracts

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IGF-1 generation tests (IGF-1GT) have been used extensively in children to investigate growth hormone (GH) responsiveness. To help understand differences in the GH/IGF-1 axis in health and disease in adulthood interest has turned to the use of the IGF-1GT in adults. Different designs of IGF-1GT have been used with no clear evidence delineating which is the most sensitive to describe subtle changes in GH responsiveness. In order to design an IGF-1GT we have performed the first ...

The index patient is a 40 year old male with BPES (Blepharophimosis, Ptosis, Epicanthus inversus Syndrome) associated with isolatedgrowth hormone deficiency. BPES is a rare genetic disease occurring either sporadically or as an autosomal dominant disorder. There are two phenotypes; in type 1, eyelid abnormalities are associated with ovarian failure and in type 2 eyelid abnormalitiesonly. The genes for both types have been mapped ...

Radiation-induced growth hormone neurosecretory dysfunction (GHNSD) is, primarily, the result of radiation-induced hypothalamic damage. Consequently, reduced hypothalamic growth hormone releasing hormone (GHRH) secretion results in secondary somatotroph atrophy and attenuated peak GH responses to a bolus of exogenous GHRH. For the first time we have studied the presence of GHNSD and/or somatotroph atrophy in cranially irradiated adult survivors of childhood cancer. We have uti...

Survival figures following the treatment of brain tumours continue to improve. Patients receiving cranial radiotherapy (XRT) frequently suffer a progressive loss of anterior pituitary function secondary to radiation damage to the hypothalamic pituitary axis (HPA), therefore long-term follow up is required. The time frame of radiation damage to the HPA is not known. There is also a suggestion from animal data that the HPA is more sensitive to damage by radiation when treated at...

Cytotoxic chemotherapy is a well recognised cause of premature ovarian failure (POF). A proportion of women with biochemical evidence of POF following treatment recover ovarian function with a return of normal menses and fertility, but there are no indicators that allow the identification of this subgroup of patients. In addition, we have previously reported only minor reductions in BMD in a cohort of women with POF following cytotoxic chemotherapy and had postulated that this...

Background: In GHD adults short-term studies of GH replacement have been reported to improve several aspects of quality of life, in particular energy levels. Only one study to date has examined whether this beneficial effect on QoL is maintained on long-term replacement of greater than five years. Patients & Methods: In 1992 six-twelve months GH replacement was offered to severely GHD adults as part of a randomised placebo controlled study. At baseline 86 pat...

Considerable overlap in IGF-I levels exists between normal and severely GHD subjects; the mechanisms underlying this observation remain poorly understood. Under various clinical circumstances therefore, IGF-I estimation is an unreliable marker of GH status. A polymorphism in the IGF-I gene influences IGF-I levels in normal populations; a higher IGF-I is associated with the presence of 2 wild type alleles of the IGF-I gene (WTG). The possibility that an IGF-I gene polymorphism ...

We have used a sensitive chemiluminescence GH assay to analyse 24-hour GH profiles (20 minute sampling) from 11 adult cancer survivors with severe GH deficiency acquired following brain irradiation in childhood for non-pituitary brain tumours and 30 matched healthy normal volunteers. Cluster analysis revealed that the area under the curve for GH (AUCGH), absolute (maximum) GH peak height, mean peak height, maximum pulse area, mean pulse area, absolute (minimum) nadi...

The risks of over and under-replacement with glucocorticoid replacement therapy are well-known. In an attempt to minimise these risks cortisol day curves (CDC) are performed in many centres, however there is a dearth of data on the reproducibility of this assessment and the relationship between symptoms and serum cortisol levels. To address these issues, we have performed 2 cortisol day curves within 7 days in 20 patients (9 male, mean age 54 years, range 25-79, 6 primary and ...