Endocrine Abstracts

Introduction: Most prolactinomas in females are diagnosed during the years of reproductive age and the majority are microadenomas. Prolactinomas diagnosed after menopause are very rare with limited published data on their presentation and outcomes.Aim: The aim of our study was to assess the presenting clinical, biochemical and imaging findings, as well as the outcomes of women diagnosed with a prolactinoma in the post-menopausal period.<p class="abst...

Aims: To assess the incidence of Ipilimumab associated hypophysitis and its common presentations.Methods: All patients who developed Ipilimumab induced hypophysitis following treatment for Malignant melanoma at a large tertiary care centre in West Midlands, United Kingdom from 2012 to 2014 were included in the study. Patients with known pituitary disease prior to treatment and/or received other systemic immunotherapy following Ipilimumab treatment were e...

Management of newly-diagnosed non-functioning pituitary adenomas (NFPAs) has evolved over the last decade. Whilst surgical debulking remains the mainstay of treatment for patients presenting with compressive disease, the use of pituitary irradiation has declined, with greater emphasis on observation or further surgical debulking. We aimed to compare outcomes of treatment for NFPAs at our institution since 2004 with older management strategies.We reviewed...

Objective: The past 2 decades have seen advances in the surgical management of Cushing’s disease (CD). Our aim was to meet the need for current data on clinical features, long-term outcomes, and prognostic indicators.Patients and methods: We conducted a retrospective study of 71 patients treated by trans-sphenoidal surgery (TSS) for CD. All patients were operated on by the same surgeon in a single centre between 1988–2009. Diagnosis was confirm...

Glycogen storage diseases (GSD) are autosomal recessive inborn errors of carbohydrate metabolism. With current dietary therapy, life expectancy in patients with GSD has improved considerably and almost all children reach adulthood. Notwithstanding intensive therapy, patients with GSD have an increased risk of osteoporosis. We followed 20 patients aged 22–62 (mean age of 37) years with GSD type I, III and IX, for up to 5 years with serial measurements of bone turnover mark...

Severe growth hormone (GH) deficiency in adults is associated with adverse changes in quality of life (QoL), body composition and cardiovascular risk profile. NICE guidance restricts GH replacement in the UK to those with impaired QoL, defined by a score of >11 in the QoL-AGHDA questionnaire.Aims: To assess whether the NICE guidance differentiates other clinical or biochemical features in GH deficient adults.Patients and...

GH deficiency (GHD) in adults shares several clinical features with syndromes of glucocorticoid excess. Many patients with GHD also receive glucocorticoid therapy. GH inhibits the generation of active glucocorticoid by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), but the confounding effect of ACTH deficiency/ cortisol replacement therapy has not been evaluated.Aims: To assess corticosteroid exposure and metabolism and body composition in...

In vivo the 11β-HSD1 enzyme converts inactive cortisone to the active glucocorticoid cortisol. 11β-HSD1 is implicated in the metabolic syndrome through its expression in liver and adipose tissue by increasing local cortisol concentrations. However, little is known regarding the expression and function of 11β-HSD1 in muscle.Murine C2C12 muscle cells (myocytes) were differentiated from myoblasts to myotubules for 8 days, with and without the...

The insulin tolerance test (ITT) is used to determine the integrity of the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-somatotroph (GH) axes in patients suspected of ACTH and GH deficiency. In adults a cortisol response <500nmol/L is considered pathological and a GH peak <9mU/L is consistent with severe GH deficiency. Exercise is an alternative stimulus to GH release which may be used to diagnose GH deficiency during childhood but is rarely used during adult li...

A 16-year-old boy was referred to our endocrine unit. He had been diagnosed with constitutional short stature (height <10th centile) aged 11, having not grown well for two years. At that time there were no features to suggest Cushing's syndrome (CS), though he was overweight (BMI 22kg/m2, >90th centile) and bone age was delayed by 2 years. A trial of growth hormone (GH) therapy did not increase growth velocity. By age 15, he was developin...