Endocrine Abstracts

Background: Patients with uncomplicated hyperthyroidism referred by their GP to our Department had a waiting time of 3–4 months before been seen by a Consultant. As a result of this, funding was provided for setting-up a Thyroid Nurse-Led Clinic (TNLC) aiming to resolve the problem. The clinic started running in May 2005.Aim: To assess the benefits of the TNLC for the NHS.Patients and methods: The data of visits of patients se...

Background: A Thyroid Nurse-Led Clinic (TNLC) was set up within the Department of Endocrinology in Oxford aiming primarily to reduce waiting times of patients with uncomplicated thyrotoxicosis from 3 to 4 months to 2 to 4 weeks. It proved to be a cost effective measure.Aims: To explore the patients’ perspective on the provision of care and on the service delivery of the TNLC.Patients and methods: A structured questionnaire wit...

A 62-year-old lady was referred to our Department with a nine-month history of facial swelling, easy bruising, and centripetal weight gain. She had a longstanding history of depression, hypertension, and osteoarthritis. She was taking citalopram, buspirone, atenolol and bendrofluazide. A few months earlier she had received bilateral intra-articular knee injections at her local hospital for arthritic pain. On examination she had thin skin with multiple bruises, facial puffiness...

Introduction: Metyrapone is used as holding treatment in patients with Cushing’s syndrome awaiting definitive treatment or as adjunctive treatment following pituitary irradiation. The metyrapone day curve is used to assess the adequacy of suppression of cortisol synthesis, and in our institution involves taking four blood cortisol samples at 9 am, 12 pm, 3 pm and 6 pm respectively. A mean result between 200 and 300 nmol/l is deemed satisfactory.Aims...

Background: Insulin-induced hypoglycaemia (ITT) is considered the gold standard method for the evaluation of the hypothalamo-pituitary-adrenal axis. The standard short Synacthen test (SST) has been proposed as an alternative, but it may be associated with falsely reassuring results and potentially serious sequelae.Aim: To compare the serum cortisol response achieved in the SST with the one obtained during the ITT in patients with hypothalamo-pituitary di...

Objective: There is little data on suprasellar meningiomas regarding their effect on pituitary hormones and outcome following surgical intervention.Methods: In a database of patients undergoing surgical treatment for a pituitary mass set up in 1997, all cases of histologically proven meningioma were identified. Medical records were reviewed in order to determine menigioma site, size, pre- and postoperative vision as well as pre- and postoperative pituita...

Acute adrenal insufficiency requires immediate treatment with high-dose glucocorticoid and represents a life-threatening emergency. Previous research suggests that primary hypoadrenalism patients (Addison’s disease) are more vulnerable to adrenal emergency than steroid-dependent pituitary patients (Arlt & Allolio 2003).In 2006, we surveyed the membership of the UK Addison’s disease Self-Help Group, comprising 982 hypoadrenalism patients, an...

We present a rare case of acute falciparum malaria complicated by hypocalcaemia while having normal renal function.Case: A 64 year old African lady presented with a 2 week history of lethargy, weakness and oliguria. She had returned from Malawi a fortnight previously and had not taken antimalarial prophylaxis. Her malaria screen was positive for Plasmodium falciparum and she was commenced on quinine. On day 5 of her admission she developed perioral pares...

Introduction: In our centre prior to 2003, testosterone implantation was undertaken by rotational junior medical staff. A specialist nurse role in testosterone implantation was developed within the Oxford Department of Endocrinology over a nine month period.Aim: To assess the adverse effects and the complications from testosterone implants offered by a specialist nurse committed to this task.Method: Since 2003, 200 implants have be...

The value of the somatostatin analogues in the treatment of acromegaly is well established. The experience on their efficacy in gigantism is limited involving the administration of octreotide. To our knowledge, no such cases treated by lanreotide have been reported.An 18-year old student presented to the A&E with a month history of blurred vision and headaches. CT showed a suprasellar pituitary tumour with obstructive hydrocephalus. Emergency inserti...