Endocrine Abstracts

Background: In the UK, adults with growth hormone deficiency (GHD) are treated with recombinant Growth Hormone (GH) therapy according to NICE guidelines (TA64). Provided that patients show an initial improvement in their quality-of-life score, assessed using the Quality-of-Life Assessment of GHD in Adults (Qol-AGHDA) questionnaire, they can continue with their GH treatment long-term. However, in clinical practice, many patients are observed to discontinue GH r...

Background: In November 2017, a nurse-led Adrenal Incidentaloma (AI) clinic was launched at the University Hospital of Wales (UHW), Cardiff, based upon the 2016 European Society of Endocrinology AI management guidelines.Objectives: To evaluate the effectiveness of a nurse-led clinic in managing AI patients at UHW.Methods: Retrospective analysis of electronic records of patients see...

Background: Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, autonomic dysregulation (ROHHAD) is a rare syndrome associated with high morbidity. An immune-inflammatory aetiology has been postulated; however, the immune characteristics and effect of immunomodulation have not been well described.Case report: We describe the immune profile and the effect of rituximab on the immunomodulation potentially ca...

Background: Thyrotropin secreting adenomas (TSHoma) are considered to be rare pituitary tumours. However, improvements in imaging techniques and greater use of more sensitive thyrotropin (TSH) assays has led to a recent increase in the detection rate of TSHomas and, specifically, the identification of more microadenomas. Surgery is considered the mainstay of treatment, however, primary medical therapy with somatostatin analogues is an emerging alternative therapeutic option.</...

Background: Endocrine Society guidelines classify macroprolactinomas as ‘resistant’ if there is failure to normalise prolactin, or to achieve radiological tumour shrinkage of >50%, on standard doses of dopamine agonist. In this context, escalation of treatment to maximal tolerable doses and/or referral for surgery is advised. However, we have recently observed several ‘discordant responders’, where tumour shrinkage lags significantly (>6 months) beh...

Although MRI remains the investigation of choice for pituitary imaging, it does not provide information about ‘functionality’ of lesions (e.g. residual adenoma vs post-surgical scar tissue) and cannot reliably identify all microadenomas.We hypothesised that i) imaging with the PET ligand 11C-methionine, which is taken up at sites of peptide/protein synthesis, would permit more reliable identification of functioning pituitary adenoma ...

Understanding how pancreatic beta-cells develop during human development is essential to advance current protocols aimed at developing insulin-producing beta-cells in vitro and highlight therapeutic targets for diabetes treatment. Identifying the single-gene mutations which result in individuals developing diabetes in the first 6 months of life (a condition called neonatal diabetes) has the potential to give unique insights into the genes regulating human beta-cells w...

Introduction: Clinical Practice Guidelines1 advocate adrenal vein sampling (AVS) to distinguish between unilateral and bilateral primary aldosteronism (PA). Cannulating the right adrenal vein is difficult, and there is a lack of standardisation in sampling procedure and interpretation2. We audited our local service to identify improvements.Methods: All AVS procedures performed between January 2018-December 2020 (n = 31) wer...

Background: Glucocorticoids (GCs) modulate glucose homeostasis by acting on metabolic tissues including liver, adipose, and skeletal muscle. ABCC1 is a transmembrane ‘drug-resistance’ transporter expressed in adipose tissue and skeletal muscle with previously unknown physiological function. We recently showed that ABCC1 modulates intracellular GC concentrations and action in adipose. Here, we tested the hypothesis that Abcc1 regulates GC concentrations in skeletal mu...

Background: The clinical presentation of non-functioning pituitary adenomas (NFAs) can range from an incidental finding on imaging to pituitary hormone deficiencies and visual compromise.Objective: To assess the clinical presentation of patients who had undergone surgical resection of histologically proven NFAs.Methods: Patients presenting to the University Hospital of Wales, Cardiff, with non-functioning pituitary adenomas (histol...