Endocrine Abstracts

Back ground: Pituitary adenomas are the most common cause of a mass in the sella, accounting for up to 10–15% of intracranial neoplasm’s1. However, when dealing with abnormal intrasellar masses, a number of different etiologies are possible: germ cell tumour, metastatic tumours, granulomatous, and inflammatory processes2. We report an unusual case of primary pituitary lymphoma diagnosed on biopsy presenting as panhypopituitarism and Diabetes Ins...

Ocular and orbital tissues are extremely susceptible to damage by immune-mediated inflammatory conditions, such as thyroid-associated-ophthalmopathy (TAO). Recent studies have implicated fibroblasts in the development of chronic inflammation. Once activated by inflammatory cytokines, fibroblasts secrete pro-inflammatory cytokines perpetuating the inflammatory process, causing significant tissue damage. Synovial fibroblasts have been reported to regulate inflammation by increas...

Background: Autoimmune thyroid disease is a common cause of thyroid dysfunction, either Graves’ disease causing hyperthyroidism or Hashimoto’s thyroiditis causing hypothyroidism. It has been noted that patients suffering from autoimmune hypothyroidism can transform to hyperthyroidism and vice versa. We report the case of a patient with long standing autoimmune hypothyroidism presenting with active thyroid eye disease and subsequently diagnosed with Graves’ disea...

It is well established that the use of therapeutic glucocorticoids to treat inflammatory disease has detrimental effects on bone and we have proposed that these clinical effects are determined by intracellular glucocorticoid generation (inactive cortisone/prednisone to cortisol/prednisolone) by 11beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1). We have recently shown that glucocorticoids and cytokines are able to act cooperatively to upregulate the action of 11b-HSD1, a fi...

When used to treat inflammatory disease therapeutic glucocorticoids (GCs) cause rapid bone loss. However clinical studies suggest that in patients without inflammation GCs have little impact on the skeleton. The mechanism by which inflammation magnifies the effects of GCs is unknown. We have proposed that intracellular GC generation (inactive cortisone/prednisone to active cortisol/prednisolone conversion) via the 11 beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1) enzyme d...

Historically, acute neurosurgical decompression has been considered treatment of choice for pituitary apoplexy with some studies advocating a conservative approach. We describe a patient, with reduced consciousness due to apoplexy of a gonadotroph adenoma, in whom there was spontaneous tumour shrinkage. A 68-year-old gentleman presented following a collapse with hypothermia, bradycardia and bitemporal hemianopia. Initial investigations showed low plasma sodium and glucose. Ove...

Evaluation of male fertility, based on semen analysis, is complicated by high variability of semen parameters and the lack of evidence-based reference values. The standards are currently set by the WHO laboratory handbook (1999). We investigated whether taking into account abstinence time and testicular volume would reduce variation in sperm concentration / count and thereby consolidate the underlying principles of spermatogenesis.The database of our Ins...

Acute inflammation plays an important role in the normal immune system by helping to coordinate host responses to danger signals such as infection. In most cases the inflammation is rapidly resolved but in chronic inflammatory diseases such as rheumatoid arthritis (RA) the inflammation persists leading to localized accumulation of potentially damaging immune cells. It remains unclear why inflammation persists in some tissues and not in others. Recent studies have shown that st...

Glucocorticoids (GCs) are important therapeutic agents for a wide-variety of inflammatory diseases but are known to have potentially detrimental side-effects such as osteoporotic bone-loss. These effects of GCs are mediated via the intracellular GC receptor (GR) and by local GC metabolism catalyzed by 11beta-hydroxysteroid dehydrogenase (11beta-HSD). We have postulated that autocrine activation of GCs via 11beta-HSD1 plays a key role in counteracting the effects of inflammator...

IntroductionThe association between Type 2 diabetes and decreased quality of life (QoL) scores has been well documented. Insulin resistance (IR) is a key factor in the pathogenesis of both cardiovascular disease and Type 2 diabetes. In this study we assess the impact of increasing IR on QoL scores in patients yet to develop or with previously unknown diabetes diagnosed at screening review, and consider the effect of IHD as a potential confounder of these...