Endocrine Abstracts

Successful reproduction in humans at a population level, is reliant on the careful co-ordination of reproductive hormones with associated behaviours. Kisspeptin is a neuropeptide that is critical for normal hypothalamic function of the reproductive hormonal axis. However beyond its hormonal effects, non-human data suggests an emerging role for kisspeptin in a range of animal behaviours through extra-hypothalamic downstream neuroendocrine pathways. Until recently, the roles of ...

Kisspeptin, the endogenous ligand of the GPR54 receptor, is a key regulator of reproduction. Inactivating mutations of the GPR54 receptor in mice and humans is associated with a failure of reproductive function. Activating mutations in the GPR54 receptor result in precocious puberty. The endogenous neuropeptide agonist for GPR54, kisspeptin, potently stimulates release of gonadotrophins in rodents and primates.Objective: We determined the effects of elev...

A 65 year old lady presented to her GP in 1997 with an extensive rash. She was referred to a dermatologist but the rash which failed to settle with topical treatments. A plasma glucagon level was elevated at 275 pmol/l (NR 0-50). CTscan revealed a mass in the pancreatic tail and hepatic metastases consistent with malignant glucagonoma. She was commenced on octreotide and the rash resolved. She underwent a distal pancreatectomy, partial left hepatic lobectomy and intraoperative...

Background: Hypercalcaemia is defined as an elevated serum calcium level above 2.6 mmol/l and occurs in 1 in 1000 of the population. It commonly results from primary hyperparathyroidism (PHP) which is usually treated with parathyroidectomy. A less common cause of hypercalcaemia is familial hypocalciuric hypercalcaemia (FHH) which is caused by mutations inactivating the calcium-sensing receptor; however FHH is relatively benign and requires no treatment. It is clearly important...

PYY is secreted postprandially from the endocrine L-cells of the gastrointestinal tract. PYY3–36, the major circulating form of PYY, reduces food intake in humans and rodents via high affinity binding to the auto-inhibitory NPY receptor, Y2R, within the hypothalamic arcuate nucleus.Aims: To investigate (1) the effects of length of fast on the anorexigenic actions of PYY3–36; (2) the effects of early light phase administrat...

Establishing failure of trans-sphenoidal surgery (TSS) to cure Cushing’s disease in the immediate post-operative period is essential for early surgical re-exploration. However, there is no consensus regarding the definition of apparent cure. We studied whether the dexamethasone-suppressed corticotrophin-releasing hormone test (LDDST-CRH test) immediately following TSS could accurately identify those with Cushing’s disease requiring further definitive treatment.<p...

IntroductionYttrium-90 pituitary implants were used in the past as one of the first line treatments for pituitary tumours in many endocrine centres. The procedure involved inserting radioactive rods of Yttrium oxide in to the pituitary fossa. This treatment has been replaced by medical treatment for prolactinomas and transsphenoidal surgery for all other pituitary tumours.AimTo investigate long-term efficacy ...

Non-functioning pituitary adenomas (NFAs) constitute 25-30% of all pituitary tumours. NFAs do not secrete hormones and patients present with clinical features due to mass effects of the tumour such as visual field defects or hypopituitarism. Surgery and radiotherapy (RT) have been considered standard therapy for patients with a non-functioning macroadenoma. However, since MRI scanning has become widely available fewer patients are routinely referred for RT following surgery.</...

IntroductionPatients treated with radioiodine (RAI) for thyrotoxicosis, secondary to Graves or a toxic nodule, require close follow up to determine whether they have become hypothyroid or have a recurrence. National guidelines state that patients should have their first blood test at about six weeks post RAI. Telephoning patients with their results, rather than reviewing them at outpatient appointments, can be a more convenient and efficient method of fo...

Headaches associated with acromegaly are common even after hypophysectomy. Medical treatment with dopamine agonists and Somatostatin analogues often help. We report two cases when pharmacological therapy failed but further surgical removal of residual pituitary tissue cured the headaches.A 38 year-old lady presented with an eight year history of headaches, unresponsive to simple analgesia. Acromegaly was confirmed by a raised serum growth hormone (GH) 33...