Endocrine Abstracts

The diagnosis of hypogonadism in a young person represents reduced sex steroid production and subfertility.Optimising sex steroid replacement both in terms of preparation and dose occurs after pubertal induction. Clinical practice has changed in the UK in respect to females. The management of subclinical hypogonadism and benefits of testosterone replacement in male cancer survivors and klinefelter syndrome remain unclear. The endocrinologist needs to nav...

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GH deficiency (GHD) has implications throughout the lifespan. In childhood, reduced linear growth is the primary consequence of untreated GHD, while in adulthood, untreated GHD is associated with a number of abnormalities. The phenotype of GHD in adulthood differs depending on timing of onset. Childhood onset (CO) patients have reduced bone mineral content (BMC) and lean body mass (LBM) despite GH replacement therapy (GHRT) during childhood compared with adult onset. These dif...

The effects of cancer therapy on pituitary and thyroid function evolve over many years and therefore careful long term screening strategies are required. Knowledge of the initial cancer diagnosis, age at diagnosis, radiation field, radiation dose and duration of follow up can aid identification of survivors most at risk.Cranial irradiation to the hypothalamic pituitary axis increases the risk of pituitary dysfunction. The most common pituitary hormone to...

In the UK 1 in 500 children will develop cancer in childhood. Survival from childhood cancer has more than doubled since the 1960s. Survivorship is increasingly on the agenda and the National Cancer Survivorship Initiative has been launched in the UK.During adolescence the endocrinologist is faced with four challenges in managing childhood cancer survivors:-1. Managing the immediate endocrine consequences of cancer therapy, in part...

The GH-IGF-1 axis alters through the menstrual cycle. During the periovulatory period when oestrogen levels have risen serum growth hormone (GH) levels increase 2-fold. IGF-1 levels have been reported as unchanged or modestly increased in the periovulatory period. Similarly exogenous oestrogens also increase GH levels while IGF-1 levels have been reported as reduced, unchanged or increased. Peripheral responsiveness to GH as reflected by the IGF-1 response to an acute bolus of...

Introduction: To date, psychological research on pancreatic transplantation has focused mainly on illness and quality of life. Research has been predominantly quantitative rendering it impossible to identify specific psychological issues faced by patients. Uniquely, this work considered post-transplant issues in the context of the pre-transplant psychological burden of patients with T1DM.Methods: 21 individuals with T1DM were interviewed (11 males; five ...

Aim: To evaluate the current service provisions and provide action plan for improvement within the YAE service.Methods: A friends and family questionnaire given to all patients attending the YAE service from October 2018 – January 2019. Survey questions included: whether they thought this was a good clinic for friends and family to be looked after in, what we did well and what we could do better. For YA patients transferring from children’s s...

A forty-three year old woman (SR) presented to her GP in 2004 with persistent back pain. Following MRI, an incidental right adrenal mass was discovered. Laparoscopic adrenalectomy was performed in the private sector and histology was consistent with a phaeochromocytoma. No further biochemical investigations were performed at that stage. Six years later, her fourteen year old daughter presented with a solitary neck lump. Fine needle aspiration was inconclusive and subsequent le...

The hypothalamic-pituitary-thyroid axis can be affected following therapy for brain tumours. Primary thyroid damage is frequent following craniospinal irradiation(CSI). Central hypothyroidism is less commonly reported following cranial irradiation(CI), however, some investigators have argued it is underdiagnosed and may be more prevalent than growth hormone deficiency(GHD). Utilising thyroid function tests(TFT) for the diagnosis of central hypothyroidism is notoriously difficu...