Endocrine Abstracts

Background: Primary hyperparathyroidism (PHPT) is a common endocrine disease expected to be curable in 95% of patients undergoing surgical treatment. The aim of this study was to assess the postoperative course of patients with failed surgical treatment.Methods: Prospective database recorded clinical, biochemical, radiological, operative and pathological details of patients operated in a large tertiary referral centre.Results: Betw...

Case History: An 84-year-old women presented to a psychiatric unit with a 5-month history of fluctuating confusion, paranoid behaviour, anxiety, reduced cognition and unsteadiness. There was no history of galactorrhoea, headache or visual field disturbance. Past medical history included hypertension, chronic kidney disease, congestive heart failure, premature menopause and hyperlipidaemia. She had been taking bendroflumethiazide, furosemide, mirtazepine and sulpiride. A CT hea...

Background: Concordant parathyroid localization studies using sestamibi and ultrasound scans allow minimally invasive parathyroidectomy to be the procedure of choice for patients with non-familial primary hyperparathyroidism (PHPT). This study investigates the financial implications of scan-directed parathyroid surgery.Methods: Analysis of hospital records for a cohort of consecutive unselected patients treated in a tertiary referral centre over a 5-year...

Considerable overlap in IGF-I levels exists between normal and severely GHD subjects; the mechanisms underlying this observation remain poorly understood. Under various clinical circumstances therefore, IGF-I estimation is an unreliable marker of GH status. A polymorphism in the IGF-I gene influences IGF-I levels in normal populations; a higher IGF-I is associated with the presence of 2 wild type alleles of the IGF-I gene (WTG). The possibility that an IGF-I gene polymorphism ...

The most appropriate way to manage growth hormone replacement (GH) in the transition to adulthood in children treated with GH for GH deficiency (GHD) is controversial. The GH Research Society suggest that retesting of GH status at final height (FH) is unnecessary in the presence of 'severe organic GHD' and cranial irradiation falls into this etiological category. This recommendation has never been validated.To investigate whether patients diagnosed in ch...

Final height outcome is important in survivors of childhood brain tumours. Growth hormone replacement is indicated in those found to be GH deficient (GHD). More recently, GnRH analogues (GnRHa) have been introduced to delay early or rapidly progressing puberty. Studies to final height are important to determine the effectiveness of growth promoting strategies.SUBJECTS & METHODS Final height results in children receiving GH replacement for radiation i...

BACKGROUND We examined the relationship between cigarette smoking exposure and serum IGF-I, IGF-II, IGFBP-2, and IGFBP-3 levels in a broad-based population, as both smoking and changes in the IGF/IGFBP system have been implicated as risk factors for common epithelial cancers.METHODS Blood was collected from 442 unselected individuals (M, 232: F, 210) attending the Flexi-Scope colorectal cancer screening trial. All individuals were healthy and aged 55-64...

Childhood survivors of cancer are prone to a number of adverse sequelae related to the therapeutic interventions used. Growth hormone deficiency (GHD) is common after cranial irradiation, and it is unclear to what extent GHD contributes to the abnormalities observed in adult survivors of childhood cancer, and whether GH replacement can reverse these anomalies. We compared 27 GHD survivors of childhood cancer with 27 adult age- and sex-matched controls, and went on to replace G...

Background: Most women with androgen excess have polycystic ovary syndrome (PCOS); however, rarer pathology is considered in a severe phenotype such as ovarian or adrenal androgen-producing tumours. Simultaneous adrenal and ovarian vein sampling is rarely performed to aid the localisation of the androgen excess source. We report four cases that underwent this procedure.Case descriptions: Case 1: A 27-yea...

Introduction: Patients with adrenal insufficiency (AI), continue to face many challenges including: dealing with symptoms and associated disorders; managing medication regimens; prevention and management of complications, and effective engagement and interactions with healthcare providers. In patients with AI, adrenal crisis (AC) continues to lead to unnecessary deaths. We illustrate how University Hospitals Birmingham NHS Foundation Trust used the 4E framework (En...