Endocrine Abstracts

Patient groups share the view that individual accounts of their condition and its’ subsequent management convey important messages. This highly anecdotal and personalised information can provide emotional support to help others with the same or similar conditions. It may also be useful in empowering patients to overcome the many potential psychological and social difficulties. It has become increasingly recognised that patient groups can form an adjunct to more traditiona...

We present the case of a 24 year old childhood cancer survivor with non-compliance of medication. Patient SB d.o.b. 30/07/1987, presented with a squint and loss of vision in the right eye at the age of four years. He was diagnosed with a craniopharyngioma and had a frontal craniotomy. Two years later, an MRI showed recurrence so he had further frontal surgery followed by irradiation (50 Gy in 28 fractions). Post operatively he was diagnosed with panhypopituitarism and remained...

Introduction: Research suggests long-term survivors of childhood cancer have an increased risk of manifesting the metabolic syndrome including insulin resistance (IR) despite many survivors of childhood malignancy if anything being underweight. It has been suggested growth hormone deficiency may be a factor in IR.Case report: We present a 20-year-old boy with partial hypopituitarism following allogenic bone marrow transplant in 1993 for treatment of acut...

Background: Addison’s disease is characterised by immune mediated destruction of the adrenal glands. This process is widely deemed to be irreversible. We present a case of confirmed Addison’s disease where adrenal function appears to have spontaneously recovered.Case report: A 37-year-old presented in 1997 with classical Addison’s disease: pigmentation, dizziness, weight loss, and nausea. There was no relevant family history. Random cortis...

We present a 45-year-old lady who initially presented with neurological symptoms and MRI was noted to show asymmetry of the pituitary gland. There were no endocrine symptoms. In 2011 she developed some visual symptoms (not typical of pituitary disease) and was referred to the ophthalmic department. MRI scan showed an 11 mm right-sided pituitary lesion and she was referred to the endocrine department. She gave a 2-year history of feeling increasingly unwell with back pain, sens...

We would like to present a case which, through unexpected results, caused us to examine the communication, both written and verbal, that is provided to patients prior to undergoing dynamic tests in our unit, and which subsequently led to a change in our practice.A 48-year-old lady was referred from the GP with a raised testosterone of 5.0 nmol/l (reference range 0.2–2.9 nmol/l), irregular periods and late onset hirsutism. A low dose dexamethasone te...

Aims: There is a lack of literature about mental and emotional dysfunction in patients with acromegaly or other pituitary tumours although impaired quality of life is well recognised. We examined whether adult patients with acromegaly experience a lower quality of life (QoL) than adult patients with other pituitary tumours and whether any difference in QoL is attributable to the patient’s perceived body image.Methods: Medical records were used to id...

Background: The gold standard investigation for suspected spontaneous hypoglycaemia is the supervised 72 h fast. This aims to ‘capture’ a hypoglycaemic episode, to confirm Whipple’s triad, and to measure simultaneous insulin and C-peptide levels. These should confirm or refute endogenous hyperinsulinaemia.75% patients with confirmed insulinoma actually develop hypoglycaemia within 24 h of fasting. However, some confirmed cases require sign...

Introduction: Discordance between growth hormone (GH) and insulin-like growth factor 1 (IGF1) is observed in up to 30% patients with acromegaly, with the most common finding being high IGF1 with normal GH levels. Recently published guidelines recommended a nadir GH of 0.4 μg/L rather than 1.0 during growth hormone suppression test as being indicative of controlled disease. This may lead to reduced discordance between GH and IGF1. Methods We measured nadir GH (Beckman Coul...

Introduction: Guidelines suggest definition for cure in acromegaly is to achieve a nadir growth hormone (GH) <2 mU/l during a growth hormone suppression test and a normal IGF-1 level (Gustina 2000). Following an earlier retrospective audit (Brown et al. 2002), showing limited achieved cure success, we re-audited our patients.Methods: All patients with acromegaly were invited to undergo growth hormone suppression test and IGF-1measurement over ...