Endocrine Abstracts

Introduction: Patients with acromegaly have an increased risk of colorectal cancer and pre-malignant adenomatous polyps; however the frequency of colonoscopic screening remains unclear.Aims: To determine optimum frequency for repeated colonoscopy of acromegalic patients.Methods: Since 1992, 254 patients (mean age 56.6 years) at our centre have undergone at least one fibre-optic colonoscopic surveillance; 156, 60 and 15 patients hav...

Cushing’s disease (CD) is very rare in prepubertal children, and remains a challenge to diagnose and manage. We review the diagnostic features and therapeutic outcome of prepubertal (defined as testicular volume <4 ml (M) and breast stage <2 (F)) CD patients treated in a single centre. Fifteen prepubertal patients (median age 9.4 years; range 5.8–13.7) fulfilled standard diagnostic criteria for CD and there was male preponderance (12 M (80%), median age 9.1 y...

Background: Cyclical Cushing’s syndrome has been considered to be a rare clinical entity, characterised by periodic increases in cortisol levels followed by regression of the Cushing’s syndrome. The cycles of hypercortisolism may occur before the establishment of the diagnosis, rendering actual diagnosis difficult, or may occur after inadequate or ineffective treatment and affect disease management. The aim of this study was to investigate the prevalence of cyclicity...

We have previously shown that the orexigenic and peripheral adipogenic effects of ghrelin are mediated by its effect on the metabolic enzyme AMPK. As the cannabinoid (CB1)-antagonist rimonabant inhibits the orexigenic effect of ghrelin, we suggest that there is an interaction between cannabinoids and ghrelin.To study the involvement of CB1 in the effects of ghrelin, wild-type (WT) and CB1-knockout mice were treated with ghrelin and rimonabant.<p clas...

Pituitary adenomas are present in ∼25% of autopsy samples, and recent studies have also suggested that clinically important pituitary adenomas are some 5 times more common than previously recognised. Acromegaly is almost always due to a sporadic growth-hormone secreting pituitary adenoma, but familial acromegaly has been reported occasionally. Linkage and loss of heterozygosity studies have shown that it is caused by a tumour suppressor gene located at 11q13; very recent...

Differentiating aldosterone-producing adenomas (APA) from bilateral adrenal hyperplasia (BAH) as a cause of Conn’s syndrome (CS) is crucial for appropriate management. We have prospectively evaluated the relative contributions of PST, adrenal imaging by Computed Tomography (CT) and AVS in the differential diagnosis of CS.We investigated 25 consecutive patients with CS referred to our unit with an identical protocol. Every patient underwent PST, CT a...

The preparation of Sandostatin LAR® injections using a 2 ml ampoule of vehicle solution may be associated with some technical difficulties of administration, with adverse consequences for patients. The development of a 2.5 ml prefilled syringe may alleviate some of these problems. We have compared these two methods of Sandostatin LAR® administration in 17 patients with acromegaly and 5 patients with neuro-endocrine tumours, (6 drug naïve, 1...

Background: Standard trans-peritoneal adrenalectomy has disadvantages, which are minimised by a less invasive procedure, but laparoscopic adrenalectomy is time consuming and unsuitable for large or malignant tumours.Aims: To evaluate our experience of all laparoscopically assisted mini-adrenalectomy using a subcostal incision 10 cm or less, since July 1999.Methods: Data were collected on wound size, operative time, blood loss (fall...

Background: Addison’s disease is probably under-diagnosed in South Africa, given that the prevalence is considerably lower than reported in Western countries (Chabre O 2017); this is important as patients may be dying from a highly treatable condition. In addition, large populations of HIV and tuberculosis infected patients in South Africa may have some symptoms erroneously attributed to these conditions, rather than Addison’s disease. We determined the prevalence an...

The 250 mg short synacthen test (SST) is the most commonly used tool to assess the integrity of hypothalamic-pituitary-adrenal (HPA) axis. There are many instances when compromise to HPA-axis function is potentially reversible (including the use of suppressive dose of prescribed glucocorticoids), but currently there are no data to guide clinicians as to the frequency of repeat testing or to the likelihood of HPA-axis recovery. We performed an observational, retrospective, anal...