Endocrine Abstracts

In a double-blind study, 106 patients (44 males, 62 females, age 20-64 years) with Addison's disease, were randomised to receive either 50mg of micronised DHEA or placebo orally daily for 12 months. Psychological and biochemical parameters were measured at baseline, 3 to 6 month intervals and post-washout; bone mineral density (BMD) and body composition were assessed by DEXA at baseline and 12 months.DHEAS levels rose significantly and were maintained th...

Background/methodsPatients with uncontrolled acromegaly or receiving high cost medical therapy despite initial treatment, usually transsphenoidal surgery (TSS), were considered for a ¹¹C-methionine PET-CT scan (11C-Met PET-CT). This imaging technique may identify a target for TSS or radiotherapy when MRI appearances are inconclusive1. In preparation, four patients on long-term SSA were taken off treatment 3 months prior to the scan. ...

Background: Image reconstruction is a key step for the accurate interpretation of positron emission tomography (PET) scans. Nuclear medicine phantoms play a critical role in this process. However, existing phantoms (based on simple geometric shapes) do not reflect the complexity of sellar/parasellar anatomy. We therefore created a novel pituitary phantom and examined the impact of image optimisation on the detection of microadenomas, using 11C-methionine PET s...

Background: Pituitary apoplexy is a relatively rare but important clinical syndrome which may be associated with acute headache, visual compromise and hypopituitarism. It can be the initial presentation of a previously unsuspected pituitary macroadenoma. Recognised risk factors include hypertension and the use of antiplatelet agents and/or anticoagulant therapy. It may be life-threatening, requiring emergency endocrine (e.g hydrocortisone) replacement therapy[1] and...

Case history: A previously healthy 39 year-old male presented to his optometrist with visual disturbance. Visual field perimetry confirmed bitemporal hemianopia, prompting referral to endocrinology. On questioning, he reported an increase in hand and shoe size, but no headache or diaphoresis. Examination revealed classical acromegaloid features including prognathism, spatulate hands and prominent orbital margins, as well as marked bilateral macro-orchidism.<p class="abstex...

Introduction: Primary aldosteronism (PA) is a common and potentially reversible cause of secondary hypertension, characterised by resistance to standard antihypertensive therapy and possible hypokalaemia. Lateralisation investigations, including adrenal vein sampling (AVS), are required to distinguish between unilateral or bilateral disease, with unilateral disease representing a potentially surgically curable form of PA. The majority of patients proceeding to adrenalectomy re...

Background & Aims: The aims of transsphenoidal surgery (restoration/preservation of vision and amelioration of hormonal excess) are balanced against the risk of inducing new post-operative pituitary deficits. This study aims to assess the rate of new anterior hormonal deficits following transsphenoidal pituitary adenoma surgery in our centre and to assess whether the visibility of normal pituitary gland on pre-operative imaging predic...

Background & Aims: The aims of transsphenoidal surgery (restoration/preservation of vision and amelioration of hormonal excess) are balanced against the risk of inducing new post-operative pituitary deficits. This study aims to assess the rate of new anterior hormonal deficits following transsphenoidal pituitary adenoma surgery in our centre and to assess whether the visibility of normal pituitary gland on pre-operative imaging predic...

Case history: A 41 year old female was admitted following development of severe hypertension (226/146 mmHg), complicated by heart failure and acute kidney injury. She otherwise had no relevant past medical history. On clinical examination she was obese (BMI 51.94 kg/m2). As part of her cardiac investigations, she underwent a cardiac magnetic resonance imaging (MRI) which detected a 3 cm right sided adrenal nodule. An adrenal biochemical screen identified an elevated...

Background: Cushing’s disease is the most common cause of endogenous Cushing’s syndrome in adults, affecting females>males (ratio 3:1). In suspected cases, careful clinical assessment is required to ascertain a pre-test probability. This is followed by robust biochemical testing, which guides further management.One-week test protocol: Congruent biochemical tests are conducted over a one-week period in an outpatient setting. Patients attend on d...