Endocrine Abstracts

Gonadotroph pituitary adenomas are common but majority of them are classified as non-functional as they do not lead to features of hormonal excess. Functional gonadotroph adenomas are rare and there are only few small series or individual case reports about these.Case report: 45-year-old gentleman presented with headaches, progressive visual failure and complaint of excessive tiredness. He had normal libido and had an 8-year-old child. On examination, he...

A 34-year-old male with no significant past medical history presented with severe abdominal pain. On detailed questioning his symptoms included tremors, headache, sweating, and agitation. Despite recent weight gain he had obvious muscle wasting. On admission blood pressure was 166/107 mmHg. Abdominal examination revealed a palpable left upper quadrant mass.CT scan demonstrated a 15 cm mass in the left supernal region with extensive signs of haemorrhage i...

Case: A 25-year-old lady was incidentally found to have hyponatremia while she was investigated for painful left ankle and hand swelling. At the time of review in endocrine clinic, she was completely asymptomatic. Her menstrual period was normal. On examination she was found to be hypertensive with consistent blood pressure of 188/110. Rest of the systemic examination was unremarkable. Investigations revealed biochemical findings consistent wi...

High dose glucocorticoids reduce hepatic and peripheral insulin sensitivity and insulin secretion. However, the metabolic consequences of typical therapeutic glucocorticoid doses (e.g. prednisolone <10 mg/day) are poorly characterised. The aim was to determine the acute effect of low dose prednisolone on carbohydrate metabolism and then assess whether subjects taking chronic prednisolone had increased adiposity that amplified carbohydrate metabolism perturbations.<p cl...

This is a case of a 49 year old obese Caucasian female who was referred to an endocrinology clinic for investigation of Cushing’s syndrome, based on raised blood pressure and cushingnoid facies. The patient had underlying schizophrenia and was stable on clozapine. Her blood pressure was 150/99 mmHg on bendrofluoriomethiazide and candesartan. Her 24 hour urinary free cortisol was normal but 24 hour urinary free noradrenaline was elevated at 835 nmol (76–561) with norm...

An 82-year-old man presented with weight loss and lethargy. Thyroid function tests showed a fT4 7.6 pmol/l and TSH 0.08 mU/l. Short synacthen test confirmed hypoadrenalism with baseline cortisol of 34 nmol/l and 30 min sample 156 nmol/l. He had low gonadotrphin levels and Prolactin was 551 μ/l. He was commenced on hydrocortisone and levothyroxine treatment with symptomatic improvement. An urgent CT scan revealed multiple enlarged lymph nodes above and below the diaphragm ...

FNA of the thyroid is used for fast and early assessment of thyroid nodules, however it is sensitivity as a useful diagnostic test depends largely on the technique, experience of the aspirator and expertise of the cytologist. We undertook a retrospective audit of FNA to evaluate our results and compliance with the national guidelines.We examined 121 patients had FNAs at Pinderfields Hospital from October 2000 to June 2007. The cohort was comprised of 106...

Background: The growth hormone/ IGF-I axis is important in the pathogenesis of breast cancer and increased IGF-I signalling through the IGF-I receptor (IGF-IR) has been implicated in the development of tamoxifen resistance in breast cancer.Aims: To compare mRNA and protein expression of IGF-I & IGF-IR in (i) wild type (WT) and tamoxifen resistant (TR) MCF-7 breast cancer cells and (ii) breast cancer tissue from women with primary and recurrent, tamox...

Historically, acute neurosurgical decompression has been considered treatment of choice for pituitary apoplexy with some studies advocating a conservative approach. We describe a patient, with reduced consciousness due to apoplexy of a gonadotroph adenoma, in whom there was spontaneous tumour shrinkage. A 68-year-old gentleman presented following a collapse with hypothermia, bradycardia and bitemporal hemianopia. Initial investigations showed low plasma sodium and glucose. Ove...

Background: Due to its cross-talk with estrogen receptor (ER) signalling, increased IGF-I signalling through the IGF-I receptor (IGF-IR) has been postulated as an important factor in the development of tamoxifen resistance in breast cancer.Aims: To investigate the importance of IGF-I signalling in tamoxifen resistant (TR) and wild-type (WT) MCF-7 breast cancer cells by (i) assessing cell proliferation in response to IGF-I and tamoxifen and (ii) using sma...