Endocrine Abstracts

Introduction: Diabetes mellitus (DM) is a common co-morbidity in patients with heart failure and reduced left ventricular ejection fraction (HF-REF), and is associated with adverse prognosis. Subgroup analyses of randomized controlled trials suggest patients with DM benefit prognostically from beta-adrenoreceptor blockers (BB) and angiotensin converting enzyme inhibitors (ACEi). However, it remains unclear whether escalating doses of these age...

Case history: We present a rare case of Langerhans cell histiocytosis (LCH) of pituitary stalk and hypothalamus in a 40 year old lady. She presented with 9 weeks history of a sudden onset of polyuria and polydipsia. She had extreme thirst even during night which led to significant nocturia and tiredness. She denied headache, blurring of vision, galactorrhoea or menstrual irregularity. She had no significant past medical history and was not on any medications. Physical examinat...

Case history: A 42-year-old lady was referred from neurology clinic after being assessed for symptoms of headaches, dizziness, transient visual problems and paraesthesia over her limbs for 2 months. On review, she complained of amenorrhoea and was noted to be pale, however, her neurological examination including visual fields to confrontation and ocular movements were normal. Subsequent investigations were consistent with pan-hypopituitarism and she was promptly commenced on h...

Case notes of 150 consecutive patients (58% male) who underwent pituitary surgery by a single surgeon for non-functioning pituitary adenoma and endocrine follow up at our centre between July 2005 and February 2015 were reviewed. All patients underwent endoscopic transsphenoidal surgery as the first approach. Post-operative pituitary function was assessed by measurement of baseline pituitary hormonal profile and a glucagon stimulation test to assess ACTH and GH axis. Mean age a...

Introduction: Current literature suggests that the incidence of GH deficiency (GHD) post subarachnoid haemorrhage (SAH) ranges from 0 to 37%. We present the results from a large single centre study and discuss factors that should be considered when testing for GHD in this population.Method: One hundred survivors of SAH were screened with a glucagon stimulation test (GST) for pituitary hormone deficiency. Participants with isolated GHD were required to un...

Introduction: Lymphocytic hypophysitis (LH) is a rare condition that has been increasingly recognised. We studied the natural history and current management of patients with lymphocytic hypophysitis.Methods: We performed a multi-centre retrospective review of all patients that either had histologically proven disease or a strong clinical suspicion for its presence, diagnosed from 2000 onwards. Cases of secondary hypophysitis or granulomatous or xanthomat...

Background: Short synacthen test is used to assess adrenal function by injecting 250 μg of synacthen (tetracosactide) and measuring cortisol at baseline and subsequently after 30 and 60 min of the injection. In our hospital the cut-off for a normal test is a peak cortisol of 480 nmol/l or an increment of 200 or more from the baseline value.Methodology: We reviewed the results of 50 short synacthen tests performed in our hospital within the last year...

A 32-year-old female presented with a 6-week history of worsening headaches associated with bitemporal visual field defects. An urgent MR scan demonstrated a sizeable pituitary lesion with chiasmal compression and suprasellar extension. Endocrine tests revealed hyperprolactinaemia (2550 mU/l) with hypocortisolaemia (<37 nmol/l). Cabergoline and hydrocortisone replacement were initiated. Unfortunately, 24 h later her visual fields deteriorated further and the patient underw...

TSH receptor antibodies (TRAB) are now routinely measured in patients with Graves’ disease (GD) to aid diagnosis. Thyroid peroxidase antibodies (TPO) sometimes co-exist in these patients but not always. Some studies have suggested a functional and prognostic role for these antibodies. However, the phenotypic characteristics of the patient with positive TPO (with or without TRAB) and the influence of TPO on the clinical course of GD are not known.A r...

Hypopituitarism is a recognised complication of pituitary and hypothalamic pathology. It can also be a consequence, less commonly, of traumatic brain injury. It has never been described in patients following recovery from a cardiac arrest. We present a case history of hypopituitarism following successful cardiopulmonary resuscitation for a ventricular tachycardia (VT) cardiac arrest. A 51 year old patient with known prolonged QT (Romano ward) syndrome and chronic obstructive a...