Endocrine Abstracts

A 70-year-old female with known schizophrenia presented in hyperthyroid crisis. Examination revealed muscle wasting, tremor, sweating, low-grade fever, and sinus tachycardia. Biochemistry confirmed the diagnosis (TSH <0.1 mlU/l, thyroxine 41 pmol/l (9–25), tri-iodothyronine 25 pmol/l (3.5–6.5)). The patient was commenced on i.v. esmolol and carbimazole (40 mg) crushed into warm milk.However, lacking mental capacity, and refusing to take all...

The glucagon stimulation test is commonly used to assess the hypothalamic–pituitary axis when the insulin stress test (IST) is contraindicated. The mechanism behind glucagon induced secretion of GH and cortisol is unclear. To determine whether these responses are dependent on symptoms during the glucagon test, a retrospective case note study of glucagon tests performed over 3 years in patients with pituitary disease was undertaken.Methods: Fifty-six...

Introduction: Current guidelines recommend that thyroid nodules classified as Thy 3 following fine needle aspiration (FNA) should be managed surgically. This results in over-treatment of benign disease. The purpose of this study was to review multi-disciplinary team (MDT) management of Thy 3 FNAs at our institution.Patients and methods: A total of 109 FNAs were performed between April 2008 and October 2009; 31 were reported as Thy 3. The management of al...

Severe growth hormone (GH) deficiency in adults is associated with adverse changes in quality of life (QoL), body composition and cardiovascular risk profile. NICE guidance restricts GH replacement in the UK to those with impaired QoL, defined by a score of >11 in the QoL-AGHDA questionnaire.Aims: To assess whether the NICE guidance differentiates other clinical or biochemical features in GH deficient adults.Patients and...

GH deficiency (GHD) in adults shares several clinical features with syndromes of glucocorticoid excess. Many patients with GHD also receive glucocorticoid therapy. GH inhibits the generation of active glucocorticoid by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), but the confounding effect of ACTH deficiency/ cortisol replacement therapy has not been evaluated.Aims: To assess corticosteroid exposure and metabolism and body composition in...

Introduction: 18-hydroxycortisol (18-OHF) is known to be elevated in glucocorticoid remediable aldosteronism but there are few data relating to 18-OHF in the differential diagnosis of primary aldosteronism.Aim: We evaluated the usefulness of lying and standing 18-OHF in patients with primary aldosteronism in differentiating between aldosteronoma, bilateral adrenal hyperplasia (BAH) and normality.Methods: Patients (n=27) with...

Background and aims: Diabetes insipidus (DI) is a common complication after transsphenoidal surgery (TSS), but resolves in the majority of patients. We determined the osmolalities and timing of DI most that best predicted long-term outcome.Methods: Case series study randomly including 54 patients out of total 99 patients who underwent transsphenoidal surgery over 18 months. Follow up information was ascertained from clinic review or by telephone intervie...

Most authorities recognise adult growth hormone deficiency (AGHD) as a distinct endocrine disorder, although determining an appropriate strategy for optimising replacement remains controversial.We reviewed the outcome of a cohort of patients treated with a fixed graded initiation phase followed by an individualised titration phase. Patients were initiated on a starting dose of 0.3 mg recombinant human growth hormone (rhGH) for one month, with increases t...

Introduction and aims: Following treatment for acromegaly, both growth hormone (GH) and insulin-like growth factor-I (IGF-I) levels are predictive of mortality. These data are derived from studies of either a single GH or the mean circadian GH, with a threshold of 2 mcg/l. However, consensus target criteria (Giustina et al. 2000) require: a nadir GH of <1 mcg/l on OGTT and IGF-I within the age/sex-adjusted normal range. We aimed to determine the degree to which norm...

Background: Prolactin levels are affected by stress, and in patients with moderate hyperprolactinaemia, a repeat test and/or a resting prolactin has been recommended, but there are very few data addressing the utility of these additional measurements.Aim: To study the value of: A) Repeat measurement and B) Resting measurement of serum prolactin in mild to moderate prolactin excess (510–7500 IU/L).Methods and subjects: Case not...