Endocrine Abstracts

Background: Radioiodine (RAI) is highly effective in the treatment of hyperthyroidism. Lithium reduces thyroidal release of organic iodide and thyroid hormones, thus increasing thyroid retention of RAI and subsequently, the delivered dose of radiation. Controversy surrounds whether lithium increases the efficacy of RAI.Aims: To assess whether lithium improved outcome after radioiodine treatment and analyse fT4 and eye disease changes in lithium treatment...

Background: Close follow up of patients treated with radioiodine (RAI) for hyperthyroidism is imperative to ensure that resultant hypothyroidism or ensuing hyperthyroidism is detected promptly and treated. Protocols of follow up vary between hospitals. In our centre, a telephone clinic is used and patients are called after thyroid function tests at 1, 3, 6, 9 and 12 weeks post radioiodine.Aims: To audit patient follow up in the telephone clinic, comparin...

A 46-year-old lady presented with a short history of thirst and polyuria. She had a past history of hypertension. Diabetes mellitus was ruled out as she had normal blood glucose levels. She was found to be normocalcaemic but hypokalaemic. In view of the latter finding and her hypertension, her plasma renin activity and aldosterone was measured, and found to be 45 pmol/ml/hr and 410 pmol/l respectively (aldosterone:PRA ratio of 9.1). The diagnosis of secondary hyperaldosteronis...

Establishing failure of trans-sphenoidal surgery (TSS) to cure Cushing’s disease in the immediate post-operative period is essential for early surgical re-exploration. However, there is no consensus regarding the definition of apparent cure. We studied whether the dexamethasone-suppressed corticotrophin-releasing hormone test (LDDST-CRH test) immediately following TSS could accurately identify those with Cushing’s disease requiring further definitive treatment.<p...

IntroductionYttrium-90 pituitary implants were used in the past as one of the first line treatments for pituitary tumours in many endocrine centres. The procedure involved inserting radioactive rods of Yttrium oxide in to the pituitary fossa. This treatment has been replaced by medical treatment for prolactinomas and transsphenoidal surgery for all other pituitary tumours.AimTo investigate long-term efficacy ...

Non-functioning pituitary adenomas (NFAs) constitute 25-30% of all pituitary tumours. NFAs do not secrete hormones and patients present with clinical features due to mass effects of the tumour such as visual field defects or hypopituitarism. Surgery and radiotherapy (RT) have been considered standard therapy for patients with a non-functioning macroadenoma. However, since MRI scanning has become widely available fewer patients are routinely referred for RT following surgery.</...

A 37-year old gentleman with MEN 1 was referred to our Centre for further assessment. MEN 1 had manifested as recurrent primary hyperparathyroidism and multiple pancreatic gastrinomas. He complained of reduced libido, with absent early morning erections for the preceding 18 months. Biochemistry confirmed hyperprolactinaemia (prolactin 1494, NR 0–625 mU/l, testosterone 12 NR 10–28 nmol/l, LH 2.6 NR 2–12 IU/l, FSH 3.7 NR 1.7–8 IU/l). During investigation of h...

IntroductionPatients treated with radioiodine (RAI) for thyrotoxicosis, secondary to Graves or a toxic nodule, require close follow up to determine whether they have become hypothyroid or have a recurrence. National guidelines state that patients should have their first blood test at about six weeks post RAI. Telephoning patients with their results, rather than reviewing them at outpatient appointments, can be a more convenient and efficient method of fo...

Headaches associated with acromegaly are common even after hypophysectomy. Medical treatment with dopamine agonists and Somatostatin analogues often help. We report two cases when pharmacological therapy failed but further surgical removal of residual pituitary tissue cured the headaches.A 38 year-old lady presented with an eight year history of headaches, unresponsive to simple analgesia. Acromegaly was confirmed by a raised serum growth hormone (GH) 33...

A 69-year-old female presented in 2002 with symptoms of hyperthyroidism. Thyroid function tests confirmed thyrotoxicosis with elevated fT4 and fT3 but with an elevated TSH (TSH 5.8 mU/l, fT4 31.7 pmol/l, fT3 8.1 pmol/l). Pituitary function tests other than the TSH were normal. Pituitary MRI showed a mass in the left half of the pituitary fossa, displacing the stalk to the right with no suprasellar extension. A T3 suppressi...