Endocrine Abstracts

The most effective means of treating macroprolactinomas, including those associated with significant visual loss at presentation, is with dopamine agonist (DA) therapy. Improvement in visual function often occurs within days of commencing DA therapy, and usually precedes significant reductions in prolactin (PRL) concentrations and may predate significant evidence of tumour volume reduction by months or years. The temporal association between PRL concentration reductions and tu...

Growth Hormone (GH) deficiency in the adult is associated with sub-optimal bone mineral density (BMD) and reduced bone turnover. GH replacement therapy results in increased bone turnover and new bone formation with biphasic changes in BMD: We report a case in which the anabolic effects of GH on bone precipitated profound Vitamin D (Vit D) deficiency.The patient 56-year-old man with panhypopituitarism following treatment for acromegaly commenced adult GH ...

Introduction: Cardiac paragangliomas are rare endocrine neoplasms. Surgical resection is first line treatment. Here, we describe a case of cardiac paraganglioma where surgical resection was aborted due to involvement of important cardiac structures. Systemic therapy was instead pursued with tyrosine kinase inhibitor cabozantinib.Case: A 64-year-old man with a past medical history significant for tobacco use and poorly controlled type 2 diabetes mellitus ...

Background: Current practice of monitoring adrenal incidentalomas with biochemical follow-up and repeat imaging studies is under review by the ESE.Following an audit presented in 2015, we proposed that this extensive follow-up was unnecessary in radiologically benign lesions, as neither functional nor malignant lesions were present in this subgroup.Methods: A retrospective review of the same cohort of 145 patients with adrenal inci...

Background: Symptoms consistent with hypercalcaemia are an indication for surgery in patients with primary hyperparathyroidism (PHPT). However, symptoms can be subtle and may not be documented systematically. We analysed the documentation of symptoms in a large series of patients with PHPT, and the subsequent impact of introducing a symptom scoring questionnaire.Methods: A standardised proforma was used to retrospectively analyse symptom documentation by...

Objectives: To determine long-term functional outcome following traumatic brain injury (TBI) in childhood.Patients: Longitudinal study of 49 participants with TBI (21 mild, 28 moderate/severe TBI) and 16 healthy controls matched for age, gender and socioeconomic status. Age at TBI (median (range)) 11.8 (1–16) years; 17 were prepubertal, 16 peripubertal, 16 postpubertal. Age at study 19.7 (10–26) years, time post TBI 8.6 (5.8–10.8) years. A...

Androsterone glucuronide (ADG) is a major metabolite of the androgen dihydrotestosterone and has also been shown to arise from the intracrine conversion of other adrenal androgens such as androstenedione and androsterone. ADG has been shown to be raised in some women with clinical signs of hyperandrogenism such as acne and hirsutism, even when levels of androgens, e.g. testosterone or DHEA-S are normal. This indicates that raised ADG levels may be an early indication of hypera...

The fusion of insulin-stimulated GLUT4-containing vesicles (GSV) with the plasma membrane (PM) of adipose or skeletal muscle cells is governed by regulated exocytosis. In all such membrane fusion events cognate t- and v-SNAREs interact in an ordered way to allow vesicles to first dock with, and then fuse with the plasmalemma. In neurons, the best-studied example of this well conserved process, the protein species responsible for directing the final (rate-limiting) fusion step ...

Contemporary management of macroprolactinomas relies heavily on the use of dopamine agonist (DA) therapy. However, historically a proportion of patients may have undergone surgery and/or pituitary radiotherapy. We aimed to determine the long-term outcome in terms of tumour control and prolactin normalisation in a large cohort of patients with macroprolactinoma who received various treatment modalities. 80 patients (54 male) with macroprolactinoma (tumour diameter >10 mm, p...

Animal and clinical models of GHRH excess suggest that GHRH provides an important trophic drive to pituitary somatotrophs. Mice in which GHRH neurons have been ablated using a novel viral ion channel transgene (GHRH-M2 mice) show marked anterior pituitary hypoplasia and GH deficiency although GH cells are present. GHRH-M2 mice are also deficient in prolactin which is surprising as GHRH has little or no direct effect on PRL synthesis or release (Le Tissier, Mol Endo 19). In mic...