Endocrine Abstracts

Introduction: Pituitary conditions are rare and diagnosis may be slow because symptoms are ambiguous. The treatment may be a combination of surgery, radiotherapy and medication so patients see many healthcare professionals. This survey sought to assess patient satisfaction with the information and support they receive from GPs, endocrinologists, neurosurgeons, radiotherapists, specialist nurses, and other agencies (e.g. the pituitary foundation).Method: ...

A 50-year-old man presented with a week history of feeling unwell and urinary symptoms. He was confused. His wife gave H/O 2 stone weight loss. Recent investigation for haematuria showed 3.6 cm bladder tumour. He underwent TURBT and the histology was awaited. No other significant PMH or family H/O. Not on any medication and was an ex-smoker.Initial investigations showed leucocytosis and evidence of UTI. CXR showed chronic fibrotic changes. As a part of c...

A 24-year-old women (wt 63 kg, BMI 23) presented with history of secondary amenorrhea. Menarche occurred at age 16 years and was followed by a regular cycle (7/35). She started the combined oral contraceptive pill (OCP) at 18 years of age for menorrhagia and stopped this 16 months before her presentation, before undergoing elective surgery. Four months after discontinuing the OCP she experienced a single episode of PV bleeding, but otherwise remained amenorrhoeic. Past history...

Hyperthyroidism in pregnancy is associated with increased foetal and maternal morbidity. Hyperthyroidism occurs in 0.2–0.6% of pregnancies. This suggests that based on 23,000 deliveries in the 3 major Dublin maternity hospitals that 40–60 cases per year would be expected to be at risk of a poor outcome from hyperthyroidism.To clarify those factors associated with poor outcome in hyperthyroidism in pregnancy we undertook an audit of 53 cases of ...

A minority of patients with hyperthyroidism resulting from relapsed Grave’s disease or autonomous nodules refuse definitive treatment with surgery or radioiodine, and request long-term anti-thyroid medication. There are few data concerning the safety and efficacy of this therapeutic modality.We performed a retrospective analysis of 13 patients (8 relapsed Grave’s disease, 5 toxic MNG), 12F, median age 60 (31–76) yrs and duration of long-te...

Adult survivors of haematological malignancies are subject to a number of putative insults to the skeleton. Adverse impacts on bone mass include sex-hormone deficiency, radiotherapy, chemotherapy, inadequate nutrition and a generalised catabolic state. We assessed BMD using DXA at the lumbar spine (LS) and femoral neck (FN) in 34 women with POF, defined by secondary amenorrhoea, elevated gonadotropins, and low oestradiol levels. Mean age at diagnosis was 29.7 (range 14–45...

The optimal oestrogen dose required to maintain bone mass in young women who develop POF is contentious. We reviewed longitudinal BMD data in 21 women with POF resulting from multi-modality cancer therapy for haematological malignancies. The 21 women were of mean age 30.6 (range 17–45) years at onset of amenorrhoea and weight 64.1+/−11.2 kg. Primary diagnoses were acute myeloid leukaemia (n=12), chronic myeloid leukaemia (n=5), acute lymphocytic leukae...

Without adequate treatment patients with acromegaly die prematurely from cardiovascular disease (CVD); however the contribution of atherosclerosis in this process is controversial. Increased carotid IMT is an early morphological marker of atherosclerosis and predictor of subsequent cardiovascular events. Contradictory data exist regarding IMT in patients with acromegaly.We measured carotid IMT in 79 patients with acromegaly (47 male, mean age 55±14 ...

We have previously shown that adults with partial GHD have increased total body and truncal fat mass, an adverse lipid profile, and insulin resistance. In this study we have gone on to analyse suggogate markers of vascular risk and carotid IMT. We defined GH status using the combination of two stimulation tests, the ITT and arginine stimulation test, in to patients with severe GHD (pGH<3 ng/ml, n=30) or GH insufficiency (pGH 3–7 ng/ml, n=24). Thirty age ...

Use of somatostatin (SRIF) analogs in acromegaly indicates greater lowering of IGF-I than predicted from GH reduction. Studies using hypophysectomized rats suggest a direct SRIF action on GH-induced IGF-I, however, interpretation is complicated by effects of SRIF on other hormonal axes. In isolated rat hepatocytes we showed SRIF and octreotide to have a direct inhibitory effect, via hepatic SSTRs, on GH-induced IGF-I production. GH (500 ng/ml) caused ~4 fold induction of IGF-I...