Endocrine Abstracts

Thyroid hormone resistance is a rare but recognised cause of clinical hypothyroidism. We explain a case of clinical hypothyroidism that was associated with thyroid hormone resistance.A 48-year Caucasian female with no known personal or family endocrine history was referred with a 12-month-history of weight gain and increased tiredness. Past history included depression and osteoarthritis, with regular medications being NSAIDs and amitryptiline. There was ...

Introduction: Prader–Willi syndrome (PWS) is characterised by hypotonia, obesity, short stature, and hypogonadism probably due to hypothalamic dysfunction (hypogonadotropic hypogonadism (HH)). Exaggerated adrenarche is however commonly noted in these patients. Early puberty is rarely described: we report two girls with PWS diagnosed with premature sexual maturation.Case reports: Case 1: this 8-year-old girl was neonatally diagnosed with PWS (materna...

Introduction: Measurement of the anterior pituitary hormone prolactin is often performed in patients with pituitary pathology. Mild hyperprolactinemia occurs in subjects with hypothalamic disorders and/or pituitary stalk dysfunction, and is also described in patients with isolated optic nerve hypoplasia (ONH), this is proposed to be due to decreased dopaminergic tone.Objective: To assess prolactin levels in patients with septo-optic dysplasia (SOD) (with...

Background: Thyrotropinomas (TSHomas) are traditionally considered a rare albeit important cause of thyrotoxicosis, accounting for ∼1% of all pituitary adenomas. Although early case series reported a preponderance of macroadenomas, emerging evidence suggests microadenomas are being increasingly diagnosed. In addition, the clinical/biochemical phenotype appears to be more variable than previously suspected. We therefore examined the clinical, metabolic, biochemical and ra...

High IGF2 has been associated with longitudinal weight loss. We wished to study associations of genes coding for IGF2 and for binding proteins that have preferential IGF2 affinity (IGFBP2, IGFBP5 and IGFBP6) in 991 Caucasian subjects from Salford with type 2 diabetes.Fifteen IGF2, four IGFBP2, eight IGFBP5 and one IGFBP6 SNPs were successfully genotyped. Longitudinal BMI data for the years 2002 to 2009 was obtained fro...

Vandetenib has been used as novel treatment of locally invasive medullary carcinoma of thyroid. We report the use of Vandetenib in a paediatric patient with inoperable medullary carcinoma of thyroid gland. Our patient presented to the dental surgeons at age 12 years with tongue and lip swellings. Biopsy demonstrated mucosal neuromas suggestive of MEN2B. He was clinically euthyroid but had a firm goitre. Ultrasound showed a large heterogenous thyroid mass encasing the common ca...

Background: The recently published ‘Consensus on Criteria for Cure of Acromegaly’ (Giustina et al. JCEM, 2010) highlighted concerns regarding the quality of currently available insulin-like growth factor 1 (IGF1) immunoassays which may contribute, at least in part, to the discordance between GH and IGF1 that is observed in up to 30% of patients with acromegaly after treatment. The development of mass spectroscopy (MS)-based technology has been proposed ...

Background: Adrenal incidental masses (incidentalomas) are present in up to 10% of patients. The majority of these adrenal masses are clinically inapparent, but may be functionally active in a significant proportion; thus assessment by endocrinologists is essential.We assessed the functionality of adrenal incidentalomas referred to the endocrinology team at the Queen Elizabeth Hospital in Gateshead.Methods: Patients with adrenal in...

Background: The insulin stress test (IST) is accepted as the gold standard investigation of the hypothalamio-pituitary–adrenal axis (HPA). The test has been shown to be reliable though potentially unpleasant for the patient and has been associated with complications such as loss of consciousness, seizures, arrythmias, angina, myocardial infarction and death. To this effect close medical supervision is always required when an IST is performed.Methods...

Between March 1998 and October 2002, 62 patients requiring trans-sphenoidal pituitary surgery (PS) and 36 patients requiring endoscopic sinus surgery (controls, C) were recruited. Patients were aged 18–65 years and had not had previous surgery or radiotherapy to the brain. The mean ages (p>0.05) and genders (p>0.05) of the two groups were similar 47 years, 41% male (PS) compared with 43 years, 39% male (C). Baseline IQ of the two groups was also similar, 101&#177...