Endocrine Abstracts

We have investigated inter-individual transfer of 17β-estradiol (E2) and progesterone (P-4), and related it to mammalian ‘pheromonal’ effects. Assays of unconjugated E2 and P4 revealed their presence in male and female urine of laboratory mice and big brown bats (Eptesicus fuscus), which are phylogenetically very distant from each other. These small and lipophilic steroids readily pass through biological membr...

Fibrous dysplasia (FD) is a rare bone disease which usually presents to Endocrinologists as part of McCune albright syndrome or as precocious puberty. A variety of other co-morbidities have been described for FD including renal phophate wasting secondary to an excess of FGF23; abnormal thryoid and growth hormone production and abnormal cortisol production. A large number of children are referred to our Regional Sarcoma Service with lytic bony lesions, many of which are subsequ...

PANCH tumour (pituitary adenoma with neuronal choristoma), is a very rare form of pituitary pathology composed of a mixed pituitary adenoma/gangliocytoma. We describe a patient with acromegaly who had evidence of GH synthesis in the neuronal component of a PANCH tumour. A 55-year-old woman was found to have facial features of acromegaly, confirmed biochemically: basal GH 13.56 ng/ml, GTT nadir 8.87 ng/ml, and IGF1 raised at 97.2 nmol/l (ref 9–40). Pituitary function was o...

Large corticotroph adenomas are uncommon pituitary mass lesions, representing around 10% of cases of Cushing's disease, and are often found to be locally invasive. 'Silent' corticotrophinomas stain for ACTH, but do not secrete sufficient ACTH to cause Cushing's disease. We describe a patient with an unusual mass presentation of a pituitary adenoma in whom there was also a marked discrepancy between the clinical and laboratory findings in the assessment of suspected Cushing's d...

Pituitary apoplexy is a rare condition caused by haemorrhage or infarction into a pituitary tumour. The majority of patients do not have any identifiable triggering event, although situations altering the blood flow to the pituitary gland and pre-existing systemic hypertension have been identified as potential causal factors.We retrospectively reviewed the presentation and outcome of 15 patients with pituitary apoplexy (8 men, 7 women; age 16-87, mean 5...

Introduction: We present two pregnant women who were referred to obstetric endocrinology service with polyuria and polydipsia. They were investigated and treated for diabetes insipidus (DI). In both cases, the underlying pathophysiology was ADH insufficiency secondary to autoimmune lymphocytic hypophysitis. There are currently no consensus guidelines on the diagnosis of DI during pregnancy. These cases highlight best practice and endorse MDT management of chronic hypopituitari...

Introduction: Association between lymphoma and pituitary dysfunction is well documented, though most commonly through mechanism of infiltrative pituitary metastasis, or primary lymphoma of the pituitary, rather than autoimmune lymphocytic hypophysitis. Here we present a highly unusual case whereby investigation into the cause of Diabetes Insipidus with radiological features of lymphocytic hypophysitis, led to diagnosis and cure of Diffuse Large B-cell lymphoma (DLBCL). Diabete...

Background: Given the technically challenging nature of adrenal venous sampling (AVS) there is a drive to centralise services to improve successful outcomes. This has potential implications for patients living in remote and rural areas.Methods: We retrospectively reviewed the case notes of 15 patients who underwent AVS in our hospital, for investigation of primary hyperaldosteronism between 2002 and 2015. We assessed the success rate of cannulation of th...

Background: Environmental factors play a role in the aetiology of type 1 diabetes. A particular role for infectious exposures has been postulated. Temporal variation in incidence would be consistent with this hypothesis. We specifically aimed to test predictions of increasing incidence occurring among cases of type 1 diabetes in children (aged 0–14 years) that might arise as a result of an environmental mechanism.Subjects and methods: The study anal...

We examined the results of treatment of adult Cushing's disease by transphenoidal surgery by a single neurosurgeon (MP). Patients with Nelson's syndrome and those who previously had received treatment for Cushing's by a different surgeon were excluded. We reviewed the pituitary database and patient records for all patients operated between 1988 and 2000 with clear pre-operative evidence of Cushing's disease. 117 patients had clear evidence of a pituitary source of excess ACTH....