Endocrine Abstracts

A 43-year-old man presented with aching legs, gynaecomastia, erectile dysfunction, central obesity, and generalised hair loss. Examination confirmed these findings as well as showing him to be hypertensive at 160/100 mmHg. Routine haematology and biochemistry as well as levels of anterior pituitary hormones were normal, except for an inappropriately low TSH in the face of normal T3 and T4 levels. A pituitary MRI showed the presence of an ill defined area of reduced signal inte...

Itraconazole increases glucocorticoid levels through inhibition of CYP3A4 in the liver. Recent case-reports have shown that the co-administration of itraconazole with inhaled glucocorticoids in asthmatics may result in suppression of their HPA axis and a Cushing’s phenotype. We have evaluated the impact of this interaction on the cortisol axis in a double-blind randomised placebo-controlled study.Twenty-seven patients with severe asthma (17 women; m...

Familial Hypocalciuric Hypercalcaemia (FHH), originally described in 1966, was first linked to mutations in the Calcium-Sensing Receptor (CaSR) gene in 1993. FHH results from inactivating mutations affecting a single allele inherited in an autosomal dominant pattern. The calcium-sensing receptor is a cell surface-expressed G protein-coupled receptor with 1078 amino acids. Gene mutations are usually single-point in nature and result in an elevated set point for calcium sensing ...

The opportunity to study the effects of prolonged fasting is rare. In this study we recorded anthropometric, biochemical and endocrine changes during the refeeding period following a 44 day fast, and compared them with results from 16 age-, sex- and body mass index (BMI)-matched controls.The index subject took only water to drink during the fast. He lost 24.5kg changing his BMI from 29 to 21.6. He underwent careful slow refeeding for the first 4 days usi...

Hyperprolactinaemia in the presence of pituitary tumour can occur from tumour secretion or from stalk compression causing loss of dopaminergic inhibition. It is generally accepted that, in the presence of a large pituitary mass, a serum prolactin level up to 3000mU/l indicates stalk compression rather than a prolactinoma; the clinical diagnosis of prolactinoma depends on the degree of hyperprolactinaemia in the context of pituitary tumour size. Our aim was to examine more form...

The results of transsphenoidal surgery for acromegaly by a single neurosurgeon (MP) operated between 1981 and July 2002 were examined retrospectively. 141 database and case note records for patients with a clear pre-operative diagnosis of acromegaly were reviewed. Patients with incomplete pre- or postoperative data on growth hormone (GH) status were excluded from further analysis (n=14). The remaining 127 formed the audit group.Pituitary imaging data was available in 84 of...

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...

Objectives: Thyroid peroxidase (TPO) is a key enzyme in the synthesis of thyroid hormones and is a target for autoimmune responses in autoimmune thyroid disease. TPO autoantibody (TPOAb) binding epitopes have been mapped on the peroxidase domain (POD) and the complement control protein like domain (CCP). This study aimed to solve the molecular structures of TPO bound to TPO antibodies.Methods: An extracellular domain (ECD) of human TPO (amino acids; aa 1...

Prostate cancer is currently treated with hormonal therapies, which aim to block the production and/or action of androgens. However, tumours eventually progress to castration-resistant prostate cancer and there is a great need for new therapeutic approaches. We have designed and tested engineered repressors which could be effective in circumstances where current therapies fail. These consist of two modules: an interaction domain, which binds directly to the androgen receptor (...