Endocrine Abstracts

Case: A 73-year-old lady presented with hyponatraemia six days post-transphenoidal surgery for a non functioning pituitary macro-adenoma. Peri-operatively she developed diabetes insipidus requiring short term desmopressin whilst on the neurosurgical ward. At post-operative presentation she complained of weakness, confusion and nausea; sodium 125 mmol/l, serum osmolality 268 mOsmol/kg, urine osmolality 474 mOsmol/kg. Over the next few days she became symptomatically worse and h...

Primary hyperparathyroidism is a common endocrine disorder. Diagnosis is more frequently made where calcium testing forms part of routine screening bloods. The clinical profile has shifted from a symptomatic disorder with hypercalcaemic symptoms, kidney stones and overt bone disease towards a more asymptomatic state. The National Institutes of Health (NIH) have produced guidelines on diagnosis and management of primary hyperparathyroidism but no UK guidelines are in existence....

Obesity and adipokines are associated with a state of chronic low grade inflammation (Trayhurn & Wood 2004).In view of our findings that the adipokines resistin and fiaf (fasting-induced adipose factor) are also expressed in mouse brain and pituitary gland (Wiesner et al 2004), we tested the hypothesis that these factors would be induced in brain tissue following cerebral hypoxia/ischemia (H/I). Neonatal H/I (postnatal day 8; unilateral common c...

Background: The role of post-operative radiotherapy (RT) in the treatment of non-functioning pituitary adenomas (NFA) remains controversial. We compared the difference in outcome between patients receiving transsphenoidal surgery (TSS) alone and TSS plus RT in 93 patients treated for NFA between 1986 and 2005. 64 (69%) had TSS alone whilst 29 (31%) received TSS plus RT (45GY, 25Fr, 3 field). All patients were followed up by CT and then MRI scans repeated at increasing interval...

We report 28 patients (21M 7F; 17-86y) with pituitary apoplexy presenting between 1988 and 2004. Presenting features included: headache in 25 patients, 'collapse' in 3, vomiting in 13, complete blindness in 4, decreased visual acuity in 13, visual field loss in 12 and ophthalmoplegia in 16. Only 4 had no initial visual deficit. Predisposing factors included a known pituitary tumour in 4 patients, anticoagulant therapy in 3 patients and ITP in 1 patient. CT was initial imaging ...

We present two families illustrating complex management issues introduced by mutational analysis in CAH.Family 1. A female index case presented at birth with ambiguous genitalia and was diagnosed with severe salt losing CAH. She is a compound heterozygote with two severe mutations: 659G (intron 2 splice site mutation) from her mother and CYP21 deletion from her father. Mother and mother's identical twin sister have compound heterozygosity for the mild mu...

Background: World Gastroenterology Organisation (WGO) quotes gallstones prevalence of 9-21%, incidence of 0.63/100 persons/year in Europe; 10-15% of UK population have gallstones (1). Acromegaly patients’ prevalence is 8.3% and 35% developing incidental gallstones during somatostatin analogue (SSA) treatment (2).Objective: To evaluate the prevalence of gallstones in SSA treated Acromegaly patients in University Hospitals of Leicester (UHL).<p cl...

Approximately 10% of essential hypertension cases is attributed to primary aldosteronism (PA), where inappropriately high levels of aldosterone are secreted. Almost half of these PA cases result from aldosterone-producing adenoma. microRNAs are single-stranded, short non-coding RNAs that negatively regulate gene expression post-transcriptionally. In a previous study, we showed that microRNAs directly modulate CYP11B2 (aldosterone synthase) gene expression and aldoster...

Background: While few hypothyroid patients require more than the expected weight related dose of levothyroxine, the underlying causes of larger-than-expected dosing requirements have not been studied in a single cohort. Our aim was to determine and quantify the multiple factors contributing to high dose levothyroxine requirements in a cohort of patients with hypothyroidism.Methods: The Grampian Automated Follow-Up Register (GAFUR) monitors around 17 500 ...

Background: Radiotherapy is a third line treatment in Acromegaly. Pituitary radiotherapy (RT) is known to have cardiovascular complications (MI/IHD, CCF & CVA) due to radiation effects on normal pituitary and surrounding structures over and above the excess Growth hormone risk on metabolism (1).Objective: To compare RT vs non-RT treated Acromegaly cohorts’ cardiovascular (CV) outcomes in unselected consecutive Acromegaly patients.<p class="a...