Endocrine Abstracts

IntroductionThe prognosis in head and neck cancer has remained unchanged over the last 20 years (overall 5 year survival 50-60 percent), and is adversely affected by tumour angiogenesis. The effects of the anti-proliferative and anti-angiogenic peptide somatostatin (SST) are mediated through a family 5 receptors (SSTRs 1-5), whilst the angiogenic cytokine vascular endothelial growth factor (VEGF) acts predominantly via 2 receptors: FLK and FLT. The objective of this study ...

Acromegalic patients have increased morbidity and mortality, which correlate with post-treatment growth hormone (GH) level. Target post-treatment plasma GH level should be less than 2.5 nanograms per millilitre, which predicts normal life expectancy.We evaluated the prevalence of complications and treatment outcome in 76 acromegalic subjects who attended our unit for surgery between 1978-2002. 60 patients are followed up in a specialised pituitary clinic in Beaumont Hospit...

Background: Denosumab is a monoclonal antibody against RANK ligand used for the treatment of osteoporosis. Although clinical trials demonstrate that denosumab is highly effective at reducing fragility fractures in postmenopausal osteoporosis, there have been few studies looking at real world outcomes. Our primary aim was to assess the efficacy of denosumab in practice.Methods: We retrospectively formed a database of 257 patients seen in endocrinology out...

Background: Denosumab, given 6 monthly as a subcutaneous injection, is well established as a treatment for osteoporosis. In the UK it is initiated in secondary care with most patients continuing with injections in primary care. Given concerns with hypocalcaemia and possible adverse effects on fracture risk due to abrupt cessation, robust monitoring in primary care is important. Our study compares two groups of patients on denosumab, one following a well-defined treatment pathw...

Craniopharyngioma is a rare benign pituitary tumour that occurs in children and adults. Recurrence rates are high (up to 90%) but factors underpinning this are unclear, particularly in cases of childhood onset. We aimed to investigate factors that may influence subsequent recurrence rates in childhood onset craniopharyngiomas in patients attending our centre. A retrospective study of patients followed up at the Oxford Late Effects of Childhood Cancer service was conducted. Pat...

Cranial Diabetes Insipidus (CDI) is associated with significant polyuria and is treated with desmopressin. Inappropriate or missed treatment can result in significant electrolyte imbalance and potential harm. A recent UK survey of Endocrinologists reported 55% had concerns about knowledge in their trust, 39% felt they had observed patients come to harm. Patients not receiving desmopressin have been associated with death, leading to an NHS England (NHSE) safety alert in 2016. W...

Familial hypocalciuric hypercalcaemia (FHH) is an autosomal dominant disorder characterised by hypercalcaemia and inappropriately low renal calcium excretion. FHH can be classified into three types: FHH1, caused by calcium-sensing receptor (CaSR) loss-of-function mutations, accounting for >65% of cases; FHH2, due to loss-of-function mutations of the G-protein α11 subunit (Gα11); and FHH3, resulting from loss-of-function mutations in the adap...

Adaptor protein-2 (AP2) is a heterotetramer of α, β, μ, and σ subunits that is pivotal in clathrin-mediated endocytosis and facilitates internalisation of plasma membrane constituents such as the calcium-sensing receptor (CaSR). AP2 σ subunit (AP2σ) missense mutations (Arg15Cys, Arg15His and Arg15Leu) result in familial hypocalciuric hypercalcaemia type 3 (FHH3) and decrease the sensitivity of CaSR-expressing cells to changes in extracellular calc...

Iodine deficiency may lead to reduced thyroid hormone production and ultimately hypothyroidism. The UK has previously been considered to be iodine sufficient, however recent evidence suggests the UK may be iodine deficient. Iodine status can be assessed in several ways, including measurement of urinary iodine excretion, for which inductively coupled plasma-mass spectrometry (ICP-MS) is considered the gold standard method.An ICP-MS method for determinatio...

Subarachnoid haemorrhage (SAH) is a well reported cause of hypopituitarism but the precise incidence is controversial. We aimed to prospectively determine the incidence of acute and long term hypopituitarism in SAH.We prospectively recruited 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium, urea, osmolality, glucose, and 0900 h cortisol (PC) measured on days 1, 2, 3, 4, 6, 8, 10...