Endocrine Abstracts

Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH). Retrospective data suggests that the Syndrome of Inappropriate Antidiuresis (SIAD) is the most common cause, although glucocorticoid deficiency and rarely cerebral salt wasting may also cause hyponatraemia.We prospectively studied 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (p...

Measurement of plasma cortisol by immunoassay after ACTH1–24 stimulation is used to assess the hypothalamic–pituitary–adrenal (HPA) axis. Liquid chromatography–tandem mass spectrometry (LC–MS/MS) has greater specificity and equilibrium dialysis allows measurement of free plasma cortisol. We investigated whether measuring cortisol by LC–MS/MS improves the sensitivity of ACTH1–24 stimulation testing in pituitary patients. ...

Patients with craniopharyngioma have increased mortality attributed to cardiorespiratory disease, when compared to other hypopituitary populations. There is little data on the cause for excess of fatal respiratory disease in this condition. Clinical observation had identified sleep apnoea in some craniopharyngioma patients in our cohort. Sleep apnoea increases cerebrovascular and cardiovascular morbidity and mortality. Our hypothesis was that sleep apnoea could be a contributo...

Microprolactinomas are considered not to cause pituitary hormone dysfunction, but there is little data available on the prevalence of hormone deficiencies. We aimed to establish the frequency of pituitary hormone dysfunction in patients with hyperprolactinaemia.We examined the casenotes of 124 consecutive patients (85 females) with documented hyperprolactinemia from our pituitary data-base. 52 patients had macroadenomas (tumour > 1cm diameter), 64 mic...

The insulin tolerance test (ITT) is the gold standard for assessing growth hormone (GH) and cortisol production in pituitary disease, However it is potentially hazardous, requires medical supervision and adequate hypoglycemia may not be achieved. We retrospectively examined the records of 185 consecutive patients aged 14-76 years with pituitary disease who underwent the ITT over 18 months. Testing was performed in the endocrine day ward by an experienced endocrine nurse. Absol...

Hypopituitarism is associated with premature vascular mortality. Growth hormone (GH) deficiency, over-replacement with glucocorticoid, cranial irradiation and traditional vascular risk factors are possible contributing factors to the excess mortality.We studied 200 consecutive adult hypopituitary age (mean standard deviation) 51.7 plus/minus 15.3 years, who attended our pituitary clinic between July and December 2002. Hypertension was defined as blood pr...

Pituitary hormone abnormalities have been reported in up to 50% of survivors of traumatic brain injury (TBI), tested several months or longer after the event. No information is available on the frequency of hypopituitarism in the immediate post-TBI period.We studied 50 consecutive patients who were admitted to the neurosurgical unit with severe or moderate TBI [initial Glasgow Coma Scale (GCS) score 3-13]. Testing was performed at a median of 12 days pos...

Background: The expression of BCL-2, an anti-apoptotic protein, has been implicated in the aggressive behavior of NENs. Dysregulation of BCL-2 expression, controlled by the pRb1-E2F1 axis, has been linked to the development of various cancers, including NENs. Studies have shown that higher BCL-2 expression is associated with poorer survival outcomes in NEN patients.Methods: We report a unique case of a patient with a pancreatic neuroendocrine tumor who h...

Introduction: Giant cell tumour of bone (GCTB) is a benign, locally aggressive tumour whose neoplastic stromal cells express receptor activator of nuclear factor kappa-B ligand (RANKL) and activate its receptor RANK on osteoclast-like giant cells. Denosumab (RANKL inhibitor) is an FDA/EMA approved treatment for GCTB in adults and ‘skeletally mature’ adolescents. Safety concerns include oversuppression of bone remodelling, with risk of osteonecrosis of the jaw (ONJ) a...

Multiple myeloma (MM) is a B-cell tumor of monoclonal plasma cells in the bone marrow and is the second most common age-related hematologic malignancy reported in the United States. Very late antigen-4 (VLA-4, α4β1 integrin, CD49d/CD29) is overexpressed on MM. LLP2A is a highly specific peptidomimetic ligand that targets activated VLA-4 with high affinity. In this study, we evaluated 68Ga radiolabeled-DOTA-PEG4-LLP2A tracer...