Endocrine Abstracts

Hyponatraemia is a well-recognised neurosurgical complication, but the incidence and complications are unknown.Objective : We aimed to define the incidence, pathophysiology and effects of significant hyponatraemia following neurosurgical admissions.Methods: All neurosurgical patients with significant hyponatraemia (plasma sodium <130 millimol per litre) between January 2002 and September 2003 were identified from computerised la...

Hyponatraemia occurs in 25-40% of patients with subarachnoid haemorrhage (SAH) but the pathogenesis is unclear.Objective: We aimed to establish the incidence, pathophysiology and consequences of hyponatraemia following SAH.Methods: A retrospective case note analysis of all patients with radiologically-proven SAH admitted to Beaumont Hospital between Jan 2002 and September 2003. Of 580 patients coded as SAH on HIPE records, 316 were...

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...

A 51 year old presented with headaches, fatigue and generalised weakness. She had a background history of hypertension diagnosed one year prior to presentation. Initial laboratory evaluation demonstrated life-threatening hypokalaemia, potassium 0.9mmol/l(R.I. 3.5-5.3). This profound hypokalaemia required ICU admission for replacement of potassium and monitoring. Management of subsequent fluid overload necessitated a brief period of hemofiltration. During the course of evaluati...

Background: Adrenal insufficiency remains a potentially life-threatening condition, necessitating adequate glucocorticoid replacement and appropriate stress-related adjustment to avoid crisis. Flu-like illness is a key precipitant of adrenal crisis. While some authorities recommend annual influenza vaccination for such patients, uptake rates in this population are unknown. Additionally, while seasonal vaccines may lead to minor symptoms in the general population, there are no ...

Although cardiovascular disease (CVD) is greatly increased in type 1 diabetes mellitus (T1DM), patients typically have apparently healthy lipid profiles. Simple measurement of plasma lipids however does not provide information regarding lipoprotein particle size which in the nondiabetic population is independently predictive of CVD. Plasma lipids and lipoprotein subclasses (using polyacrylamide gel-tube electrophoresis) were studied in reproductive age women with T1DM and comp...

Context: The syndrome of inappropriate antidiuresis(SIAD) is the commonest cause of hyponatraemia. Data on the aetiology of SIAD is mainly derived from retrospective studies, often with poor ascertainment of minimum criteria for correct diagnosis. Although central adrenal insufficiency(CAI) is known to cause euvolaemic hyponatraemia, the incidence of undiagnosed CAI in SIAD is unknown.Objective: To establish the incidence of CAI in SIAD.<p class="abs...

Acute hyponatraemia is a medical emergency with high mortality. Recent expert guidelines advocate treatment with intravenous boluses of 3% saline with the aim to reduce cerebral oedema more rapidly than traditional slow intravenous infusion, but there is a poor evidence base for this policy change. We retrospectively audited treatment of symptomatic hyponatraemia due to SIAD (n=57, age 22–76 year), comparing low dose (20 ml/h) and bolus infusion of 3% saline. Bol...

TSH-secreting pituitary adenomas (TSHomas) are rare. Previously, the reported prevalence was one case per million populations although this is probably an underestimate. A recently published study reported a prevalence of TSHomas in Sweden of 2.8/million inhabitants.Methods/design: Observational study conducted in four tertiary referral centres in Ireland. We retrospectively collected data on the prevalence, demographics, hormonal profile, tumour charact...

Acromegaly is a rare condition resulting from excess secretion of GH and IGF1. Acromegaly is frequently associated with subfertility. As such there is little data on the course of the disease during pregnancy, and of the effects of the disease and its treatments on the foetus.Objective: We describe known pregnancies in women with acromegaly within the Republic of Ireland over a 15-year period.Methods: We collected clinical, biochem...