Endocrine Abstracts

Pegvisomant is a novel medical therapy for acromegaly that functions as a GH receptor antagonist. Insulin resistance is an important factor in the increased cardiovascular morbidity and mortality associated with acromegaly. The aim of this study was to compare insulin sensitivity (IS) in a group of 7 patients with acromegaly (3 male, mean age 59+/-13 years, SD), treated first with a stable dose of depot octreotide (OT) (median dose 20mg four weekly, range 10-20) for at least t...

Patients with acromegaly treated with medical therapy intermittently discontinue therapy to allow assessment of underlying disease activity. This is particularly so in patients treated with pituitary irradiation. Typical 'washout' times include 5 weeks for bromocriptine and 2 weeks for short-acting sc octreotide; longer periods are required for cabergoline and slow-release somatostatin analogues. Pegvisomant is a novel medical therapy for acromegaly that functions as a GH rece...

Background: The short synacthen test (SST) is the most commonly performed investigation to assess for suspected adrenocortical dysfunction. We investigated how random cortisol levels may relate to pass/fail on the STT.Methods: We analysed the relation between random cortisol measurements taken between 04.40 and 20.52 in the day and results of SST baseline and 30/60 min cortisol performed over a 12 month period (338 SSTs) at Salford Royal Hospital. Serum ...

Introduction: Hydrocortisone therapy in adrenal insufficiency and medical management of Cushing’s syndrome requires accurate monitoring of glucocorticoid status. Currently, this necessitates admitting patients to hospital for serial measurements of serum cortisol. From previous studies in Cushing’s, the goal of medical therapy is a mean (based on five samples) serum cortisol of 150–300 nmol/l, which is known to equate to a normal cortisol production rate. Saliva...

Introduction: Giant cystic phaeochromocytomas are an exceedingly rare variant of adrenal phaeochromocytomas. We report a case in an 83-year-old lady who initially presented with a swinging pyrexia, initially diagnosed as a hepatic abscess.Case report: An 83-year-old lady with a history of hypertension was admitted as an emergency with nausea and vomiting, dehydration and rigors. She was pyrexial and dehydrated; pulse 163 and BP 167/86. There were signs o...

Introduction: Patients with pituitary deficiencies suffer from impaired quality of life regardless of substitution therapy with hydrocortisone, thyroxine (T4), sex hormones or GH. Central hypothyroidism (CH) is difficult to diagnose and treat because symptoms are non-specific and TSH-levels cannot be used for assessment. There is no consensus for the fT4-goal of thyroxine-replacement in patients with CH.Aim: To determine the impact ...

Objective: Our study evaluates the contribution of untreated GHD to the phenotype in controlled CD, by comparing patients with GHD due to CD (n=322) and those with non-functioning pituitary adenoma (NFPA n=748) before and after 3 years of GH treatment.Methods: The patient cohorts were obtained from KIMS (Pfizer International Metabolic Database) and matched for age and gender. Duration between pituitary disease onset and GH start was 9.7 (CD...

Inherited CBG deficiencies are rarely reported and only 3 causative mutations in 4 families have been described. The objective of this study was to investigate a family with potential CBG deficiency.The index case, a 29-year-old female of Pakistani origin with consanguineous parents, presented with hirsutism and a slightly elevated 17-OHP. In a subsequent Short Synacthen Test (SST) 17-OHP was normal but serum cortisol (SerC) values were abnormal (case 1 ...

Metyrapone is a potent inhibitor of the conversion of 11-deoxycortisol (11-DOC) to cortisol and is used in the treatment of Cushing's syndrome. This study has assessed the clinical significance of 11-DOC cross-reaction in five serum cortisol assays provided on automated immunoassay analysers. Cross-reaction was determined from the linear regression of increase in measured cortisol against increasing levels of 11-DOC (0, 1590, 4310, 6490, 7040 nmol/L) added to a serum pool. In ...

CRN04894 is a potent, orally bioavailable nonpeptide that is a highly selective antagonist for melanocortin type 2 receptor (MC2R). This receptor is found exclusively in the adrenal cortex and is the primary mediator of adrenal activation. We report results from a randomized, double-blinded, placebo-controlled (6 active:3 placebo/cohort), multiple ascending dose (40, 60, and 80 mg) study in health volunteers evaluating safety, pharmacokinetics, and pharmacodynamics of oral, on...