Endocrine Abstracts

A 40 year old gentleman presented to his GP with a 12 month history of tiredness and breathlessness on playing basketball with his son. Initial investigations revealed he had a normocytic anaemia with haemoglobin of 9.8 and white cells and platelets were normal. He was referred to the Gastroenterologists and had normal renal function, liver function, bone profile, ESR and serum electrophoresis. His B12, folate and ferritin were normal. CT Abdomen was normal and duodenal biopsy...

Endocrine manifestations of arachnoid cysts, including suprasellar arachnoid cysts(SAC) are not well recognized. The effect of neurosurgical interventions on such manifestations is also not well reported. Here in we report a case of a young man with hypothalamic dysfunction secondary to SAC who made a good recovery after surgical treatment of the cyst.A 22-yr-old man was referred to our endocrine clinic for evaluation of progressive weight loss and malai...

ObjectiveThe aim of the study was to evaluate the peripartum changes in the level of anterior pituitary hormones, due to iron deficiency anaemia and also to evaluate whether severe iron deficiency anaemia leads to postpartum pituitary changes.MethodThe female albino rats of Wister strain were fed on iron deficient diets (30, 15, 7.2 mgFe/kg of diet) and control diets (50 mgFe/kg of diet). Prior to one month o...

A 35year old man presented to the cardiology clinic with effort dyspnoea, palpitations and light-headedness. He had just returned from a 6 month “round the world’ trip during which he had suffered a diarrhoeal illness. An echocardiogram performed in Bangkok revealed left ventricular dilatation but no other significant changes. A diagnosis of possible myocarditis was entertained and he was treated with 2.5 mg of Ramipril and 75 mg of Aspirin. When seen in the cardiolo...

The pathogenesis of gonadotrophin secreting pituitary tumours (gonadotrophinomas) remains poorly understood. Bone morphogenetic proteins (BMPs) are important for the control of cell proliferation and differentiation and BMP2 is essential for commitment of undifferentiated pituitary cells to the gonadotroph cell lineage. In addition, BMPs have been implicated in tumourigenesis in a variety of tissues, associated with up-regulated expression of Id (Inhibitors of differentiation)...

Rationale, aims and objectivesThe GHRH/Arginine and Short Synacthen Tests (SST) have been validated as safer alternatives to the Insulin Tolerance Test for the assessment of the growth hormone reserve and Hypothalamic-Pituitary-Adrenal axis integrity, respectively. However, these two tests are performed separately. The objective of this study was to see whether the synacthen and GHRH/Arginine tests could be combined to save time, blood samples and minimi...

IntroductionYttrium-90 pituitary implants were used in the past as one of the first line treatments for pituitary tumours in many endocrine centres. The procedure involved inserting radioactive rods of Yttrium oxide in to the pituitary fossa. This treatment has been replaced by medical treatment for prolactinomas and transsphenoidal surgery for all other pituitary tumours.AimTo investigate long-term efficacy ...

Non-functioning pituitary adenomas (NFAs) constitute 25-30% of all pituitary tumours. NFAs do not secrete hormones and patients present with clinical features due to mass effects of the tumour such as visual field defects or hypopituitarism. Surgery and radiotherapy (RT) have been considered standard therapy for patients with a non-functioning macroadenoma. However, since MRI scanning has become widely available fewer patients are routinely referred for RT following surgery.</...

A 30 year-old man was assessed for gynaecomastia. He had been treated for GH deficiency from the age of 3 to 16. His non-consanguineous parents were of short stature (maternal height 1.22 m, paternal height 1.58 m), as was a half-sister (1.55 m). The patient’s height was 1.55 m with an arm span of 1.48 m and his BMI was 31. Testicular volume was 18 mL and secondary sexual characteristics were normally developed. Lipomastia was diagnosed and subsequently treated surgically...

We describe a case of pituitary apoplexy in a patient with a known non- functioning macroadenoma. A 57 year old female was incidentally found to have a 20 x 16 mm solid and cystic pituitary mass abutting the optic chiasm on MRI scanning. She had gonadotrophin deficiency on endocrine testing and normal visual fields. Although repeat perimetry 12 months later revealed a mild superior bi-temporal hemianopia, the patient elected not to have surgery.Several m...

Pituitary disorders are relatively uncommon conditions which leave patients feeling isolated and distressed. Acromegaly and Cushing’s are associated with obvious and visible differences to appearance, while other pituitary conditions are associated with profound, yet hidden, physical changes which impact significantly on psychological well being.AimTo explore the subjective experiences of patients living with and managing a pi...

ObjectiveThis explorative study is concerned with assessing the psychosocial impact of living with a pituitary condition. In collaboration with the Pituitary Foundation, who work to understand and represent the experiences of patients, this study explored the psychosocial issues that are evident for and identified by patients with a pituitary condition (anxiety, depression and appearance related distress).Method<p class="abstex...

A 23 year-old male was assessed for recommencement of growth hormone replacement therapy. He had discontinued treatment a year ago but not experienced any adverse symptoms since.The patient had been born with multiple congenital malformations. Midline defects included oesophageal atresia, imperforate anus and partial sacral agenesis. Urogenital abnormalities required a left nephro-ureterectomy soon after birth and an orchidopexy was performed at the age ...

A 37-year old gentleman with MEN 1 was referred to our Centre for further assessment. MEN 1 had manifested as recurrent primary hyperparathyroidism and multiple pancreatic gastrinomas. He complained of reduced libido, with absent early morning erections for the preceding 18 months. Biochemistry confirmed hyperprolactinaemia (prolactin 1494, NR 0–625 mU/l, testosterone 12 NR 10–28 nmol/l, LH 2.6 NR 2–12 IU/l, FSH 3.7 NR 1.7–8 IU/l). During investigation of h...

A 55 year old gentleman, previously fit and well, presented with an insidious onset of visual disturbance, tiredness and frontal headaches over 2 years, which had been worsening during the previous 3 months. A routine optician review revealed bi-temporal hemianopia and prompted endocrine referral. Apart from superior bi-temporal hemianopia, clinical examination was otherwise normal. Serum prolactin levels were grossly elevated at 544,800 mU/l with no macroprolactin. Despite th...

IntroductionThe Epworth Sleepiness Scale (ESS) is a validated simple method of measuring subjective daytime sleepiness in a variety of situations whereby patients are asked to score the probability of dozing as no chance, slight, moderate or high chance. An ESS>10 is regarded as excessive daytime sleepiness which may be a result of sleep apnoea or sleep disorders. The British Thoracic Society advise that patients who have ESS>10 or sleepiness in ...

Cabergoline is a dopamine agonist that may be used as primary or adjunctive therapy for acromegaly. Although one study suggested biochemical control may be achieved in a substantial proportion of patients (Abs et al, JCEM 1998), it is still commonly perceived to be a relatively ineffective treatment, possibly on account of inadequate dosing.We performed a retrospective case notes review of 9 consecutive acromegalic patients to determine the effectiveness...

We present an unusual cause for symptomatic hypopituatism presenting due to a metastatic deposit. A 77 year old smoker and ex-miner was admitted with a 3 week history of breathlessness, malaise and weight loss. He had clinical evidence of a severe pneumonia but also had clubbing, was hypotensive, hypothermic and hypoglycaemic. He had no clinical features of Addison’s disease, no neurological symptoms or signs and a normal breast examination. Chest X-ray suggested extensiv...