Endocrine Abstracts

Paragangliomas (PG) originating from the nasal cavity are very rare and usually have an indolent growth. Surgery offers the only possibility of cure for these patients while radiotherapy can only slow their growth rate. Intracranial or leptomeningeal dissemination is very rare, with only 7 cases described in the literature. A 77 year old man with a 4-years history of nasal obstruction. He underwent a nasofibroscopy with a biopsy that revealed a nasosinusal neuroendocrine tumou...

Background: Pituitary hyperplasia is a relatively common yet frequently overlooked condition which can occur in both physiological and pathological states. Pregnancy is one of the most common conditions associated with physiological pituitary enlargement.Case Presentation: 22-year-old normally fit and well lady presented to AMU (acute medicine unit) with a week history of headache and 10-month history of amenorrhoea following cessation of combined contra...

Background: FSH (Follicular stimulating hormone) secreting pituitary adenoma rare entity among functional pituitary tumors, with a few reported cases, almost certainly missed because of the lack of clinical examination skills. Approximately, 40-50% represent gonadotroph adenoma of all pituitary tumors. Only small percentage of these tumors secrete biologically active gonadotropins leading to gonadal stimulation.Case presentation: Here, we report a unique...

Fertility represents a major concern in patients with acromegaly and the peculiar PCOS-like condition is commonly found in acromegalic women. The current retrospective study aimed at investigating gonadal function and fertility rate in acromegalic women with disease onset (DO) within the reproductive age. In 50 women hormonal parameters and gynecological ultrasound were evaluated at diagnosis (DD) and after disease control (DC). Data about menstrual disturbances (MD), pregnanc...

Background: Functioning gonadotroph adenomas (GA) account for 20 to 25% of all pituitary adenomas. Clinical presentation consists in multiple ovarian follicles and cysts, higher estradiol level and endometrial hyperplasia. The treatment of choice is transphenoidal tumor resection.Case Presentation: A 40 year old woman presented with abdominal pain and menstrual cycle dysfunctions. Hormonal evaluation showed: FSH:13.8 mU/ml, estradiol:1549 pg/ml, PRL:81.7...

Background: Hypothalamus pituitary adrenal axis (HPA) dysfunction is associated with serious morbidity and mortality. Its symptoms can be non-specific. Objective diagnosis depends on clinical suspicion and confirmed on assessment of early morning cortisol or dynamic assessment of cortisol secretion. The cosyntropin or short synacthen test (SST) has emerged as the most common test to assess the HPA. The insulin stimulation test (IST) is the traditional ‘gold standard’...

Background: Diabetes Insipidus (DI) is uncommon during pregnancy. It may predate pregnancy, be unmasked by pregnancy or arise de novo during pregnancy secondary to other pathology. We present a case of DI in pregnancy to highlight challenges in management.Case Report: A 27-year-old lady at 21 weeks’ gestation, presented to A&E with worsening headache and confusion for three to five months. She was hemodynamically stable, had bitemporal hemianopi...

Lipocalin-2 (LCN2) is a glycoprotein synthetized by various cell types, including neutrophils, that acts as siderophores scavenger and play an important role in different chronic inflammatory processes. Metabolic Syndrome (MetS) and Adult Growth Hormone Deficiency (AGHD), both partial and total, are characterized by inflammatory features. The objectives of our cross-sectional study were: 1) to compare LCN2 levels in these clinical pictures; 2) to evaluate the relations between...

Background: Pituitary metastasis (PM) is a rare occurrence in malignancy, associated with poor prognosis. Only 7% of patients are symptomatic. High index of suspicion and prompt investigation are essential. We report a case of PM, highlighting challenges in diagnosis and management.Case Report: Sixty-six year old male was referred to endocrinology due to headaches and hyponatremia. He had metastatic colorectal carcinoma, treated with bowel, liver and lun...

Background: Ghrelin and its endogenous antagonist liver-expressed antimicrobial peptide-2 (LEAP-2) are involved in GH secretion, both acting on GSH-r1α, and regulation of glucose and lipids metabolism. Metabolic impairments are often accompanied by an upregulation of LEAP-2 expression, with a usual concomitant reduction in ghrelin secretion. Adult growth hormone deficiency (aGHD), characterized by weight gain, increased fat mass and insulin resistance, represent a conditi...

Background: Little is known about possible predictors for hormonal function following pituitary surgery. Tumor consistency has recently emerged as a key factor in surgical planning for pituitary adenomas, influencing both the surgical outcome and the onset of postoperative complications. However, its impact on postoperative endocrine function has yet to be explored.Objectives: To evaluate the impact of tumor consistency on the development of postoperativ...

Introduction: Silent corticotroph adenomas(SCA) are defined as pituitary adenomas showing positive staining for adrenocorticotrophic hormone in immunohistochemical studies not associated with clinical/laboratory features of hypercortisolaemia. We report a case of SCA in a 61-year-old man, who presented with pituitary apoplexy.Case presentation: Patient presented with persistent diplopia of 3 months duration, associated with severe headache for 1 week. He...

Context: The occurrence of different subtypes of endogenous Cushing’s syndrome (CS) in single individuals is extremely rare. We here present the case of a female patient who was successfully cured from adrenal CS 4 years before being diagnosed with Cushing's disease (CD).Case Description: A 50-year-old female was diagnosed with ACTH-independent CS and a left-sided adrenal adenoma in January 2015. After adrenalectomy and histopathological co...

Background: Hyponatraemia occurs in 10- 15% of hospital admissions and is associated with an increased rate of mortality, length of stay in hospital and readmission rates when compared to patients with normal sodium levels. We developed a hyponatraemia algorithm pdf document to all non endocrine general physicians (GPs) in our hospital to aid in managing hyponatraemia effectively. However when we re-audited our practice, these guidelines were rarely used and there was a large ...

Introduction: Emerging evidence indicates that dysregulation of alternative splicing represents a new hallmark of cancer. This dysregulation may arise from mutations or altered expression of specific components of the splicing machinery. To date, splicing machinery status has not been studied in lung neuroendocrine neoplasms: typical and atypical pulmonary carcinoids.Objectives: Here, we aimed to analyzing the splicing machinery in pulmonary carcinoids a...

65-year-old lady presents to GP with 3-month history of fatigue, weight loss and nausea with background of stable Chronic Lymphocytic Leukaemia (CLL). GP started Levothyroxine 25 mg OD due to low T4 of 5.9 pmol/l (12-22) and low TSH of 0.25 mU/l (0.27-4.2). As she continued to feel tired, random cortisol was requested which was low at 25nmol/l leading to admission. Admission cortisol was 55nmol/l with an inappropriately normal ACTH of 11.6 ng/l (7.2-63.3). Pituitary profile sh...

Background: Incidental macroprolactinoma is an unsuspected prolactin-secreting pituitary adenoma larger than 1 cm that is discovered by an imaging test performed for an unrelated reason.Case presentation: A 25-year-old man was diagnosed with incidental macroprolactinoma (30.3×23.4×22.6 mm) following a head MRI scan after trauma. At the initial investigation, the patient had no complaints and denied any sexual dysfunction. Physical examination s...

Background: Cushing’s disease is the result of prolonged and excessive exposure to cortisol caused by a pituitary tumor. Treatment with somatostatin analogs (SSA), which can reduce hormone secretion and tumor growth in other pituitary tumors (e.g., somatotropinomas), is usually ineffective in corticotropinomas. Previous studies indicated that presence of the truncated SST5TMD4 receptor variant is associated with a lack of response to SSA in acromegaly; but, its presence a...