ODP357 The Effect of Hyperbetacarotenaemia on Pituitary Homeostasis – A Case Series

Abstract

Abstract Betacarotene is an antioxidant pigment found in red, orange and yellow coloured leafy fruits and vegetables. Recent studies have found that beta carotene is involved in cell cycle arrest with apoptotic effects in ACTH secreting pituitary cells. It may have desirable anti-tumorigenic effects. Hyperbetacarotenaemia is commonly caused by excess intake of carotene rich food. However, correlating the clinical picture with liver, thyroid and lipid profiling, vitamin A concentrations and exclusion of nephrotic syndrome is necessary to underpin the causative mechanism. We present two cases of hyperbetacarotenaemia with clinical manifestations of hypopituitarism. Case 1 – A 55 year old lady presented with partial hypopituitarism. She had a history of restrictive eating disorder and excessive exercise regime. She cycled 140 miles a week and ate 4lbs of leafy vegetables a day. Her pituitary profile reflected partial hypopituitarism with inappropriately undetectable LH/FSG, low IGF-1 and central hypothyroidism. Her cortisol response to tetracosactide testing was normal. Betacarotene reached a peak of 2.7umol/L (upper reference range 1.58umol/L). Case 2 – A 29 year old lady was diagnosed and treated for a 4mm microprolactinoma, which subsequently regressed and prolactin levels returned to normal. Despite this, she continued to experience menstrual irregularities and found to have elevated serum beta carotene levels. On direct questioning she admitted to drinking 1.5L of Lucozade® per day. Betacarotene reached a peak of 3.81umol/L. These cases illustrate the importance of taking a detailed dietary history when considering the causes of pituitary dysfunction. Presentation: No date and time listed