Endocrine Abstracts

Aims and objectives: Poor attendance in clinics remains a concern shared by diabetes services nationally and internationally. We surveyed our children’s diabetes service users to identify local reasons for non-attendance. We used the opportunity to seek feedback from service users about service design.Study population group: The group included parents/carers of children and young people who use children’s diabetes service delivered by Walsall H...

I was diagnosed with type 1 diabetes when I was 10 years old. Then in 2014, when I was around 15 years old, I begin developing an eating disorder which was diagnosed as a combination of both anorexia and bulimia tendencies. After struggling with the condition, as it got increasingly worse, by myself for around 4 months I was referred to CAMHS. Having an eating disorder made my HBA1C very unsteady and rather high (but never above 9%/ 75 mmol/mol), which in turn made me suffer w...

In most species progesterone acts to inhibit cervical ripening and myometrial contractility throughout pregnancy and labour is heralded by prostaglandin stimulated withdrawal of progesterone. Human labour is associated with increased prostaglandin synthesis, via COX-2 but there is no clear systemic withdrawal of progesterone at the time of labour. There is upregulation of genes which are normally repressed by progesterone leading to the concept that human labour is associated ...

Dexamethasone reduces mortality in COVID patients who require oxygen therapy. Dexamethasone-related hyperglycaemia however is a known complication. Capillary blood glucose (CBGs) above 10.0 mmol/l have been linked to increased mortality in COVID patients. Approximately a third of COVID patients with dexamethasone-related hyperglycaemia may develop diabetes later. It is therefore important to manage acute episodes of hyperglycaemia effectively and identify these patients for fo...

We present a case of acquired hypogonadotrophic hypogonadism (HH) in a 54-year-old man that illustrates the need for wider endocrine screening in such patients. Having undergone complete pubertal development as a teenager and subsequently fathered two children, the patient presented with a nine-month history of reduced libido, erectile dysfunction, hot sweats and headaches. His GP had diagnosed HH on the basis of a low testosterone with inappropriately low gonadotrophins. Exam...

Case presentation: A 40 year old woman with a history of epilepsy was referred to the endocrine clinic with hypertension and significant weight gain (BMI 42.3 kg/m2). She had a sleeve gastrectomy performed in Turkey several years previously, resulting in an 18 kg weight loss. However, she regained this weight, most of which occurred in the six months prior to presentation. She had also noted the recent development of striae and was complaining of myopathy, so severe...

Case history: A previous healthy 69 year-old female was brought into the ED by her worried husband after he noticed worsening confusion. She developed seizures post arrival to the ED and was admitted under ITU for further care. Retrospective history from the husband indicated she had started feeling unwell around Christmas with a feeling of malaise. She self-medicated with amoxicillin which she had access to as a nurse practitioner. Over the next 2 days she developed headaches...

In respect to growth, the adrenal is a dynamic organ that requires constant stimulation from peptides derived from the ACTH precursor pro-opiomelanocortin (POMC) to maintain its tonic state. Previous studies have suggested that the adrenal mitogen resides in the N-terminus of pro-gamma-MSH, which upon cleavage results in the generation of shorter mitogenic peptides not containing the gamma-MSH sequence. This hypothesis has recently been substantiated by our characterisation of...

Background: Recent NICE guidelines1 suggest imaging the parathyroid with ultrasound as first line prior to parathyroidectomy, MIBI as an alternative and surgical exploration if discordant. Investigation should also include a renal ultrasound and DEXA. This audit compares a single surgeon practice in one hospital to the guidelines.Methods and Results: All patients with a parathyroidectomy performed by a single surgeon between July 2016 and July...

Adrenal gland anomalies are common incidental findings when imaging tests are performed for other reasons, but are usually unilateral. We present a case where bilaterally abnormal adrenal glands held the key to a rare diagnosis. A 79 year old female ex-smoker with a background of Type 2 Diabetes Mellitus and hypertension presented to our emergency department with a four month history of falls and progressive decline in mobility. Examination revealed evidence of weight loss, wi...