Endocrine Abstracts

Background: Incorporating the ideas and views of children and young people (CYP) with endocrine conditions from early stages in the research life cycle will increase the benefit for patients and contribute to high impact research.Methods: We conducted two days of patient and public involvement (PPI) sessions with patients from a tertiary endocrine centre who are living with Congenital Adrenal Hypoplasia (CAH). We explore...

Hypertension and diabetes are prevalent conditions. Population studies suggest that blood pressure in excess of 140/90 mmHg is found in nearly 30% of adults while type 2 diabetes occurs in 3-4%. However, both conditions are strongly age-dependent, and exhibit large geographical variations. Non-european populations typically have much higher prevalence rates. Worldwide, there has been a dramatic increase in the occurrence of type 2 diabetes. It has long been known that these co...

We present a case of discordant pituitary biochemistry which resolved after discontinuing a commercially available combination vitamin supplement. A 35 year-old man presented following an episode of headache and dizziness, preceding collapse and possible seizure activity. Investigations revealed deranged pituitary function: TSH 0.02 mU/l (0.35-5.50), fT4 3.6 pmol/l (10.0-20.0), 9 am cortisol 18 nmol/l (200-500), testosterone >52 nmol/l (8.4-28.7), FSH <0.3 U/l (1.0-18....

Introduction: Foot disease in diabetes is associated with significant morbidity and mortality. Diabetic foot disease requires complex care with input from a range of healthcare professionals. Scottish Intercollegiate Guidelines Network guideline 116 recommends that all patients with diabetes and foot ulceration are seen at a multidisciplinary foot clinic. Our aim was to assess the impact on patient outcomes of introducing a multidisciplinary foot clinic within NHS Fife.<p ...

Rationale: Although many adolescents meet the NICE criteria for bariatric surgery there is a reluctance to undertake or commission such irreversible procedures in young people. Balloons are temporary, reversible, safer and more acceptable and in adults have been shown to promote a clinically significant change in BMI of 4.0–9.0 kg/m2 But due to subsequent weight regain, bypass surgery is preferred.This is a feasibility study of endocsopic...

There have been several case reports over the years of hypopituitarism occurring after cerebral oedema caused by diabetic ketoacidosis (DKA). The case reports have ranged from a single hormone defect to a more extensive loss of hormone production. What is not reported in the literature so far is what happens to these patients and their hormone deficiencies in the longer term.This is a case report of a young man who presented with DKA aged twelve who rapi...

Background: Transsphenoidal tumour resection (TSS) is the first-line treatment for Cushing’s disease (CD). With an experienced neurosurgeon, immediate remission rates >80% are expected for patients with microadenomas (<10 mm).Aim: To report initial and long-term remission rates in a specialist centre, and to ascertain factors associated with disease recurrence after TSS.Methods: Patients with CD (n=101, 28M, 7...

Background: Effective acclimatization to high altitude involves a natriuresis and diuresis facilitated by a suppressed aldosterone. Acute mountain sickness (AMS) is common but poorly understood. A cardiac hormone, brain natriuretic peptide (BNP), is released primarily in response to cardiomyocyte stretch but animal models suggest BNP secretion is also stimulated by acute hypoxia. An increase in BNP causes a diuresis, natriuresis and a reduction in aldosterone. We hypothesized ...

Introduction: ‘Primary Aldosteronism Detection, Diagnosis and Treatment Guidelines’ from the Endocrine Society (2008) recommend the use of the aldosterone- renin ratio (ARR) to detect primary aldosteronism (PA) in patient groups with high prevalence of PA. The guidelines suggest cut-offs specific to assay type and measurement units. The department of Clinical Chemistry and Metabolic Medicine at RLBUHT recently moved to a direct renin method (iSYS, Immunodiagnostics) ...

Normal ageing is accompanied by increased organismal frailty, reflecting organ specific functional decline, with an associated increase in the likelihood of disease. The immune system undergoes significant decline with age, termed immunesenescence, which results in increased susceptibility to infection and reduced vaccination responses. Significant changes in the hormonal milieu also occur with age and it is clear that age-related changes in adrenal hormone secretion can impos...