Endocrine Abstracts

Introduction: Assessment of diabetes with daily blood glucose fluctuations including peaks and nadirs forms the crux of the modern management. Use of glycemic variability (GV) as a parameter to assess these fluctuations is emerging. Diabetes mellitus patients follow different clinical trajectories which can be traced by the ambulatory glucose profile (AGP) obtained from flash glucose monitoring system (FGMS).Methodology: This comparative observational st...

Introduction: Musculoskeletal manifestation is one of the leading cause of morbidity and disability among type 2 diabetics. Also management of these conditions with steroids and non-steroidal anti-inflammatory drugs, adversely impact the glycaemic control of diabetics. Our study aims to look for prevalence of different musculoskeletal manifestation among type 2 diabetes.Methodology: Our study is a cross-sectional observational study and it is comprised o...

Patients with Cushing’s syndrome usually have characteristic phenotypical features but this is not always true in case of Ectopic ACTH secretion. This is mainly because this develops more acutely and underlying malignancy can cause significant weight loss. We report a 71 years old male with background of Prostatic malignancy who was found to have new profound hypokalaemia which was resistant to treatment. There were no signs of Cushing’s syndrome but index of suspici...

Parathyroid hormone is involved in calcium homeostasis through interactions with vitamin D. Because intact and truncated forms of PTH vary in their biological activity, assays that can accurately quantify the ratio of intact hormone to its fragments are of increasing significance in the diagnosis of endocrine, renal and bone diseases. Vitamin D and its metabolites circulate tightly bound to vitamin D-binding protein (DBP). Because DBP concentrations are altered in pregnancy, l...

Parathyroid hormone is involved in calcium homeostasis through interactions with vitamin D. Because intact and truncated forms of parathyroid hormone (PTH) vary in their biological activity, assays that can accurately quantify the ratio of intact hormone to its fragments are of increasing significance in the diagnosis of endocrine, renal and bone diseases. Vitamin D and its metabolites circulate tightly bound to vitamin D-binding protein (DBP). Because DBP concentrations are a...

TSH receptor antibody (TRAb) assays are highly sensitive and specific for the diagnosis of Graves’ disease. TRAb can minimise need for additional radiological modalities such as ultrasound and isotope scan in excluding other causes of hyperthyroidism. The relapse rates of hyperthyroidism following a course of anti- thyroid drugs (ATDs) remains disappointingly high at between 50-70%. TRAb levels at diagnosis and at the completion of a course of ATDs can be useful in predic...

A 20 year old male presented with short stature (height below 3rd centile for age since aged 13 years) and lack of secondary sexual characteristics. Past history included repaired Fallot’s Tetralogy, sensorineural deafness, repaired cleft lip and palate, learning difficulties, possible unilateral coloboma, and surgery for undescended testes. There was no significant family history. Clinical examination revealed a BMI of 22.7 (height 1.68 m, weight 64 kg). He had a narrow ...

Introduction: The psychiatric consequences of inoperable Cushing’s syndrome can be difficult to manage medically. Etomidate, an imidazole derived anaesthetic agent, inhibits cortisol synthesis and may be useful in this circumstance.The case: A 57-year-old woman presented with symptoms and signs of hypercortisolism. She gave a history of recent onset intermittent right sided stabbing chest pain and worsening breathlessness.Two ...

A 33-year-old male presented with headache and visual loss in May 2003. MRI pituitary showed a large tumor arising from pituitary fossa extending to suprasellar cistern compressing the optic chiasm with features recent infarction. He subsequently underwent urgent trans-sphenoidal decompression and a necrotic prolactinoma was excised with full recovery of his vision. His prolactin level remained elevated and so he was treated with cabergoline. Further questioning revealed that ...

This 46 year old lady with no significant past medical history was referred urgently to the Endocrine Investigation Unit with a 9 month history of increasing lethargy and gradual weight loss of around 5 kg. Two months prior, she had been diagnosed with subclinical hypothyroidism and after commencing Levothyroxine, quickly lost another 5 kg in weight over a period of 6 weeks and had postural dizziness with systolic BP readings between 80 and 90 mmHg. She was having a normal men...