Endocrine Abstracts

Introduction: Type 1 Diabetes Mellitus (T1DM) causes autoimmune destruction of insulin producing b-cells, affecting approximately 8.4 million individuals worldwide. Autologous stem cell derived b cell (sc-b cell) transplantation is a promising treatment, however receipient immunological responses remain a challenge. This pilot study utilised mass cytometry (CyTOF) to assess immune responses in co-cultures of peripheral blood mononuclear cells (PBMC) with autol...

Introduction: Improved survival following treatment for paediatric medulloblastomas has resulted in increased incidence of late effects, particularly endocrine sequelae. The complete picture of late effects, however, has been limited by short duration of follow up.Aims 1: To establish the evolution of endocrine sequelae in patients treated for medulloblastomaAim 2: To compare the prevalence of endocrine dysfunction among three majo...

The epidemic of obesity, insulin resistance and type 2 diabetes has heightened the need to understand the mechanisms that contribute to their pathogenesis. Endogenous glucocorticoid (GC) production and metabolism have been implicated based upon parallels with Cushing’s syndrome. The interaction between GC metabolism and insulin sensitivity in the context of significant weight loss has not been explored. 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that gen...

Glucocorticoid (GC) production rates are elevated in obese, insulin resistant individuals. We and others have demonstrated decreased hepatic cortisol regeneration through reduced 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity that converts inactive cortisone to cortisol. In addition, there is enhanced cortisol clearance by A-ring reductases, (notably 5α-reductase). We have argued that these changes drive the hypothalamo-pituitary–adrenal axis a...

The role of endogenous glucocorticoid (GC) production and metabolism in the pathogenesis of obesity, insulin resistance and type 2 diabetes remains unclear. Patients with Cushing’s syndrome develop central obesity, insulin resistance and in some cases type 2 diabetes (T2DM), yet circulating cortisol levels are not elevated in simple obesity. Alterations in GC metabolism, including 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that generates active cortisol ...

Introduction: Sarcoidosis is a multisystem noncaseating granulomatous disease with prevalence of 40/100 000. One percent of patients with sarcoidosis have isolated neurosarcoidosis, few cases involve the hypothalamus/pituitary (65 reported cases from 2002 to 2014). We present a case of hypothalamic-pituitary sarcoidosis with hypothermia (one case reported between 2002 and 2014), leptomeningitis, diabetes insipidus and pan-hypopituitarism.Case report: Fam...

Introduction: Calcium metabolism during pregnancy changes significantly but ionized calcium level remains normal. During pregnancy, there is two-fold increase in intestinal calcium absorption mediated by increase in 1,25-dihydroxyvitamin D. Hypercalcemia in pregnancy is uncommon and most reported cases are primary hyperparathyroidism.Case report: A 18-year-old 10 weeks’ pregnant African American female presented to hospital with epigastric pain, nau...

Introduction: Radiation-induced hypopituitarism has been well-described in childhood-onset brain tumour survivors, however in adults has received less attention. The aim of this study was to assess the pituitary-related outcomes following cXRT in adults with extra-sellar gliomas.Methods: We retrospectively collected longitudinal data regarding pituitary-related outcomes from medical records of 59 patients, diagnosed with extra-sellar gliomas in adulthood...

Introduction: Radiation-induced hypopituitarism is a well-recognized complication of cranial radiotherapy (cXRT) for childhood brain tumours when the hypothalamo–pituitary axis is within the irradiation field. Few data are available for survivors of adult brain tumours who have received cranial irradiation.Methods: We retrospectively reviewed medical records of patients referred to Endocrinology following cXRT for primary non-pituitary brain tumours...

Dysregulation of the enzymes that control local tissue steroid metabolism has been implicated in the pathogenesis of obesity and insulin resistant states, however longitudinal changes in glucocorticoid metabolism over time have not been investigated. This study was designed to evaluate the role of pre-receptor glucocorticoid metabolism in the development of insulin resistance and obesity. 24 h urinary glucocorticoid and mineralocorticoid metabolites were measured by gas chroma...