Endocrine Abstracts

A 48-year-old male presented with headache, cough and recurrent nose bleeds. Clinical examination showed saddle shape nose deformity. His past medical history included primary hypothyroidism diagnosed at the age of 10 years, was taking levothyroxine. His brother had a Rathke’s cleft cyst, surgically removed. His blood test were as follows: Sodium 125mmol/l, TSH 0.10mU/l, free T4 10.2pmol/l, freeT3 2.6pmol/l, cortisol < 28nmol/l, prolactin 240mU/l, FSH 1.8U/l, LH 0.3U/...

Granulomatosis with Polyangitis (GPA) typically affects the lungs, kidneys and ENT system. Pituitary involvement is extremely rare, affecting less than 1% of all cases. The most common pituitary manifestations are secondary hypogonadism and Diabetes Insipidus (DI).Corticosteroids and immunosuppressive agents represent mainstay of medical management. Treatment needs to be initiated promptly and individualised according to clinical response.Case 1: A 54-ye...

Background: Many patients require IV insulin during their critical illness. Maintenance of insulin in St James’s Hospital ICU is governed by a local protocol. At the time of ICU discharge, IV insulin therapy is often stopped. Transitioning from IV to subcutaneous insulin is often done with endocrinology input. If this is unavailable inappropriate insulin dosing may increase the risk of hypo-/hyperglycaemia.Aims: To reduce the number of episodes of h...

James A Fagin, Memorial Sloan-Kettering Cancer Center, New York, USA. AbstractJames A. Fagin is Chief of the Endocrine Service and a Member of the Human Oncology and Pathogenesis Program at Memorial Sloan-Kettering Cancer Center in New York, and a Professor of Medicine at Weill Medical College of Cornell University. He was formerly the James Heady Professor of Medicine and Director of the Division of Endocrinology and...

Polycystic ovary syndrome (PCOS) is a clinical triad of anovulation, hyperandrogenism and insulin resistance. Patterns of fat distribution in PCOS may be associated with androgen activation, glucocorticoid metabolism and insulin resistance. Here we analysed the relationship between fat distribution, steroid metabolism and insulin resistance in women with PCOS.We compared results from 100 PCOS patients (Rotterdam criteria) with 80 sex- and BMI-matched con...

Idiopathic intracranial hypertension (IIH) is a condition of unknown aetiology characterised by raised intracranial pressure, chronic headaches and blindness. Akin to polycystic ovary syndrome (PCOS), IIH patients are almost exclusively obese females of reproductive age. A distinct androgen excess profile has been noted in PCOS. Here, we aimed to delineate androgen metabolism in IIH compared to PCOS and simple obesity.Women w...

Idiopathic intracranial hypertension (IIH) is a condition of unknown aetiology characterised by raised intracranial pressure, chronic headaches and blindness. Akin to polycystic ovary syndrome (PCOS), IIH patients are almost exclusively obese females of reproductive age. A distinct androgen excess profile has been noted in PCOS. Here, we aimed to delineate androgen metabolism in IIH compared to PCOS and simple obesity.Women w...

Non-alcoholic fatty liver disease is the hepatic manifestation of the global epidemic of metabolic disease. Steroid hormones, including glucocorticoids and sex steroids, regulate metabolic phenotype, and in addition, bile acids have recently been identified as potent metabolic regulators. 5β-reductase (AKR1D1) is predominantly expressed in the liver and is a crucial regulator of steroid hormone clearance as well as bile acid synthesis. Its role in pathogenesis of metaboli...

Non-alcoholic fatty liver disease is the hepatic manifestation of the global epidemic of metabolic disease. It is tightly associated with obesity and type 2 diabetes, yet the precise mechanisms that drive its aetiology are not fully defined. Steroid hormones, including glucocorticoids and sex steroids, regulate metabolic phenotype, and in addition, bile acids have recently been identified as potent metabolic regulators. AKR1D1 (5β-reductase), is predominantly expressed in...

Abstract: Idiopathic intracranial hypertension (IIH) is a devastating neurological condition, with elevated intracranial pressure of unknown aetiology. IIH is largely a disease of obese females of reproductive age. The clinical phenotype of IIH overlaps with polycystic ovary syndrome (PCOS), with prevalent obesity, hyperandrogenism and anovulation. In this study, we aimed to delineate the androgen excess phenotype of IIH women compared to those with PCOS and simple obesity. Wo...