Endocrine Abstracts

Isolated change in serum TSH concentration occurs in 15% of hospitalised patients in response to non-thyroidal illness or various drugs, which interfere with thyroidal synthesis and secretion, thyroid hormone metabolism and absorption. Significant change in concentration of either suppressed (<0.1 mU/l) or elevated (>10 mU/l) TSH level is seen in 1–2% of them but only less than half have underlying thyroid disorder.UK Guideline for use of TF...

Adipocytes have a key role in obesity and precursor cells can differentiate into white or brown adipocytes, with different metabolic functions. However the process by which stem cells commit to these lineages, and the factors that distinguish white adipogenesis from brown, are poorly understood.Fetal mesenchymal stem cells (fMSCs) can differentiate into adipocytes, but neither the regulation of this process, nor the phenotype differentiated cells has bee...

A 60 year old female from Zimbabwe with an eight year history of HIV infection presented with malaise and facial swelling. She had been established on antiretroviral treatment (Kivexa (lamivudine / abacavir) and Kaletra (lopinivir / ritonavir)) since shortly after her initial diagnosis. One month earlier she had received an injection of intramuscular triamcinolone acetate to treat an inflammatory polyarthropathy. She was also prescribed inhaled salmeterol xinafoate 50 mcg/flut...

Introduction: 3-Iodothyronamine (T1AM) is a novel thyroid hormone derivative, which has been detected in rat blood and tissues. In vivo, T1AM has been reported to produce several functional effects, including the switch of fuel utilization from carbohydrates to lipids. In the present work we used rat white adipocytes to investigate T1AM uptake, metabolism, and metabolic effects.Methods: Rat white adipocytes were incubated with exogenous T1AM. The ...

Good clinical practice encourages patients to minimise long-term glucocorticoid overexposure to preserve bone density and prevent the development of glucose intolerance or hyperlipidaemia. However, the absence of a protective “cushion” of excess cortisol implies an increased risk of adrenal crisis. (White & Arlt 2010) This assumption has been challenged by a leading adrenal specialist, who suggested instead that chronic over-replacement may increase the susceptib...

Background: Excess adipose tissue accumulation and obesity are characterised by a chronic, low-grade, systemic inflammation that contributes to obesity-related cardio-metabolic disease. Nestfatin-1 is a neuropeptide derived from the precursor protein nucleobindin-2 (NUCB2), which was initially reported to exert anorexigenic effects. We have previously shown that NUCB2/Nesfatin-1 is highly expressed in human and mouse subcutaneous white adipose tissue (Sc-WAT) and that circulat...

A 57-year-old gentleman presented with a very sudden change in hair colour to bright white and eyebrow loss. On further questioning, he had been shaving much less and had not been getting any erections. On examination he had gynaecomastia. Initial blood tests showed hypogonadotrophic hypogonadism (LH 0.6 IU/l, FSH 0.1 IU/l, testosterone 1.6 nmol/l) with an otherwise normal anterior pituitary hormonal profile. Oestradiol was found to be significantly elevated at 582 pmol/l. He ...

Introduction: Carcinoid crisis, as an entity is poorly defined, but can be seen in patients with small bowel NET tumours after open bowel surgery or tumour unrelated procedures as cardiovascular instability (CI). Recent evidence suggests that cardiovascular instability (CI) during NET surgery is more common than previously considered.Aims and methods: We audited the incidence of CI during procedures and determined the relationship to perioperative octreo...

Introduction: There remains controversy about which patients benefit from removal of their primary small bowel tumour and whether this should be performed in a specialist tertiary referral hospital as an elective procedure. Part of the decision making and consenting process in patients with metastases will be a shared decision about surgery with the patient in light of symptoms, morbidity from surgery and survival. The aim of this study was to elucidate important institution s...

Background: In acromegaly, few in vivo data exist on changes of the brain parenchyma as a pathology caused by systemically elevated levels of GH and IGF-1. This is in contrast to neuropsychiatric symptoms such as depression, cognitive impairment, personality changes and pain syndromes that accompany the condition. We aimed at measuring brain tissue volumes and white matter pathology in acromegaly.Methods: Forty-three patients (age 54±14 years...