Endocrine Abstracts

Patients with primary hyperparathyroidism (PHP) should have assessment of urinary calcium excretion as part of routine work up. This helps in the differential diagnosis of PHP in that urine calcium is low in familial benign hypocalciuric hypercalcaemia. Possible measures of calcium excretion include 24 h urine collection, spot sample for urine for urine calcium concentration and calcium/creatinine ratio (UCa/creat), and fractional excretion of calcium (FrExCa=urine calcium&#21...

This group has previously audited the effect of a protocol for investigation of primary hyperparathyroidism (PHP); the protocol stating that only patients meeting criteria for parathyroidectomy should have parathyroid imaging carried out. This showed a reduction in the number of radiological investigations (USS, CT, MRI and sestamibi scans) done in patients with primary hyperparathyroidism following introduction of this protocol.The aim of this audit was...

A 38-year-old lady presented in 2003 with a 2 years history of recurrent pneumonia, with CXR having demonstrated intermittent right lower zone consolidation. CT of chest revealed dense right lower lobe consolidation and a 2.5 cm tumour occluding the right lower lobe orifice was found on bronchoscopy. Strongly positive immunohistochemical staining for chromogranin, NCAM, PGP 9.5 and synaptophysin suggested carcinoid so right lower and middle lobectomy was performed. Histology c...

Introduction: Noonan syndrome (NS) (OMIM 163950) is an autosomal dominant clinically heterogeneous disorder characterised by multisystem involvement. Mutations in genes in the RAS/MAP signaling pathways are known to be responsible for ~70% of cases of NS. We report an infant with NS with early onset fragility fractures.Case report: A 15-month-old male infant with a history of atopic eczema, sparse hair on the scalp, slow motor development, feeding diffic...

Physiology shows vitamin D has a role in the immune system and glucose metabolism. Experimental and epidemiological studies demonstrate associations between type 1 diabetes mellitus (T1DM) and vitamin D levels. Vitamin D deficiency appears undesirable in T1DM, although its significance in aetiology and progression is controversial.We reviewed the outcome of implementing vitamin D screening at T1DM diagnosis. Methods were review of diabetes register, hosp...

Obesity and its major consequence, type II diabetes mellitus (T2DM), is epidemic throughout Western society. T2DM accounts for 95% of the diabetes worldwide. One limitation to the development of new diabetes treatments has been a lack of effective animal models to use in research. There are no rodent models that recapitulate the pancreatic β-cell lesions of humans with T2DM. Moreover, animal models of obesity either require overfeeding which is expensive and takes weeks t...

Objective: To investigate whether genetic variants in the glucocorticoid receptor (GR) and corticotropin releasing hormone receptor 1 (CRHR1) genes are associated with increased susceptibility for postnatal depression (PND).Methods: A prospective longitudinal cohort study at University Hospital, Coventry, England. Two hundred pregnant women were recruited and assessed for PND using the Edinburgh postnatal depression score (EPDS) upon recruitment and agai...

Subarachnoid haemorrhage (SAH) is a well reported cause of hypopituitarism but the precise incidence is controversial. We aimed to prospectively determine the incidence of acute and long term hypopituitarism in SAH.We prospectively recruited 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium, urea, osmolality, glucose, and 0900 h cortisol (PC) measured on days 1, 2, 3, 4, 6, 8, 10...

Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH). Retrospective data suggests that the Syndrome of Inappropriate Antidiuresis (SIAD) is the most common cause, although glucocorticoid deficiency and rarely cerebral salt wasting may also cause hyponatraemia.We prospectively studied 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (p...

The pathophysiological effects of glucocorticoid (GC) excess (Cushing’s syndrome) are similar to the aging phenotype. As such, we hypothesise that age-related changed in body composition (central obesity, reduced bone density, reduced muscle mass and skin thinning), and resultant chronic disease (type 2 diabetes, osteoporosis, sarcopenia and heart disease) may be caused by increased GC exposure with age. However, circulating GC’s show little change with advancing age...