Endocrine Abstracts

Over 700 patients with known adrenal insufficiency are treated across the trust. Whilst unwell or fasting for a procedure, these patients potentially risk suffering an adrenal crisis. A flagging system has already been implemented on the electronic patient records (EPR) which identifies patients who are ‘on replacement Hydrocortisone’. Following an inpatient adrenal crisis which could have been more optimally managed, we sought to highlight care of this vulnerable co...

Background: The standard synacthen test (SST) is commonly utilised to interrogate the hypothalamo-pituitary-adrenal (HPA) axis in children. It comprises baseline and 30-minute serum cortisol concentrations (SCC), after injecting synthetic adrenocorticotropic hormone (ACTH)[1–24]. There is debate regarding the utility of a 60-minute SCC in the SST protocol with most studies to date conducted in adults.Aim: To assess the utility of a 60-minute SCC in ...

Mutations in the HSD11B2 gene explain the syndrome of apparent mineralocorticoid excess (AME), which is characterised by severe hypokalaemic hypertension. Cortisol acts as a mineralocorticoid through failure of its inactivation to cortisone by 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2). Patients are diagnosed by a raised THF+allo-THF/THE ratio. To date, approximately 30 mutations have been described in HSD11B2. Recently, three apparently unrelated kindreds with A...