Endocrine Abstracts

Successful management of diabetes requires an empowered patient/family that is well-educated about their condition and feels confident to self-manage with the support of their medical team. The linchpin to assessment and effective change is the quality of available information. Most patients/families have no way of pulling all their diabetes information together efficiently, and consequently often feel helpless and do not take charge of making their therapy adjustments. Diasen...

Objective: Impaired linear growth is a common complication of end stage renal failure (ESRF), with recombinant human growth hormone (rhGH) being the suggested treatment until renal transplantation (RTx). Growth improvement post RTx has been reported, however data on the degree of catch up growth post RTx and final height (FH) is limited. We aimed to evaluate the effect of RTx on FH standard deviation score (SDS) and the possible contributing factors.Meth...

Background: Growth hormone (GH) stimulation testing is necessary for the diagnosis of growth hormone deficiency (GHD). Insulin tolerance test (ITT) has been considered the gold standard for evaluating GHD in adults. However, it carries a risk of rare but severe adverse effects secondary to hypoglycaemia and is therefore avoided in many centres. There is no consensus for the first test in children.Aim: Audit to compare ITT to Arginine test as a first line...

Background: Wolfram Syndrome (WS) is a rare autosomal recessive disorder characterised by early-onset diabetes and optic atrophy as well as a variable spectrum of other endocrine and neurological conditions. It is caused by mutations in the WFS1 gene. Previous reports have documented a variable prevalence of hypogonadism (6.3% of the international EURO-WABB registry, 34% of a German cohort); however the only UK cohort reported was of 10 males, 7 of whom had primary gonadal atr...

Background: The investigation of short stature includes evaluation of a number of clinical, radiological, and biochemical factors. This often includes dynamic function testing to rule out abnormalities of the hypothalamic–pituitary axis to rule out GH deficiency (GHD). NICE guidance advises that two GH stimulation tests demonstrating subnormal GH peak <6.7 μg/ml (20 mU/l) is required to confirm the diagnosis of GHD.Objectives: To interrogat...

Background: Hypothalamic hamartomas (HH) are congenital, benign tumours consisting of disorganised neuronal cells within the hypothalamus. They usually present with precocious puberty, seizures, behavioural abnormalities, either in isolation or combined.Aims: To look at the endocrine outcomes of patients with HH.Methods: A retrospective casenote review of all patients diagnosed with HH over a 20-year period within a single endocrin...

Background: The diagnosis of isolated GH deficiency (IGHD) is based on multiple factors: clinical, radiological and biochemical along with suboptimal peak GH levels demonstrated on dynamic testing. Recent guidance from the National Institute of Clinical Excellence (NICE; UK; 2010) advises that two GH stimulation tests must demonstrate a subnormal GH peak <6.7 μg/l (20 mU/l) to confirm the diagnosis of IGHD. In our centre, three different GH provocation tests are used:...

Objectives: Many successful European centres provide intensive education as 2 week inpatient admissions for newly diagnosed type 1 diabetes. Prolonged inpatient stay is resource intensive and disrupts the family unit. Our centre aimed to determine the feasibility of delivering an intensive education programme in an ambulatory care setting.Methods: The curriculum, introduced in October 2013, comprised 20 hours face to face education by paediatric diabetes...

Introduction: Wolfram Syndrome (DIDMOAD) is an autosomal recessive disease caused by mutations in WFS1 gene, resulting in childhood onset diabetes mellitus and optic atrophy. There have been limited functional assays for WFS1 genetic variants. We aimed to investigate WFS1 protein expression in patients and relate this to their genotype and phenotype.Methods: Nine patients from a regional paediatric centre consented to skin biopsies. Six patients had comp...

Introduction: In children, tumours occupying the pituitary fossa are mainly craniopharyngioma (80–90%) and pituitary adenomas (2–3%). We present two cases of pituitary adenoma and the challenging management when complete surgical resection is not possible. Case 1: A 13.5 year old girl presented with tall stature. Pituitary hormone profile revealed high IGF1 123 nmol/l (24.5–66) and prolactin 722 mU/l (102–496). Growth hormone (GH) was not completely suppres...