Endocrine Abstracts

The process of sexual differentiation has been defined by examining animal models and human conditions where errors of sexual development result in ambiguous genitalia. The study of transsexualism where the cognitive sexual phenotype is not concordant with the individual's physical and genetic phenotype has also been important.The sex determining region of the Y chromosome controls male gonadal development by inducing SOX 9 which causes testicular differ...

A 55 year old woman presented in May 2002 with symptoms of chronic fatigue, depression, intermittent and headaches. She had a history multinodular goitre and was found to have a fT4 of 15 pmol/L (N: 11–23) and TSH of 0.32 mU/L (N: 0.5–4). Medication was citalopram and thyroxine 50 ug once daily commenced by her GP. On examination her BMI was 24 kg/m2. She had scant body hair, was normotensive, and had normal visual fields on confrontation. Baseline investi...

We report the case of a seventy year-old type 2 diabetic man presenting with a fifteen year history of erectile dysfunction. He had micro- and macrovascular complications of diabetes and liver cirrhosis secondary to Hepatitis C infection. Investigations showed a high total testosterone of 32.3 nmol/l, raised SHBG at 127 nmol/l with elevated LH 20.4 IU/l and FSH 14.9 IU/l. Initial calculated free testosterone was 281 pmol/l with a bioavailable testosterone of 1.67 nmol/l, both ...

Subclinical Cushing’s syndrome (CS) has not been adequately characterised and the natural history is unknown. We report two cases of subclinical CS that presented as perforated duodenal ulcers (DU) and in both cases the disease rapidly progressed to overt CS.Case 1A 60-year-old women presented with perforated DU requiring laparotomy and repair. Abdominal CT scanning demonstrated a right adrenal mass 4.2 cm. There were no clini...

A 76 year-old man presented with back pain anorexia and cachexia. CT scan confirmed a pancreatic mass with liver metastasis. Liver biopsy confirmed a neuroendocrine tumour. Because of left ventricular failure he was unsuitable for tumour reduction therapy. He was hypercalcaemic (2.54–3.1 mmol/l), PTH and PTHrP were elevated [2.5 pmol/l (1.9–6.9), 7.1 pmol/l (<1) respectively]. A diagnosis of PTHrP secreting neuroendocrine tumour with coexisting primary hyperparat...

Background: The most significant hypotheses regarding biological causes of transsexualism are based on the role of environmental hormonal exposure on neural development.Aim: This study was to analyse the baseline hormonal results in a population of transsexuals attending a single clinic to identify any abnormalities in hormone levels in these individuals.Method: A retrospective cohort study was carried out using data collected from...

Background: Transsexuals in Britain are prescribed hormones as part of Gender Reassignment Treatment. Oestrogen therapy is associated with the development of deep vein thrombosis (DVT) with a 25 fold increased risk, and breast cancer; particularly in the older age group and smokers.Aims: To investigate the risk of developing deep vein thromboses in male to female transsexual patients who are, or have been, on oestrogen therapy, and seeing if this differs...