Endocrine Abstracts

A 58 year-old man presented with backache and was found to have T10-T12 vertebral fractures on spinal-MRI. He was diagnosed with osteoporosis on a DEXA-scan (lumbar-spine T-score-2.6) and was treated with Alendronate and Cholecalciferol at a neighboring hospital. He was referred to the endocrine bone-clinic for a second opinion regarding his osteoporosis. He had a history of multiple small bone fractures and Brucellosis that required a 2-month bed-rest. His family history incl...

A 35 year old lady presented with a one week history of back pain, myalgia, fatigue, epigastric pain, and persistent vomiting. She reported a four week history of reduced appetite and 4 kg weight loss. She had recently recovered from an uncomplicated COVID-19 infection. Past medical history included a previous eating disorder (anorexia and bulimia), and subsequent chronic gastritis. Drug history included Omeprazole 20 mg daily, Laxido 2 sachets daily and antacids (Rennies 4-8 ...

Introduction: Kallmann syndrome (KS) is a rare genetic disorder typically due to defective migration of olfactory-axons and GnRH-neurons. KS results in congenital hypogonadotrophic hypogonadism (CHH) typically associated with absent (anosmia) or reduced (microsmia) sense of smell. Unilateral hypoplastic/absent olfactory bulbs on MRI are reported, although disturbance in smell is usually bilateral. Here, we present an unusual case of KS with unilateral anosmia....

Introduction: Kallmann syndrome (KS) is a rare condition characterised by congenital hypogonadotropic hypogonadism (CHH), usually due to defective migration of olfactory axons and GnRH-neurons. KS is typically associated with absent (anosmia) or reduced (microsmia) sense of smell. Unilaterally hypoplastic or absent olfactory bulbs on MRI are reported, although disturbance in smell is usually bilateral. Kisspeptin is a potent stimulator of hypothalamic GnRH-neurons, and endocri...

Background: Distressing low sexual desire, termed Hypoactive Sexual Desire Disorder (HSDD), affects 10% of women and 8% of men. The established ‘top-down’ neurofunctional model of HSDD in women suggests that in response to erotic cues, excessive activation of higher-level cognitive brain regions (involved in introspection/self-monitoring) suppresses lower-level sexual brain centres, thereby impeding normal sexual function. By contrast, the neurodysfunction in men wit...

Background: Polycystic Ovary Syndrome (PCOS) and Functional Hypothalamic Amenorrhoea (FHA) are the two commonest causes of menstrual disturbance in pre-menopausal women. In practice, differentiating these two common reproductive disorders can be challenging. A fundamental abnormality that underpins both conditions is altered gonadotrophin releasing hormone (GnRH) pulsatility, being increased in PCOS but reduced in FHA. Likewise, congenital (e.g. congenital hypogonadotropic hyp...

Background: The neuropeptide kisspeptin is a key endogenous activator of the reproductive system. Due to its crucial role in modulating reproductive and behavioural processes, there has been accelerating interest in targeting kisspeptin-pathways to treat reproductive and psychosexual disorders. However, contradictory pre-clinical data from animal models suggests that kisspeptin can have an anxiolytic, anxiogenic or have no effects on anxiety. Given the rapid development of kis...