Endocrine Abstracts

Case History: A 47 year-old female was referred to the Endocrine Bone Unit with worsening back, rib and leg pain associated with significantly reduced mobility. In the preceding year, she had repeatedly presented to healthcare providers with no clear neurological deficit, no fractures identified on X-Ray and normal MRI appearances of the whole spine. Aside from well-controlled asthma and gestational diabetes, she had no significant past medical, medication, social or family hi...

Section 1: Case history: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. He had an unremarkable past medical history, did not take any regular medications and denied the use of any illicit drugs. There was a family history of consanguinity, with his parents being first cousins. On examination, his BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual c...

Background: Successful reproduction relies on integration of sensory cues of attraction with corresponding emotions and behaviours. However, the intrinsic factors integrating these fundamental aspects of human attraction with limbic and reproductive pathways have not been fully identified. Kisspeptin is a crucial activator of the reproductive axis and together with its receptor is widely expressed throughout the limbic and olfactory systems in humans suggesting a potential rol...

A 33-year-old lady was referred to the endocrinology clinic with mild hyperprolactinaemia on the background of having missed a single period, with a raised testosterone of 4.1 nmol/l (0–2). She had no other medical problems. Her menstrual cycles normalised by the time she attended clinic. She had no galactorrhoea, visual disturbance or features of hyperandrogenism. Her BMI was normal and she was normotensive. Blood tests revealed mild hyperprolactinaemia of 709 nU/l (100&...

A 33 year old primip presented to the local ophthalmic hospital at 34+4 weeks’ gestation with two weeks of blurred vision. Examination revealed a bitemporal hemianopia and reduced visual acuity. She was previously fit and well, and a pre-eclampsia screen was negative. An MRI scan demonstrated a haemorrhagic pituitary lesion extending into the suprasellar cistern with mild compression of the optic chiasm. Pituitary function tests showed a raised prolactin 3844 mU/l, isolat...

Case: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. On examination, BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual characteristics. Hypogonadism was confirmed by two morning fasting total testosterone levels of 4.7 and 5.2 (RR 9.2–31.6 nmol/l). Haemoglobin was normal (152 g/l) and serum oestradiol was <100 pmol/l. He had inappropriate...

Background: During IVF treatment, a pharmacological dose of recombinant FSH (rFSH) is used to induce multi-follicular growth (controlled ovarian stimulation; COS). An insufficient dose of rFSH negatively impacts the number of oocytes retrieved, whereas an excessive dose risks the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’. Hence, appropriate rFSH dosing is regarded as a key treatment decision affecting both the success and safety of...

Background: Obesity is a major medical health problem. Human brown adipose tissue (BAT) is potently activated by cold exposure and is a potential novel anti-obesity target. The current gold standard for measuring BAT activity in humans is 18F-FDG PET/CT. However it has two major limitations – exposure to ionizing radiation and high cost. Since BAT is a thermogenic organ located in the supraclavicular and neck regions, we hypothesised that an increase in tempera...

Background: Obesity is a global health concern. Elevating energy expenditure (EE) would be a highly effective treatment approach to treat obesity but no current drugs can safely achieve this. Cold exposure potently increases EE through brown adipose tissue (BAT) thermogenesis in humans. Glucagon elevates EE via BAT in rodents but the mechanism in humans is unknown. We investigated for the first time the mechanism by which glucagon increases EE in humans....

Background: Women with hypothalamic amenorrhoea (HA) have reduced LH pulsatility causing amenorrhea and infertility. Estrogen supplementation provides symptomatic relief for women with HA, but does not restore the pulsatile pattern of LH secretion which necessary for fertility. Kisspeptin-54 is a recently identified hormone, which potently stimulates GNRH secretion within the hypothalamus. The effect of exogenous kisspeptin-54 administration on LH pulsatility in women with HA ...