Endocrine Abstracts

Case history: We present the case of a 40-year-old man who was referred to a cardiologist with hypertension. He was initiated on bisoprolol and doxazosin. Investigations revealed elevated urinary metanephrines and catecholamines, with normetadrenaline 7.4 μmol/24 h (normal <2), noradrenaline 820 nmol/24 h (normal <500) but normal dopamine levels. He was referred to our clinic. Two further 24 h urine catecholamine assays were elevated. Dexamethasone suppression tes...

The use of herbal intervention in the treatment of tumors is widely spread in all regions of the developing world even though there are insufficient data on their possible molecular mechanism of action. Thirty percent of all cancers in women occur in the breast making it the most commonly diagnosed female cancer. The cytotoxic properties of the 80% aqueous-ethanol crude, n-hexane, chloroform, ethylacetate, detannified, and tannin fractions of Curculigo pilosa&#146...

PANCH tumour (pituitary adenoma with neuronal choristoma), is a very rare form of pituitary pathology composed of a mixed pituitary adenoma/gangliocytoma. We describe a patient with acromegaly who had evidence of GH synthesis in the neuronal component of a PANCH tumour. A 55-year-old woman was found to have facial features of acromegaly, confirmed biochemically: basal GH 13.56 ng/ml, GTT nadir 8.87 ng/ml, and IGF1 raised at 97.2 nmol/l (ref 9–40). Pituitary function was o...

A 27 year old lady presented in 2016 with a 3 month history of intermittent headache and visual disturbance, 3.5 months post-partum. She had a past medical history of cluster headache; treated with verapamil and short courses of oral steroids (she had no recent steroid courses prior to presentation). She was found to have a partial right sixth nerve palsy but normal visual fields on Goldmann’s testing. She had biochemical evidence of secondary adrenal insufficiency (sodi...

A 56 year old lady was investigated by her GP for arthralgia and found to be thyrotoxic (TSH < 0.01 mU/l, free T4 34.8 (10–20 pmol/l), TPO 50 (<35 IU/ml)). She gave a history of anterior uveitis some 20 years earlier. She was commenced on carbimazole and referred to the endocrinology clinic, where her thyroid function rapidly normalised and a biochemical diagnosis of subacute thyroiditis was made. Thyroid pertechnatate scan showed reduced uptake throughout the gl...

The ratio of the glucuronidated epitestosterone (E) and testosterone (T), used in doping tests, is currently under question. The key enzyme involved in E metabolism is UGT2B7 in contrast to T which is mainly metabolised by UGT2B17. Previous results demonstrated that at very high concentrations E acts as a competitive inhibitor to UGT2B17. Similarly, the literature reports competitive inhibition of UGTs by NSAIDS and phenolics that are not substrates of UGT2B17. The aim of this...

Parathyroid cysts are rare, usually asymptomatic and typically present as a neck lump. They are most commonly detected in middle-aged women and can occasionally present with compressive symptoms. True parathyroid cysts are non-functional and benign in nature, allowing a more conservative approach to their management in many patients. We present the case of an 82-year-old lady with a past medical history of a presumed parathyroid cyst which was drained by the ENT surgeons. Thre...

Introduction: Symptomatic hypogonadism affects 5–6% of men aged 30–79 years and is associated with increased morbidity and mortality. There are currently no trust guidelines for the diagnostic workup of these patients.Methods: Retrospective analysis was performed of diagnosis and assessment of adult men with low serum total testosterone (TT) and compared with clinical practice guidelines of The Endocrine Society. We identified all patients with...

Background: One in five women is obese at antenatal booking. Maternal obesity increases risk of offspring complications including higher birthweight. We hypothesised that this is mediated by altered action of maternal glucocorticoids, key regulators of fetal growth and development. We compared cortisol levels during pregnancy and placental glucocorticoid sensitivity in obese and lean women.Methods: With ethical approval serum cortisol levels were measure...

Background: Oral corticosteroids are a known risk factor for developing osteoporosis and subsequent fracture at higher bone mineral density than post menopausal osteoporosis. Bone loss is thought to be most pronounced in the first 12 weeks of steroid use, and existing guidelines recommend a fracture risk assessment and appropriate osteoporosis prophylaxis with calcium and vitamin D supplements and bisphosphonates. There is also a recognized role for FRAX scoring to help strati...