Endocrine Abstracts

Introduction: Diabetes teams need to keep electronic data records for supporting participation in the National Paediatric Diabetes Audit (NPDA), and other governance activities. NPDA benchmarks diabetes services against each other, and services are keen to make sure their data is accurate so that it gives a good reflection of their service. Twinkle is a specialised database that is widely used for this purpose.Twinkle allows units to produce specific rep...

Background: During childhood, growth hormone (GH) doses are usually calculated using total body weight (TBW). This may result in inappropriately high doses in obese children where the intravascular compartment does not increase in proportion with the increase in weight, as the volume of distribution of GH is consistent with the majority of the drug being distributed in the total body water compartment.Methods: Single centre, retrospective cohort study of...

Background: The 250microgram synacthen test may give false negative responses, and will not allow easy discrimination between primary and secondary dysfunction. Furthermore, the use of synacthen is contra-indicated on the data sheet in certain common conditions such as asthma, and may not easily be interpreted in women taking oral oestrogen. Some patients with incipient adrenal failure may have elevated plasma ACTH, whilst passing the synacthen test. We have routinely measured...

Background: Recent NICE guidance recommends radioactive iodine as the first line treatment for relapsed thyrotoxicosis as it reportedly produces better control than long-term anti-thyroid drugs (ATDs).However, almost all studies of long-term ATDs relapse occurs after discontinuation of a medication. We present a retrospective analysis of efficacy of ATDs. Methods: Data of all patients with hyperthyroidism, attending Endocrinology clinic at Morriston Hosp...

Case history: A 43-year-old man was admitted to Intensive care with life-threatening pneumonia, along with acute hypertension and hypokalaemia. There were several Cushingoid clinical features, therefore ectopic ACTH syndrome was suspected.Investigations: The diagnosis of severe ACTH-dependent Cushing’s syndrome was confirmed with unsuppressed cortisol after low dose dexamethasone (763 nmol/l with ACTH 131 ng/l, 24-h urinary cortisol levels (x2) of >...

Section 1: Case history: A 52 years old gentleman initially presented with visual field defect and headache due to a large multi-lobulated pituitary adenoma and underwent an endoscopic transsphenoidal sub-total resection in March 2018. Histology revealed a non-functioning adenoma with mitotic index Ki-67 of 3%–5%. His visual field defects resolved post-operatively and he was monitored with serial imaging. A year later he suffered a collapse at his GP surgery and was found...

A new radiopharmaceutical using the somatostatin analogue octreotide has been developed for use in humans. SARTATE consists of the novel bifunctional chelator, MeCOSar, conjugated to (Tyr3)-octreotate. MeCOSar is a superior chelator for copper over a wide pH range and at room temperature, which allows for SARTATE to be used as an imaging/therapy pair when radiolabelled with copper-64 and copper-67.4Cu-SARTATE was produced by radiola...

Background: Altered connexin expression and/or function is linked to the development and progression of secondary microvascular complications associated with diabetes. Despite this, we know little for the role of these small membrane proteins in the diabetic kidney. This study examines if glucose-evoked changes in TGF-β1 modulate connexin expression and gap junction-mediated intercellular communication in diabetic nephropathy.Methods: Biopsy materia...

Background: Changes in the expression of connexins have been linked to renal damage in diabetes and both hemi-channels and gap junctions represent potential therapeutic targets for the treatment of diabetic nephropathy. In the current study, we utilize model epithelial cells from human renal proximal tubules (HK2), to demonstrate a role for glucose and its downstream beta1 isoform of the pro-fibrotic cytokine transforming growth factor (TGFβ1) on connexin expression and h...

Thyrotoxic period paralysis is a rare endocrine emergency associated with hyperthyroidism that needs urgent treatment. We present a case of a 19-year-old Chinese student who was admitted with progressive weakness in his lower limbs developing overnight. He was resident at the students’ hostel and went to sleep after ignoring mild leg weakness overnight but could not even get up from his bed in the morning. Luckily his friend called the ambulance and brought him in hospita...