Endocrine Abstracts

A 30-year-old Caucasian lady was diagnosed with type 2 diabetes in July 2005 on an oral glucose tolerance test and was treated with metformin. Sixteen months later she presented with urinary symptoms and was noted to have 2+ ketonuria. Her blood glucose was 13.4 mmol/l. Her BMI was 26 kg/m2 and she was noted to have Cushingoid habitus and acanthosis nigricans. Her blood pressure was normal. Her serum sodium was 130 mmol/l, potassium 3.7 mmol/l and bicarbonate 8 mmol...

Background: Hyponatraemia is the commonest electrolyte abnormality in clinical practice, and may be a biochemical manifestation of different diseases including malignancy. Uterine neuroendocrine tumours causing hyponatraemia are rare and can cause a diagnostic challenge.We present a case of 68 years widow who presented with 3 weeks history of nausea, occasional vomiting, confusion, increased urinary frequency, urinary incontinence, chronic constipation, ...

Introduction: Studies have reported a rising incidence of congenital hypothyroidism (CHT) although the pathophysiology of most cases is unknown. A rising incidence is not simply a reflection of changing assay methodology and environmental factors may have an aetiological role. If so, then cases may exhibit space-time clustering, where cases occur at similar times and close proximities to other cases.Methods: We investigated whether there is evidence of s...

Introduction: Adverse drug reactions (ADRs) are a significant cause of morbidity in childhood. We undertook a prospective study to investigate ADRs causing admission to a UK paediatric hospital: this report focuses on corticosteroids (CS).Methods: Three investigators assessed all acute admissions over a 1 year period and identified ADRs by cross-referencing clinical presentations to known ADR profiles using a standardised causality tool.<p class="abs...

Introduction: Lithium-induced nephrogenic diabetes insipidus (NDI) occurs in approximately 20% of patients on chronic lithium therapy, and additionally 30% of patients have impaired concentrating ability of urine. Perioperative precipitation of NDI is an uncommon phenomenon complicating fluid management in a surgical patient and masking signs of renal hypoperfusion.Case: A 70-year-old man on chronic lithium therapy for bipolar disorder presented with 24 ...

Familial Juvenile Hyperuricaemic Nephropathy (FJHN) is an autosomal dominant disorder that is associated with gout and progressive renal failure. FJHN in 43 families has been reported to be caused by mutations in the UMOD gene, which encodes Uromodulin, also known as the Tamm-Horsfall Glycoprotein, and two families have been reported to have mutations in the transcription factor Hepatocyte Nuclear Factor 1β (HNF-1β), mutations of which usually cause maturity-o...

Background: Treatment of patients with acromegaly caused by pituitary adenoma with somatostatin analogues leads to significant tumour shrinkage in 23–73% of the cases. Although not widely accepted, it has been suggested that the surgical remission rate may be improved by pre-operative treatment with these agents.Aim: To assess whether the degree of tumour shrinkage by lanreotide offered pre-operatively affects the surgical success in acromegalics wi...

Background: Nadir GH<2 mU/l in OGTT, normal IGF-I and mean GH<5 mU/l in the growth hormone day curve (GHDC) are considered the therapeutic endpoints in patients with acromegaly. However, discrepancies between these parameters have been reported.Aim: To compare the utility of the above tests in assessing the acromegaly status following surgical treatment.Patients and methods: Twenty-six consecutive patients (16 females) diag...

Adrenocortical carcinoma (ACC) is a rare and highly malignant tumour with a poor prognosis with an incidence of 1 – 2 per million population per year. We report 2 cases of functioning ACC.Case 1: An 80 yr old with a history of hypertension, paroxysmal atrial fibrillation and cerebrovascular disease presented with leg ulcers, peripheral oedema, tiredness, weight gain, plethora and proximal myopathy. ACTH-independent Cushing’s syndrome was confir...

Introduction: Pituitary adenomas causing acromegaly are immunocytochemically divided into 3 main groups: growth hormone (GH) cell (A), those with GH and prolactin (PRL) cell differentiation (B) and plurihormonal (C). Recent large series comparing the hormonal and imaging features of these tumours at diagnosis are lacking.Objectives: To investigate differences in the presenting hormonal and imaging data associated with the above groups of adenomas.<p ...