Endocrine Abstracts

The philosophy of my research over the years has been to ask clinically relevant questions which will enhance the practice of decision making in endocrinology, based on scientific assessment of reasonable cohorts. In hitherto unpublished data, we have done work on the assessment of somatostatin responsive headaches in acromegaly and show that they persist over many years, may respond to radiotherapy and may also remain problematic even if acromegaly is cured. We have also look...

This review was published in Nature Reviews Endocrinology. It covers recent advances in treatment of pituitary tumours secreting prolactin including long-term adverse effects of dopamine agonist therapy, outcomes following dopamine agonists withdrawal, advances in surgical tumour resection. In addition, there are sections on management during pregnancy, effects of hyperprolactinemia on bone and fracture risk, the management of cystic and aggressive prolactinomas. Prolactinomas...

PCOS has major long-term health implications that are closely linked to the Metabolic Syndrome. The prevalence of the Metabolic Syndrome is high among migrant and indigenous South Asian populations. We have previously demonstrated that migrant South Asians with PCOS have a greater degree of insulin resistance than white Europeans with PCOS. As there is a paucity of data on PCOS among indigenous South Asian populations, consecutive consenting anovular PCOS subjects (80) and age...

Background: Chronic SIAD with its disabling impact is challenging to manage in elderly patients as fluid restriction or demeclocycline often has a limited success. Tolvaptan is a novel selective antagonist of vasopressin receptor (V2R) which is safely used in patients with SIAD and other conditions with hypervolemia. We report a case of longest Tolvaptan use with significant challenges amongst our case series which we had previously publishedMethod: A Ca...

Familial glucocorticoid deficiency is an autosomal recessive disorder characterised by resistance to ACTH of the adrenal cortex, leading to isolated glucocorticoid deficiency and life-threatening hypoglycaemia. Half of all cases are caused by mutations in MC2R, MRAP, MCM4 or STAR. Recent work in our group has identified defects in nicotinamide nucleotide transhydrogenase (NNT) to be causal in a further 10% of cases. NNT generates the high con...

Background: Familial Glucocorticoid Deficiency is an autosomal recessive disorder characterised by ACTH resistance of the adrenal cortex, leading to isolated glucocorticoid deficiency. Causative genes include MC2R, its accessory protein MRAP and StAR which account for 50% of cases. Recently nicotinamide nucleotide transhydrogenase (NNT) has been associated with a further 10% of cases. NNT generates the high concentrations of NADPH in mitochondria necessary for detoxification o...

This abstract has been withdrawn....

Background: Fertility in CAH women is impaired: 0.25 live births vs 1.8 in the UK population and 45% have irregular menses vs 13.6% in healthy women1. Male fertility is also impaired in CAH with oligospermia reported in 48%2. Treatment of infertility usually involves increasing the glucocorticoid dose to normalise adrenal androgens and progesterone to facilitate ovulation and implantation, respectively. Modified-release hydrocortisone (MRHC) capsules, (Ef...

Objective: Despite of conflicting data, reduced levels of endogenous sex hormones and especially sex hormone binding globulin (SHBG) seem to be associated with metabolic syndrome (MS). In this study we determined relationship between endogenous sex hormone levels and SHBG and components of metabolic syndrome in both sexes.Methods: In 39 men (median age 70.2) with total testosterone level in the lowest quartile of normal range (median 12.8 nmol/l) and 29 ...

Introduction: Weight loss is a key initial treatment strategy in obese women with polycistic ovary syndrome (PCOS) and improves insulin sensitivity and metabolic risk factors. In some women with PCOS it may reduce hyperandrogenism and restore menstrual function, ovulation and fertility. The aim of this study was to reveal clinical predictors of menstrual response to weight loss in overweight women with PCOS.Design: overweight unovulatory women with PCOS ...