Endocrine Abstracts

Background: Thyroid function is affected by critical illness – termed as non-thyroidal illness – and usually presents with low serum TSH and FT3 levels but normal FT3 concentrations. Critically ill patients may also have impaired immune function that could contribute to increased susceptibility to acquired infections and mortality. Thyroid hormones influence neutrophil levels and function but the effect of non-thyroidal illness on neutrophil fun...

Introduction: We present a case of a patient with type two diabetes mellitus (T2DM) who started empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor and the P90X diet and presented with euglycemic DKA seven days later.Case Presentation: A male in his 5th decade of life with a history of T2DM presented for a routine office appointment and had a measured hemoglobin A1C of 9.3. His home diabetes regimen consisted of metformin and sitagliptan. D...

Background: Clinical scoring systems were used traditionally in the diagnosis of hypothyroidism before biochemical diagnosis became the norm. There are two well validated clinical scoring systems (Billewicz and Zulewski) for diagnosing hypothyroidism. Both these scores were validated in younger patients with hypothyroidism and may not be useful in older patients. We conducted this study to determine the clinical utility of these two scoring systems among patients over the age ...

Denosumab is a monoclonal antibody used in the treatment of osteoporosis to prevent bony injuries by increasing bone density. It does so by binding to RANK-L, which is then unable to activate RANK, thereby preventing osteoclast maturation and viability. Although rare, the effect of denosumab can interfere with the body’s calcium homeostasis and lead to a hypocalcemic state. We present a case where a post-menopausal female developed severe, symptomatic hypocalcemia from a...

Introduction: 46,XX gonadal dysgenesis without the phenotype of Turner’s syndrome is described as ‘pure’ and is not usually associated with other anomalies with the exception of the rare Perrault syndrome (46,XX-GD with sensori-neural deafness). We describe a girl in whom tall stature was a dominant feature.Case report: A girl was referred aged 15.6 years with primary amenorrhoea and slim build. Examination showed height 172.5 cm (+1.56 <s...

Introduction: Paragangliomas (PGLs) are extra-adrenal, neural crest-derived neuroendocrine tumours. There are sympathetic (usually abdominal and thoracic regions) or parasympathetic PGLs (head and neck). Catecholamine excess usually occurs in sympathetic PGLs.Case: A 34-year-old lady initially presented with left-sided neck swelling. She was diagnosed with left cervical PGL which was excised. Twenty years later, she noticed another lump in the same regio...

Whilst bariatric surgery is the most effective therapy for idiopathic morbid obesity in adults, little is known about its effectiveness in patients with monogenic obesity syndromes. We report 5-year outcome of gastric bypass surgery in a young man with severe super-obesity associated with melanocortin four receptor (MC4R) mutation.A 22-year-old male with a weight of 221.6 kg and BMI 76.7 kg/m2 was referred to our centre for bariatric surgery. ...

Type 2 diabetes is a metabolic disorder characterised by insulin resistance and is associated with diminished signalling through the insulin receptor. Protein tyrosine phosphatase 1B (PTP1B), encoded by the PTPN1 gene, has been shown to attenuate insulin’s actions by de-phosphorylating the activated insulin receptor and downstream signalling components such as IRS1. Several studies have highlighted PTP1B as a potential therapeutic target for type 2 diabetes and obesity; h...

Folliculo-stellate (FS) cells exert a paracrine regulation on their neighbouring endocrine cells in the anterior pituitary gland. FS cells are non-granular cells characterized by long cytoplasmic processes and form follicles with microvilli on their luminal cavity, suggesting a transport function. Moreover, FS cells form monolayers in primary culture and develop domes after reaching confluence, characteristics of polarized transport epithelia. However little is known about tra...

Hyperprolactinaemia is the most common endocrine disorder of the hypothalamic-pituitary axis and represents a significant referral volume to secondary care. It is therefore necessary to employ a timely, structured management pathway.This retrospective cohort study at University Hospitals Birmingham, included 450 patients with serum hyperprolactinaemia, measured between 2011 and 2012. Patients with a known hyperprolactinaemia were excluded. 71 patients re...