Endocrine Abstracts

Background: Chromogranin A is an acidic 48 kDa glycoprotein originating from the chromaffin granules of most neuroendocrine cell types. In health chromogranin A is released as a pro-hormone together with other peptide hormones in response to stimulation. In disease larger quantities of Chromogranin A are produced by neuroendocrine derived tumours thus allowing its use as a tumour marker. Due to the different clinical scenarios for measuring Chromogranin A requesting practices ...

Steroid-dependent patients have a lifelong dependency on replacement therapy and a lifelong vulnerability to sudden death from under treated adrenal crisis. Yet evidence about the adequacy of medical response to adrenal crisis within the UK is largely anecdotal.We invited members of the main UK support groups representing steroid-dependent patients to complete an online questionnaire identifying the frequency, causes and location of their adrenal crises ...

Steroid-dependence is a life-long condition with a risk of premature mortality from undertreated adrenal crisis, hospital omission of steroids, or running out of maintenance drugs at home. We invited members of the main UK support groups representing steroid-dependent patients to complete an online questionnaire about their experiences of adrenal crisis. Respondents (n=1042) were asked to provide demographic information that explored predisposing factors, including co...

Aims: We aimed to assess the effectiveness of an insulin pump service for children, describe the demographics of the pump population and to review the change in glycaemic control following initiation of pump therapy. We also assessed patient and staff perceptions of the service.Method: Patients commenced on CSII from July 2013 to July 2014.Data collected included demographics, deprivation scores, HbA1c before and during pump therap...

Conventional hydrocortisone dosing does not mimic the normal cortisol circadian rhythm making treatment optimisation difficult in patients with adrenal insufficiency. We described the first use of a continuous variable subcutaneous hydrocortisone infusion (CSHI) via an insulin pump to replace cortisol in a patient with congenital adrenal hyperplasia (CAH) to mimic the normal plasma cortisol circadian rhythm. We report the long term experience of CSHI in seven patients with adr...

The aim of cortisol replacement in adrenal insufficiency is to mimic the normal cortisol circadian rhythm. Timing of the last dose varies. Paediatric practice doses as close to midnight or after as possible compared to no dose after 18.00 h in adults. Using a detailed questionnaire, we ascertained side effect prevalence in 226 patients with adrenal insufficiency (77 CAH, 82 Addison, 67 hypopituitarism) and compared frequency of problems with timing glucocorticoid replacement. ...

Introduction: Bowel preparation is known to cause minor electrolyte disturbances. There are only five reported cases of severe electrolyte disturbances following bowel preparation that have caused seizures. We report the case of a patient with severe hyponatraemia and hypokalaemia, resulting in a seizure, following the administration of picolax.Case report: A 60-year-old female patient with no significant past medical history and taking no regular medica...

There are two issues: i) dopamine agonist (DA) safety for mother and baby, and ii) risk of oestrogen-induced prolactinoma enlargement. Bromocriptine (BC) and Cabergoline (CAB) are both safe for ovulation induction but the safety database is larger for BC (6239 pregnancies) than for CAB (789). Neither drug causes increases in miscarriage, premature delivery, multiple births or congenital malformations, compared to data for normal pregnancy. Risk of symptomatic tumour enlargemen...

A 55-year-old lady was referred by her GP to the acute medical unit with a 4-week history of fatigue, generalised swelling and weight gain of a stone, together with a potassium 2.8 mmol/l and sodium 146 mmol/l. Her blood pressure was 211/85 mmHg and she was suspected of having Conn’s syndrome. Treatment was started with Amlodipine 5 mg daily and Spironolactone 25 mg daily which was increased to 100 mg daily on subsequent follow-up in the acute medical unit. She remained u...

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity characterized by seizures (91.7%), headache (83.3%), visual disturbance (62.5%),encephalophathy (29.2%), and paralysis (8.3%). Co-morbidities included systemic lupus erythematous (29.2%), kidney disease (20.8%), eclampsia(20.8%), renal artery stenosis (12.5%), Takayasu arteritis (4.2%), Sheehan's syndrome(4.2%), and acute intermittent porphyria (AIP) (4.2%). We report a 31-year-old woman w...