Endocrine Abstracts

Context: Polycystic ovary syndrome (PCOS) has been linked to non-alcoholic fatty liver disease (NAFLD) that carries an increased risk of liver cirrhosis. The Enhanced Liver Fibrosis (ELF) score comprises serum hyaluronic acid (HA), procollagen III N-terminal peptide (PIIINP) and tissue inhibitor of metalloproteinase-1 (TIMP1) that correlate with hepatic fibrosis staging.Objective: To determine the effect of vitamin D suppleme...

Background: The well-differentiated grade 3 neuroendocrine tumor (G3NET) category was introduced in the 2017 WHO classification as a new category of high-grade neuroendocrine neoplasm (NEN). G3NET is thought to have worse overall survival (OS) than lower grade NET, but better OS than poorly differentiated neuroendocrine carcinoma (NEC). However, challenges in pathologic diagnosis and changes in terminology have limited our understanding of the G3NET category. We compared outco...

Background: Patients with neuroendocrine neoplasms (NENs) have chronic symptoms from hormone overproduction, tumor growth and metastasis, and side effects from prolonged treatment. We assessed the feasibility of using a digital health platform to recruit patients with NENs to evaluate symptoms and quality of life.Methods: eNET is a prospective, web-based, cohort study for patients with advanced NENs of any primary site, histologic grade, differentiation,...

Neuroendocrine tumors (NETs) of the breast are very rare. They represent less than 1% of breast carcinomas. It is important to differentiate metastatic neuroendocrine neoplasia from primary neuroendocrine neoplasia of the breast. Histopathological misinterpretation of a breast NET is common. In a study of 18 NET cases that metastasized to the breast, it was found that 62% of these tumors originated from the gastrointestinal tract and 28% from the lung. Forty-four percent of th...

A 59-year-old male patient, who is fit and well, presented with abdominal discomfort, night sweats, back pain and lower urinary tract symptoms. The CT scan, organised by the GP, demonstrated a 17 cm heterogenous mass with central necrosis and scattered calcification in right side of abdomen, possibly right adrenal origin or liver or kidney. He was referred to Adrenal MDT. Baseline functional testing showed unsuppressed cortisol level in an overnight dexamethasone, high DHEA su...

Background: TE is indicated for the treatment of carcinoid syndrome diarrhea in patients with metastatic neuroendocrine tumors.Objective: To evaluate the effects of a proton pump inhibitor (OMP) and H2 antagonist (FAM) on the PK of TE and its active metabolite LP-778902 via an open-label study of OMP (40 mg orally QD × 4 days) or FAM (40 mg orally BID × 4 days) with a single 250 mg oral dose of TE. Eligible subjects: healthy, nonsmoking, aged &...

Reproduction requires the temporal and spacial control of specific and exact signals, delivered by locally regulated hormonal flux. In the case of androgen biosynthesis, cytochrome P450 17α-hydroxylase, 17,20-lyase (P450c17) is the key enzyme. However, P450c17 is a multi-functional P450, so, it synthesizes cortisol in the zona fascicula of the adrenal cortex and also androgen precursors in the adrenal zona reticularis and the gonads. The regulation of this dual activity h...

Prednisolone has been reported to have greater deleterious effects on bone turnover than other glucocorticoids, although the evidence for this is confounded by the effects of higher dose prednisolone, as used in conditions such as asthma. We hypothesise that a physiological replacement dose of prednisolone will have a less dramatic effect on bone than has previously been suggested, and might be safer than hydrocortisone for replacement in adrenal insufficiency. We investigated...

Mrs. M is a 66-year-old female who has had secondary adrenal insufficiency for many years following the withdrawal of prednisolone therapy for pulmonary eosinophilia. Synacthen tests revealed complete adrenal suppression when the dose of prednisolone was weaned to 5 mg in previous years. The dose was further reduced by switching to hydrocortisone three times daily, following a 10 mg-5 mg-5 mg regimen. Occasionally, a flare of eosinophilia required restarting high-dose predniso...

Objectives: Kids in control of food (KICK-OFF) is a 5-day structured education programme for 11–16 year olds with type 1 diabetes who use multiple daily insulin injections. This study evaluates whether KICk-OFF would be considered a cost effective use of NHS resources by decision makers in the UK.Methods: A cost effectiveness analysis comparing KICk-OFF to usual care was conducted. Data from the KICk-OFF trial were extrapolated to simulate lifetime ...