Endocrine Abstracts

A 50-year-old man with poorly controlled type 2 diabetes mellitus on oral hypoglycaemics was under review as a diabetic outpatient. In April 2007, he developed idiopathic thrombocytopaenic purpura which, on a background of probable diabetic nephropathy, precipitated end-stage renal failure. He was treated with oral steroids and was established on haemodialysis. To achieve better glycaemic control, he was converted to twice daily insulin. His treatment dose of prednisolone was ...

The bioavailability of activin, GDF11, and myostatin, members of the TGFβ superfamily, is regulated by the soluble antagonists follistatin (FST) and follistatin like-3 (FSTL3). Activin influences tissue fate determination and organogenesis in embryos as well as organ homeostasis in adults while myostatin decreases muscle mass in adults and GDF11 regulates pancreatic β-cell differentiation. In addition, the FST gene produces three protein forms (FST288, FST303, and FS...

The intraperitoneal environment of the ovarian surface epithelium (OSE) has an oxygen (O2) tension of 5–12%. This could impact cellular events leading to ovulation. Furthermore, ovarian cancers arising from the OSE (∼80–90% of ovarian malignancies) are likely to experience increased hypoxia due to the relatively poor vascularisation of solid tumours.Using 1%, 5% or 20% O2, we measured the expression of HSD11B1, COX-2...

Introduction: 18-hydroxycortisol (18-OHF) is known to be elevated in glucocorticoid remediable aldosteronism but there are few data relating to 18-OHF in the differential diagnosis of primary aldosteronism.Aim: We evaluated the usefulness of lying and standing 18-OHF in patients with primary aldosteronism in differentiating between aldosteronoma, bilateral adrenal hyperplasia (BAH) and normality.Methods: Patients (n=27) with...

The diagnosis of Cushing’s syndrome (CS) remains a major clinical challenge especially in a proportion of patients that have discordant results in the available tests. Although the measurement of 24-h urine free cortisol (UFC) is a useful test for the diagnosis of CS, 10–15% of patients have at least one measurement within the normal range and multiple measurements may be required in order to raise its sensitivity. In this study we sought to evaluate the value of the...

Ligand binding by the calcium-sensing receptor (CaSR), which belongs to family C of the G-protein coupled receptor super-family, activates the phospholipase C-inositol triphosphate pathway and leads to an increase in intracellular calcium. CaSR inactivating mutations result in the hypercalcaemic disorders of familial benign hypocalciuric hypercalcaemia (FBHH) and neonatal severe primary hyperparathyroidism (NSHPT), whilst activating mutations result in the hypocalcaemic disord...

A 64-year-old morbidly obese female was admitted with a history of bilateral lower leg ulceration, chronic venous insufficiency and biventricular cardiac failure. There was no relevant family history. She was commenced on furosemide and prophylactic enoxaparin. Biochemical investigations showed persistently elevated serum potassium concentrations (5.7 to 8.2 mmol/L) and low sodium levels (111 to 131 mmol/L). She had not been prescribed non-steroidal anti-inflammatory agents, a...

Most authorities recognise adult growth hormone deficiency (AGHD) as a distinct endocrine disorder, although determining an appropriate strategy for optimising replacement remains controversial.We reviewed the outcome of a cohort of patients treated with a fixed graded initiation phase followed by an individualised titration phase. Patients were initiated on a starting dose of 0.3 mg recombinant human growth hormone (rhGH) for one month, with increases t...

Objective: To assess adherence to RCP guidelines on radioiodine (RAI) treatment (1995) and management of thyroid eye disease, and also to look at patterns of thyroid function following RAI treatment.Method: Retrospective case notes review of 78 randomly selected patients from one acute trust. An audit performa was developed, based on the RCP guidelines.Results: The audit demonstrated significant deviations from standards. Communica...

Hypoparathyroidism is a rare disorder characterised by hypocalcaemia and insufficient or undetectable parathyroid hormone (PTH). Recombinant human PTH, rhPTH(1-84), has been approved in the United States and Europe as an adjunctive treatment for adult patients with hypoparathyroidism. When hypoparathyroidism is established, long-term administration of rhPTH(1-84) is a treatment option. Thus, long-term safety and efficacy data for rhPTH(1-84) are needed. To this end, we evaluat...