Endocrine Abstracts

Childhood onset GH deficiency (CO-GHD) usually presents with aberrant growth. Treatment is recombinant GH (r-GH) to attain target height. The 2005 European Consensus statement on management of CO-CHD at transition indicates that most adolescents will require repeat GH testing at completion of linear growth. Patients with persistent GHD will require continuation of r-GH for wellbeing, optimal body composition and metabolism. However, there is little data supporting predictors o...

Hypothyroidism presents diagnostic challenges when occurring in an extremely unwell infant with hepatoblastoma. This case indicates a possible link between Beckwith–Wiedemann syndrome (BWS) and severe hypothyroidism.Antenatally, the baby had polyhydramnios and an abdominal mass. After normal vaginal delivery at 38+4 weeks, examination showed macrosomia (4007 g) small nose, low set ears and inverted V-shaped mouth. Transient hypoglycaemia on day 1 re...

Background: Thorough history taking and clinical examination is vital in the assessment of all medical patients. However, diagnosis of endocrine disease also relies on appropriate biochemical tests. Previously in our unit, tests were only performed after new patients attended clinic. We proposed that diagnosis and management would be improved if this system was inverted.Method: In 2009 clinicians, nurses and chemical pathology representatives reviewed av...

Introduction: Hypocalcemia has been linked to a decreased myocardial performance and even congestive heart failure, while acute chest-pain as leading symptom of hypocalcemia is an unusual presentation.Case report: A 29-year-old Caucasian man presented to the emergency department with relapsing chest-pain since several days, lasting seconds sometimes lasting several minutes, radiating to the left shoulder and combined with mild tingling in the neck. A det...

Introduction: 13.1-year-old boy referred for growth hormone (GH) treatment with extreme short stature.Background: Born premature at 28 weeks gestation, fraternal twin, birth weight: 1.06 kg (−0.58 SDS). Neonatal course complicated by respiratory distress syndrome, grade 2 Intraventricular haemorrhage, grade 2 Retinopathy and failure to thrive. Although not born small for gestational age, he was small at term (1.67 kg (−4.18 SDS)).<p class...

Endogenous hypercortisolism and chronic glucocorticoid (GC) therapy reduce bone mass, increase central fat mass, alter adipokines and enhance cardiovascular risk. Surgery (pituitary, adrenal or for ectopic ACTH) can control hypercortisolism in 90% of patients in experienced hands, and is often followed by inhibition of the adrenal axis, requiring substitution therapy with GC for months or years. We have been interested in learning on long-term outcome of ‘cured’ CS p...

Annexin-1 (ANXA1) is a 37 kDa calcium- and phospholipid-binding protein expressed abundantly in S100-positive folliculostellate (FS) cells in the anterior pituitary gland. ANXA1 is localised both intracellularly and on the cell surface in high density foci appearing at points of contact between the FS cells and the neighbouring secretory cells, where it has been demonstrated to mediate the glucocorticoid-induced negative feedback on the secretion of ACTH from corticotrophs. Gl...

Stressors engage a neural stress response network that is mediated in large part through the immediate actions of the stimuli on corticotropin-releasing factor (CRF) neurons in the amygdala (CeA) and in the long-term by the actions of glucocorticoids (GC) on increased synthesis of CRF in CeA and secretion of CRF on the monoaminergic cell groups as well as forebrain. The consequences of this bias behavioral, autonomic and endocrine outputs in the stressed organism. However, the...

Primary hyperparathyroidism is a common endocrine disorder. Diagnosis is more frequently made where calcium testing forms part of routine screening bloods. The clinical profile has shifted from a symptomatic disorder with hypercalcaemic symptoms, kidney stones and overt bone disease towards a more asymptomatic state. The National Institutes of Health (NIH) have produced guidelines on diagnosis and management of primary hyperparathyroidism but no UK guidelines are in existence....

The epidemic of obesity, insulin resistance and type 2 diabetes has heightened the need to understand the mechanisms that contribute to their pathogenesis. Endogenous glucocorticoid (GC) production and metabolism have been implicated based upon parallels with Cushing’s syndrome. The interaction between GC metabolism and insulin sensitivity in the context of significant weight loss has not been explored. 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that gen...