Endocrine Abstracts

Endocr Connect 2015 vol. 4 no. 1 37–42. DOI: 10.1530/EC-14-0137...

Tolvaptan is an ADH antagonist licensed for the treatment of the syndrome of inappropriate ADH secretion (SIADH). We describe the case of a patient with severe symptoms due to refractory SIADH who was successfully treated with tolvaptan. A 35-year old patient developed a chordoma involving the pituitary gland and optic chiasm and was treated with surgery, radiotherapy and gamma knife therapy. After several years, she developed recurrent, severe, symptomatic hyponatraemia due t...

Nineteen cases of insulinoma were treated in this centre between 2003 and 2012 (12 female, 7 male, 5 associated with MEN-1). Of the cohort, 14 had their primary investigation and management here. All presented with symptoms consistent with hypoglycaemia and had a supervised fast demonstrating serum glucose <2.2 mmol/l with inappropriately normal/elevated insulin.11 of 14 patients proceeded to surgery. Two elderly patients declined further investigati...

Background: Obesity is strongly associated with insulin resistance (IR). IR at the molecular level may be defined as a diminished activation of PI3K/Akt signaling and its related molecules (IRS-1/Akt/AS160) as well as reduced glucose uptake. Subjects with obesity have elevated plasma levels of saturated fatty acids, such as palmitic acid (PA), which triggers insulin signaling disruption in vivo and in vitro. Oregano (Origanum vulgare L.) is a plant u...

Background: Rapid progression of corticotroph tumours can occur after bilateral adrenalectomy for treatment of Cushing’s disease. There are currently no guidelines to assist with management of aggressive cases of Nelson’s syndrome, particularly after surgery and radiotherapy.Clinical case: A 53 year old woman presented with classic clinical features of hypercortisolism. Initial investigations showed a markedly elevated 24 hour urine cortisol le...

Background: Hashimoto’s encephalopathy is a rare steroid-responsive condition associated with high antithyroid antibody titres. We report a case of autoimmune thyroiditis presenting with status epileptics.Case: A 36-year-old non-epileptic Caucasian lady presented as an emergency with uncontrolled generalised seizures requiring sedation, short-term ventilation and maintenance sodium valproate therapy. Further enquiry revealed a 3–4 week history ...

A 55-year-old post-menopausal female presented with hirsutism and increased libido. Testosterone was elevated at 9.7 (RR <1.8 nmol/l). LH/FSH were appropriate post-menopause (LH 28.8; FSH 54.1U/l). DHEAS, androstenedione and 17-hydroxyprogesterone were unremarkable. GnRH analogue suppression testing (GnST) appropriately suppressed LH/FSH and testosterone (testosterone 0.2 nmol/l), suggesting an LH-dependent source of testosterone. Pelvic MRI suggested a left ovarian tumour...

Case history: A 54-year-old lady was diagnosed with primary hypoparathyroidism in 2006, after being referred by her Rheumatologist as her father and brother had familial hypoparathyroidism and sensorineural deafness. She was followed up in endocrine clinic for management of primary hypoparathyroidism. Her hypocalcaemia is well managed with calcium supplementation, with no specific symptoms of hypocalcaemia. She has recurrent urinary tract infections with known borderline chro...

BackgroundEctopic ACTH secretion accounts for 9–18% of ACTH dependent Cushing’s’ syndrome. The most common causes are intrathoracic neuroendocrine tumours. Gastric tumours as a cause of ectopic ACTH secretion are remarkably rare.Case reportA seventy-five-year-old gentleman complained of a four month’s history of epigastric discomfort, anorexia, and weight loss. He was a known diabetic and ...

Objective: Reactive oxygen species and nitric oxide (NO) have recently been considered involved in the cardiovascular complications of patients with type 2 diabetes as NO is supposed to loose its physiological beneficial effects, due to the presence of oxygen radicals. For this reason, we tested the effects of L-arginine (ARG) and N-acetylcisteine (NAC) administration with the aim to increase NO physiological production reducing free radical formation.</p...