Endocrine Abstracts

Introduction Carcinoid heart disease most frequently involves the tricuspid or, more rarely, the pulmonary valve and presents with right heart failure as 5-HT is metabolized by the lung. Left-sided valve involvement is quite rare. We describe our experience of 3 patients presenting with heart failure secondary to carcinoid heart disease affecting all four cardiac valves. There are only four previous isolated case reports in the literature. Methods All th...

For several years, steroid hormones including testosterone (T), androstenedione (A4) and 17-hydroxyprogesterone (17-OHP) have been utilised in the diagnosis of a range of conditions with clinical features of hyperandrogenaemia including polycystic ovary syndrome (PCOS) and congenital adrenal hyperplasia. In recent years a potential role for the 11-oxygenated androgens has emerged in the diagnosis and characterisation of androgenic disorders. Specifically, the 11-oxygenated and...

Background: Aromatase inhibitors block the aromatization of androgens to oestrogen. They are used off-label to delay bone maturation where bone age (BA) is advanced secondary to androgen excess. Side effects include hair loss, headache, decreased appetite, bone pain, drowsiness, and osteoporosis. There is limited data on Anastrozole’s safety in paediatrics. We report our experience (Anastrozole 1 mg OD) in 4 pre-pubertal boys with advanced BA.<p class...

Background: Glutamic acid decarboxylase 65-kilodalton isoform (GAD65) antibody is a known to be present in inhibitory interneurons and pancreatic islet β-cells. Arino et al suggests that high levels of GAD65 present with neurological symptoms should prompt physicians to screen patients for occult cancer. The literature also suggests high GAD65 antibodies have been associated with various malignancies; although large studies are lacking. This research focuses on i...

Introduction: Intestinal cholesterol absorption is known to be important in post-prandial lipid levels, and implicated in the development of vascular disease. This study evaluated the effect of intestinal gene expression on markers of early vascular disease in a cohort of diabetic and non-diabetic subjects.Methods: Subjects were identified from routine upper GI lists and enrolled as per local ethics approval. Intestinal gene expression was measured on du...

Introduction: The traditional approach to mediastinal ectopic parathyroid adenomas has been through a median sternotomy. With improved localization techniques it has become possible to use less invasive approaches to access the mediastinum. We present our recent experience of three cases of mediastinal parathyroid adenomas successfully treated using a manubriotomy approach which provides good access to the superior and anterior mediastinum.Method: All pa...

Introduction: Asprosin is a novel adipokine that is released in response to fasting and can elicit orexigenic and glucogenic effects. Circulating asprosin levels are elevated in a number of cardio-metabolic diseases, including obesity and type 2 diabetes mellitus. In vitro studies have reported pro-inflammatory effects of asprosin in pancreatic β-cells and skeletal muscle cells, which appear to be mediated via a toll-like receptor 4 (TLR4) mediated pathway, and m...

A 53 year old gentleman from Ghana was referred to our clinic for further management of his Conn’s syndrome. This had been diagnosed at another hospital 3 years previously when he presented with hypertension and hypokalaemia on the back of 14 years of poorly controlled hypertension. Serum aldosterone was raised at 3178 pmol/l and serum renin mass was 3.9 mU/l. MRI revealed a 5 mm nodule in the medial limb of the right adrenal gland. He was initially commenced on medical t...

Introduction: Structured education is an integral part of type one diabetes care for children and young people and their families, delivered at diagnosis. There is currently no validated curriculum or outcome measures of diabetes education in the UK. We evaluated the outcome of using the diabetes education app (deapp), using flipped learning against historical practice, to determine if it conferred any benefit in our single centre.Methods: Two cohorts of...

Thiamine-Responsive Megaloblastic Anaemia (TRMA) is a rare autosomal recessive disorder emerging due to mutation in the thiamine transporter 1 gene. It presents with sensorineural hearing loss, non-immune diabetes mellitus and megaloblastic anaemia. Ocular manifestations of TRMA described so far include optic atrophy and cone-rod retinal dystrophy. This case-report presents an adolescent British-Pakistani boy with TRMA, who was unexpectedly diagnosed with bilateral severe prol...