Endocrine Abstracts

Steroid-dependence is a life-long condition with a risk of premature mortality from undertreated adrenal crisis, hospital omission of steroids, or running out of maintenance drugs at home. We invited members of the main UK support groups representing steroid-dependent patients to complete an online questionnaire about their experiences of adrenal crisis. Respondents (n=1042) were asked to provide demographic information that explored predisposing factors, including co...

In early 2010, the Addison’s Disease Self-Help Group sent an information pack to 10 500 GP practices across the UK, outlining the GP’s role in diagnosis and care of the Addison’s patient. We asked the practice head to return a reply-paid questionnaire, detailing the number of steroid-dependent patients in the practice, their repeat prescription length, if they had an in-date supply of injectable hydrocortisone, and any comments on the challenges they faced in pr...

Impaired quality of life in patients with treated Addison’s (primary adrenal insufficiency) has been identified in several recent studies, which have also identified high rates of working-age disability. However, causation in patients whose replacement endocrine medications appear adequate remains unclear.To try and identify factors influencing this reduced quality of life, we analysed demographic information reported by a UK patient sample (n</i...

Introduction: Primary hyperparathyroidism (PHP) is common; Prevalence and Incidence are now much higher than the past. There is also a change in practice related to medical management, surveillance, and defining criteria for diagnosis as well as the recommendation for surgery.Decision to send patients for surgery was considered primarily on their calcium level.Other criteria for surgery were largely ignored.E...

Prolactin is produced by pituitary lactotrophic cells and by several extrapituitary tissues, including immune cells and the endometrium in man. It has a wide range of actions at different sites, and hyperprolactinaemia and prolactinomas give rise to common clinical problems. The human prolactin gene contains six exons, with two distinct promoters that direct pituitary or extra-pituitary transcription respectively. The pituitary-specific promoter extends over 5000 base-pairs an...

We examined online questionnaire responses received Dec 2017 – Jan 2018 from a sample of well-informed adrenal patients belonging to the Addison’s Disease Self-Help Group (N=374). ADSHG members reported levels of preparedness to self-manage during adrenal emergencies that were strikingly higher than any UK clinic survey.• 88% reported wearing medical jewellery• 80% had an in-date injection kit with them at the t...

Small cell lung cancer (SCLC) is an aggressive neuro-endocrine tumour with an abysmal prognosis. These cancers are characteristically resistant to glucocorticoid (Gc) action, and display glucocorticoid receptor (GR) abnormalities. We therefore selected model cell lines displaying reduced GR expression and Gc insensitivity as tractable in vitro systems in which to discover the effects of restored GR expression. GR fused to the yellow fluorescent protein, eYFP, was over-e...

Autoimmune hypoadrenalism (Addison’s disease) is a relatively rare condition; recent research has found the European prevalence to be up to 140 per million [Lovas & Husebye 2002]. It frequently occurs in association with other organ-specific autoimmune diseases, both endocrine and non-endocrine. Previous studies identified a considerable range in the prevalence of associated conditions and, because of the rarity of the disease, were often drawn from relatively small s...

Bone loss in treated Addison’s disease (autoimmune hypoadrenalism) is often attributed to supraphysiological doses of glucocorticoid. The largest international survey to date (N=613) suggests that other factors are also likely to be associated with bone loss in these patients and that an intrinsic risk of bone loss in autoimmune hypoadrenalism cannot be ruled out. This survey also found significant rates of osteoarthritis among autoimmune hypoadrenalism patients. 1...

Addison’s disease is notoriously difficult to diagnose and has been labelled ‘the master of unforgiving disguise’. In the largest international survey of autoimmune Addison’s disease to date (N=613), we asked patients to recall their symptoms at diagnosis. The results confirm the challenges of diagnosis, in that no patients recalled all the standard symptoms.Hyperpigmentation with dizziness on standing/blackouts and weight loss...