Endocrine Abstracts

Introduction: Morgagni-Stewart-Morel syndrome is a disorder defined by the presence of internal frontal hyperostosis, variably associated with metabolic disorders, endocrine and neuropsychiatric disorders. Hyperostosis frontalis interna (HFI) is a morphological change of the frontal bone like a single or multiple bilateral nodules on the inner lamina, characteristically sparing the diploë and the midline calvaria.Case presentation: We present a 61-y...

Paul Stewart, Division of Medical Sciences, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK AbstractBorn in Harrogate in 1959, Paul received his undergraduate medical training at Edinburgh University. His house officer and senior house officer posts were undertaken at the Royal Infirmary and Western General Hospital Edinburgh, and it was here that his interest in endocrinology was kindled, largely th...

Paul Stewart, University of Birmingham, UK AbstractBorn in Harrogate in 1959, Paul received his undergraduate Medical training at Edinburgh University. His house officer and senior house officer posts were undertaken at the Royal Infirmary and Western General Hospital Edinburgh, and it was here that his interest in endocrinology was kindled, largely thanks to the clinical skills and mentorship of Christopher Edwards a...

Glucocorticoids (GC), such as prednisolone, are widely prescribed for their anti-inflammatory and immunosuppressive properties. However, they have significant side-effects including insulin resistance and hepatic steatosis. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts 11-dehydrocorticosterone (11DHC) to active corticosterone (CORT) and thus amplifies local GC action. We hypothesise that enhanced local GC regeneration of exogenously administered GCs by ...

100 years have passed since Harvey Cushing linked a basophilic pituitary adenoma to bilateral adrenal hyperplasia, and in doing so elegantly depicted the clinical phenotype of “Cushing’s syndrome. Today we are uncovering the molecular basis for these tumours and pioneering novel surgical and medical therapies to improve clinical outcome, but fortunately they remain rare. Conversely iatrogenic Cushing’s with concomitant adrenal suppression is seen in the 1% of th...

The widespread use of abdominal CT/ MRI has resulted in a new and common diagnosis for the clinical endocrinologist – the management of patients with adrenal incidentalomas. Defined as an adrenal mass discovered incidentally in the work-up or treatment of clinical conditions not related to suspicion of adrenal disease, incidentalomas cover a spectrum of underlying adrenal pathologies with a common pathway of discovery. Because of the risk of malignancy, they raise uncerta...

Incidentalomas are common affecting 1% and 7% of 40 and 70 year olds respectively. By contrast endogenous Cushing’s syndrome is excessively rare. 10% of cases of Cushing’s syndrome are caused by an autonomous adrenal tumour where, having confirmed the diagnosis (symptoms and signs, cortisol excess, suppressed ACTH, suppressed contralateral adrenal) the treatment of choice is indeed adrenalectomy. Complexities arise around the suggestion that 10–15% of all incide...

The widespread use of abdominal CT/MRI has resulted in a new and common diagnosis for the clinical endocrinologist – the management of patients with adrenal incidentalomas. Defined as an adrenal mass discovered incidentally in the work-up or treatment of clinical conditions not related to suspicion of adrenal disease, incidentalomas cover a spectrum of underlying adrenal pathologies with a common pathway of discovery. Because of the risk of malignancy, they raise uncertai...

In mammalian tissues, two isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD) catalyze the interconversion of hormonally active cortisol (F) and inactive cortisone (E). 11β-HSD2 is a high affinity dehydrogenase expressed in adult kidney that inactivates F to E protecting the mineralocorticoid receptor (MR) (which has equal affinity for F and aldosterone in vitro) from cortisol excess. ‘Cushing’s disease of the kidney’ occurs in the hyper...

One percent of the UK population takes chronic oral corticosteroids and this rises to 3% in subjects aged over 70 years old. When inhaled, topical and parenteral steroids are added to this burden, iatrogenic Cushing’s becomes a major health issue. High doses of medroxyprogesterone acetate can cause glucocorticoid effects and drug interactions may impair the metabolism of some glucocorticoids (e.g. fluticasone), thereby increasing their potency. In each case, patients may ...