Endocrine Abstracts

Introduction: Disruption of the hypothalamic/pituitary axes may lead to hypopituitarism. Anterior pituitary deficiencies (APD) and arginine-vasopressin deficiency (AVP-D) are well established and are treated with hormone replacement. Over the last decade, preliminary studies support the presence of an oxytocin (OXT)-deficient state that might be clinically relevant in patients with hypopituitarism and hypothalamic damage (HHD). Therefore, identifying a provocative test to diag...

Introduction: Bile acid malabsorption (BAM) may be a contributing factor causing diarrhoea in patients with NETs, particularly among those who have undergone previous surgical resection of the terminal ileum and/or right colon or cholecystectomy (Naraev et al 2019). Aim(s): To identify the prevalence of bile acid malabsorption in neuroendocrine tumour patients (NET) at the Queen Elizabeth Hospital Birmingham (QEHB). Materi...

Background: In the UK, adults with growth hormone deficiency (GHD) are treated with recombinant Growth Hormone (GH) therapy according to NICE guidelines (TA64). Provided that patients show an initial improvement in their quality-of-life score, assessed using the Quality-of-Life Assessment of GHD in Adults (Qol-AGHDA) questionnaire, they can continue with their GH treatment long-term. However, in clinical practice, many patients are observed to discontinue GH r...

Adult growth hormone deficiency (AGHD) is a metabolic syndrome characterised by osteoporosis, increased visceral fat, adverse lipid profiles, decreased muscle mass and reduced energy levels. As such, it is associated with reduced quality of life (QoL) and increased mortality from cardiovascular disease. Synthetic growth hormone (GH) can be given to replace natural GH; however, treatment is costly at around £3350 per patient per year and could cause side effects including ...

In peripheral target tissues, levels of active glucocorticoid hormones are controlled by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) which catalyses the reduction of cortisone to cortisol within the endoplasmic reticulum. For functional 11-ketoreductase activity, 11β-HSD1 requires the NADPH-generating enzyme hexose-6-phosphate dehydrogenase (H6PDH). Loss of 11-ketoreductase activity results in increased cortisol clearance and activation of the HPA axis wi...

Cardiovascular diseases account for more deaths in the Western world than from any other cause. Atherosclerosis has a chronic inflammatory component involving Th1 pro-inflammatory cytokines such as IFN-γ, which is known to induce endothelial cell inflammatory responses. CNP, acting via its receptors to elevate intracellular cGMP, is produced by endothelium and endocardium and is upregulated in atherosclerosis. It is believed to be protective yet its role in vascular infla...

The hepatic peptide hormone hepcidin is the principal regulator of iron absorption and tissue iron distribution. Hepcidin circulates in blood plasma and acts at nanomolar concentrations by inducing degradation of its receptor, the cellular iron exporter ferroportin. Ferroportin exports iron into plasma from absorptive enterocytes, from macrophages that recycle the iron of senescent erythrocytes, and from hepatocytes that store iron. Therefore, hepcidin-mediated degradation of ...

Introduction: Psychological symptoms such as aggression, confusion, irritation, anxiety and depression have been observed clinically in patients with carcinoid syndrome. It has been suggested that vasoactive-hormone secretion are involved in provoking psychological symptoms. The objective of this qualitative study is to explore the presence and experience of specific psychological symptoms in vasoactive hormone-secreting NET (carcinoid syndrome).Methods:...

Advances in childhood cancer treatment have led to an overall 5 year survival rate of almost 80%. As a result 1 in 900 adults are now childhood cancer survivors but have increased risk of long-term health consequences. Data from the USA, UK, and Europe have demonstrated a standardised mortality rate of 8.4–10.8. Cardiovascular morbidity (congestive heart failure, myocardial infarction, and strokes) have been reported as the commonest non-neoplastic causes of mortality, wi...

A 69-year-old South Asian male presented in A+E with hyponatremia. He had pervious history of Lyme Node TB (treated 2014), Asthma and Nasal Polyps. Medication history, patient was taking Fludrocortisone nasal spray for the 30–40 years and Seretide inhaler. Also, CT scans at admission did not identify relapse in Lyme Node TB. Upon investigation he was found to have undetectable morning cortisol (<28 mmols). He was started on Hydrocortisone 10 mg, 5 mg and 5 mg regime, ...