Endocrine Abstracts

Background: Hypercalcaemia is a commonly encountered electrolyte abnormality within the acute medical take; identification of the underlying aetiology can guide optimised care.Case : A 23 year old male patient with a background of insulin dependent diabetes, diabetic nephropathy (chronic kidney disease stage 1) was admitted feeling acutely unwell. Clinical and bed side investigations identified he was in severe diabetes ketoacidosis. His condition prompt...

Background: Adrenal crisis is a potentially life-threatening situation which can affect any patient with adrenal insufficiency (AI). Patients with AI and healthcare professionals looking after them should know the sick day rules and when and how to use parenteral hydrocortisone. Patient stories and feedback from patients with AI indicated low standards locally. We therefore aimed to empower patients through education and provide them with a hydrocortisone emergency kit.<p ...

Case history: Thyrotoxic periodic paralysis (TPP) which was first described in 1902 is characterised by episodes of painless muscle weakness, hypokalaemia and thyrotoxicosis without any total body potassium deficit. It predominantly affects people of Asian descent between 20 and 40 years old with a 2 percent incidence compared to 0.2 percent in non-Asian descent. The pathogenesis of TPP is related to an increase Na+/K+-ATPase activity in the skeletal muscle leading to an influ...

We present a case of 18 Year male with autoimmune polyendocrine syndrome who presented with seizures to A and E presumed secondary to his profound severe hypocalcemia. Adjusted calcium levels of 1.80 mmol/l.Background: Primary adrenal insufficiency, Hypoparathyroidism, Pancreatic insufficiency and malabsorption, Pernicious anaemia, Aspergers syndrome and Stem cell deficiency in the eye. On admission he received calcium gluconate stat doses which was foll...

Background: The benefits of patient education in women with polycystic ovary syndrome (PCOS) are known but a cost effective way to offer the education to these patients need to be assessed. As part of a quality improvement project in an outpatient setting we tested the idea of incorporating group education for women with PCOS in their routine care process. We tested two different methods.Methods: 1. January-June 2017: Ad hoc open patient invitation<p...

Retinol binding protein-4 (RBP4) is an adipokine reportedly linked to physiological states of insulin resistance and impaired glycaemia. Pregnancy is a physiological state characterised by changes in carbohydrate metabolism and increased insulin resistance. Our aim was to determine plasma levels of RBP4 during early pregnancy, late pregnancy and postpartum in normal women.Fasting plasma levels of RBP4, insulin and glucose were collected and assayed (ELIS...

A 54-year-old Asian man with type two diabetes diagnosed 6 years ago was admitted to hospital in May 2011 because of deteriorating renal function. His eGFR had been stable until April 2011 when his eGFR dropped from 37 in January 2011–2021. Repeat eGFR 2 weeks later was 17 and his family doctor felt he needed to be admitted to hospital. He was on metformin alone which was stopped. His HbA1c was 6.4% (48 mmol/mol). He had hypertension and was on four antihypertensive agent...

Insulin resistance and androgen excess are the cardinal features of polycystic ovary syndrome (PCOS). The severity of hyperandrogenism and metabolic dysfunction in PCOS are closely correlated but the underlying mechanisms are poorly understood. Aldoketoreductase type 1C3 (AKR1C3) is an important source of adipose androgen generation (converting androstenedione to testosterone) and we have postulated that it may have a critical role linking androgen metabolism and meta...

Cardiovascular disease and diastolic hypertension are major causes of morbidity in Cushing’s although left ventricular failure is more rarely described. There are three other cases of documented dilated cardiomyopathy with subsequent left ventricular failure.Thirty-five year old lady who presented with obesity and striae was found to have a suppressed ACTH, elevated cortisol (914 post dexamethasone suppression test) and a right adrenal adenoma (on C...

A genome wide meta-analysis by the CORtisol NETwork (CORNET) consortium1 has identified genetic variants spanning the SERPINA6/SERPINA1 locus on chromosome 14 associated with changes in morning plasma cortisol and predictive of cardiovascular disease (Crawford et al, Unpublished). SERPINA6 encodes Corticosteroid Binding Globin (CBG) which binds most cortisol in blood and influences delivery of cortisol to target tissues. We hypothesised th...