Endocrine Abstracts

Background: PCOS is associated with a clustering of cardiovascular risk factors. Increased serum levels of vascular endothelial growth factor (VEGF) are thought to be proatherogenic, and have also been found to be elevated in PCOS. This study was undertaken to determine the changes of VEGF in patients with PCOS after rimonabant and/or metformin intervention.Methods: A 6-month randomised open labelled parallel study of rimonabant or metformin in 20 patien...

Phaeochromocytomas (Phaeo) and paragangliomas (PGL) are rare catecholamine producing tumours. It can be difficult to predict their malignant potential and patients can sometimes present with metastatic disease many years after their original diagnosis (1). Therefore, we offer a single dose of adjuvant 131I-Metaiodobenzylguanidine (131I-MIBG) to subjects felt to be at higher risk of local recurrence (demonstration of capsular or vascular invasion on pathol...

A 38-year-old lady, who was 9 months post-partum, presented in 2008 with hirsutism, acne and abdominal discomfort. She was virilised and had an easily palpable right upper quadrant mass. Biochemistry revealed mild hypokalaemia (K 3.3 mmol/l), low albumin and gross elevation of serum androgens (androstenedione 93.9 nmol/l, DHAS 37.7 μmol/l and testosterone 13.7 nmol/l). UFC was 380 nmol/24 h but following 1 mg dexamethasone, cortisol suppressed fully. Urine steroi...

A 38-year-old lady presented in 2003 with a 2 years history of recurrent pneumonia, with CXR having demonstrated intermittent right lower zone consolidation. CT of chest revealed dense right lower lobe consolidation and a 2.5 cm tumour occluding the right lower lobe orifice was found on bronchoscopy. Strongly positive immunohistochemical staining for chromogranin, NCAM, PGP 9.5 and synaptophysin suggested carcinoid so right lower and middle lobectomy was performed. Histology c...

Polycystic ovary syndrome (PCOS) is a triad of insulin resistance, hyperandrogenism and anovulation. PCOS is associated with increased adrenocortical drive and 5alpha-reductase activity, which may have adverse metabolic consequences. Here we analysed the relationship of urinary androgen and glucocorticoid metabolite excretion with markers of insulin resistance in a large PCOS cohort. We compared results from 127 PCOS patients fulfilling Rotterdam diagnostic criteria with 100 B...

Background: Continuous subcutaneous insulin infusion (CSII) is proving superior in reducing HbA1c compared to multiple daily injections (MDI) in both the adult and paediatric populations. This study aims to compare the two methods, and evaluate the importance of education when starting insulin pump therapy in children.Design: Patients who attended a ‘pump school’ provided by the Royal Manchester Children’s Hospital between January 2010 and...

Aims: Childhood obesity is reaching epidemic proportions. Obesity may be primary (obesogenic environment), secondary (hormonal imbalance, drugs), monogenic (POMC) or be part of a complex phenotype-genetic obesity syndromes. It is important to distinguish between classifications. Our aim was to review our cohort of ‘obese’ patients with this in mind.Methods: Patients referred to our Paediatric Endocrinology Service specifically for management of...

A 52-year-old man was referred in June 2009 with weakness, unsteadiness, diarrhoea and weight loss of 14 kg in the last 4 months. His past medical history included hypertension, ischaemic heart disease and chronic obstructive pulmonary disease. He was a heavy smoker and admitted to drinking heavily for the past 9 months. His serum sodium was 126 mmol/l, serum potassium 2.0 mmol/l, serum bicarbonate 31 mmol/l. His chest X-ray was normal. He had had persistent hypokalaemia for 4...

A 30-year-old Caucasian lady was diagnosed with type 2 diabetes in July 2005 on an oral glucose tolerance test and was treated with metformin. Sixteen months later she presented with urinary symptoms and was noted to have 2+ ketonuria. Her blood glucose was 13.4 mmol/l. Her BMI was 26 kg/m2 and she was noted to have Cushingoid habitus and acanthosis nigricans. Her blood pressure was normal. Her serum sodium was 130 mmol/l, potassium 3.7 mmol/l and bicarbonate 8 mmol...

Introduction: Insulinoma is a tumour, derived from the beta cells of the pancreas. The incidence in the general population is 4 cases per million a year. 80 to 90% of insulinomas are benign and <10% are malignant.Case presentation: A 67-year-old lady was admitted via the emergency department after being found unresponsive at home. She was found to be hypoglycaemic and responded to i.v. dextrose. She was diagnosed with type 2 diabetes mellitus a year ...