Endocrine Abstracts

Childhood obesity is a highly prevalent, chronic, and progressive disease. While lifestyle therapy is the cornerstone of obesity treatment, this intervention is usually ineffective for achieving clinically significant and durable BMI reduction. The limitations of lifestyle therapy stem from the fact that this intervention does not address the underlying pathophysiology of obesity. Anti-obesity pharmacotherapy, in contrast, directly addresses the pathophysiology, thereby enhanc...

Background: Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies.Aim: To study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery.Setting: University teaching hospital in North-West England.Methods: We performed an observational cohort analysis of longitudinal data on vitamin D and related parameters in patients who underwent b...

Background: Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies.Aim: To study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery.Setting: University teaching hospital in North-West England.Methods: We performed an observational cohort analysis of longitudinal data on vitamin D and related parameters in patients who underwent b...

Hyperinsulinaemic-hypoglycaemia has been described following Roux-en-Y gastric bypass for obesity and is thought to be due to hyperfunction of pancreatic β cells. It has been questioned whether the β cell hyperfunction may have preceded the bariatric surgery and contributed to the obesity. We report a case of hyperinsulinaemic-hypoglycaemia in a non-diabetic, lean patient (BMI 26 kg/m2) who underwent distal gastrectomy and Roux-en-Y bypass for a benign gas...

Introduction: Adrenal incidentalomas are a common reason for endocrinology referral. We present a case of an incidentally discovered adrenal mass biochemically mimicking phaeochromocytoma with rapid resolution on subsequent imaging.Case report: A 53-year-old female was found to have a 5 cm mass adjacent to the right kidney on ultrasound performed to investigate abnormal liver function tests. CT confirmed a right adrenal mass. The patient was normotensive...

Studies show men and women differ in their aptitude towards different cognitive tests, which may be attributable to hormonal differences. It has also been postulated that oestrogen has disease-assuaging properties in some mental illness. The aim of this study was to assess the Cambridge Neuropsychological Test Automated Battery (CANTAB) as a tool for measuring cognitive differences between the sexes.A total of 43 volunteers, 20 women and 22 men, aged bet...

Case history: A 37-year-old female presented to her GP with myalgia, lethargy and weight gain. Of note she was 24 months post-partum and had not experienced thyroid problems in either of her two pregnancies. On examination she was overweight with marked myxoedema and proximal myopathy.Investigations: Serum TSH was greatly elevated at 206 mIU/l and free T4 was undetectable at <3.20 pmol/l. T3 was 2.8 pmol/l. She was referred urgently to the medical te...

A 73-year-old man was referred to the general medical clinic with a 3-year history of shortness of breath and wheeze. During assessment he commented that over the same period he had also had intermittent sweats, flushing and redness of the face especially after eating and taking red wine. Echocardiogram and urinary 24-h 5-hydroxyindoleacetic acid (5-HIAA) were arranged. Surprisingly two of three urinary 24-h urinary 5-HIAA were positive (43 and 47.5 μmol/24 h and 30 &#956...

The short synacthen test (SST) is the first-line test of adrenal insufficiency. Different centres have varying protocols for cortisol response. At Derriford Hospital cortisol is measured at 0, 30 and 60 min post-synacthen 250 μg (i.m./i.v.). A normal response is judged with a measured cortisol >550 nmol/l.A recent national audit questioned the bias created by the discrepancy between true cortisol (measured by mass spectrometry) and many laborato...

A 70-year-old woman was referred to the endocrine clinic with recently diagnosed diabetes mellitus and poorly controlled systemic hypertension. At presentation she had clinical features of Cushing’s syndrome including central obesity, Cushingoid facies and marked proximal myopathy. BP was 220/190. Initial biochemistry revealed plasma sodium 140 mmol/l, potassium 3.6 mmol/l and creatinine 82 mmol/l. Overnight 1 mg dexamethasone suppression test revealed cortisol 1148 mmol/...