Endocrine Abstracts

A 66 year old woman was referred to endocrinology in January 2023 with severe hypercalcaemia of 4.7mmol/ladjusted (2.2-2.6mmol/l) and low normal PTH of 1.8 pmol/l(1.6-6.9 pmol/l). She presented with one week of cough, breathlessness and fatigue, and 3-4 days of nausea and vomiting. She had commenced Furosemide 40 mg for bloating symptoms one month prior. She had a history of breast cancer treated with mastectomy and lymph node clearance in 2019, with subsequent Letrozole (ongo...

Introduction: Nephrolithiasis and osteoporosis are more common in people with primary hyperparathyroidism (PHPT), although the clinical factors associated with this risk are not well characterised. Recent evidence has suggested parathyroid hormone concentration, but not calcium, is associated with mortality in PHPT.Methods: Retrospective analysis of all patients presenting to the Edinburgh Centre for Endocrinology & Diabetes wi...

Introduction: The performance of biochemical and imaging investigations in contributing towards successful surgical outcomes is not well characterised in PHPT.Methods: Retrospective analysis of all patients presenting to the Edinburgh Centre for Endocrinology & Diabetes with PHPT between 2006 and 2014 (n = 611). Parathyroid surgery was performed in 44.8%.Results: PTH was greater than 2x ULN in 34...

Introduction: Nephrolithiasis and osteoporosis are more common in people with primary hyperparathyroidism (PHPT), although the clinical factors associated with this risk are not well characterised. Recent evidence has suggested parathyroid hormone concentration, but not calcium, is associated with mortality in PHPT.Methods: Retrospective analysis of all patients presenting to the Edinburgh Centre for Endocrinology & Diabetes wi...

Introduction: The performance of biochemical and imaging investigations in contributing towards successful surgical outcomes is not well characterised in PHPT.Methods: Retrospective analysis of all patients presenting to the Edinburgh Centre for Endocrinology & Diabetes with PHPT between 2006 and 2014 (n = 611). Parathyroid surgery was performed in 44.8%.Results: PTH was greater than 2x ULN in 34...

IntroductionPituitary macroadenoma requires extensive endocrine investigations to diagnose any evidence of hormone excess or deficiency. As a part of routine investigation, IGF-1 is frequently used to exclude growth hormone excess. Here we report 3 cases of pituitary macroadenoma, who had a normal pre-operative IGF-1 but post-operatively developed biochemical evidence of growth hormone excess.CasesWe report 3...

Patients with Polycystic ovarian Syndrome (PCOS) present to an endocrine clinic with weight gain, hirsutism or period irregularities. Dianette is widely used to treat these problems but can lead to weight gain. Weight loss in PCOS has been shown to improve these clinical features but difficult to achieve. More recently Metformin therapy has been shown to improve period irregularities in PCOS. The role of slimming agents has not been studied previously.Pa...

PCOS is the most common endocrine disorder affecting the women of reproductive age group and weight loss is the mainstay of management of PCOS. We performed an open-label randomised controlled trial to compare the effects of a conventional energy deficit approach (-600 kcal/day of the total energy requirements) vs. a very low-calorie diet (VLCD: 800 kcal/day) on free androgen index (FAI), body weight, and metabolic markers in women with PCOS. Forty-one eligible patients were r...

Medical treatment of acromegaly is based on either suppressing pituitary GH secretion or inhibiting GH action by preventing interaction with its receptor in order to suppress the elevated levels of IGF1. AZP-3813 is a 16-amino acid, bicyclic peptide antagonist of the GH receptor (GHR) derived from peptide sequences discovered using a unique, cell-free in vitro transcription-translation system screened against the human GHR, and that was optimized by rational design to increase...

Case history: We present the case of a 72-year-old lady who presented to the surgical team with sudden onset abdominal (flank) pain. On initial assessment, she was significantly hypertensive (213/110 mmHg) and tachycardic (pulse 98 bpm) but afebrile. She was not on any anticoagulation. On physical examination, her abdomen was tender with mild guarding and retroperitoneal tenderness.Investigations: Admission blood tests showed a normal haemoglobin (149 g/...