Endocrine Abstracts

Background: Menopause marks the permanent cessation of periods for a woman. It is commonly associated with cognitive impairment. Oestrogens and progestins have been known to have a profound effect on the central nervous system and can exert neuroprotective effects on the cellular level. This led to the hypothesis that administration of oestrogens, progestins or a combination of both in the form of hormone replacement therapy (HRT) can have a protective or therapeutic effect ag...

A 72-year-old man known to have Churg-Strauss syndrome, Type 2 diabetes mellitus, hypertension and asthma presented with history of polyuria, night sweats, weight loss of 6 kg over 8 weeks and poor mobility. Pulse rate was 88/min and blood pressure 131/74 mmHg. He had generalised muscle wasting with significant proximal myopathy and grade 4/5 power in all four limbs. There was no evidence of vasculitis, arthropathy or other neurological deficit. Blood tests showed urea 10.6 mm...

Introduction: Coeliac disease (CD) is associated with an increased risk of osteoporosis. The aim of this study was to determine the efficacy and relevance of screening for osteoporosis in CD and to determine possible risk factors in the coeliac population. There has been no conclusive study concerning the efficacy of such screening programmes to date.Method: All Coeliac patients who attended a 2003 Coeliac clinic were reviewed by questionnaire, clinical ...

A young female presented concerned that she may have Addison’s disease. She had noted increasing pigmentation and reported her sister had died from undiagnosed Addison’s disease. She was hypotensive, with no postural drop in her blood pressure. She was hyponatraemic and hyperkalaemic. An initial 250 μg Synacthen test performed in the afternoon gave a baseline cortisol of 258 nmol/L and a 30 minute cortisol of 291 nmol/L. In view of this, the Synacthen test was r...

A 39 year-old man was referred with weight loss and lethargy in 2011. On examination tremor, goitre and mild orbital oedema were present. His past medical history consisted of hypertension (ongoing treatment). Investigations: fT4: 37 pmol/l (9–21), TSH: 0.00 mU/l (0.20–4.50), Anti Thyroid Peroxidase: 242.6 U/ml (0–50) and TRAbs: 11.2 iu/l (0–1.6). Graves’ thyrotoxicosis with moderately active eye disease was diagnosed and he started on carbimazole and ...

Insulinoma is a rare tumour, but is the commonest cause of hyperinsulinaemic hypoglycaemia in adults. It is characterised by symptomatic hypoglycaemia with inappropriately elevated plasma insulin and C-peptide levels. 10% of insulinomas are malignant. The coexistence of insulinoma with diabetes mellitus is extremely rare with only 20 previously reported cases. This can therefore pose a diagnostic challenge.An 83 year old man, who developed Type 2 diabete...

A para 2+0 female, 11 weeks gestation presented with vaginal bleeding and hyper-emesis. An ultrasound scan showed a dichorionic pregnancy with one viable foetus and a hydatiform mole. β-human chorionic gonadotrophin (β-hCG) level was elevated at 159845 U/L and subsequent thyroid biochemistry revealed hyperthyroidism. Serum thyrotrophin (TSH) was suppressed at <0.05 mU/L (NR 0.2–4.5), with a FT4 37 pmol/L (NR 9–24), and Free T3 of 17.8 nmol/L (NR 2.6&#15...

Oestrogen is an important regulator of the pituitary hormone prolactin (PRL) in vivo, although the regulation mechanism is poorly understood. Liganded oestrogen receptor (ER) synergises with the pituitary specific factor Pit-1 on the rat PRL promoter to facilitate chromatin looping and increased transcription; however, no such mechanism has been reported for the human PRL promoter, in which the ERE sequence is altered.In pituitary GH3 cells stably transf...

Oestrogens are capable of inducing rat prolactin gene transcription through liganded Oestrogen Receptor (ER) binding a degenerate oestrogen response element (ERE) sequence on the promoter 1440 bp upstream of the transcription start site. ER binding is thought to interact with DNA bound Pit-1 leading to chromatin looping bringing enhancer elements into proximity with the transcription start site. This ERE sequence, TGTCActaTGTCA, differs from the consensus GGTCAnnnTGACC by two ...

Alternative promoters control many genes including prolactin (PRL), which in man is expressed at extra-pituitary sites controlled by an alternative promoter located 5.8 Kbp upstream of the pituitary transcription start site. Previous studies using short promoter fragments may be misleading, as the human hPRL genomic locus has many conserved far-upstream regions. To study the function of the alternative promoter, we engineered a bacterial artificial chromosome (BAC) expressing ...