Endocrine Abstracts

A 29 year old gentleman was referred for investigation of subfertility and hypogonadism. He gave a history of normal erections and libido but had never shaved in his life. Though he denied anosmia, his maternal uncle had a poor sense of smell and his great uncle had needed to adopt children. He was markedly undermasculinised with micropenis and an empty scrotal sac. Neurological assessment showed subtle features of bimanual synkinesis (mirror movements), suggesting X-linked Ka...

A 43-year-old policeman was referred for investigation of recurrent symptomatic hypomagnesaemia. He initially presented with a one week history of dizziness, headaches, and ‘funny turns,’ on a background history of bronchial asthma, reflux oeosphagitis and hypertension. Initial investigations demonstrated hypocalcaemia, hypomagnesaemia and hypophosphataemia. These disturbances were attributed to his thiazide diuretic which was subsequently discontinued; his symptoms ...

Background and Objective: CB1 antagonism may have potential benefits in the metabolic syndrome, with effects mediated through central orexigenic mechanisms and peripheral action on adipose tissue. We have previously described the effects of CB1 activation/inactivation on murine white preadipocyte 3T3-L1 proliferation; we now extend these studies to human tissue.Method: Ethical approval was obtained for this study. Human preadipocytes were isolated from w...

Case Summary: A 72 year-old man presented with a one month history of anorexia, weight loss, lethargy, constipation, increased thirst and generalised aches and pains. He had a background of hypertension, ischaemic heart disease, aortic stenosis, and a renal transplant 23 years ago with declining renal function. No significant abnormalities were noted on physical examination. Investigations confirmed hypercalcaemia, with serum calcium rising from 2.8–3.05 mmol/l. This was ...

Hypoglycemia is an uncommon clinical problem in patients without diabetes mellitus. Potential aetiologies include drugs, critical illness, hormone deficiencies, and non islet cell tumors. In the absence of these causes, the possibility of accidental, surreptitious, or even malicious hypoglycemia should be considered. We present three cases of severe, prolonged hypoglycemia occurring spontaneously in healthy young men without a history of diabetes mellitus or chronic illness. A...

A 46-year-old gentleman presented with a history of general lethargy, weight gain, limb weakness, easy bruising and severe back ache. Examination showed central obesity, proximal myopathy, with marked thinning and extensive bruising of the skin. His blood pressure and glycemic control were suboptimal and resistant to treatment. Routine blood tests including a chest X-ray were normal. An overnight dexamethasone suppression test showed failed serum cortisol suppression (749 nmol...

A 51-year-old woman with no significant past medical history presented with left flank pain, accelerated hypertension, progressive deterioration in renal function and left sided pleuritic chest pain. CTPA revealed pulmonary oedema and left adrenal haemorrhage. Urinary catecholamines were marginally elevated (24 h Urinary Metadrenalines 7.58 μmol/24 h) raising the possibility of an underlying phaeochromocytoma. Short synacthen test showed a sub-optimal response (0 min cort...

Background and aims: Subjects with primary (PAI) and secondary adrenal insufficiency (SAI)/hypopituitarism have an increased cardiovascular mortality for reasons that are unclear. Arterial stiffness is an independent risk factor for increased cardiovascular mortality. We sought to measure arterial stiffness in subjects with AI and aimed to identify which factors might account for any increase observed.Methods: Ethical approval was obtained for this study...

Background: CB1 antagonism has potential benefits in the metabolic syndrome, with effects mediated through central orexigenic mechanisms and peripheral action on adipose tissue. We have previously demonstrated the inhibitory effects of CB1 inactivation on preadipocyte proliferation and now extend these studies to in vitro adipogenesis.Aims: To compare the effects of CB1 agonism and antagonism on differentiation in both preadipocyte cell lines and ...

Hypoparathyroidism post-thyroidectomy is a recognised complication and treated with calcium supplements, vitamin D, and rather recently with recombinant human parathyroid hormone therapy (teriparatide). We report a case of a 68-year-old female who developed refractory hypocalcaemia and hypomagnesaemia following thyroidectomy for a multinodular goitre. Her management was complicated by inflammatory bowel disease, surgically treated with an ileostomy in situ. Post-opera...