Endocrine Abstracts

Background: Numerous studies have reported the role of the N-terminal of pro-opiomelanocortin (N-POMC1-76) and its smaller fragments; 1-28 and 1-49, in adrenal steroidogenesis and mitogenesis. A full understanding of this area will help to understand the pathophysiology of certain adrenal tumours but exactly how these peptides elicit this effect is unclear. We have recently identified an orphan G protein-coupled receptor (GPCR) as a possible N-POMC receptor. Preliminary data s...

Plasma adrenocorticotrophin (ACTH) is extremely labile and far from an ideal analyte for use in the diagnosis of Cushing’s syndrome. Processing of ACTH by some ectopic tumours releases high levels of smaller ACTH-like fragments, α-MSH and CLIP, which can interfere with individual antibodies in current diagnostic immunoassays. Furthermore, cross-reactivity with the precursor of ACTH, pro-opiomelanocortin (POMC), increases the likelihood of erroneous interpretations an...

A 51 year old woman presented with severe Cushing’s syndrome. In addition to a typically Cushingoid appearance she demonstrated increased cutaneous pigmentation in her face and upper chest. Biochemical investigation confirmed elevated serum cortisol levels with loss of circadian variation, and failure to suppress with low dose dexamethasone (0.5 mg 6 hourly for 48 hours). Serum ACTH levels were undetectable. Cross-sectional imaging revealed bilateral macronodular adrenal ...