Endocrine Abstracts

A 24-year old male who, was normal at birth, became listless and volume depleted at 3 weeks of age. Investigations yielded an Addisonian picture (serum Na+ 115 mmol/l; K+ 8.2 mmol/l; urea 15.8 mmol/l). Serum 17-hydroxyprogesterone (17-OHP) levels were measured and found to be high (2,564 nmol/l). Urinary 17-oxosteroids and 17-OHP were also elevated. The neonate was thought to have 21-hydroxylase-deficient congenital adrenal hyperplasia (CAH) and therapy with fludrocortisone an...

A thirty year old woman with complete 21-hydroxylase deficiency presented with a five centimetre adrenal mass necessitating operative removal to exclude malignant change. Her medical management had always been unsatisfactory, and she had been tried on both hydrocortisone and dexamethasone. When taking 1 milligram dexamethasone daily she had partially suppressed androgen levels, (evidenced by a fall in 17-hydroxy-progesterone levels to 29 nmol/l), at the expense of marked Cushi...

WF a 52 year old female was referred to the Hammersmith Hospital in August 2001 for further investigation of her persistently elevated fasted gut hormones (GIH) [all previously assayed at the Hammersmith Hospital]. WF was initially diagnosed with irritable bowel syndrome 16 years ago. Following an exacerbation of her condition 9 years ago, fasting gut hormones were performed, which showed gross elevation of all peptides measured.The possibility of a neuroendocrine tumour was p...

Kisspeptin, encoded by the KiSS-1 gene activates the G protein coupled receptor 54 (GPR54). The kisspeptin/GPR54 system plays an essential role regulating reproductive development. The human placenta has a high expression of both the KiSS-1 and GPR54 genes. Plasma kisspeptin levels increase several thousand fold in pregnancy. The physiological role of kisspeptin in pregnancy is not clear. Kisspeptin causes vasoconstriction during in vitro studies and may play a r...

A 60-year-old gentleman who had previously undergone a right nephrectomy for renal cell carcinoma was admitted electively for a left adrenalectomy due to metastatic disease. Prior to this he had been treated with immunotherapy (Sunitinib) and radiotherapy for pulmonary and bony metastases respectively. He was given perioperative cover with hydrocortisone. A short synacthen test (SST) performed the morning after discontinuing hydrocortisone showed a baseline cortisol of 406 nmo...