Endocrine Abstracts

Prohormone convertase 1/3 (PC1/3), encoded by protein convertase subtilisin kexin type 1 (PCSK1), converts inactive prohormones such as pro-opiomelanocortin, proinsulin, proglucagon into biologically active peptides. Inherited genomic mutations of PCSK1 present with malabsorptive diarrhoea, hyperinsulinemic hypoglycaemia, central adrenal and thyroid defects and severe obesity. Somatic mutations of insulinomas are associated with genetic defects interfering with insulin secreti...

Prednisolone is widely prescribed in the UK, whereas prednisone is used instead for the same indications in the United States. Both have utility as anti-inflammatory agents and for use as glucocorticoid replacement therapy at lower doses. Oral prednisone is converted to prednisolone by first pass hepatic metabolism by 11 beta HSD-1. This study was undertaken to compare the bioavailability of prednisone against prednisolone. To determine the conversion of prednisone to predniso...

Background: Dexamethasone significantly improved outcomes in patients requiring supplementary oxygen and in ventilated patients with COVID-19 in the RECOVERY trial. Consequently, dexamethasone is now routinely used in these patients. However, dysglycaemia is commonly associated with steroid use and is an established risk factor for poorer outcomes in COVID-19. In this study, we aimed to elucidate the effect of dexamethasone use in patients hospitalised with COVID-19 in a real-...

Introduction: Subactue thyroiditis (SAT) is a self-limiting inflammatory condition caused by follicular destruction of the thyroid gland, commonly precipitated by viral upper respiratory tract infection 2 weeks preceding the onset of thyroid symptoms. However, SAT following COVID-19 vaccination is rare. Herein, we report two cases of subacute thyroiditis which presented after administration of COVID-19 vaccine. Case series: The first patient was a 42 yea...

Background: Adrenocortical carcinomas (ACC) are rare aggressive tumors occurring at a rate of less than two per million per year. Uncommonly, there can be intravascular extension into renal veins and inferior vena cava (IVC), with resultant poorer prognosis.Clinical Case: A 26-year-old woman was referred for investigation of a two-month history of persistent left-sided abdominal pain - Computed tomography (CT) revealed a heterogeneous 12 cm left adrenal ...

Introduction: Free ionised calcium is the biologically active component of total circulating calcium but is infrequently measured due to sampling requirements. Therefore, total calcium is ‘adjusted’ for albumin to provide a closer estimate of the biologically active ionised calcium level (e.g. James, Orell, Payne and Berry formulae). Here, we aim to derive a novel equation to estimate ionised calcium from readily available biochemical parameters and compare its perfo...

Objective: To determine if the impact of pre-pregnancy body mass index (BMI), fasting glucose levels and post load glucose levels on large for gestational age neonates varies with ethnicity.Data sources: Electronic health records of all eligible pregnant women in an inner city service. Study designRetrospective analysis of pregnant women at risk of developing gestational diabetes mellitus (2016-2019) of. Population or sampleEligible pregnant women. Synth...

Introduction: Kallmann syndrome (KS) is a rare genetic disorder typically due to defective migration of olfactory-axons and GnRH-neurons. KS results in congenital hypogonadotrophic hypogonadism (CHH) typically associated with absent (anosmia) or reduced (microsmia) sense of smell. Unilateral hypoplastic/absent olfactory bulbs on MRI are reported, although disturbance in smell is usually bilateral. Here, we present an unusual case of KS with unilateral anosmia....

Background: The Short Synacthen test (SST) is commonly used in clinical practice to evaluate adrenal function. Appropriate patient selection for SST is needed to ensure accurate interpretation of the results and to mitigate increased healthcare costs associated with unnecessary testing and inappropriate glucocorticoid (GC) steroid replacement. This study aimed to investigate the indications of inpatient SSTs over a one-year period, to determine the accuracy of testing.<p c...

Background: Hypogonadotrophic Hypogonadism (HH) is characterised by hypogonadism in the context of low gonadotrophin levels, frequently due to a defect in hypothalamic function e.g. Kallman’s syndrome. However, no direct test of hypothalamic function currently exists. Kisspeptin is a hypothalamic neuropeptide that stimulates endogenous GnRH release. Thus, we investigated whether kisspeptin could be used to interrogate hypothalamic function in men with HH.<p class="abs...