Endocrine Abstracts

Human studies have suggested that local glucocorticoid (GC) generation within osteoblasts plays a critical role in bone loss seen during aging, in response to inflammation and treatment with GCs. Human osteoblasts express the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that converts inactive GCs (cortisone, dehydrocorticosterone, prednisone) to their active counterparts (cortisol, corticosterone, prednisolone). Enzyme expression increases with age, in r...

Myelinolysis is a recognised complication following over-rapid correction of hyponatraemia. However, the risk of myelinolysis following the treatment of Addisonian crisis is rarely reported. We report 2 cases of primary adrenal insufficiency (PAI) both associated with severe hyponatraemia. In the first case, myelinolysis developed following treatment with corticosteroids and isotonic saline in line with current recommendations. In the second case, deliberately cautious correct...

Glucocorticoids (GCs) are important therapeutic agents for a wide-variety of inflammatory diseases but are known to have potentially detrimental side-effects such as osteoporotic bone-loss. These effects of GCs are mediated via the intracellular GC receptor (GR) and by local GC metabolism catalyzed by 11beta-hydroxysteroid dehydrogenase (11beta-HSD). We have postulated that autocrine activation of GCs via 11beta-HSD1 plays a key role in counteracting the effects of inflammator...