Endocrine Abstracts

Oestrogen implants are one method of delivering hormone replacement therapy to post-menopausal women. The use of such implants has been associated with the phenomenon of tachyphylaxis, where menopausal symptoms return before the next implant is due, even in the presence of normal or high serum oestrodiol levels. It has been suggested that intervals as long as one year should be left between implants and that trough oestrogen levels should be measured prior to implantation....

Introduction: Diabetes Ketoacidosis, DKA, is a serious condition with significant morbidity and mortality. Most DKA patients are potassium deficient, but present with hyperkalaemia due to severe acidosis and insulin deficiency. Hypokalaemia at presentation of DKA is extremely uncommon.Clinical case: A 25 year old man was admitted with severe DKA as a first presentation of diabetes. His venous pH was 6.97, bicarbonate 3.0 mmol/l, potassium 3.4 mmol/l. He ...

Aim: We present an unusual case of long-term accidental ingestion of androgenic steroid in a young female.Case: A 28-year-old lady presented with male pattern of hair growth, weight gain of three stones, change in voice, and secondary amenorrhea. On direct questioning she admitted she was taking ‘fat bursting pills’ for nearly 6 months, obtained from a gym, to lose weight. Examination revealed a blood pressure of 150/77 mmHg, increased muscle b...

We present a case of primary hyperparathyroidism in a pregnant woman presenting with recurrent vomiting.A 34 year-old Asian woman was admitted with nausea and vomiting at 8 weeks gestation. Clinical examination was unremarkable apart from dehydration. Electrolytes and thyroid function were within normal limits. A diagnosis of hyperemesis gravidarum was made and patient was discharged after rehydration. Over the next eight weeks she presented with similar...

ObjectiveThe incidence of maturity-onset diabetes of the young (MODY) in the UK diabetic population is around 1–2% and MODY can also present for the first time in pregnancy. About 70% of cases are caused by mutations in the HNF1α gene. A diagnosis of MODY can affect management following delivery and informs patients. However, untargeted testing is not cost-effective. We wished to see whether screening a sub-group of pregnant women with a high r...

Ritonavir is a protease inhibitor used in the treatment of HIV infection. It can potentiate the effect of inhaled corticosteroids, resulting in iatrogenic Cushing’s syndrome.We present a case of a 21-year-old female who had acquired HIV infection at birth, who also had moderately severe asthma since childhood treated with inhaled salbutamol 100 mcg prn and fluticasone 500 mcg bd. She had twice-yearly exacerbations requiring oral steroids. She commen...

Primary hyperaldosteronism is now recognised as the most frequent underlying cause of hypertension. We recruited 94 patients (age (mean±S.D.) 56±11 years) with hypertension from primary care in order to study the role of corticosteroid hormone action in this cohort. Random, blood pressure (BP), plasma renin activity (PRA) and aldosterone (Aldo) was measured both on and off antihypertensive medication. In addition, a 24 h ambulatory blood pressure (ABP)...

Introduction: A previous case-report described one individual whose significant sleep disturbance in association with septo-optic dysplasia (SOD) was corrected with melatonin administration. Subsequently a trial of melatonin treatment in children with SOD and sleep disruption has become accepted clinical practice in many centres. There are however no published data describing melatonin secretion in these individuals.Methods: We studied six children with ...