Endocrine Abstracts

ISPAD’s revised ‘sick day guidelines 2022’ highlighted the necessity to review Oxford University Hospital Guidelines. Prevention and correct management of ketosis is essential when children with Diabetes are unwell and involves confident management of advanced and increasingly common Diabetes Technologies. Inpatient admissions were reviewed over 1 year. Medical records were studied to assess monitoring of blood glucose levels and ketones. In the presence of keto...

Background: The calcium sensing receptor (CaSR) plays a pivotal role in systemic calcium metabolism by regulating parathyroid hormone (PTH) secretion and urinary calcium excretion. Autosomal dominant hypocalcaemia type 1 (ADH1) is a disorder of extracellular calcium homeostasis caused by activating germline gain-of-function mutations of the CaSR.Case: A 13-year-old girl was referred from primary care with hypocalcaemia. She was under CAMHS for eating dis...

Background: The glucagon tolerance test (GTT) is used to diagnose growth hormone deficiency (GHD) in younger children or in patients where the insulin tolerance test is contraindicated. We assessed GTTs carried out over five years in a tertiary paediatric centre to assess growth hormone (GH) and cortisol axes. The aim was to assess at which time points the GH peak was observed, and assess whether any predictive value is gained from demographics or IGF-1....

GH deficiency is recognised as a complication of adult traumatic brain injury (TBI) but there are conflicting data in children possibly due to the influences such as age at TBI, trauma mechanism but also by timing, method and criteria of hormonal evaluation.Objectives: To assess the long-term impact of TBI on the GH–IGF1 axis following TBI in childhood.Patients: Longitudinal study of 28 participants with a history of moderate/...

A 6-month-old, ex premature 25-week-old girl, presented with 7 episodes of painless vaginal bleeding over 48 hours period and breast development. She was born to a non-consanguineous couple and had normal female genitalia at birth with slightly enlarged clitoris. Her mother had pre-eclampsia and focal segmental glomerulonephritis. Baseline investigations (full blood count, liver/kidney/thyroid function and clotting) were all normal. Endocrine investigations included urine for ...

Background: Insulin tolerance test (ITT) is the gold-standard investigation in children with suspected growth hormone deficiency (GHD). Despite their benefits, ITTs are resource intensive, potentially dangerous and can result in unnecessary treatment due to false positive results in children that are at low risk for GHD.Methods: Retrospective analysis of all paediatric patients undergoing an ITT in two tertiary hospitals in the UK (centre A between 2017-...

Objectives: To determine long-term functional outcome following traumatic brain injury (TBI) in childhood.Patients: Longitudinal study of 49 participants with TBI (21 mild, 28 moderate/severe TBI) and 16 healthy controls matched for age, gender and socioeconomic status. Age at TBI (median (range)) 11.8 (1–16) years; 17 were prepubertal, 16 peripubertal, 16 postpubertal. Age at study 19.7 (10–26) years, time post TBI 8.6 (5.8–10.8) years. A...

Background: The ITT has been said to be the gold standard for diagnosing GH deficiency (GHD) for 50 years. The original 0, 20, 30, 60, 90 and 120 min time points are still used in many but a survey of current UK paediatric ITT protocols identified several variations.Objective and hypotheses: To identify optimal GH sampling time points to avoid over diagnosis of GHD.Methods: Results of 502 paediatric ITTs using two different samplin...

Background: Neuroendocrine tumours (NETs) are extremely rare in children and adolescents (incidence approximately 2.8 cases per million). Around 10-20% of paediatric NETs present with metastatic disease at diagnosis.Aim: We present a case of metastatic poorly differentiated NET in a teenager with a suspected right lung primary as a rare cause of ACTH-dependent ectopic Cushing’s syndrome (CS).Case presentation: A 15-year-old se...