Endocrine Abstracts

Abstract unavailable....

Parathyroid hormone(PTH) is released by the parathyroid glands to regulate the concentration of ionised calcium in extracellular fluid.Any change in ionised calcium is followed by reciprocal changes in PTH secretion. PTH acts on the kidney to increase the renal tubular reabsorption of calcium and to increase the synthesis of the hormonal metabolite of vitamin D which enhances the intestinal absorption of calcium. Prolonged PTH secretion increases calcium release from bone as a...

Treatments of hyperglycaemia have mostly focussed on targeting fasting glucose. These include Metformin, most sulphonylureas and conventional insulin therapy and, more recently, the glitazones. However, management of postprandial hyperglycaemia in day-to-day practice in both type 1 and type 2 diabetes is now becoming clinically relevant for a number of reasons.There is now robust evidence in women with gestational diabetes that specifically targeting pos...

Primary hyperparathyroidism (PHP) is a common endocrine condition. The associated metabolic abnormalities are usually amenable to surgical treatment (PTX). Although it is generally believed that such treatment will reduce the risk of long-term complications this has not been demonstrated in a clinical trial and the current treatment guidelines are based on consensus. In order to assess the effect of parathyroidectomy on two of the most common complications of PHP, renal stones...

Cinacalcet, a calcimimetic, is licensed for the management of primary hyperparathyroidism (PHP) where surgery is deemed inappropriate. It is unclear when patients might be deemed more appropriately managed by medical treatment rather than surgery. We report two cases in which cinacalcet has been used to predict the effect of parathyroidectomy and a choice to be made between surgery and conservative management.A 43-year-old woman had a parathyroid adenoma...

A 57 year old Caucasian woman complained of severe back pain and arthralgia of large joints. Her arthralgia gradually got worse and she also noticed proximal muscle weakness. Blood tests showed normal CRP but elevated alkaline phosphatase of 521 iu/l with normal Gamma GT. Phosphate was low at 0.75 mmol/l with normal corrected calcium of 2.6 mmol/l. A DEXA scan suggested osteoporosis (Spine T −2.5). Isotope bone scan revealed increased activity in the right tibia and plai...

Introduction: The biochemical diagnosis of acromegaly is based on elevated plasma growth hormone (GH) that fail to suppress after an oral glucose load. Elevated insulin like growth factor 1 (IGF1) supports the diagnosis. Traditionally GH level of less than 2 miliunits per litre rules out acromegaly. With advent of recent sensitive GH assays, lower levels of GH are increasingly being recognized. We describe a case of acromegaly which differed from the traditional presentation.<...

An 82-year-old male was referred to the breast clinic with a four month history of painful right gynaecomastia (GM), without nipple discharge. A 4 cm plaque of tender, soft tissue was palpable. Physical examination and external genitalia were normal. There was no relevant drug history. Prolactin, Testosterone (T), CXR, Ultrasound and FNA of the breast were normal. LH 13.0 IU (1.5-10.0) and FSH 18.1 IU (1.5-10.0) were raised. FT3 was raised at 7.3 pmol/L (3.5-5.5) with TSH supp...

Metformin has gained a reputation as an effective fertility treatment in PCOS. Most publications use ovulation rate as the main outcome measure and few quote pregnancy rates. We have audited the first 39 patients with PCOS treated with Metformin in our Reproductive Unit. In this practice, as opposed to a research setting, there were often multiple factors contributing to infertility and they were usually proven resistant to other forms of treatment.In t...

Introduction: Measurement of microRNA (miRNA) in aldosterone-producing adenoma (APA) tissue from primary aldosteronism (PA) patients show levels of the miR24-1 cluster miRNAs (i.e. miRNAs 24-1, 27b and 23b) are significantly reduced relative to normal adrenal tissue. Our previous studies also show that miRNA-24 directly targets CYP11B2 (aldosterone synthase) gene expression. Circulating miRNAs released into the bloodstream may be diagnostic biomarkers or signalling mo...