Endocrine Abstracts

Introduction: Prolactinoma and macroprolactin are important differentials in the diagnosis of hyperprolactinaemia. We present the case history of a patient with hyperprolactinaemia due to an unusual coincidence of macroprolactin and a non-enhancing pituitary lesion. Case history: A previously well female police officer aged 29, was referred to the endocrine clinic with a history of amenorrhoea and mastalgia for 3 years. She also complained of nausea, dizziness, weight gain, th...

Background: Insulin, derived from a single chain precursor pro-insulin, is cleaved by convertases to form insulin (t1/2 – 4 min) and C-peptide (t1/2 – 30 min). The ratio of insulin to C-peptide levels, which is usually less than one, is reversed in presence of exogenous insulin and insulin autoimmune syndrome. We present the significance of insulin-C-peptide ratio (ICR) in the diagnostic algorithm for the investigation of endogenous hyperinsulinaemia.<p class="ab...

Background: The insulin stress test (IST) is accepted as the gold standard investigation of the hypothalamio-pituitary–adrenal axis (HPA). The short synacthen test (SST) has been advocated as an alternative to the IST. Fatigue can be a common presenting symptom of patients suffering from abnormalities in the HPA axis.Methods: We audited the results of ISTs following failed SSTs for the assessment of patients who present with symptoms of fatigue. We ...

Introduction: The current UK guidelines (NICE TA791) recommend the use of romosozumab, a monoclonal sclerostin inhibitor, for patients at high imminent risk of fragility fractures. However, elderly patients with a very high risk of fractures often exhibit frailty and other comorbidities. This retrospective survey was conducted in a major trauma centre in northern England to evaluate the potential utilisation of romosozumab in a real-world setting.<p class=...

Background: The insulin stress test (IST) is accepted as the gold standard investigation of the hypothalamio-pituitary–adrenal axis (HPA). The test has been shown to be reliable though potentially unpleasant for the patient and has been associated with complications such as loss of consciousness, seizures, arrythmias, angina, myocardial infarction and death. To this effect close medical supervision is always required when an IST is performed.Methods...