Endocrine Abstracts

The incretin access is the descriptive term behind the observed phenomenon that one can elicit more insulin secretion from oral glucose than from an equivalent intravenous stimulus. The major causes of this are two gut hormones GIP and GLP-1.GLP-1 is secreted in the intestine by the L cells and has effects at the beta cell, in the brain, and on gastric motility. At the beta cell it binds onto G protein receptors which activate the metabolic pathways rela...

Introduction: Asymptomatic hypercalcaemia in infants who are exclusively breast-fed is recognised in clinical practice but has never been evaluated and outcomes described if breast feeding is continued.Objective: We conducted a novel retrospective analysis to evaluate the biochemical and radiological outcomes of breast milk-induced hypercalcaemia. Methods: A multi-site retrospectiv...

Multiple Endocrine Neoplasia type 1 (MEN1) is a rare hereditary autosomal dominant disorder characterised by the occurrence of multiple endocrine tumours, predominantly affecting parathyroid glands, pancreatic islet cells and anterior pituitary. Consensus guidelines for MEN1 recommend intensive clinical, biochemical and radiological surveillance commencing in early childhood. The current regimen, which is subject to debate given lack of strong evidence for some aspects of care...

Background: Carcinoid Heart Disease (CHD) is a well-documented but devastating complication of metastatic neuroendocrine tumours (mNETs). Occurring in approximately 20% of patients with Carcinoid Syndrome (CS) the prognosis is poor, with a 3-year survival of 31% versus 68% in patients with mNETs without CHD1. Management of these patients requires a multidisciplinary approach to manage tumour load via medical and/or surgical options, alongside contro...

A 31 year-old woman is referred into the Endocrine clinic with a palpable mass in her right anterior neck that was found incidentally by her GP. She had no known past medical history, did not take any medications and had not noticed any dysphagia, neck pain, or compressive symptoms. On clinical exam, there was an enlarged thyroid with a 1.5-cm left-sided thyroid nodule that moved on swallowing. There was no palpable cervical lymphadenopathy. TSH was 2.5 mIU/l (0.29–5.1 mI...

Background: There may be a bidirectional association between glycaemia and pNETS. Pre-existing diabetes mellitus(DM) is a recognised risk factor for the development of pNETS. Prevalence of DM in pNETS has been reported as 12-26% depending on patient age and tumour location. DM due to pNETS is classified as type 3C pancreatogenic diabetes, Type 3D caused by hormone disorders or Type 3E induced by medications. Functional pNETS, medical therapies and pancreatic s...

Background: Insulinomas are the commonest functional neuroendocrine tumours (NETs) but metastatic insulinomas are rare (incidence <2%) and their management can be challenging. We report a case of metastatic insulinoma requiring multiple treatment modalities to achieve biochemical control.Case Presentation: A 77 year old healthy female was admitted with severe spontaneous hypoglycaemia (glucose 1.8mmol/l) due to endog...

The obesity epidemic has affected many nations. In Canada, by some estimates, more than 6 million Canadian adults age 20 to 64 are overweight and nearly 3 million are obese. The common tendency is to blame people’s dietary choices and sedentary habits. Yet, it can also be argued that poor urban planning practices have largely contributed to a lack of active lifestyles. Low-density suburban sprawl, long commutes, diminishing land for green area and the elimination of sidew...

Numerous <i>in vitro</i>studies have shown that the secretory activity of the human adrenal cortex is activated by a wide variety of neuropeptides and conventional neurotransmitters released in the vicinity of adrenocortical cells by chromaffin cells, endothelial cells, adipocytes, cells of the immune system and nerve endings. The role of these paracrine factors in the physiological control of the adrenocortical function remains unclear, especially for cortisol...

Primary aldosteronism (PA) has a prevalence of 5–15% in the general population with hypertension and patients with PA display an increased frequency of target organ damage and cardiovascular damage than patients with hypertension with matched cardiovascular risk profiles. The unilateral and bilateral forms of PA are treated differently usually surgically (unilateral PA) or by antagonism of the receptor for aldosterone (bilateral PA). Medically-treated patients with PA hav...