Endocrine Abstracts

A 36 year old man presented with collapse following weakness and vomiting for 2 weeks and 7 kg weight loss over 6 months. Thyroxine 50 mcg OD had been commenced 2 months earlier for hypothyroidism (Free T4 9.4 pmol/l, TSH 8.4 mU/l and anti-TPO antibodies 103.1 IU/mL). Examination found cachexia (weight 53.6 Kg), vitiligo, sinus tachycardia 110 bpm and BP 90/66 mmHg. Investigations: sodium 115 mmol/l, potassium 4.4 mmol/l, urea 9.9 mmol/l, creatinine 81 μmol/l, cortisol 13...

Anorexia nervosa has the highest mortality of all psychiatric conditions. Sligo University Hospital (SUH) uses the MARSIPAN protocol for the (Management of Really Sick Patients with Anorexia Nervosa) for inpatient treatment.Case 1; 22-year-old lady with a BMI of 12.06 kg/m2, admitted voluntarily and reported food and bowels dominated her life, did not leave the house, consuming only nutritional ‘supplements, l...

Anorexia nervosa has the highest mortality of all psychiatric conditions. Sligo University Hospital (SUH) uses the MARSIPAN protocol for the (Management of Really Sick Patients with Anorexia Nervosa) for inpatient treatment.Case 1; 22-year-old lady with a BMI of 12.06 kg/m2, admitted voluntarily and reported food and bowels dominated her life, did not leave the house, consuming only nutritional ‘supplements, l...

A 27-year-old woman with Carney Complex, with inactivating mutation of the PRKAR1α gene [(a 2-bp deletion of nucleotides T and G at positions 576 and 577 with frame-shift mutation beginning with aminoacid residue threonine 163 (ΔFSterThr163)], bearing a GH secreting microadenoma, Cushing syndrome from PPNAD and with high operatory risk because of the neurological sequelae of cerebral embolism from atrial myxomas, underwent a low-dose mitotane (MT) regimen.<p clas...

Introduction: Catheterisation of the right adrenal vein when performing adrenal vein sampling (AVS) is challenging. The AVS Accuracy Kit (AAK) (Trust Medical, Kasai, Japan) enables point-of-care confirmation of accuracy of AVS by rapid cortisol assay. We investigated whether use of AAK during AVS would impact upon procedural success, number of venous samples taken, radiation dose and screening time.Methods: 0.5 ml of each venous blood sample was centrifu...

Introduction: Catheterisation of the right adrenal vein when performing adrenal vein sampling (AVS) is challenging. The AVS Accuracy Kit (AAK) (Trust Medical, Kasai, Japan) enables point-of-care confirmation of accuracy of AVS by rapid cortisol assay. We investigated whether use of AAK during AVS would impact upon procedural success, number of venous samples taken, radiation dose and screening time.Methods: 0.5 ml of each venous blood sample was centrifu...

Dysregulated recruitment of leukocytes across endothelial cells into target tissues is a hallmark of the pathology of most chronic inflammatory diseases (CIDs). We have identified a novel homeostatic pathway that regulates T-cell migration during inflammation. The pathway is impaired in patients with CIDs such as type-1-diabetes and rheumatoid arthritis (RA), and is also attenuated in the elderly. The dysregulation of this pathway across all conditions is caused by a lower lev...

Postprandial hypoglycaemia in patients with cystic fibrosis (PWCF) is frequently reported but poorly understood. The aim of this pilot study was to investigate the aetiology of postprandial hypoglycaemia in PWCF. Serum cortisol, insulin and C-Peptide were measured at the 2 hour timepoint of the annual glucose tolerance test in 32 PWCF not known to have CF-related diabetes. Hypoglycaemia was defined as glucose < 3.3 mmol/l. Patients were classified as Normal glucose toleran...

Since the introduction of national BSPED DKA guidelines we wondered whether the previous variability in DKA guidelines would be abolished.Aim: To explore the variability of guidelines in three regional diabetes networks in South West (SW) and South Central England and to compare them to the current BSPED guidelines.Methods: Within an audit of in-patient care, a copy of the DKA guidelines was requested from 27 services. General layo...

The adrenogonadal primordium develops from a thickening of the coelomic epithelium covering the urogenital ridge. After segregation of the primordium into the bipotential gonad and the adrenocortical primordium, the cortex is encapsulated by mesenchymal cells and infiltrated by migrating sympathoadrenal cells, which form the medulla. We have shown that the cell fate regulator sonic hedgehog (Shh) is not required for the formation of the adrenocortical primordium but is require...