Endocrine Abstracts

Prohormone convertase 1/3 (PC1/3), encoded by protein convertase subtilisin kexin type 1 (PCSK1), converts inactive prohormones such as pro-opiomelanocortin, proinsulin, proglucagon into biologically active peptides. Inherited genomic mutations of PCSK1 present with malabsorptive diarrhoea, hyperinsulinemic hypoglycaemia, central adrenal and thyroid defects and severe obesity. Somatic mutations of insulinomas are associated with genetic defects interfering with insulin secreti...

Introduction: Primary hyperparathyroidism (PHPT) is a clinical condition often recognized as a result of biochemical screening. While surgery is indicated in symptomatic hypercalcaemic states, the need and timing of surgery in asymptomatic patients is not always clearcut. We conducted a retrospective audit on the diagnosis and management of primary hyperparathyroidism between the years 2010 and 2014.Method: Patients were identified through our histopatho...

Prednisolone is widely prescribed in the UK, whereas prednisone is used instead for the same indications in the United States. Both have utility as anti-inflammatory agents and for use as glucocorticoid replacement therapy at lower doses. Oral prednisone is converted to prednisolone by first pass hepatic metabolism by 11 beta HSD-1. This study was undertaken to compare the bioavailability of prednisone against prednisolone. To determine the conversion of prednisone to predniso...

Background: Dexamethasone significantly improved outcomes in patients requiring supplementary oxygen and in ventilated patients with COVID-19 in the RECOVERY trial. Consequently, dexamethasone is now routinely used in these patients. However, dysglycaemia is commonly associated with steroid use and is an established risk factor for poorer outcomes in COVID-19. In this study, we aimed to elucidate the effect of dexamethasone use in patients hospitalised with COVID-19 in a real-...

Introduction: Diabetes has been associated with poorer outcomes with COVID-19 infection, but precise predictors of mortality in patients with diabetes remain unclear. We assessed predictors of adverse outcomes in patients hospitalised with COVID-19 in Imperial College Healthcare NHS Trust (ICHNT) hospitals during the first and second waves of COVID-19 to determine if outcomes for patients with diabetes have evolved with new variants and treatments.Method...

Introduction: Selenium supplementation is recommended for all patients with mild Graves’ orbitopathy (GO). The thyroid gland contains high levels of selenium, which has an anti-oxidant effect and a role in the metabolism of thyroid hormones. The study on which this recommendation is based was conducted in countries of a selenium-deficient region and did not measure subjects’ selenium concentrations. There is therefore no consensus on optimum dose, duration, or safety...

Introduction: Subactue thyroiditis (SAT) is a self-limiting inflammatory condition caused by follicular destruction of the thyroid gland, commonly precipitated by viral upper respiratory tract infection 2 weeks preceding the onset of thyroid symptoms. However, SAT following COVID-19 vaccination is rare. Herein, we report two cases of subacute thyroiditis which presented after administration of COVID-19 vaccine. Case series: The first patient was a 42 yea...

Section 1: Case history: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. He had an unremarkable past medical history, did not take any regular medications and denied the use of any illicit drugs. There was a family history of consanguinity, with his parents being first cousins. On examination, his BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual c...

Case: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. On examination, BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual characteristics. Hypogonadism was confirmed by two morning fasting total testosterone levels of 4.7 and 5.2 (RR 9.2–31.6 nmol/l). Haemoglobin was normal (152 g/l) and serum oestradiol was <100 pmol/l. He had inappropriate...

Background: During IVF treatment, a pharmacological dose of recombinant FSH (rFSH) is used to induce multi-follicular growth (controlled ovarian stimulation; COS). An insufficient dose of rFSH negatively impacts the number of oocytes retrieved, whereas an excessive dose risks the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’. Hence, appropriate rFSH dosing is regarded as a key treatment decision affecting both the success and safety of...