Endocrine Abstracts

All metabolites in the body are in a state of constant flux, and changes in their levels may reflect either increased rate of production or decreased clearance, or both. Stable isotope technology can be used in physiological studies to determine mechanisms mediating changes in metabolites. For example, the decline in blood glucose following administration of insulin could be due to either increased uptake into peripheral tissues, or (as is the case) by suppression of hepatic g...

IntroductionDiabetic ketoacidosis (DKA) affects 1-3 percent of pregnancies complicated by diabetes but can result in significant morbidity and mortality for mother and foetus. Euglycaemia in DKA is a recognised but infrequent presentation. It was originally defined as initial blood glucose less than 16.7 millimol per litre and bicarbonate less than 10 millimol per litre.Case ReportA 29-year old female with ty...

IntroductionDiabetic ketoacidosis (DKA) affects 1-3 percent of pregnancies complicated by diabetes but can result in significant morbidity and mortality for mother and foetus. Euglycaemia in DKA is a recognised but infrequent presentation. It was originally defined as initial blood glucose less than 16.7 millimol per litre and bicarbonate less than 10 millimol per litre.Case ReportA 29-year old female with ty...

Introduction: Hypercalcemia due to parathyroid-hormone-related-peptide (PTHrP) is rare in neuroendocrine tumours.A 63-year-old lady initially presented to ENT surgeons with symptoms of reflux, dysphagia, and weight loss. Past medical history included hysterectomy eight years previously for uterine prolapse. There was no family history of note. Investigations revealed corrected calcium was elevated at 2.94 (2.1–2.5) mmol/l. ALP: 184 (30–135) U/l...

A 39 yr-old female with a past medical history of a non-metastatic ductal breast carcinoma, presented to hospital with a two-week history of vomiting and dizziness. Clinical examination was essentially normal apart from pigmentation of her mastectomy scar, palmar creases and buccal mucosa. Investigations revealed a plasma sodium (Na) 102 mmol/l, potassium 4.9 mmol/l, plasma osmolality 219 mOsm/kg, urine osmolality 173 mOsm/kg and urine Na 36 mmol/kg. She was treated with fluid...

Estrogen excess is a major contributing factor to the development and progression of post-menopausal Estrogen Receptor positive (ER+) breast cancers. Increased activity of aromatase, the enzyme that converts androgens to estrogens, and upregulation of its encoding gene CYP19A1 is often observed in breast adipose fibroblasts (BAFs) surrounding ER+ tumours. Understanding the process by which CYP19A1 is regulated between normal and diseased breast stroma may help to improve outco...

Background: GH replacement during the childhood-adult transition period is important for somatic maturation. The aim of the study was to explore the factors influencing IGF1 response to GH during transition.Methods: KIMS (Pfizer International Metabolic Study) database in UK was interrogated, and 98 patients (55 male, median age 20.7 years (15.7–25.8)) with childhood-onset GH deficiency (Co-GHD), who were started on adult dose of GH during transition...

We present a fascinating and instructive case of unexplained suppression of thyroglobulin (Tg) levels following resection of a presumed carcinoid tumour, subsequent re-examination of which revealed it to be a solitary metastasis from a follicular thyroid carcinoma.The patient, RB is a 79-year-old woman who presented 11 years ago with a 2-week history of neck swelling. Examination revealed a 5 cm diameter nodule in the left lobe of the thyroid, confirmed ...

A 67-year-old lady presented with hypoglycaemic coma, treated with dextrose infusion. Previously she had a 3-month history of weight gain with increasingly frequent episodes of shaking and blurred vision, particularly at night, relieved by food.A 72-hour fast was undertaken. Within 2 h, she became confused. Serum glucose was 1.1 mmol/l with serum insulin 527 pmol/l (0–60 pmol/l), proinsulin 320 pmol/l (0–7 pmol/l) and C-peptide 2991 pmol/l (174...

Background: Insulin resistance (IR) commonly manifests in acromegaly leading to impaired glucose tolerance (IGT) and diabetes mellitus (DM). Studies have shown that ‘control’ of growth hormone (GH) and insulin-like growth factor 1 (IGF1) hypersecretion typically ameliorates glucose homeostasis. However, suppression of beta-cell function by somatostatin analogues may potentially attenuate glycaemic benefits of reduced IR. Effects on insulin’s other pleiotropic ef...