Endocrine Abstracts

Pituitary hyperplasia secondary to primary hypothyroidism (PHPH) is a consequence of long term untreated or uncontrolled primary hypothyroidism. The proliferation of thyrotrophs in the pituitary gland, due to the lack of negative feedback on the hypothalamus from low circulating thyroid hormone levels, causes elevated thyroid stimulating hormone (TSH) levels. Hyperprolactinaemia can also be present due to the stimulatory effect of TSH on lactotrophs. Pituitary hyperplasia caus...

Background. The endothelial dysfunction prevalent in hypertension and diabetes is associated with an imbalance in the levels of nitric oxide (NO) and superoxide (SO). NAD(P)H oxidase is the predominant source of SO in the vasculature. Objectives. To manipulate levels of SO using the NAD(P)H oxidase inhibitors, apocynin, phenyl arsine oxide (PAO) and 4(2aminoethyl)benzenesulfonyl fluoride (AEBSF) and relate this to NO bioavailability. Methods. NO bioavailability was compared in...

Background: Monogenic obesity is generally considered to only be responsible for a small proportion of genetic obesity with the vast majority attributable to polygenic obesity. Previous studies estimate that monogenic obesity accounts for less than 5% of obesity in Caucasian populations.Aims and method: To identify prevalence and clinical characteristics of monogenic obesity, we reviewed clinical notes of 219 patients currently, or recently (within 24 mo...

Case History: A 27 year-old lady, seven weeks gestation presented to ED during her second pregnancy with abdominal pain, vomiting, constipation and hyponatraemia (Na = 114mmol/l). She had attended twice earlier during her pregnancy with presumed hyperemesis gravidarum. Because urinary sodium was elevated at 181mmol/l, dehydration was deemed unlikely and she was initially treated as SIADH with 1.2L fluid restriction and 2.7% 200mls of hypertonic saline. Sertraline was held. Rep...

Introduction: Children with Down’s Syndrome (DS) have altered immunity with higher rates of diabetes, thyroid autoimmunity, coeliac disease, respiratory tract infections and leukemia. Diabetes in children with DS appears to be accelerated with an earlier age of onset compared with the general population, with 22% diagnosed before the age of 2 years. Increased HLA class II DR3/4 susceptibility is seen in in children with DS and diabetes but the prevalence is reduced compar...

Much interest has recently focused on the effects in adulthood of an altered in utero environment. We have previously shown that the adult offspring of diabetic rats show reduced urinary calcium output and re-modelling of bone (Hamilton et al 1998, Proc. 3rd Europ. Kidney Res. Forum). Here we tested the hypothesis that changes in renal handling of calcium are the primary in utero effect of diabetes mellitus and are present immediately after birt...

Background: The National Institute for Health and Care Excellence (NICE) guidelines on childhood type 1 diabetes (T1D) do not recommend cholesterol screening. However, the National Paediatric Diabetes Audit (NPDA) has an annual cholesterol measure (>12 years) as a key outcome indicator. This is confusing for professionals managing children with T1D.Methods: An online survey was sent to 280 members of the Association of Children’s Diabetes Clinic...

Background and Objectives: Abuse in childhood is associated with obesity in adult life. However, little is known about the relationship between abuse and obesity during childhood or adolescence. The aim of this study was to investigate, using a birth cohort study, whether there was an association between pre-adolescent child abuse and overweight and obesity in later childhood. We hypothesised that abuse and obesity may be associated.Methods: Using data f...

Background: Thyroid stimulating receptor hormone receptor antibodies (TRAb) markers are useful in confirming diagnosis of Graves’ disease, but also recognised as a predictor of relapse. Good practice dictates that a TRAb is measured at the commencement of treatment, to confirm a diagnosis of graves’ disease. Repeating the TRAb before discontinuation of treatment can assist in guiding treatment. If TRAb remains elevated, the chances of relapse are inc...

Background: Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, autonomic dysregulation (ROHHAD) is a rare syndrome associated with high morbidity. An immune-inflammatory aetiology has been postulated; however, the immune characteristics and effect of immunomodulation have not been well described.Case report: We describe the immune profile and the effect of rituximab on the immunomodulation potentially ca...