Endocrine Abstracts

Background: A four-tiered system is currently in place for weight management in the National Health Service (NHS). Tier 3 comprises specialist weight management services and aims for a clinically meaningful weight loss of ≥5%, as recommended by the National Institute for Health and Care Excellence (NICE). Within the Imperial Weight Centre (IWC), patients receive support from a multi-disciplinary team including endocrinologists, surgeons, dietitians, nurs...

Background: Acromegaly is associated with multiple co-morbidities and increased mortality. Surgery is the first-line intervention and remission of acromegaly can restore normal life-expectancy. Pre-operative somatostatin analogues (SSA) may increase the likelihood of remission in large invasive tumours by causing tumour shrinkage prior to surgery.Aims: To audit the management of acromegaly patients at Imperial College Healthcare NHS Trust (ICHNT) against...

A 38-year-old man presented on the acute medical take with a week’s history of sore throat, dysphagia, neck swelling, and fever. One month prior he had suffered a respiratory tract infection, which resolved without antibiotics. He had no notable past medical and family history. He was a non-smoker and drank 15 units of alcohol per week. On examination he looked well, was afebrile, sweaty and flushed; chest was clear, heart sounds were normal, regular pulse (110 bpm) and B...

Background: Non-alcoholic fatty liver disease (NAFLD), encompasses hepatic steatosis alone (NAFL), steatohepatitis (NASH), NAFL/NASH with fibrosis and cirrhosis. Severe fibrosis and cirrhosis are associated with increased risk of morbidity and mortality (due to cardiovascular events, end-stage liver failure and cancer). Postmenopausal women are a high-risk group of patients that have worse outcomes, but the specific factors that place them at higher risk are incompletely under...

Background: It is apparent that COVID-19 may cause persistent symptoms beyond 12 weeks (‘long COVID’). However its underlying pathophysiology is unclear. Several symptoms of long COVID draw similarities to that of endocrine diagnoses. We recently observed that adrenal and thyroid function were normal in survivors of COVID-19 at follow-up. Here we assess additional endocrine axes that could plausibly have a role in long COVID to determine their relationship to ongoing...

Background: Due to practical limitations, the diagnosis of hypogonadism is predominantly based on a single measure of reproductive hormones, often with confirmation on a second occasion. Factors associated with reproductive hormone variation include: pulsatile secretion, diurnal rhythm, and food intake, which can affect the accuracy of diagnosis of reproductive disorders. There is limited data quantitatively estimating the variability of reproductive hormone levels over the da...

Background: Non-alcoholic liver disease (NAFLD) affects up to 30% of adults worldwide. With the prevalence of NAFLD increasing after menopause, women aged >55 years are more likely to progress to advanced fibrosis than men. Moreover, liver decompensation secondary to NAFLD is more frequent in women compared to men. However, the causes of these differential outcomes are not fully understood.Methodology: We performed a retrospective cohort study utilis...

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...

A 33 year old primip presented to the local ophthalmic hospital at 34+4 weeks’ gestation with two weeks of blurred vision. Examination revealed a bitemporal hemianopia and reduced visual acuity. She was previously fit and well, and a pre-eclampsia screen was negative. An MRI scan demonstrated a haemorrhagic pituitary lesion extending into the suprasellar cistern with mild compression of the optic chiasm. Pituitary function tests showed a raised prolactin 3844 mU/l, isolat...

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...