Endocrine Abstracts

Case report: A 68 year old lady was admitted for an elective partial hepatectomy for a solitary metastasis in the liver. Two years ago she had an uneventful colectomy for a colorectal cancer. During induction for her operation she was noted to be hypertensive {blood pressure (BP) 200/120 mm of mercury (Hg)}, though had not been observed to be so previously, and hence her partial hepatectomy had to be abandoned. She was commenced on atenolol and operation rescheduled. The secon...

Case report: A 40-year old male with a background history of autism, severe learning difficulties and childhood Hirschsprung’s disease had been on long-term lithium carbonate therapy, without any history of polyuria or polydipsia. During admission he underwent a subtotal colectomy for malignant colonic polyps. Pre-operative serum urea and electrolytes, glucose and lithium levels were normal. Pre-operative fluid balance was normal. The post-operative period was turbulent; ...

Background: Prolactin is found in serum in different molecular forms, differing in molecular size. Macroprolactin is a complex of prolactin with immunoglobulin and has limited biological activity due to failure to cross capillary wall because of its high molecular weight complex.Objective: To assess the response of the inactive macroprolactin and the biologically active monomeric prolactin, in patients with hyperprolactinaemia, during TRH and metoclopram...

Adult Growth Hormone Deficiency (AGHD) is associated with osteoporosis. PTH is secreted in a circadian rhythm and temporal fluctuations in PTH concentration, particularly at night, appear to be important in the regulation of bone turnover. Serum phosphate is an important determinant of PTH, with changes in phosphate preceding fluctuations in PTH concentration. We examined the difference in PTH and phosphate circadian rhythmicity in AGHD patients with normal and reduced bone mi...

Adult Growth Hormone Deficiency (AGHD) is associated with reduced bone mineral density (BMD) and bone turnover. Abnormalities in PTH circadian rhythmicity, including blunted nocturnal rise in PTH concentration have been reported in AGHD and may underlie the pathogenesis of osteoporosis. Serum phosphate is an important regulator of PTH, with changes in phosphate concentration preceding fluctuations in PTH. We examined the effect of oral phosphate therapy on PTH circadian rhythm...

A 24 yr old man complaining of visual disturbances for 7 weeks presented with acute severe headache and bitemporal visual field defects. A high density lesion in the pituitary fossa suggestive of pituitary apoplexy was initially observed on a CT scan but an MRI of the pituitary revealed an irregular structure in the suprasellar cistern and the differential diagnoses of a pituitary adenoma or an aneurysm were proposed. Routine haematological and biochemical investigations were ...

Human obesity is characterized by abnormalities in sympathetic cardiovascular control. We present two cases to demonstrate the relationship between weight, BP and catecholamines (UC).Case 1: A 39 year-old man reported symptoms of flushing and palpitations. His BMI was 50 kg/m2, consistent BP of 240/140 mmHg, with normal renal, thyroid function and normal fasting glucose. Urinary noradrenaline (UNA820 nmol/24 hrs) and dopamine (UDA-4500 nmol/24...

Introduction: Strontium ranelate (SR) is a dual action bone agent that increases bone formation and reduces bone resorption. Previous long term studies with SR have demonstrated minimal reductions in parathyroid hormone (PTH) and adjusted calcium (ACa) levels with increase in phosphate (PO4) concentrations, but the exact mechanism of action of SR remains unclear. Postmenopausal women with low bone mineral density (BMD) have relatively high circulating PTH concentrat...

Introduction: The effect of oestrogens on the male skeleton has been demonstrated in a number of studies and oestradiol (E2) plays an important role in regulating bone mineral density (BMD). The concentration of bioavailable oestradiol (BE), rather than total oestradiol (TE), is associated with bone loss in elderly men.Oestradiol circulates in the bloodstream in one of three forms: bound to SHBG; bound to albumin; and unbound/free. The albumin-bound plus the free fraction comp...

An 18 year old lady was seen in endocrine clinic in October 2004 with 10 month history of polyuria, polydypsia and lethargy. Previous medical history includes Graves thyrotoxicosis which is treated with carbimazole.Clinical examination was unremarkable.Investigations and management: Urine osmolality −84 mosmol (250–750), serum osmolality −290 mosmol (288–298), full blood count, fasting glucose, renal, liver fu...