Endocrine Abstracts

Background: Diagnostic work-up for Cushing ’s syndrome (CS) can be challenging, with variable performance characteristics on screening tests. We were recently referred a young female patient with Cushing’s disease (CD) due to a microadenoma. She presented with a seizure and initial biochemical work-up included a Synacthen stimulation test (SST). Her peak cortisol rose to over 1,000 nmol/l. Exaggerated response during SST is expected in hyperestrogenic states due to e...

Objective: The 250 µg short Synacthen stimulation test (SST) is the most commonly used dynamic assessment to diagnose adrenal insufficiency (AI). There are challenges to the use of the SST in routine clinical practice, including staff and resource limitation in the current COVID-19 pandemic and Synacthen cost. We aimed to investigate the value of basal cortisol level for predicting AI in our selected cohort of patients at risk of secondary adrenal insufficiency from pitui...

Background: Environmental factors play a role in the aetiology of type 1 diabetes. A particular role for infectious exposures has been postulated. Temporal variation in incidence would be consistent with this hypothesis. We specifically aimed to test predictions of increasing incidence occurring among cases of type 1 diabetes in children (aged 0–14 years) that might arise as a result of an environmental mechanism.Subjects and methods: The study anal...

INTRODUCTION: Hyperprolactinaemia frequently causes secondary hypogonadism through central suppression of gonadotropin secretion. Macroprolactinomas (>1cm diameter) may additionally cause more generalised hypopituitarism; a recent series finding the prevalence of TSH and ACTH deficiencies to be 35% and 9%, respectively. Recovery of the thyrotropic and/or corticotropic axes is well described following surgery to pituitary tumours, but remains poorly defined in relation to me...

Radioiodine ablation of differentiated thyroid cancers and their metastases utilises the ability of the thyroid to accumulate iodide. However, most differentiated thyroid tumours exhibit reduced iodide uptake, with the mechanisms underlying this remaining poorly understood. Pituitary tumor transforming gene (PTTG) binding factor (PBF) is a proto-oncogene over-expressed in thyroid tumours, which we have shown to repress sodium iodide symporter (NIS) mRNA expression and inhibit ...

High protein diets suppress appetite, but are difficult to adhere to. Understanding how the gut senses protein may identify mechanisms to drive satiety. Amino acid products of protein digestion are thought to be sensed by G protein coupled receptors in the gut, including the calcium sensing receptor (CaSR). Calcium ions are the major ligand of the CaSR, but aromatic amino acids, particularly L-phenylalanine (L-Phe), allosterically modulate CaSR activity....