Endocrine Abstracts

BACKGROUND Recent evidence has suggested that minor degrees of thyroid dysfunction are associated with adverse outcomes and this argues for tight control of thyroid hormone replacement. Thyroxine (T4) tablets are available in 25, 50 and 100 microgram strengths in the UK but some patients require doses which cannot be obtained with these strengths. We have examined data from a thyroid register to determine the proportion of patients whose mean daily T4 dose cannot be achieved w...

A 68-year-old previously well man was referred to the endocrinology department in April 2007 with generalised tiredness and dizziness following a recent viral upper respiratory illness. He had no symptoms to suggest pituitary dysfunction. He was normotensive and lacked clinical features of hypopituitarism or dysthyroidism. Visual fields were normal to confrontation. Testicular volumes were normal. Initial baseline pituitary function tests (reference ranges in brackets): FT<sub...

A 62-year-old woman was referred to the endocrine clinic with new onset thyrotoxicosis. She had previously had two other conditions affecting her thyroid gland. In 1977, she underwent a right thyroid lobectomy for a non-functioning thyroid adenoma. In 2002, she presented with a rapidly enlarging left sided goitre, which proved to be thyroid B-cell lymphoma on core biopsy. She was treated with chemotherapy alone and remains under regular haematology follow up. Serial thyroid fu...

Introduction: Prostate carcinoma is a recognised yet rare cause of Cushing’s syndrome. This report describes two cases in which Cushing’s syndrome was associated with advanced prostate cancer.Case 1: A 70-year man presented with a very short history of swelling of his face and legs. He was known to have prostate adenocarcinoma with bony metastases. He was hypokalaemic and resistant to standard potassium replacement. He had a Cushingoid appearan...

Background: Tamoxifen is a partial estrogen agonist used to treat estrogen receptor positive breast cancer. It has been discovered however that resistance to tamoxifen develops in some cancers. In order to investigate the mechanisms underlying the development of resistance we have created a tamoxifen resistant breast cancer cell line.Aims: To develop a breast cancer cell line that is resistant to the anti-growth effects of tamoxifen.<p class="abstext...

A 30-year-old woman with long standing type 1 diabetes presented with recurrent severe hypoglycaemia. One month earlier she had given birth to her first child. Before pregnancy her HbA1c had been 7.8 to 9.2 percent (RR 3.1 to 5.0 percent) but improved by the third trimester to 6.8 percent. Before pregnancy her total daily insulin dose was 50 units and by the third trimester it had only increased by 25 percent to 60 units. The pregnancy and birth were uneventful with no hypogly...

Background: The growth hormone/ insulin-like growth factor-1 (GH/IGF-1) axis has been increasingly implicated in the pathogenesis of breast cancer. We have recently demonstrated the local expression of both GH and IGF-I in normal and malignant breast tissue. However, the regulation of this local GH/IGF-1 expression is unknown. Aims: (i) To quantify the mRNA levels of GHRH, ghrelin and their receptors in malignant and adjacent normal breast tissue, and (ii) to determine any cor...

Introduction: The GH/IGF-I axis has been implicated in the pathogenesis of breast cancer and development of tamoxifen resistance. We have previously used siRNA to successfully silence the IGF-I receptor (IGF-IR) in MCF-7 breast cancer cells. To further characterize the growth changes that occur when elements of the GH/IGF-I axis are disrupted we investigated the use of siRNA to cause long term silencing of IGF-IR.Methods: MCF-7 cells were cultured in phe...

A 34-year-old woman was referred by her GP in 2000 with thyrotoxicosis (TSH undetectable, free T4 36.4 pica moles per litre, reference range 10-25). She had no ophthalmic symptoms or signs and no goitre. There was no family history of thyroid disease. Her thyroid peroxidase antibodies were undetectable but thyrotropin-binding inhibitory immunoglobulin was 30 (Reference range 0-15) confirming Graves' disease. Carbimazole was initiated but changed to propylthiouracil after a pre...

Background: There is considerable evidence to support a role for the GH/IGF-I axis in the development of breast cancer. We have previously demonstrated that IGF-I is expressed in both normal and malignant breast tissue, but that approximately 10% of primary breast cancers reveal no IGF-I mRNA expression. However the molecular differences between IGF-I positive and IGF-I negative tumours is unknown.Aims: To investigate the molecular differences between IG...