Endocrine Abstracts

Auto-immune diseases are complex diseases, that occur as a result of the influence and interaction of multiple genes, (at least 20, could be more than 100). However, the critical feature of these diseases is that they only occur after exposure to an environmental trigger. As yet, most environmental triggers have not been identified.Most human autoimmune diseases have been shown to have an association with genes in the Major Histocompatibility Complex (MH...

This retrospective review of all adult women referred to a dedicated University Clinic for presumed polycystic ovarian syndrome (PCOS) aims to determine i) the true PCOS prevalence and ii) to evaluate baseline demographics by diagnostic criteria and their relationship to metabolic and cardiovascular risk parameters. All charts were reviewed. The diagnosis of PCOS rests on excluding another endocrinopathy, and fulfilling any two of the three criterias as per the Rotterdam state...

Oestrogen implants are one method of delivering hormone replacement therapy to post-menopausal women. The use of such implants has been associated with the phenomenon of tachyphylaxis, where menopausal symptoms return before the next implant is due, even in the presence of normal or high serum oestrodiol levels. It has been suggested that intervals as long as one year should be left between implants and that trough oestrogen levels should be measured prior to implantation....

A 35-year-old lady presented 20 years ago with difficulty in walking. She was born in Newcastle and was brought up by her mother with no contact with father. Early childhood was further traumatised when mother moved in with a man affected from multiple sclerosis with whom she never adjusted. Consequently, she was placed with two foster parents but could not adjust there either. Two years earlier, she was admitted in hospital with drug overdose. By age 25, she had hypothyroidis...

A 22 year old female was referred for investigation of cramps in both hands, and tingling in her face. She also complained of lethargy and occasional dizziness. Routine testing by her General Practioner had demonstrated a low serum calcium. She had had problems at birth with hypocalcaemia. A diagnosis of hypothyroidism had been made previously, but she had stopped taking thyroxine medication. Both her mother and grandmother had required intermittent calcium supplementation. On...

J. Q. presented initially at age 2 years with hypoglycaemia following a six-hour fast prior to an elective surgical procedure. Investigations demonstrated a low plasma glucose (1.6mmol/l), elevated beta Hydroxybutyrate (5.2 mmol/l), normal lactate (1.09nmol/l) and a detectable serum insulin level (2.5 mU/L). A plasma amino-acid profile was normal. The dorsum of his hands and the extensor region of his arms were noted to be pigmented, however a synacthen test at that time, ind...

Background: Graves’ disease (GD) is an autoimmune condition accounting for up to 80% of thyrotoxicosis cases.1 90% of these patients have TSH receptor antibodies (TRAbs).2 Current NICE guidance recommends testing for TRAbs in adults with confirmed thyrotoxicosis to differentiate between thyrotoxicosis with hyperthyroidism (e.g GD and toxic multinodular goitre) and thyrotoxicosis without hyperthyroidism (e.g thyroiditis).2Objective: To evaluate the n...

Background: The global uptake of bariatric surgery in men, despite high prevalence of morbid obesity and associated co-morbidities, is significantly lower compared to women. It is unclear if this is due to a perception of poorer outcomes in men. AimsTo compare weight loss and metabolic outcomes in men versus women after bariatric surgery.Design and methods: We performed a retrospective, observational cohort analysis of 80 men matched to 80 women for base...

Severe hypomagnesaemia associated with the use of proton pump inhibitors (PPIs) is now increasingly recognised. The exact underlying mechanism is unclear but is likely to involve altered intestinal absorption of magnesium ions. Hypomagnesaemia from any cause results in functional hypoparathyroidism. PTH levels vary widely in reported cases of hypomagnesaemia associated with the use of PPIs. We examined PTH levels in patients admitted to hospital with severe (Mg<0.4 mmol/l)...

Background: There are over 650 liver transplants performed in the UK each year and about 5000 throughout Europe. After transplantation patients suffer from bone loss due to multiple factors. We present a unique case of severe Vitamin D deficiency resulting in life threatening hypocalcaemia following liver transplantation.Case: A 65-year-old Indian lady underwent an uncomplicated liver transplant, for hepatocellular carcinoma related to Hepatitis C. Pre a...