Endocrine Abstracts

A 64 year old female presented to A&E with a 3 month history of general decline, low mood and 8 kg weight loss. On examination there was facial plethora, thin skin with generalised bruising and peripheral oedema. Initial blood tests showed raised inflammatory markers, low potassium (2.6 mmol/l) and deranged liver function tests. A CT chest/abdomen/pelvis found a 2 cm lesion in the left lung with extensive liver metastases but no nodal deposits in the abdomen so this was fe...

Introduction: Pituitary – dependent Cushing’s disease accounts for approximately 80% of endogenous Cushing’s syndrome but a target lesion is only detectable on MRI in 60% of cases. 11C-methionine PET CT improves detection of indeterminate pituitary lesions. Osilodrostat is a novel steroidogenesis inhibitor which reduces cortisol levels with resultant rise in ACTH and may further enhance the sensitivity of 11C-methionine PET CT in difficult cases...

We present two uncommon cases of cyclical ectopic ACTH-dependent Cushing’s syndrome due to diffuse idiopathic pulmonary neuroendocrine tumour (DIPNECH).Case 1: 62 yr lady presented with rapid onset of muscle weakness, diabetes and hypokalaemia. Random cortisol:1710 nmol/l, ACTH level:610 ng/l. LDDST: failure to suppress cortisol levels. Imaging: normal pituitary gland and bilateral adrenal hyperplasia, consistent with ACTH dependent Cushing’s s...

Background: The glands most commonly affected in MEN1 are parathyroid, pituitary and pancreas. Pancreatic neuroendocrine tumours (pNETs) are of foregut origin, but a number of other so-called ’foregut carcinoid tumours’ may also occur in MEN1, including tumours of bronchial, thymic, and gastrointestinal origin. Reported rates of prevalence of these latter tumours vary from 2% for thymic and bronchial carcinoids, to 10% for gastric carcinoids. Thymic carcinoids have b...

Case history: An 18-year-old Caucasian female presented with primary amenorrhoea after her younger sister aged 16 years old started menstruating. She had a normal childhood and progressed through puberty normally, with no past medical history or family history. BMI was 22.6 with a normal examination including secondary sexual characteristics (Tanner Stage 5) and no signs of hyperandrogenism.Investigations and Results: Bloods showed an elevated LH:FSH rat...

Background: Successful reproduction relies on integration of sensory cues of attraction with corresponding emotions and behaviours. However, the intrinsic factors integrating these fundamental aspects of human attraction with limbic and reproductive pathways have not been fully identified. Kisspeptin is a crucial activator of the reproductive axis and together with its receptor is widely expressed throughout the limbic and olfactory systems in humans suggesting a potential rol...

Background: Kisspeptin is a critical activator of hypothalamic gonadotrophin-releasing hormone neurons, inducing release of downstream reproductive hormones. Intravenous or subcutaneous kisspeptin administration has been shown to have significant potential to treat reproductive disorders. However, intranasal administration could offer a novel non-invasive delivery route, which would be clinically preferable. We therefore sought to determine the effects of intranasal kisspeptin...

Background: Hypoactive Sexual Desire Disorder (HSDD) is associated with dysfunctional brain activation in regions governing sexual responses, resulting in a deficiency/absence of sexual desire with marked distress. It affects up to 8% of men with detrimental effects on quality of life, interpersonal relationships and fertility, but so far has no licensed treatment options. The reproductive neuropeptide kisspeptin offers a putative therapeutic target owing to its emerging role ...

Background: Kisspeptin is a critical activator of hypothalamic gonadotrophin releasing hormone (GnRH) neurons and has significant potential to treat common reproductive disorders. To date, kisspeptin has solely been administered to humans via the intravenous or subcutaneous routes, however intranasal administration could offer a novel non-invasive delivery route. We therefore sought to determine the effects of intranasal kisspeptin on reproductive hormone release in humans for...

Background: Placentation (invasion of the placenta into the maternal endometrium) is hypothesised to be critical for healthy placental function and is abnormal in two thirds of miscarriages. Kisspeptin has emerged as a putative regulator of physiological placentation; it is highly expressed in placental syncytiotrophoblasts and could play an important paracrine role in the regulation of placentation. Circulating kisspeptin levels are considerably raised during healthy pregnanc...