Endocrine Abstracts

Introduction: Antiphospholipid syndrome (APS) is the association of anti-cardiolipin antibodies and venous & arterial thrombosis. APS accounts for <0.5% of cases of hypoadrenalism. We present a series of 5 such cases occurring at our institution plus a further patient identified with unilateral adrenal haemorrhage. Case 1 presented with nausea, vomiting and weight loss. Lupus anticoagulant positive. Commenced aspirin 300 mg. 6-weeks later represented with dehydration, ...

Introduction: Food reward stimuli elevate dopamine levels in brain reward circuits. Decreased dopaminergic signalling may be involved in pathophysiological processes leading to obesity and D2 receptor antagonists (antipsychotics) are associated with a higher risk of obesity. One study has demonstrated an association between the use of a dopamine D2 agonist (bromocriptine) and weight-loss in patients with prolactinoma. We have investigated the effect of cabergoline on body weig...

A 30-year-old Eritrean female presented with a 1 month history of nausea and vomiting, with 15 kg weight loss but no bowel disturbance. Past medical history included an open cholecystectomy. There was no family history of mineral or bone disorders. She denied any prescribed/over-counter medication and abstained from alcohol. Examination revealed marked cachexia (BMI 16.1 kg/m2). ECG revealed ST depression and T wave inversion.Investigations in...

Introduction: Hyperprolactinaemia associated with antipsychotic drug use is a commonly encountered clinical problem, yet no decision-making tools exist to guide whether to scan the pituitary gland.Methods: A 10-year data series was reviewed of 246 patients who were evaluated for prolactin excess with a cannulated prolactin study. All patients had a prolactin drawn immediately following the insertion of a forearm cannula (P1) and a second sampl...

The risk of death with severe hyponatraemia is well known. What is less clear is the mortality risk according to the pattern of the developing hyponatraemia.Methods: From our laboratory database we retrospectively collected data of all adult patients with severe hyponatraemia (<120 mmol/l) over 6 months. Of 49 155 samples, 101 (0.2%) were <120 mmol/l, obtained from n=54 patients. Two paediatric cases were excluded leaving n=52. Norm...

Introduction: Hypo-&hyperkalaemia are common laboratory abnormalities, complicating up to 10% of all hospital admissions and contributing to mortality. Ideally, patients with mild deviations can be treated as outpatients, and only those patients with objectively severe or life-threatening levels are hospitalized. Once admitted, there are few data as to whether the degree of electrolyte disturbance consumes greater resource(s). We analysed the admission and discharge data, ...

Introduction: Hyponatraemia is a common biochemical abnormality, complicating up to 15% of all hospital admissions and associated with increased mortality. Hypernatraemia, occuring less frequently, is strongly associated with mortality and is almost always due to a free water deficit. There is limited data about hospital healthcare burden of these two relatively common electrolyte imbalances. We analysed the length of stay, for acute admissions, with reference to the admission...

Introduction: Glucagon-like peptide-1(GLP-1) agonists are widely used for treatment of type 2 diabetes(T2D). To date a number of reports have described improvements in glucose control with the addition of a GLP-1 agonist to the insulin regime in treatment of type 1 diabetes(T1D). From a physiological perspective there is credence to the notion that a GLP-1 agonist will lower glucose levels in people with T1D as they do in T2D. GLP-1 is an endogenous hormone th...

Recent data suggest that critically-ill medical patients might not obtain as much benefit from insulin therapy as cardiothoracic patients. This may be because medical patients are more insulin resistant. We have investigated this in both groups.10 medical patients (age 67.0±4.4 y; 7M:3F, BMI 24.0±1.7 kg/m2; studied within 36 hours of admission to the ICU) and 7 post-operative cardiothoracic patients (age 71.4±3.8 y; 5M:2F, BMI 2...