Endocrine Abstracts

A 50-year-old woman was admitted to hospital feeling unwell.Biochemistry: Calcium 3.46 (2.15–2.6),PO4 0.42 (0.8–1.5), AlkalinePhosphatase 259 (30–95). She had been diagnosed 3 years ago with Carcinoma breast and had undergone surgery,chemotherapy and radiotherapy. Regular follow-up had not shown any recurrence.No breast lump or bony tenderness was recorded.Further biochemistry: PTH 30 (0–6...

Cushing’s syndrome is a rare disorder of hypercortisolism with an incidence of three cases per million each year. The 1 mg overnight dexamethasone suppression test (ODST) is a commonly used screening test. Other screening tests include 24 h urinary free cortisol and diurnal variability of serum cortisol.We carried out an audit of ODST with the intention of examining patient outcome.Data were collected retrospectively over a tw...

Background: A recent study by the author suggests up to 73% of growth hormone (GH) secreting pituitary adenomas produce multiple hormones on histological analysis and 16% immunostain positive for TSH. We report the case of an acromegalic patient with a plurihormonal adenoma where diagnosis of thyrotoxicosis was made several years post-hypophysectomyCase history: Mr JT was diagnosed with acromegaly at the age of 59 having been noted to have acromegalic ph...

Congenital Generalised Lipodystrophy (CGL) is characterised by an inability to store energy in adipose tissue. Integral to CGL is severe insulin resistance resulting in hyperinsulinaemia and premature Type 2 diabetes (DM). Sulphonylureas are ineffective in CGL whilst insulin therapy is complicated by insulin resistance and absence of subcutaneous fat. We explored the possibility of using Metformin and Pioglitazone (both insulin sensitising agents) in CGL.PD presented aged ...

BACKGROUND: Dynamic function tests are needed to diagnose a range of endocrine disorders but often require in-patient investigation. A recent audit of our endocrine service revealed deficiencies that included frequent delay to investigations and cancellation of planned appointments. We developed an Endocrine Nurse Specialist (ENS) post whose role included carrying out endocrine testing in an out-patient setting to assess whether this might improve quality of care for our patie...

Clinical practice suggests that low dose steroid treatment delivered locally to the site of action may rarely lead to disturbances of the hypothalamic-pituitary-adrenal axis. We present three clinical examples:Case 1: A 72 yr old man with a history of severe sinusitis was referred because of three episodes of profound anorexia, vomiting and proximal muscle weakness which coincided with discontinuing his Betnesol (betamethasone sodium phosphate 0.1%) nose...

Introduction: Studies have suggested that PCOS is associated with increased cardiovascular (CVS) risk. The mechanisms that may contribute to increased CVS susceptibility include endothelial dysfunction, vascular inflammation and atherothrombosis.Aim: To compare CVS risk profiles in women with PCOS and healthy age and weight matched controls using novel biochemical and biophysical markers of these pathological processes.Method: Fo...