Endocrine Abstracts

Background: Newborn infants have multiple risk factors for developing hypoglycaemia of which, hyperinsulinism is an important cause of both transient and persistent hyperinsulinaemic hypoglycaemia (HH). It can present in newborns infants at term, preterm and newborns with intrauterine growth retardation (IUGR). There have been no previous reports of HH occurring in twins and triplets.Aims and objectives: We report the occurrence of HH in 4 sets of twins ...

Introduction: Resistance to thyroid hormone (RTH) is a rare inherited syndrome characterised by refractoriness of target tissue to thyroid hormone. Over 80% of cases are due to mutations in the thyroid hormone receptor beta (THR β) gene with over 100 mutations identified to date. The clinical manifestations vary from common feature as goitre to less common sinus tachycardia, learning disabilities, growth and developmental delay. Aim: We rep...

Background: The paediatric diabetes team at our Children’s Hospital were part of a national clinical trial considering whether long term outcomes are better for patients on MDI (multiple daily injection therapy) or insulin pump therapy from diagnosis. Patients and their families had to be approached, consented and treatment for the trial commenced within two weeks of diagnosis. Many centres struggled to recruit, but this was not the case with our centre.<p class="abst...

Introduction: ROHHADNET is a rare syndrome characterized by rapid onset obesity, hypoventilation, hypothalamic dysfunction, autonomic dysregulation and neuroendocrine tumours. Although obesity is the first recognisable feature, there is variable onset of other features, resulting in delayed or missed diagnosis, potentially leading to fatal consequences. We describe two cases with features of ROHHADNET, who had high heterogeneity in clinical spectrum. Cas...

Introduction: 3M syndrome is a rare autosomal recessive condition that causes short stature, unusual facial features and skeletal abnormalities with normal intelligence. Mutations in CUL7, OBSL1 and CCDC8 genes have been identified as pathogenic. GH treatment outcomes for 3M syndrome appear controversial. Use of human recombinant GH for the treatment of short stature has been trialled in previous studies with some suggesting dysregulation in GH/IGF1 axis while others report no...

Aim: To compare the BMI z-score of children with type 1 diabetes (T1DM) in Nottingham with that of national and local background populations and to identify factors associated with increased BMI.Methods: A retrospective observational cohort study of patients with T1DM aged 2–15 years under the care of the paediatric diabetes team at Nottingham Children’s Hospital, between April 2013 and March 2014. Mean BMI-z-score for the year was com...

Background: Congenital adrenal hyperplasia (CAH) is the underlying diagnosis in most newborns presenting with 46,XX disorders of sex development (DSD). Cytochrome P450 oxidoreductase deficiency (PORD) is a rare form of CAH caused by inactivating mutations in the POR gene. The hallmark feature of PORD is combined sex-steroid and glucocorticoid deficiency due to impairment of CYP17A1 and CYP21A2. Skeletal malformations resembling the Antley-Bixler Syndrome phenotype are common i...

Introduction: Focal congenital hyperinsulinism (F-CHI) is caused by dual-hit pathology, comprising a paternally-inherited ABCC8/KCNJ11 mutation and somatic loss of the maternal allele at chromosome 11p15. This leads to dysregulation of insulin secretion and β-cell overgrowth with a focal domain.Objectives: To compare the proliferative index (PI) of the F-CHI lesion and non-lesion pancreatic tissues to age-matched control pancreata and insul...

Introduction: Adrenal insufficiency is a rare cause of life-threatening hyponatraemic collapse in the neonatal period. The initial investigations taken at the time of presentation, and prior to the institution of hydrocortisone, are a key step in the diagnostic pathway.Aim: We present a case series where the initial biochemical test results could have led to a delay in diagnosis or early discontinuation of hydrocortisone.Ca...

Background: Nutritional rickets (NR), due to poor dietary calcium intake or vitamin D deficiency is still the most common form of growing bone disease despite the efforts of health care providers to reduce its incidence. Clinical history, physical examination and laboratory evaluation are mainstay of diagnosis.Aim: We report a case of NR where the radiological report was misleading causing significant parental anxiety and delay in diagnosis.<p class=...