Endocrine Abstracts

Angiogenesis, which is tightly regulated in health and disturbed in many diseases, is inhibited by glucocorticoids. Local glucocorticoid availability within the vessel wall is determined by the pair of enzymes 11beta-hydroxysteroid dehydrogenase type 1 and 2 (11HSD-1 and 2) that catalyse the interconversion of active glucocorticoid (corticosterone in mice, cortisol in humans) with inactive 11-dehydrocorticosterone or cortisone. We hypothesized that regeneration of active gluco...

Glucocorticoids possess potent angiostatic properties. 11β-Hydroxysteroid dehydrogenase type 1 (11βHSD1) amplifies local glucocorticoid action in a tissue-specific manner, and we have shown that inactivation of this enzyme enhances angiogenesis within sponges implanted subcutaneously, wounds and infarcted myocardium. 11βHSD1 is present within ocular tissues but its role in the pathogenesis of proliferative retinopathy is unknown. We hypothesised that inhibition ...

The tachykinin neurokinin B (NKB) has prominent roles in neuroendocrine function, behaviour and the control of reproductive processes, yet little is known about its evolution, potential splice variants or the manner in which it is processed. Indeed, the cloning of human TAC3 in 2000 revealed a single gene transcript encoding a single precursor and single tachykinin. Here, we deduce the phylogenetic relationship of a family of NKB peptides, and identify novel TAC3...

Topical glucocorticoid therapy causes adverse effects in human skin including a reduction in dermal fibroblast proliferation and extracellular matrix protein secretion (e.g. collagen 1) and epidermal thinning – effects paralleled in photoexposed and elderly skin. These cause reduced wound healing rates and a loss of elasticity with increased fragility and transepidermal water loss – signs also typical of Cushing’s syndrome characterised by raised circulating cor...

Phaeochromocytomas and paragangliomas arising as part of familial syndromes such as multiple endocrine neoplasia (MEN)2 or von-Hippel Lindau syndrome (VHL) are more likely to be malignant and multiple. Recently the role of mutations in the SDH genes (encoding subunits of succinate dehydrogenase) have also been identified as important in the aetiology of such tumours. We report a case where identification of an apparently sporadic metastatic phaeochromocytoma was found to be co...

The route of oestrogen replacement has an important influence on growth hormone (GH) sensitivity, but it remains unclear whether the route of testosterone treatment in hypopituitarism influences the response to GH replacement. We have compared IGF-I levels, body composition and BMD in hypopituitary male patients with severe GH-deficiency receiving either oral testosterone undecanoate (T.U.)(80-160 milligrams per day) or intramuscular testosterone (I.M.) (250-500 milligrams per...

A 61 year old woman presented with a six months history of nausea, vomiting and lethargy. She is a non-smoker and drinks little alcohol. She was on 100mcg of Thyroxine following partial thyroidectomy. Physical examination was unremarkable apart from postural hypotension (BP 140/80mmHg laying, 105/75mmHg standing). Blood tests showed plasma sodium of 121mmol/L with normal potassium, urea, creatinine, FBC, random glucose and TFTs. A short synacthen test (1mcg) was normal with a ...

Urine 18-hydroxy cortisol ('18OHF') measurements are claimed to have the potential to discriminate between primary hyperaldosteronism due to either Conn's syndrome/adrenal adenoma (increased values) or idiopathic adrenal hyperplasia (normal values), and also to identify cases of glucocorticoid-suppressible hyperaldosteronism ('GSH').We have evaluated three urine 18-OHF methods using a panel of samples from patients with primary hyperaldosteronism [due to either adenoma (N=...

A 42 year old gentleman presented for a second opinion regarding management of Congenital Adrenal Hyperplasia (CAH) of the salt losing variety. The patient had been under long term follow up elsewhere but had discontinued his medication of his own accord 14 months prior to seeking consultation. Examination revealed a heavily pigmented male patient with protuberant belly. He had easily palpable masses in both flanks. An abdominal CT showed bilateral massive adrenal enlargement ...

An 18 year old young man was first seen in the ENT department with bilateral swelling of the supraclavicular fossae. A clinical diagnosis of Cushing's syndrome was made and the patient was referred to the Endocrine team. Examination showed a BP of 150/100 and clinical features of gross Cushing's syndrome. Initial investigations revealed normal electrolytes, fT4 8.7 pmol/L, TSH 0.69 mIU/L and a basal prolactin of 68280 mIU/ml. A 24 hr urinary free cortisol (UFC) was 3860 nmol/L...