Endocrine Abstracts

Genitalia appear larger and swollen in all neonates due to the circulating maternal hormones and this subsides spontaneously over few weeks or months. Additionally, general growth of the rest of the body outpaces any growth of the genitalia during childhood, resulting in apparent reduction in the size of the genitalia comparatively. There are high levels of circulating androgens in children with CAH until the commencement of medical replacement therapy (MRT). It is universally...

Introduction: The National Growth Hormone (GH) audit was initiated in 2013 with funding from BSPED, to establish the ongoing trends in GH prescriptions in the UK and facilitate future long term follow up studies through a central database. Here we have studied the trends in GH prescribing and the indications for treatment from 2013 to 2015.Method: We examined data collected on a quarterly basis from centres across the UK on subjects less than 16 years of...

Based on the traditional belief that the lower vagina does not form owing to excess androgens in utero, extensive dissections are undertaken to bring the vagina down to the skin level in 46XX CAH individuals. However, long held knowledge about the embryological origins of the lower vagina and the key role of androgens has been questioned by genetic and molecular studies [Cai Y. 2009. https://doi.org/10.1387/ijdb.082846yc ]. Our aim was to assess the level of the vaginal introi...

Androgen-producing tumours of the adrenal are extremely rare. The androgen effects and malignancy potential can be detrimental in children. Adrenal adenomas are usually small, whereas carcinomas are larger and aggressive. We present the challenges in managing a female toddler with a large androgen secreting adrenal adenoma. A 22 months old 46 XX girl presented with features of hyperandrogenism but not of glucocorticoid or mineralocorticoid excess: tall stature, facial and pubi...

Background: Childhood obesity is a growing problem worldwide, with serious effects on child health. Obese children are at a higher risk of developing metabolic co-morbidities earlier in life (WHO, 2013). Manchester has worse than national average levels of obesity, with an estimated 14 000 obese children (PHE, 2014).Aims and methods: A retrospective case note analysis of 117 obese paediatric patients, seen in our service between March 2012 and 2014, was ...

Introduction: Congenital hyperinsulinism (CHI) is a rare condition of dysregulated insulin secretion causing hypoglycaemia. Oral Diazoxide is used as first line therapy for CHI. In those who are Diazoxide unresponsive, subcutaneous Octreotide is used as second line treatment. Octreotide has recognised side effects of biliary stasis. Additionally, we report hepatitis as a complication of Octreotide therapy in a child with CHI.Case report: A neonate with C...

Introduction: Congenital hyperinsulinism (CHI) is characterised by abnormally regulated and excessive insulin secretion by pancreatic β cells. First line management includes an oral suspension of Diazoxide but a standardised formulation is not universally employed. Anecdotal evidence suggests that different formulations can alter the management of glucose levels. Lack of glucose control can lead to permanent brain damage and adversely affect neuro development.<p class...

Background: Obese young people are likely to suffer significant morbidity in adult life. Successful intervention during adolescence may have far-reaching benefits. Evidence is emerging that patient-responsive clinical services may deliver improved outcomes.Aims: To assess the perceptions of obese young people about weight and weight-management services.Method: Annonymised, postal questionnaire survey of 116 obese young people (9&#1...

Background: Severe primary IGF1 deficiency (SPIGFD) is defined in children as a height less than −3sds, low IGF1 levels with normal growth hormone levels. Recombinant IGF1 (rhIGF1, Mecasermin) given twice daily as a subcutaneous injection is the only therapy available to improve the height potential in this group of children. However it may have important side effects including hypoglycaemia, growth of lymphoid tissue and injection site lipohypertrophy.<p class="abst...

Background: Seeing the doctor alone has been associated with a better outcome following transition to adult services.Methods: A simple questionnaire was designed for young people (YP) to enquire about being seen alone in paediatric endocrine clinics.Results: The questionnaire was administered to 72 YP young people (37 male) with long term endocrine conditions. The mean age was 15.5 (2.5). 10% of YP thought they should be offered th...