Endocrine Abstracts

A 58-year-old man was diagnosed with subclinical hypothyroidism on routine biochemistry in primary care. His initial thyroid stimulating hormone (TSH) was 10.7 mu/l, Free T4 (fT4) 24 pmol/l and thyroid peroxidase antibody negative. He was treated with levothyroxine and doses escalated due to elevated TSH (9.6–20.58 mu/l) and low fT4 (12.0–24.9 pmol/l). Despite good adherence to treatment his TSH was persistently raised and hence he wa...

We report a 29-year old primiparous woman, presenting 3-days post vaginal delivery with a severe frontal headache of gradual onset but particularly severe whenever she tried breastfeeding and accompanied by vomiting. She was conscious, mildly dehydrated and apyrexial. Reflexes were globally brisk and besides for neck stiffness the rest of her central nervous system and major systemic examination was normal. FBC and clotting were normal, C-reactive protein 35 (normal <5). G...

We report a 26 year old Asian lady referred to our clinic with secondary infertility and a raised testosterone. She had miscarried at 6 weeks a year earlier. Over the last 6 months her periods had become irregular (every 6–8 weeks) had gained 9 kilograms in weight despite an unchanged diet. Along with this she had noticed an increase in facial and body hair. Testosterone checked by her GP was markedly elevated at 5.2 nmols/L (N<2.8).Prolactin 214 mu/L (0–650), ...

Fertility preservation is a rapidly advancing area of medicine. Its clinical potential in adult women was demonstrated by ovarian function and successful pregnancy following ovarian cortical tissue cyropreservation and replacement in the sheep in the 1990s with the first successful human pregnancy reported in 2004. Since then some 25 babies have been born to women who have had ovarian tissue cryopreserved and subsequently replaced, with most of these women having been treated ...

Congenital adrenal hyperplasia (CAH) is a genetic disorder arising from defective steroidogenesis resulting in glucocorticoid deficiency; the commonest mutation is in the gene encoding 21-hydroxylase. Lifesaving glucocorticoid treatment was introduced in the 1950s and there is now an enlarging cohort of adult patients; however, there is no consensus on management. To address this issue, the Congenital adrenal Hyperplasia Adult Study Executive (CaHASE) was formed in 2003 to stu...

Congenital adrenal hyperplasia (CAH) is a recessively inherited deficiency of cortisol production affecting an estimated 1 in 10 000–20 000 live births. The salt-wasting form, which is found in over half of all children with CAH, may present with a potentially life-threatening crisis in with the newborn period while associated excess androgen production may result in girls being incorrectly assigned as boys at birth. Early detection by newborn screening, combined with cor...

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We have found that many of the receptors and downstream signalling elements involved in taste detection and transduction are expressed also in intestinal hormone producing (endocrine) cells where they underlie key chemosensory functions of the gut. In one example of gastrointestinal chemosensation it is known that glucose given orally, but not systemically, induces secretion of the ‘incretin’ hormone glucagon like peptide-1 (GLP-1), which in turn regulates insulin se...

During the 10-year UK Prospective Diabetes Study (UKPDS) post-trial monitoring period, sustained reductions were seen in the risks of diabetic complications, despite the previously randomised conventional and intensive treatment groups becoming identical with respect to median HbA1c values and glucose-lowering therapies. This continuing benefit of an earlier intervention in people with type 2 diabetes has been termed the ‘legacy effect’. A similar phenomenon seen in ...

The developing fetus adapts to an adverse in utero environment, and is ‘programmed’ to an increased risk of developing disease in later life. Fetal growth is regulated via a complex interplay between mother, placenta and fetus. Maternal nutrients, transported via the placenta, are essential for fetal growth. Conversely, the placenta may also respond to fetal endocrine signals to regulate maternal metabolism. The placenta also regulates fetal growth via production and...