Endocrine Abstracts

A 52-year-old, previously well Indian lady was admitted in May 2008 with pneumonia. Concurrently, she was diagnosed with diabetes mellitus (blood glucose 20 mmol/l). Her BMI was 19 kg/m2 and she was initially commenced onto sulphonylurea therapy. She had a further admission in July 2008 with dizzy episodes, falls, postural hypotension (systolic postural drop 75 mmHg) and erratic blood glucose levels (range 1.1–30 mmol/l). Blood ketones were 3.6 mmol/l without a...

A 35-year old female presented with a 5 day history of headache, diplopia and reduced visual acuity preceded by 6 months of lethargy and weight gain. Visual field testing revealed left temporal hemianopia. Magnetic resonance imaging (MRI) showed a benign pituitary adenoma with intra-tumoural haemorrhage compressing the optic chiasm. Neurosurgical opinion advised on transphenoidal surgery. However, in view of spontaneous resolution of diplopia and recovery of peripheral vision,...

Cabergoline has long been used to treat prolactinomas for symptomatic, radiological and biochemical resolution of pituitary tumours. As clinicians we are well-versed at screening for physical side effects, but are we holistic enough? We present two cases illustrating the damaging social consequences of cabergoline treatment for prolactinomas.Case 1A 49-year-old married father of two presented with a seizure in April 2018. MRI showe...

Background: Kisspeptin stimulates hypothalamic GnRH secretion resulting in gonadotrophin release and has the potential as a future therapeutic for infertility. Previous studies have observed that kisspeptin increases LH and to a lesser degree FSH when administered to healthy women, which may limit its therapeutic potential. However, studies in women with hypothalamic amenorrhoea show that i.v. infusions of kisspeptin-54 stimulated both LH and FSH equally. Chronic s.c. infusion...

Background: The KISS1 gene, is a critical regulator of normal reproductive function. In humans, KISS1 deletion results in a failure to go through puberty while activating mutations result in central precocious puberty. Administration of kisspeptin induces ovulation in rodents and sheep. However chronic exposure to exogenous kisspeptin-54 leads to profound tachyphylaxis in women with hypothalamic amenorrhoea. It is not known whether exogenous kisspeptin can alter the m...

Introduction: Kisspeptin-54 is a recently identified hormone, which potently stimulates GnRH secretion within the hypothalamus. Women with hypothalamic amenorrhoea (HA, hypogonadotrophic hypogonadism associated with low body weight) have reduced LH pulsatility causing amenorrhea and infertility. We have previously demonstrated that exogenous administration of kisspeptin-54 acutely stimulates gonadotrophin secretion in women with HA. However, it is not known whether exogenous k...

Clinical Endocrinology 2016 84 939–945. DOI: 10.1111/cen.12603...

Clinical Endocrinology 2016 84 939–945. DOI: 10.1111/cen.12603...

Background: In vitro fertilisation is an effective therapy for infertility, but can result in the potentially life-threatening complication, Ovarian Hyper-Stimulation Syndrome (OHSS). We have previously reported that a single injection of kisspeptin results in an LH surge of ~12–14 hrs duration, sufficient to safely induce oocyte maturation, but eliminate OHSS. However, the physiological LH surge in a normal menstrual cycle has a plateaux lasting 24–28 hrs. ...

As the nation gets fatter, the incidence of diabetes is also rising. The brain is now emerging as a critical mediator of blood sugar control, re-directing focus away from the traditional pancreas-centred model. The enzyme glucokinase (GK) acts as a glucose sensor in many tissues including glucose-sensitive neurones within the hypothalamic arcuate nucleus. However, the role of GK here is unclear. We investigated the role of arcuate GK in glucose homeostasis in both healthy and ...