Endocrine Abstracts

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Radioimmunoassays are used to measure hormones and the technique is based on recognition of an antigen by antibodies largely derived from animal sources. Heterophilic antibodies have been reported to cause interference in 0.05–0.5% of immunoassays. We present a case in which the presence of heterophilic antibodies led to unnecessary interventions.A 32 year old gentleman was referred to our centre to localise neuroendocrine tumour. He presented with ...

There is an increasing pressure for nurses to have a recognised qualification in their specialist area to be able to use the title 'specialist' nurse. As there is a historical lack of a recognised qualification in endocrinology for nurses, we audited exactly where nurses gained their specialist knowledge in the first year in post.There were no publications on this topic.86 questionnaires designed to allow the individual to rate the...

The prevalence of gallstones (GS) is increased in acromegaly and is further increased by somatostatin analogue (SA) therapy. The incidence has variously been reported to be between 10 and 63%, but they are often asymptomatic and rarely require definitive management. However, there is evidence suggesting that discontinuation of SA therapy may precipitate acute biliary problems.We have analysed our experience of symptomatic gallstones in all 44 patients (2...

Background: 21-hydroxylase deficiency congenital adrenal hyperplasia (CAH) is characterised by cortisol deficiency, androgen excess, varying degrees of virilisation and salt-wasting. CAH management involves replacement therapy with hydrocortisone, and, often, fludrocortisone. High levels of androgens cause the advancement of bone age (BA) with the potential to increase bone mineralisation. Hydrocortisone therapy on the contrary can contribute to reducing bone mineralisation. P...

Fetal growth restriction (FGR), which describes the failure of a fetus to achieve its genetic growth potential, not only increases the risk of perinatal mortality and morbidity but also predisposes to metabolic disease in adulthood. In developed countries, FGR is typically attributed to dysfunction of the placenta – a transient organ that mediates nutrient supply, eliminates waste, and protects the fetus from maternal immune response. The placenta also functions as a majo...

A 36 year old man presented with collapse following weakness and vomiting for 2 weeks and 7 kg weight loss over 6 months. Thyroxine 50 mcg OD had been commenced 2 months earlier for hypothyroidism (Free T4 9.4 pmol/l, TSH 8.4 mU/l and anti-TPO antibodies 103.1 IU/mL). Examination found cachexia (weight 53.6 Kg), vitiligo, sinus tachycardia 110 bpm and BP 90/66 mmHg. Investigations: sodium 115 mmol/l, potassium 4.4 mmol/l, urea 9.9 mmol/l, creatinine 81 μmol/l, cortisol 13...

A 36-year-old gentleman presented to his GP 2 years ago with hypertension and was commenced on valsartan. In January 2008, he was noted to have mildly deranged LFT and abdominal ultrasound scan showed mild fatty liver infiltration and bilateral renal stones. He was referred to Urology for investigation of renal stones and a CT IVU showed multiple renal calculi, a 6×5×5 cm soft tissue enhancing lesion arising from the right adrenal gland and a 7 mm calcified density w...

We report 29 years old female with recurrence of adrenal carcinoma and hypercortisolism secondary to HCG responsive adrenal carcinoma.which has been surgically excised in 2003 following the birth of a live infant at 28 weeks gestation.A year latter she presented with a tenderness over the right rib cage and had CT scan which showed metastases at the liver and right renal bed.Hypercortisolism was confirmed biochemicaly with a 24 hou...

IntroductionThe Epworth Sleepiness Scale (ESS) is a validated simple method of measuring subjective daytime sleepiness in a variety of situations whereby patients are asked to score the probability of dozing as no chance, slight, moderate or high chance. An ESS>10 is regarded as excessive daytime sleepiness which may be a result of sleep apnoea or sleep disorders. The British Thoracic Society advise that patients who have ESS>10 or sleepiness in ...