Endocrine Abstracts

Anterior pituitary dysfunction is a well-recognized complication of traumatic brain injury (TBI) but recovery is an exceptional event, with only three previously published case reports.We report a case of a 25 year old man who suffered severe TBI in a road traffic accident in 1997. His neurological recovery was slow and incomplete with significant cognitive deficit and recurrent seizures. He developed polyphagia and his weight increased by 20 Kilograms i...

Hyperparathyroidism jaw tumour syndrome (HPT-JT) is an autosomal dominant disease with variable penetrance. Onset is typically in late adolescence or early adulthood. Primary hyperparathyroidism is typically caused by a single parathyroid adenoma but parathyroid carcinoma occurs in 10–15%. Ossifying fibroma of the mandible or maxilla occurs in 30–40%, and may be locally aggressive. 15% of patients have renal manifestations which include polycystic kidney disease, Wil...

Chronic kidney disease (CKD) is an important complication of diabetes and determinant of mortality. Albuminuria represents early diabetic nephropathy, and also indicates generalised vascular dysfunction. Understanding the epidemiology of CKD and albuminuria helps inform health planning and identify opportunities to prevent or delay progression of diabetic kidney disease. The last available serum creatinine and urine albumin/creatinine ratio (UACR) in patients with Type 1 (T1DM...

NADPH generated by hexose-6-phosphate dehydrogenase (H6PDH) within the lumen of the endoplasmic reticulum (ER) drives the reductase activity of 11β-hydroxysteroid dehydrogenase type 1 (11-βHSD1) allowing the production of active glucocorticoids. H6PDH knockout (H6PDHKO) mice develop a vacuolating myopathy, reduced muscle mass and display activation of the ER stress response. However, the role of glucocorticoids and 11β-HSD1 in the myopathy phenotype is not clear...

Adipsic diabetes insipidus (ADI) is a rare condition which has been reported following clipping of anterior communicating artery aneurysms, craniopharyngioma and brain trauma, but not with pituitary adenoma. We report a case of ADI following surgery for a pituitary macroprolactinoma. A 14-year-old boy presented with bitemporal hemianopia due to a large macroprolactinoma. Two debulking surgeries were performed without the development of diabetes insipidus. Following a third rad...

Adrenal mineralocorticoid biochemistry differs between people of African and European ancestry. The aldosterone/renin ratio (ARR) is the initial screening test for primary hyperaldosteronism (PHA), but little data exists regarding ethnic variations in this.Following clinical observation of a high prevalence of abnormal ARR in patients of African origin, we retrospectively reviewed all ARR measurements in a single centre over 10 years. Rates of hypokalaem...

Subarachnoid haemorrhage (SAH) is a well reported cause of hypopituitarism but the precise incidence is controversial. We aimed to prospectively determine the incidence of acute and long term hypopituitarism in SAH.We prospectively recruited 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium, urea, osmolality, glucose, and 0900 h cortisol (PC) measured on days 1, 2, 3, 4, 6, 8, 10...

Hyponatraemia is the most common electrolyte abnormality following subarachnoid haemorrhage (SAH). Retrospective data suggests that the Syndrome of Inappropriate Antidiuresis (SIAD) is the most common cause, although glucocorticoid deficiency and rarely cerebral salt wasting may also cause hyponatraemia.We prospectively studied 100 patients (61% female, median age 53 (range 16–82)) with non-traumatic aneurysmal SAH. Each patient had plasma sodium (p...

GH deficiency (GHD) in adults shares several clinical features with syndromes of glucocorticoid excess. Many patients with GHD also receive glucocorticoid therapy. GH inhibits the generation of active glucocorticoid by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), but the confounding effect of ACTH deficiency/ cortisol replacement therapy has not been evaluated.Aims: To assess corticosteroid exposure and metabolism and body composition in...

GH/IGF1 stimulate muscle function whereas excess glucocorticoids induce myopathy. Myocytes express 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), an enzyme which converts inactive cortisone to active cortisol. GH/IGF-I inhibit 11β-HSD1 expression in some tissues and thus reduce cellular glucocorticoid exposure. This suggests that anabolic actions of GH/IGF1 could be mediated indirectly through effects on 11β-HSD1. The regulation of 11β-HSD1 has be...