Endocrine Abstracts

We undertook a retrospective audit of patients with primary hyperparathyroidism. Patients were identified from the Bradford Endocrine Database.About 101 patients were identified. 13 were incorrectly labelled and excluded. Case records of 88 patients; median age 64 (range 17–87) years, 69 F:19 M, were examined. At diagnosis median corrected calcium was 2.72 (range 2.45–3.69) mmol/l, median PTH 14 (range 3–182) pmol/l and mean 24 h urine cal...

Familial hypoparathyroidism is a rare condition. A family with seven affected individuals is described. Six sets of case notes were available for comparison. The most probable type of genetic transmission is autosomal dominant. There is also a family history of renal stones and ankylosing spondylitis.At diagnosis, adjusted calcium levels ranged between 1.77 and 1.92 mmol/L. PTH levels were either undetectable or in the low-normal range. Most cases were s...

Various proinflammatory cytokines have been demonstrated to be involved in insulin resistance and other obesity related diseases. Preadipocytes and adipocytes are likely to modulate inflammatory and immune processes by intrinsic mechanisms. Toll-like receptors (TLRs) which are – together with CD14 – involved in the innate immunity and are able to recognize microbial components. Microbial components and immunosuppressive drugs modulate the cytokine expression. We addr...

A 31-year-old German lady attended A&E with a 1 week history of bilateral leg swelling. The leg swelling had been gradual in onset and was not associated with shortness of breath, chest pain or haemoptysis. She had no history of renal or cardiac disease. Her only past medical history was of mild indigestion. She did not have any regular medication use. On examination she was systemically well but had bilateral pitting lower limb oedema. Blood pressure was 120/80 mmHg (comp...

A 72 year old, non-diabetic, woman was referred with recurrent severe hypoglycaemia. Twenty-one years ago she was investigated for hypoglycaemia when inappropriate hyperinsulinaemia had been confirmed. Although a CT of her abdomen could not demonstrate an insulinoma she underwent a distal pancreatectomy and subsequent histology showed islet cell hyperplasia. She was managed with dietary intervention and diazoxide. At the time of the current referral she was suffering daily sev...

A 30 year old lady attended the Accident and Emergency department (A&E) with vomiting, collapse and confusion several hours after completing her first London Marathon in 5 hours. During the race she kept herself hydrated with water and isotonic fluids and took non-steroidal anti-inflammatory drugs (NSAIDs). On arrival in A&E her Mini Mental Test Score was 0 and Glasgow Coma Scale (GCS) was 11. She was volume replete and haemodynamically stable but confused and restless...

Neuropeptide S (NPS) is a recently discovered peptide shown to be involved in the modulation of arousal and fear responses. It has also been shown that lateral ventricle administration of NPS causes a significant decrease in food intake. Neuropeptides involved in the modulation of arousal have been shown to be involved in the regulation of the hypothalamo-pituitary adrenal (HPA) axis and food intake.Objective: To examine the effect of NPS on the regulati...

Background: Surgery is indicated for patients with prolactinomas if intolerant of or resistant to medical therapy with dopamine agonists. The transphenoidal route offers fast relief from symptoms in the hands of an experienced surgeon, with remission achieved in up to 87% of microprolactinomas and 56% in macroprolactinomas.1Aim: To evaluate the outcome of transsphenoidal adenectomy for non-responsive prolactinomas in a single centre in the UK....

BackgroundAppetite is complex, however to address the obesity epidemic, therapeutic agents would have to significantly influence appetite. Currently the most effective treatment for obesity is bariatric surgery because it reduces hunger and increases satiety. The satiety gut hormones such as peptide YY (PYY) and glucagon like peptide 1 (GLP-1) reduce appetite and food intake. Compared to lean and obese subjects, exaggerated postprandial responses of PYY ...

There are at least 60 reports of pregnancy and acromegaly. The maternal and foetal morbidity relates to associated diabetes mellitus and hypertension rather than maternal growth hormone excess. A 32-year-old Asian female who spoke no English, was noted to have acromegalic features during a hospital admission for pneumonia. She was 6 weeks pregnant and had been recently diagnosed with type 2 diabetes mellitus. Acromegaly was confirmed with GH nadir 105 mU/l during 75 g OGTT and...