Endocrine Abstracts

Case history: A 37 year old mother of two was referred to DGH by the GP for possible PCOS in 2019. She had an 18 months of weight gain, hirsuitism, oligomenorrhoea, abdominal distension, back pain and fatigue. Medical history included asthma and she worked as a teacher. On Endocrine clinic review, she was noted to be floridly Cushingoid. Urgent referral to tertiary Endocrinology in Edinburgh was auctioned and a diagnosis of Cushing’s Disease was made alongside multiple re...

Background: CYP3A4 is the most prevalent cytochrome P450 (CYP) enzyme in the liver, and is used by the majority of medications for their metabolism and elimination from the body. The inhibition of CYP3A4 can result in the accumulation of drug concentrations increasing the risk for possible toxicity. We report a case of iatrogenic Cushings’s syndrome secondary to impaired CYP3A4 metabolism of triamcinolone by coadministration of darunavir/cobicistat, with resultant seconda...

There is a significant body of research that demonstrates an association between central (visceral) obesity, insulin resistance, endothelial dysfunction and accelerated atherosclerosis, but the molecular mechanisms underlying this link are incompletely understood. In cultured human aortic endothelial cell (HAEC) models, insulin stimulates an intracellular signalling cascade resulting in activating phosphorylation of Insulin Receptor Substrate-1, Protein kinase B (PKB/Akt) and ...

A case is reported of a man with stage IV grade 2 pancreatic VIPoma. At diagnosis he had several features which may have expedited the diagnosis including refractory diarrhoea containing undigested foodstuffs, alcohol-related flushing, electrolyte abnormalities and intestinal oedema on imaging. Symptom control was challenging. There was no benefit from creon, loperamide or codeine and escalation to both short and long acting somatostatin analogues was futile. Consistent with a...