Endocrine Abstracts

A 30-year-old female presented to accident and emergency having been found collapsed. The patient had a reduced Glasgow Coma Scale of 10, was pyrexial, clinically in shock and pale in colour. Initial investigations confirmed hypoglycemia and a metabolic acidosis. A collateral history described a 3 days history of diarrhoea. Her 5-year-old child (who was conceived normally) also had diarrhoea.The impression was of shock secondary to sepsis and hypovolemia...

A 27 year old lady with a background of Langerhans cell histiocytosis (LCH) presented to endocrinology clinic for investigation of thyrotoxicosis. At the age of three years old, she presented with a rash on her forehead, which on biopsy revealed Langerhans cell histiocytosis. She was also noted to have symptoms consistent with diabetes insipidus, for which she remains on desmopressin therapy. At the age of six she received pituitary radiotherapy and 6 years ago developed secon...

A 45-year-old woman presented with a 6-week history of constipation and generalised abdominal pains. Blood biochemistry revealed a corrected serum calcium of 4.99 mmol/l, phosphate 0.82 mmol/l, and intact parathyroid hormone (i-PTH) of 0.2 pmol/l (normal range 1–6.1 pmol/l). Serum parathyroid hormone related peptide (PTH-rP) was 5.3 pmol/l (normal range <1.8 pmol/l). Computed tomography demonstrated an 11.0×11.6 cm ovarian tumour with cystic and solid areas and h...

A 37-year-old lady was referred to the endocrine clinic with a raised serum calcium of 2.73 mmol/l in the presence of an inappropriately raised parathyroid hormone of 8.7 pmol/l. Calcium:creatinine clearance ratio was elevated at 0.018, excluding familial hypercalcaemic hypocalciuria. Past medical history revealed an episode of renal stones 17 years ago but a renal ultrasound excluded nephrocalcinosis.A diagnosis of primary hyperparathyroidism was made.<...

Introduction: Obesity-associated psychopathological co-morbidities have a negative impact on quality of life. Roux-en-Y gastric bypass surgery (RYGB) has been shown to ameliorate psychological health, however, the underlying mechanisms are not fully understood. Changes in gastrointestinal and central neuroendocrine signalling have been postulated as mediators of psychological and eating behaviour changes following RYGB. Here we assess the impact of subcutaneous infusions of th...

A 36-year-old man was referred to the neurologists for leg weakness and pain, fatigue and lethargy for 2 years. Sarcoidosis was diagnosed 6 years previously, on the basis of uveitis, lower motor neurone facial palsy, hilar lymphadenopathy and transbronchial biopsy. Prednisolone had been discontinued 3 years prior to his current presentation.His blood pressure was 99/71. Examination was otherwise unremarkable. His ACE was 109 U/l (10–70). His TSH was...

Background: An increasingly recognized complication of Roux-en-Y Gastric Bypass (RYGB) surgery is the development of postprandial hypoglycaemia (PPH). However, there remains no agreed standard on how to diagnose this condition. Commonly used tests include a prolonged oral glucose tolerance test (POGTT) and mixed meal tolerance test (MMTT). Little is known regarding how these tests compare in the post-bariatric population.Methods: Ten patients who had con...

Background: Roux-en-Y Gastric Bypass (RYGB) results in sustained weight loss. Changes in food preferences and eating behaviour are postulated as possible contributing mechanisms. Post-RYGB, patients consume less sugary and fatty food. Sweet taste detection and sensitivity have been reported to be enhanced post-surgery and this may account for changes in the palatability of food. Underlying mechanisms for the changes in sweet taste function and eating behaviour are unclear....

Introduction: Improvement in glycaemia is observed early after Roux-en-Y Gastric Bypass surgery (RYGB) in patients with diabetes. Commonly cited mechanisms to account for these changes include the elevation of gut hormones, increase in bile acids levels, changes in the gut microbiota and calorie restriction. Calorie restriction is believed to play a role in improving hepatic insulin sensitivity and reduce hepatic glucose output early after RYGB, in the context of non-significa...

Background: Bariatric surgery is currently the most effective treatment for weight loss. Its metabolic effects of weight loss and improvement of type 2 diabetes are mediated mainly through the postprandial elevation of gut hormones such as GLP-1, which suppresses food intake and improves insulin secretion.Aim: To characterize the longitudinal changes in fasting and postprandial secretion of glucose, insulin and gut hormones (GLP-1 and GIP) in patients be...