Endocrine Abstracts

Presentation: A 20 year old student was brought to the Emergency Department with a 13 day history of heavy menstrual bleeding. On the day of her admission she had collapsed. On admission, she was noted to be pale with severe postural drop (70 mm Hg).Investigations: Haemogobin: 46 g/l. Blood film showed an iron-deficient picture. eGFR: 54ml/min/1.73m2. Creatinine: 124 μ mol/l. Free T4: <5.3 pmol/l. TSH: >500 mU/l. TPO antibodies positive (8.3...

Background: In 2014, Thy002 (the proportion of patients with hypothyroidism on the practice register with thyroid function tests recorded in the preceding 12 months) was removed as a Quality Outcome Framework (QOF) target.Aim: To audit the current management of hypothyroidism in primary care two years following the QOF changes.Method: Four local practices (total patient population: 37 200 (range 7300–1300 per Practice)) partic...

Background: Hyponatraemia is a frequently encountered problem in primary care. Management should be based on the cause as inappropriate treatment e.g. fluid restriction in patients with hypoadrenalism is dangerous and potentially life-threatening.Aims: We present five cases who presented with hyponatraemia in the primary care setting, to highlight diagnostic approach and implications for management.Case 1 - Hyponatraemia secondary ...

Follicle-stimulating hormone receptor (FSHR) is a Class A G protein-coupled receptor (GCPR) that is essential in reproduction. Interactions with its heterodimeric glycoprotein hormone, FSH, activates the cAMP/PKA signalling pathway, which induces steroidogenic activity and granulosa cell proliferation to support ovarian follicle growth and survival. Moreover, a number of ageing-related extragonadal roles of FSH/FSHR have been proposed, with menopausal elevation in FSH linked t...

Cellular Ca2+ signals have been proposed to activate signal for hormone secretion. In pancreatic β cell which produce insulin, Ca2+ signals have been known contributing insulin secretion. Prior to conduct this study, we confirmed Calbindin-D9k (CaBP-9k) which responsible for regulation of the distribution of free calcium in the cytoplasm. We confirmed Insulin-secreting β cell express CaBP-9k and assumed that CaBP-9k play a certain role in β...

Aim: To investigate the relationship between baseline and stimulated cortisol responses in relation to the habitual time of rising and time of test.Method: The self-reported habitual rising time and time of cortisol testing were recorded in 63 consecutive patients (47F, 17M, age 18–94) undergoing standard stimulation testing with tetracosactide (SynActhen) 250 μg i.v. In total, 75 tests were analysed. A normal response was defined as a 30 min p...

Introduction: Symptoms of hypothyroidism are very variable and are frequently present in the healthy population. The diagnosis can easily be missed if considered only in patients with classical symptoms. Aim: To describe the range of presentations in patients diagnosed with hypothyroidism in primary care.Method: Patients were recruited via the British Thyroid Foundation and from a local GP surgery. Respondents were asked to complete a questionnaire for t...

Introduction: Hyponatraemia is not uncommon in primary care and its management can be complex. It is vital that initial assessment is carried out properly as mismanagement can have serious consequences.Aim: To investigate general practitioners’ views and perceptions on the management of hyponatraemia encountered in primary care.Method: Local general practitioners were surveyed with a questionnaire via email and at local postgr...

Introduction: Hyperthyroidism may mimic many conditions, and there is potential for under-diagnosis if testing is considered only in patients presenting with classical symptoms.Aim: To describe the range of presentations in patients found to have hyperthyroidism and referred from primary care.Method: Consecutive patients diagnosed with hyperthyroidism and referred to the endocrine clinic between Jan 2009 and Nov 2009 were studied. ...

The transcription factor, Steroidogenic factor-1 (SF-1/NR5A1) is the only specific marker of the VMH, to date. Total SF-1 deficiency results in defective VMH neuronal differentiation and architecture, and mice heterozygous for SF-1 (SF-1+/−), or conditionally depleted of SF-1 in the VMH show reduced levels of the neurotrophin Bdnf and an increased propensity for weight gain. Recent studies have suggested several putative SF-1 target genes in the VMH tha...