Endocrine Abstracts

Background: Patients with hypoparathyroidism may present acutely with hypocalcaemia and these patients may have multiple admissions; however, data on the incidence of acute and recurrent acute hypoparathyroidism are scarce in the literature.Aim: We wished to determine: (1) the causes of severe hypocalcaemia amongst A&E attendances (2) the incidence of acute hypocalcaemia due to hypoparathyroidism amongst A&E attendances, and (3) the incidence of ...

Background: Patients with hypoparathyroidism may present acutely with hypocalcaemia and these patients may have multiple admissions; however, data on the incidence of acute and recurrent acute hypoparathyroidism are scarce in the literature.Aim: We wished to determine: (1) the causes of severe hypocalcaemia amongst A&E attendances (2) the incidence of acute hypocalcaemia due to hypoparathyroidism amongst A&E attendances, and (3) the incidence of ...

Background: Primary hyperparathyroidism (PHP) is the commonest cause of hypercalcaemia, with an annual incidence rate (AIR) of 4/100 000 and peak age incidence of 50–60 years. Our hospital serves a population with age ≥18 of around 500 000. A corrected calcium (cCa) ≥3.00 mmol/l is a critical phoning limit in our biochemistry laboratory.Aim: To assess the incidence of hypercalcaemia in the community, the referral pattern of hype...

Background: Three 5α-reductase (5α-R1-3) isoenzymes are described. In humans, 5α-R2 deficiency (5α-R2D) causes pseudohermaphroditism and 5α-R3 neurological defects. The role of 5α-R1 is not clear. Urine steroid profiling (USP) by GC–MS can compare 5α-reduction activity based on excretion of 5α- and 5β-reduced metabolite ratios. Finasteride predominantly inhibits 5α-R2. USP in these patients shows concordance with 5α-R...

Introduction: Primary aldosteronism (PA) is the most common endocrine cause of hypertension affecting up-to 10% of hypertensives. Saline suppression, a confirmatory test for PA helps avoiding patients undergoing invasive lateralisation procedures due to a false positive aldosterone-to-renin ratio (ARR). The proposed cut-off to exclude PA is post-saline aldosterone suppression to <140 pmol/l. We reviewed our biochemical work-up in order to optimise laboratory assessment.</p...

Background: Liraglutide is a long-acting glucagon-like peptide-1(GLP-1) receptor agonist that promotes weight loss. The minimum adequate/good response to liraglutide (≥5% weight loss at 3 months) is not achievable in all patients. Currently there are no biomarkers to predict good response. Enhanced postprandial glicentin concentration was recently considered as superior to GLP-1 in predicting weight loss following bariatric surgeries.Objective 1) T...

Introduction: Patients with neuroendocrine neoplasia (NEN) may experience psychological distress related to secretory effects of the tumour. 5-hydroxyindoleacetic acid (5-HIAA) is a metabolite of serotonin, the most important secretory product in carcinoid syndrome. This study aims to determine if urine 5-HIAA levels correlate with health-related quality of life (HRQoL) in patients with NEN.Methods: A retrospective single-centre cohort study was conducte...

Background: Phaeochromocytoma and paraganglioma (PPGLs) are rare neuroendocrine tumours arising from the adrenal medulla and paraganglia. Biochemical assessment relies on demonstrating elevated concentrations of catecholamines and their metabolites. Analytical methods for catecholamine and metanephrine measurement vary in sensitivity and specificity. We reviewed our biochemical work-up in order to optimise patient diagnosis.Methods: This retrospective au...

Background: 5α-Reductase type 2 deficiency (5ARD) is caused by mutations in the SRD5A2 gene. Inadequate masculinisation in XY individuals results from failure to convert testosterone (T) to dihydrotestosterone (DHT), a potent androgen. A decreased serum T:DHT ratio is frequently taken to identify 5ARD, but requires hCG stimulation for prepubertal patients; findings are not always supported by genotyping. Urine steroid profiling (USP) by GC-MS is established as showing sig...

Introduction: Pituitary and adrenal Cushing’s may be managed by pharmacological-inhibition of adrenal steroidogenesis, using metyrapone and/or ketoconazole. Assessment of biochemical control is challenging owing to cross-reactivity in immunoassays (e.g. cortisol and 11-deoxycortisol) leading to over/under-treatment. Off-target effects can also result, e.g. hyperandrogenism/mineralocorticoid hypertension (increased 11-deoxycorticosterone/DOC). LC-MS/MS analysis is free fro...