Endocrine Abstracts

There is increasing awareness that children with chronic illnesses, particularly those with glucocorticoid use and neuromuscular disorders, have the potential to develop significant bone fragility due to osteoporosis. In such cases, osteoporosis manifests as low-trauma extremity fractures, with vertebral fractures an under-recognized consequence of reduced bone strength. We have studied the Genant semi-quantitative classification for characterizing vertebral fractures in child...

The diagnosis of Congenital Adrenal Hyperplasia can be immensely difficult to cope with, especially if the infant presents unwell with associated salt-losing crisis. The need for education verbally and in written format is paramount. This needs to be staged and ongoing, with regular updates.New parents often need advice on general baby care/bonding. Add to this instruction on how to manage the condition, and things can become overwhelming. Practical advi...

Introduction: Primary hyperparathyroidism causes accelerated bone turnover and the consensus is to measure and act upon the 25hydroxyvitamin D level in order to reduce the drive to PTH production, slow down BMD loss, and prevent hungry bone syndrome. How best to replace vitamin D is less clear so we chose to audit our current practice.Method: In 12 months 120 patients with primary hyperparathyroidism were identified retrospectively, 98 of which were vita...

Introduction: It is well-known that prolactinomas sometimes resolve following pregnancy. We wanted to see how often this happens and pregnancy outcome.Patients and methods: From mid 2008 to mid 2013, 66 patients with hyperprolactinemia were studied. 39 had definite microprolactinomas, four probable microprolactinomas, three macroprolactinomas, eight nontumoral hyperprolactinemia and 12 patients were diagnosed elsewhere so no scan results were available. ...

A 20-year-old girl presented to the endocrine clinic with a history of three stone weight gain, and development of numerous purple striae over her lower abdomen, inner thighs and upper arms, gradually progressing over a 12-month period. The onset of symptoms had coincided with the initiation of contraceptive depot medroxyprogesterone acetate, which was discontinued two months prior to her presentation. Her 9 am cortisol was <50 nmol/l.She had a backg...

A 54 year old woman was admitted by her GP to our Medical Admissions Unit earlier this year with a suspected diagnosis of malignancy due to her history of weight loss, lethargy and breathlessness. She was found to be hypercalcaemic with calcium of 3.35 mmol/l. Unfortunately, our acute physicians treated her with pamidronate before her hypercalcaemia was fully investigated which resulted in transient but symptomatic hypocalcaemia (with a nadir calcium of 1.72 mmol/l). A resti...

A 29-year-old woman was admitted at 33 weeks gestation with pre-eclampsia (BP 145/107 mmHg, 3+ proteinuria and significant oedema). On admission her Na was 133 mmol/l and urinary Na 49 mmol/day (ref range 130–260). Twenty-four hours urine protein was 4.43 g/day. Foetal assessment revealed intra uterine growth retardation. She was started on labetolol and the dose titrated upwards to control her blood pressure.Her serum sodium level gradually fell re...

Hyperthyroidism per se can cause mild elevation in liver enzymes which normalizes with treatment. Thyrostatic medications (carbimazole or propylthiouracil) as first line therapy to treat hyperthyroidism can rarely cause potentially fatal hepatotoxicity.We report a patient who developed cholestatic jaundice after carbimazole therapy.Case report: A 32-year-old woman presented with weight loss, heat intolerance, palpitations an...

Background: Thyrotoxicosis can be associated with various psychiatric symptoms, such as emotional lability, anxiety, restlessness and rarely frank psychosis. We report such a case.Case report: Forty-seven year old female presented with palpitations, agitation, irritability, itching of her eyes in March 2007. She denied history of tremor or insomnia. No history of drug or alcohol abuse. No personal or family history of depression or any other psychiatric ...

The morphology of individual ovine placentomes is known to be influenced by several factors including; hypoxia (Gardner et.al, 2002, Placenta 23:459-466), heat stress (Bell et.al, 1987, J.Dev.Phys. 9:17-29) and the fetal and maternal nutrition (McCrabb et.al, 1991, B.J.Nutrition 65:157-168). These conditions are associated with elevated fetal plasma cortisol concentrations. However, the direct effects of fetal cortisol on placental morphology remain unknown. Hence, this study ...