Endocrine Abstracts

Background: Routine measurements of serum calcitonin levels are considered an integral part of the diagnostic evaluation of medullary thyroid cancer (MTC). We report a rare case of calcitonin and carcinoembryonic antigen (CEA) negative MTC.Case presentation: A 63-year-old retired plasterer attending a well mans clinic was referred to the endocrinology service with elevated calcium (2.75 mmol/dl). Systemic examination was unremarkable and there was no end...

Background: Urinary concentrations of the major progesterone metabolite pregnanediol glucuronide (P3G) are used clinically and in research to monitor ovulation. This ELISA is laborious and costly. If it could be replaced by the automated sensitive chemiluminescence assays routinely used for serum this would be of great value.Objective: We aimed to determine the validity of urine progesterone as measured by two widely used automated assays in comparison t...

Background: Urinary concentrations of the major progesterone metabolite pregnanediol glucuronide (P3G) are used clinically and in research to monitor ovulation. This ELISA is laborious and costly. If it could be replaced by the automated sensitive chemiluminescence assays routinely used for serum this would be of great value.Objective: We aimed to determine the validity of urine progesterone as measured by two widely used automated assays in comparison t...

A 41 year-old male was referred urgently from secondary care with high suspicion of Cushing’s syndrome. His past medical history included psychosis and bipolar disorder, previous low impact foot fractures, rib fractures on coughing and spinal wedge fractures on X-ray, all within the last 5 years. He was taking quetiapine 300 mg modified-release and amitriptyline 10 mg daily, and tramadol 50 mg as needed. The patient reported decreasing mobility with increasing back pain, ...

Medullary thyroid cancers (MTC) account for about 5% of thyroid cancers. The biochemical hallmark of MTC is the secretion of calcitonin (CT). CT levels are both a key feature of pre-operative diagnosis and post-operative follow up. CT screening in a cohort of over 10 000 patients with thyroid nodular disease has demonstrated that a positive CT test has a higher diagnostic sensitivity and specificity for MTC than fine needle aspiration (FNA). They may also secrete carcinoembryo...

Introduction: The commonest cause of orbitopathy is Graves’ disease but the differential diagnosis includes primary and secondary neoplasia, inflammatory, vascular and infective causes. We report an exceedingly rare case of orbitopathy as the presenting feature of Acromegaly.Case report: A 43 year old lady presented with ‘periorbital puffiness’ and irritable eyes. Clinical evaluation revealed orbitopathy and magnetic resonance imaging (MRI...

Aims: Exertional hyperthermia stimulates the hypothalamic-pituitary adrenal axis, increasing the availability of free cortisol in body fluids and opening a window onto physical stress for novel biosensing technologies. This study aimed to determine the impact of prolonged endurance exercise on relationships described for shorter activity bouts, by characterising interactions between salivary indices of glucocorticoid activity, serum total cortisol response and...

Introduction: Exercise in the heat can impose significant physiological strain and may result in incapacity, illness and death from exertional heat stroke (EHS). The adrenocortical response to exercise is known to be amplified with concurrent heat stress, suggesting the potential utility of cortisol measurement in dynamic surveillance for heat intolerance. In laboratory conditions, a standard Heat Tolerance Assessment (HTA) may be used to determine thermal tolerance to exercis...

Background: Heat acclimatisation (HA) describes phenotypic changes (decreased heart rate, HR; lower core body temperature, Tc) resulting from exposure to a hot environment. Heat tolerance with HA may reflect altered adrenocortical and autonomic nervous responses to heat stress, though evidence for sympathetic downregulation is lacking. Methodological limitations to further investigation (e.g. with direct catecholamine measurement) could be overcome by assaying the catecholamin...

Background: Work in a hot environment can cause elevated core body temperature (Tc), circulatory insufficiency and death from Exertional Heat Illness (EHI). Failure to undergo successful heat acclimatisation (HA) is seen in ~5% of otherwise healthy volunteers and may lead to significant EHI, but pathways to severe illness remain poorly understood. Copeptin, a glycopeptide co-secreted with the pituitary hormone arginine vasopressin, reflects osmotic and cardiovascular stress an...