Endocrine Abstracts

A 60-year-old woman was referred with a 14 mm right adrenal mass on a contrast CT abdomen whilst being investigated for left iliac fossa pain and increased bowel frequency. She reported a 2-year history of anxiety attacks, poor sleep, excessive sweating and weight loss. She had hypertension, asthma and recurrent vasovagal syncope and had previously undergone an open cholecystectomy. Her medications included Lansoprazole, Salbutamol, Losartan, Citalopram and Diltiazem. Systemic...

We report two cases of hypernatraemia with reset osmostat and pituitary dysfunction.A 35-year-old male was referred with Graves’ thyrotoxicosis associated with hypokalaemic periodic paralysis and an incidental serum sodium 154 mmol/l. He complained of polyuria and nocturia but denied excessive thirst and was otherwise well. Height was 193 cm with BMI 29.5. He had gynaecomastia and sparse body hair. He had a small 6 ml right testicle (originally und...

A 29 year old gentleman presented to Urology with scrotal pain. He had renal calculi but examination also revealed small testicles for which he was referred to Endocrinology. He achieved normal developmental milestones. He had no history of mumps or testicular torsion or surgery. He had no history of hypospadias or undescended testicles. He was not on any regular medication and denied anabolic steroids use. He reported a normal sense of smell. His body weight was 72 Kg with he...

Background: PCOS is a common female endocrine disorder, exacerbated by obesity. International guidelines therefore suggest weight loss as first line management. This service evaluation assessed the care pathway of patients referred to Queen Elizabeth Hospital Birmingham (QEHB) with suspected PCOS. We aimed to assess the referral wait time, reason for referral, treatment offered, and weight management in clinic.Methods: We undertook a cross-sectional stud...

Background: Most women with androgen excess have polycystic ovary syndrome (PCOS); however, rarer pathology is considered in a severe phenotype such as ovarian or adrenal androgen-producing tumours. Simultaneous adrenal and ovarian vein sampling is rarely performed to aid the localisation of the androgen excess source. We report four cases that underwent this procedure.Case descriptions: Case 1: A 27-yea...

Background: Management of large indeterminate adrenal masses detected during pregnancy is challenging due to the risk of malignancy and the obstetric risks of surgical intervention. The spectrum of endocrine-related complications of Covid-19 is expanding. We present a case that highlights the challenging management of a large adrenal mass during pregnancy and draws attention to a rare complication of Covid-19.Case description: 26 yr-old lady presented wi...

11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an NADPH-dependant oxo-reductase located in the sarcoplasmic reticulum (SR) lumen of skeletal muscle. It generates active glucocorticoids to regulate permissive and adaptive metabolism. Hexose-6-phosphate dehydrogenase (H6PD) interacts with 11β-HSD1 to generate an appropriate NADPH/NADP+ ratio to support activity. H6PD depletion impairs SR NADPH generation triggering 11β-HSD1 to assume glucocorticoid ina...

Androgen excess in women is most commonly caused by polycystic ovary syndrome (PCOS), but sinister ovarian and adrenal pathology requiring immediate action needs to be excluded. Here we examined whether the severity of androgen excess indicates the likely underlying pathology in women evaluated for androgen excess.We included all women undergoing assessment of serum DHEAS, androstenedione (D4) and testosterone (T) by liquid chromatogra...

11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is an NADPH-dependant oxo-reductase located in the sarcoplasmic reticulum (SR) lumen of skeletal muscle. It generates active glucocorticoids to regulate permissive and adaptive metabolism. Hexose-6-phosphate dehydrogenase (H6PD) interacts with 11β-HSD1 to generate an appropriate NADPH/NADP+ ratio to support activity. H6PD depletion impairs SR NADPH generation triggering 11β-HSD1 to assume glucocorticoid ina...

Androgen excess in women is most commonly caused by polycystic ovary syndrome (PCOS), but sinister ovarian and adrenal pathology requiring immediate action needs to be excluded. Here we examined whether the severity of androgen excess indicates the likely underlying pathology in women evaluated for androgen excess.We included all women undergoing assessment of serum DHEAS, androstenedione (D4) and testosterone (T) by liquid chromatogra...