Endocrine Abstracts

Introduction: Empirical research studies suggest that continuous glucose monitoring systems (CGMS) are safe and could optimize neonatal hypoglycaemia management. However, they need to be tested within resource-limited, time-constrained clinical practice. CGMS was piloted in our Level 3 Neonatal Intensive Care Unit (NICU) in June 2017. Five key barriers to its effective implementation were identified: 1) Lack of NICU staff confidence in device usage 2) Infant discomfort during ...

Introduction: The HPA axis is essential for mammalian life. Glucocorticoids are commonly administered and long-term HPA axis suppression is a major clinical problem. Previous experiments in our lab have shown that long-term treatment with glucocorticoids cause silencing of tpit, a pituitary-specific master regulator of the key player in HPA axis regulation – propiomelanocortin (pomc). Even after withdrawal of treatment tpit expression is silence...

Introduction:: The HPA axis is essential for mammalian life. Proopiomelanocortin (POMC), expressed in corticotroph cells of the pituitary, is the master activator of the axis, and a classical negative feedback loop exists whereby glucocorticoids from the adrenals repress its expression. Glucocorticoids are commonly prescribed medicines (10 million prescriptions in UK per year), but when used long-term, suppression of the HPA axis is a major side effect, with risk of life-threa...

Case: Acromegaly is associated with osteoarthritis due to soft tissue swelling. Our patient was first diagnosed with acromegaly in 2001 at the age of 51, subsequently undergoing a transsphenoidal pituitary adenoma resection in 2002, followed by postoperative radiotherapy in 2003, with subsequent development of anterior hypopituitarism. He has comorbidities of osteoarthritis, (having previously undergone bilateral total hip replacements and a left total knee replacement), bunio...

Acromegaly is associated with osteoarthritis due to soft tissue swelling. Our patient was first diagnosed with acromegaly in 2001 at the age of 51, subsequently undergoing a transsphenoidal pituitary adenoma resection in 2002, followed by postoperative radiotherapy in 2003, with subsequent development of anterior hypopituitarism. He has comorbidities of osteoarthritis, (having previously undergone bilateral total hip replacements and a left total knee replacement), bunionectom...

Background: Most phaeochromocytomas are unilateral and are not associated with a neuroendocrine syndrome. Although these tumours are often histologically benign, they tend to have potentially lethal presentations.Case: A 51-year-old female presented in 2016 with headache, vomiting, palpitations, and a cardiac-sounding chest pain for 16 hours. Her ECG showed a junctional rhythm with generalised ST-segment depression. Acute coronary syndrome treatment was ...

Objectives: Pregnancy and early infancy are periods when increased demand for thyroid hormone can result in subclinical hypothyroidism (SH). SH is frequently a prodrome to autoimmunity, but may be a compensation mechanism for an underlying genetic defect. The W546X mutation of the thyrotropin receptor (TSHR) is present at a frequency of 1 in 180 in a Caucasian population. We aimed to investigate whether W546X was the cause of SH presenting in pregnancy and early infancy.<p...

Pancreatitis has multiple aetiologies of which commonest are gall stones and alcohol. Hypertriglyceridaemia is a less common (1-14 %) cause of pancreatitis. We present three case histories of acute pancreatitis due to severe triglyceridaemia and its management challenge in people with diabetes.Case history: 1. A 33-year-old man with BMI of 41 kg/m2 with Hodgkin lymphoma, thyrotoxicosis and diabetes, but no history of alcohol use was diagnosed ...

Radioactive iodine (RAI) is a common treatment for hyperthyroidism, but the dosage and cure rates vary between centres. We administer 370 MBq 131I in all cases unless a large goitre is present, and repeat the dose until hyperthyroidism is cured. Patients are considered cured if euthyroid or hypothyroid one year after the last dose of RAI.We audited the outcome of RAI treatment in our institution between January 2000 and March 2002 to 112 patie...

Recent studies in non-hypertensive patients have shown aldosterone renin ratio (ARR) to be heritable and associated with increased risk of blood pressure (BP) elevation. Furthermore, a raised ARR is present in 10% of hypertensive patients although the precise significance of this is unclear. The magnitude of heritability of ARR will indicate the influence of genetic determination of the phenotype. In this study, we estimated the heritabilities of the components of ARR and the ...