Endocrine Abstracts

Autotaxin (ATX) is a secreted enzyme that generates the lipid signalling molecule LPAs from LPCs. The ATX/lPA axis is strongly linked to fibrotic diseases and therapeutic inhibitors are in development. Assessing the balance of LPC/lPA in diseased target tissues is critical to inform pharmacokinetics/pharmacodynamics (PK-PD) and predict efficacy of ATX inhibitors in vivo. Mass spectrometry imaging (MSI) allows concomitant measurement of multiple molecules with histopat...

Introduction: Gestational diabetes (GDM) affects 1 in 6 pregnancies globally, increasing babies’ risk of being born large-for-gestational-age (LGA). This can cause birth injuries and predisposes offspring to developing cardio-metabolic disease in adulthood. The cause of LGA in GDM is unclear, however GDM placentas have been shown to display abnormal morphology indicative of vascular network immaturity. MicroRNAs (miRNAs) are known regulators of vascular development, inclu...

Case history: We report a 38 year-old Caucasian woman with classical salt wasting congenital adrenal hyperplasia (CAH) who increasingly omitted medication in adolescence and eventually spent over 10 years without any adrenal replacement therapy or adrenal crises and became lost to follow up. When seen, she complained of increasing abdominal girth, fatigue, hirsutism, had type 2 diabetes, had never had a romantic/sexual relationship and was amenorrhoeic. Examination revealed ab...

Case history: A 69-year-old Caucasian male presented with persistent abdominal pain and was found to have a large right adrenal mass on CT. Interestingly his family history revealed that his daughter had been treated for Cushing’s disease. He was normotensive and denied classical symptoms of catecholamine excess. He had exertional dyspnoea in keeping with COPD. Subsequent tests were consistent with a secretory phaeochromocytoma and urine normetadrenaline 85,671 nmol/day (...

Case history: A 26 year-old lady was admitted from clinic with severe hypertension and bilateral papilloedema. Six weeks prior to admission she had undergone resection of a massive right upper quadrant lesion that was felt to be of hepatic origin. Histological analysis of the lesion revealed it to be an adrenal phaeochromocytoma and she was thus referred to the endocrine service. Pre-operative biochemical assessment had not been performed but there was no evidence of any blood...

Case history: A 17 year old previously healthy male presented to his local emergency department with a generalised tonic seizure associated with severe hypertension (systolic blood pressure 240 mmHg) and tachycardia. He was intubated and admitted to the Intensive Care Unit. Antimicrobials to cover meningoencephalitis were commenced and his hypertension was managed with intravenous labetalol. He was extubated the following day. He had experienced headaches on a monthly basis fo...

A 61-year-old lady presented to her general practitioner in July 2018 with weight loss, loose stools, hair loss, increased anxiety and dry eyes over several weeks. Blood tests revealed Graves’ thyrotoxicosis (TSH< 0.10 mU/l, (RR) 0.30-5.50 mU/l; Free T4 (fT4) 26.1 pmol/l, RR 11.5−22.7 pmol/l; Free T3 (fT3) 11.8 pmol/l, RR 0.0-7.0 pmol/l, thyroid receptor antibodies >40.0U/l, RR 0.0-1.8 U/l; thyroid peroxidase antibodies 173.0 iu/ml, RR 0.0-33.9 iu/ml). There...

Pregnancies affected by GDM commonly result in large-for-gestational-age (LGA) infants, which have an increased risk of developing cardiometabolic complications. The mechanisms responsible are unclear but are associated with altered placental physiology. We have previously reported that miRNAs, including pancreatic specific miR-375, are altered in maternal serum extracellular vesicles (EVs) prior to the onset of LGA, and in term placenta. We assessed maternal pancreatic-derive...

Background: Gestational diabetes (GDM) leads to an increased risk of delivering large-for-gestational-age infants (LGA), which has been linked to altered placental vascular development. Women with GDM who deliver LGA infants have temporal periods of mild hyperglycaemia, detectable by continuous glucose monitoring (CGM), compared to women who deliver appropriate-for-gestational-age infants (AGA). This study aimed to assess the impact of physiological periods and levels of hyper...

Metformin is a first-line therapy for type-2 diabetes mellitus and gestational diabetes mellitus (GDM) which shows significant benefits for maternal health. However, offspring exposed to metformin in-utero have an increased risk of being born small for gestational age and developing cardiometabolic complications in adulthood. The mechanisms responsible are unknown. As fetal growth is dependent on optimal placental function, we assessed whether metformin exposure alter...