Endocrine Abstracts

Introduction: SFRP-4 is a recently described inflammatory cytokine influencing insulin secretion from human β cells as an extracellular modulator of Wingless (Wnt) pathway. The aim of this study is to compare serum SFRP-4 levels in patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and type 2 diabetes (T2DM), and to investigate its relation with other parameters.Methods: The study included 152 patients who applied to the ...

Women affected by Cushing’s disease (CD) are often infertile due to abnormal follicular development or anovulation. In these patients, first line treatment is pituitary surgery, which is effective in more than 83% of cases with microadenomas, but only in about 35% of those with macroadenomas. When surgery do not normalize circulating ACTH and cortisol concentrations, such drugs, e.g. ketoconazole or metirapone, and radiotherapy are used as adjuvant treatment. Concerning r...

Thyrotoxicosis is one of the most common clinical problems in patients referred to endocrine clinic. TRAb is specific for graves disease (GD) and radioisotope scan (RIS) is useful diagnostic test in the investigation of thyrotoxicosis. RIS is commonly used when TRAb is borderline or negative to exclude thyroiditis.Aims and methods: To look at the use of RIS in the investigation of thyrotoxicosis and sub-clinical hyperthyroidism (SCH), and use of anti-thy...

Alemtuzumab is a monoclonal antibody directed against CD52 licenced for the treatment of relapsing remitting multiple sclerosis (MS). Thyroid dysfunction occurs in one third of patients, likely secondary to lymphocyte reconstitution.Case 1: A 36 year old female, treated with alemtuzumab 15 months prior, presented to antenatal clinic at 12 weeks gestation with symptoms of thyrotoxicosis. fT4 was 83.7 pmol/l (RR 12-22), TSH suppressed, TRAB positive. She w...

Case history: Ectopic adrenocorticotropic hormone (ACTH) production accounts for 10–20% of all endogeneous Cushing’s syndrome. The ideal treatment is curative surgery of the underlying tumour. In difficult cases bilateral adrenalectomy is an option. We report a 58-year-old woman with an aggressive ectopic Cushing’s syndrome that required bilateral adrenalectomy undertaken in 1989 at age 32-years.Investigations: At 16 years post adrenalecto...

Circulating oestrogen concentrations affect the incidence of and outcomes for patients with colorectal cancer (CRC). We have previously shown that steroid sulphatase (STS), the fundamental enzyme that liberates conjugated oestrogens into their active forms, is significantly elevated in human CRC tissue. Here we demonstrate that elevated STS activity correlates to increased CRC proliferation, and that these effects are mediated through G-protein coupled oestrogen receptor (GPER...

Introduction: In 2003, the UK National Institute for Clinical Excellence (NICE) established guidelines on the use of GH in adults. These guidelines state that recombinant GH should be used only for adults with a severe GH deficiency that severely affects their quality of life. To assess current practice in relation to these guidelines, a review of patients receiving GH treatment was performed. The aims were to assess if adults with GH deficiency met NICE criteria for GH therap...

Introduction: Hypocalcaemia is a frequent complication after thyroid and parathyroid surgery. We report a case of tetany occurred in a patient with normal serum levels of calcium, magnesium and phosphate after parathyroidectomy for hyperparathyroidism.Case History: 55 year old Caucasian male was referred by general physician with three month history of fatigue, loss of appetite, intermittent constipation and abdominal pain. Systemic examination unremarka...

A 56 year old man was admitted from psychiatry ward after episode of symptomatic hypoglycaemia with capillary blood glucose of 2.5 mmol/L. His background included CKD on thrice weekly haemodialysis, IHD, stroke, hypertension and paranoid psychosis but not diabetes. He denied taking hypoglycaemics, his oral intake was normal and weight was stable. He had another symptomatic hypoglycamia after 22 hours with venous glucose of 1.5 mmol/L, Insulin 320 mU/L (3.0–17.0) and C-pep...

A 54 year old Caucasian male presented with progressive muscle weakness leading to complete paralysis in upper and lower limbs evident on examination. Initial venous gas analysis showed potassium of 2.1 mmol/l, and ECG showed U waves with prolonged QTc. A diagnosis of hypokalaemic periodic paralysis was made, and intravenous potassium administered. The paralysis gradually resolved over the next 3–4 h, as repeat serum potassium level rose to 4.0 mmol/l. He described 6 mont...