Endocrine Abstracts

Background: It is apparent that COVID-19 may cause persistent symptoms beyond 12 weeks (‘long COVID’). However its underlying pathophysiology is unclear. Several symptoms of long COVID draw similarities to that of endocrine diagnoses. We recently observed that adrenal and thyroid function were normal in survivors of COVID-19 at follow-up. Here we assess additional endocrine axes that could plausibly have a role in long COVID to determine their relationship to ongoing...

Kisspeptin is integral to hypothalamo-pituitary-gonadal (HPG) axis function and overall fertility. Functional deficiency of GnRH/lH secretion in the central reproductive disease, hypothalamic amenorrhoea (HA), indicates diminished kisspeptin signalling. Clinical trials have shown kisspeptin to be a viable therapeutic intervention. However, repeated administration led to the development of tachyphylaxis and so is likely a problem for future implementation. Indeed, elevated LH r...

Introduction: Free ionised calcium is the biologically active component of total circulating calcium but is infrequently measured due to sampling requirements. Therefore, total calcium is ‘adjusted’ for albumin to provide a closer estimate of the biologically active ionised calcium level (e.g. James, Orell, Payne and Berry formulae). Here, we aim to derive a novel equation to estimate ionised calcium from readily available biochemical parameters and compare its perfo...

Background: Due to practical limitations, the diagnosis of hypogonadism is predominantly based on a single measure of reproductive hormones, often with confirmation on a second occasion. Factors associated with reproductive hormone variation include: pulsatile secretion, diurnal rhythm, and food intake, which can affect the accuracy of diagnosis of reproductive disorders. There is limited data quantitatively estimating the variability of reproductive hormone levels over the da...

Section 1: Case history: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. He had an unremarkable past medical history, did not take any regular medications and denied the use of any illicit drugs. There was a family history of consanguinity, with his parents being first cousins. On examination, his BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual c...

Background: Successful reproduction relies on integration of sensory cues of attraction with corresponding emotions and behaviours. However, the intrinsic factors integrating these fundamental aspects of human attraction with limbic and reproductive pathways have not been fully identified. Kisspeptin is a crucial activator of the reproductive axis and together with its receptor is widely expressed throughout the limbic and olfactory systems in humans suggesting a potential rol...

A 33-year-old lady was referred to the endocrinology clinic with mild hyperprolactinaemia on the background of having missed a single period, with a raised testosterone of 4.1 nmol/l (0–2). She had no other medical problems. Her menstrual cycles normalised by the time she attended clinic. She had no galactorrhoea, visual disturbance or features of hyperandrogenism. Her BMI was normal and she was normotensive. Blood tests revealed mild hyperprolactinaemia of 709 nU/l (100&...

Case: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. On examination, BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual characteristics. Hypogonadism was confirmed by two morning fasting total testosterone levels of 4.7 and 5.2 (RR 9.2–31.6 nmol/l). Haemoglobin was normal (152 g/l) and serum oestradiol was <100 pmol/l. He had inappropriate...

Background: During IVF treatment, a pharmacological dose of recombinant FSH (rFSH) is used to induce multi-follicular growth (controlled ovarian stimulation; COS). An insufficient dose of rFSH negatively impacts the number of oocytes retrieved, whereas an excessive dose risks the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’. Hence, appropriate rFSH dosing is regarded as a key treatment decision affecting both the success and safety of...

Background: Women with hypothalamic amenorrhoea (HA) have reduced LH pulsatility causing amenorrhea and infertility. Estrogen supplementation provides symptomatic relief for women with HA, but does not restore the pulsatile pattern of LH secretion which necessary for fertility. Kisspeptin-54 is a recently identified hormone, which potently stimulates GNRH secretion within the hypothalamus. The effect of exogenous kisspeptin-54 administration on LH pulsatility in women with HA ...