Endocrine Abstracts

Introduction: Turners’ syndrome (TS) affects one in 2500 live births. Multiple comorbidities affect TS patients and recommendations for long-term management advocate annual review with a ‘checklist’ approach. This audit of current practice of a specialist TS clinic aims to identify gaps in patients’ management.Methods: A checklist of recommendations for health screening based on the National Turner’s Syndrome Guidelines was devel...

A 51-year-old gentleman presented in June 2022 with pneumobilia, staph liver abscesses and rapidly conducted atrial fibrillation requiring ITU admission. He had a 2-year history of typical Cushingoid features and hypogonadism, 4 agent hypertension since 2012, fragility fractures, previous renal calculi, pulmonary emboli and diabetes. He had not been able to walk unaided for a year (was mobilising with crutches on admission). In retrospect, he had previously had a cortisol of 7...

Introduction: Paragangliomas are neuroendocrine tumours, usually found from the base of the skull to pelvis. They are extremely rare in the sellar and parasellar region which normally lacks paraganglion cells. We report a rare case of an incidental sellar paraganglioma.Case: A 66 years old female had progressive retinopathy and maculopathy of unclear cause since 2011. Lung nodules were seen on CT performed to exclude paraneoplastic retinopathy. 18F-FDG P...

Three premenopausal patients presented with high isolated testosterone without symptoms of androgen excess or illicit drug use.Case 1: A 22-year-old female presented with daily vaginal bleeds having been on depot injections of progesterone with supplementary norethisterone. Testosterone was 14.5 nmol/l with suppressed gonadotrophins (LH <0.1 IU/l, FSH 0.2 IU/l, oestradiol <19 pmol/l). Her norethisterone was stopped. A repeat biochemical profile a...

Adrenocortical carcinomas are rare malignancies (incidence 1–2/one million). They present in a variety of ways and carry a poor prognosis. Prompt diagnosis and early intervention offers better outcome.We describe 5 cases of adrenocortical carcinoma to help identify and improve delays in their pathway of care. Five patients (four females and one male), age range 38–76 years, presented between September 2011 and April 2013. Three patients referre...

Hyponatraemia is associated with an increase in morbidity and mortality, prolonged hospital stays and poor assessment and management. Two audits were performed looking at acute medical unit (AMU) admissions with sodium <130 mmol/l, before and after the introduction of a protocol and regular endocrine nurse specialist ward visits, 3 months apart (58 patients in April and 99 in July 2013).Hyponatraemic patients were older than the AMU population (>...

Fatty liver (Hepatic Steatosis) is common in men with type 2 diabetes mellitus (T2DM). Furthermore there is a high prevalence of testosterone deficiency (up to 40%) in this population. Testosterone replacement therapy (TRT) has been shown to reduce elevated serum liver transaminase levels in hypogonadal men. The testicular feminised (Tfm) mouse exhibits a non-functional androgen receptor (AR) and low circulating testosterone levels. We have previously shown that a high-fat die...

Testosterone deficiency is associated with several cardiovascular risk factors. Testosterone replacement therapy (TRT) improves insulin sensitivity, inflammation and cholesterol. Liver X receptor (LXR) is a nuclear receptor which regulates lipid and glucose metabolism, stimulates cholesterol efflux and ApoE, and suppresses inflammation. LXR agonists cause hepatic steatosis but protect against atherosclerosis. TRT attenuates high-cholesterol diet-induced hepatic steatosis in th...

Hypogonadism is highly prevalent in men with type 2 diabetes (T2D) and/or cardiovascular disease (CVD). Low testosterone levels are associated with CVD risk factors including obesity, insulin resistance, dyslipidaemia and hypertension. Testosterone replacement therapy (TRT) has been shown to have beneficial effects on these parameters; however, safety needs to be verified. An audit of 308 (50% with T2D, 32.1% CVD, 82.8% ED) hypogonadal men (age 59.02±13.23 years; mean bas...

Introduction: Low testosterone levels are associated with cardiovascular morbidity and an increased risk of non-alcoholic steatohepatitis (NASH). NASH is closely associated with insulin resistance and atherosclerosis.AIM: We studied the effect of long-term testosterone replacement therapy (TRT) on liver function and cardiovascular risk factors in hypogonadal men.Method: Retrospective audit of 308 hypogonadal men receiving TRT as in...