Endocrine Abstracts

Introduction: Moderate hyperprolactinaemia occurring in a patient with a normal pituitary MRI, assuming macroprolactin and stress are excluded, is generally considered to be due to a lesion below the level of detection of the MRI scanner. Most patients with mild-moderate hyperprolactinaemia and a normal MRI respond to dopamine agonist therapy. We describe a patient who had prolactin elevation typical of a prolactin-secreting macroadenoma, but with a normal MRI, and in whom the...

Background: Lifelong surveillance should be offered to people with hereditary phaeochromocytoma and paraganglioma (PPGL), including asymptomatic carriers of pathogenic gene variants. Regular biochemical and radiological surveillance aims to improve disease detection and prognosis. During the COVID-19 pandemic, outpatient appointments were cancelled or postponed. Departments continue to face large backlogs of work. Clinicians in the USA reported 15% PPGL patients missing at lea...

Background: Corticosteroid Binding Globulin (CBG) binds >85% of plasma cortisol and controls the circulating free cortisol pool. Proteolytic cleavage by neutrophil elastase is proposed to reduce CBG binding affinity and increase free cortisol availability to inflamed tissues. The CORtisol NETwork (CORNET) consortium found that genetic variation at a locus spanning SERPINA1 (encoding alpha-1 antitrypsin, A1AT, the endogenous inhibitor of neutrophil elastase) and SE...

Background: In patients with advanced GEPNETs, psychological symptoms may result due to potential disturbances in biogenic amines, particularly serotonin. This study compared HRQoL, anxiety, depression, and impulsivity in patients with and without carcinoid syndrome (CS) and correlated with serum 5-HIAA.Methods: Consecutive patients with advanced GEPNETs (with liver metastases) receiving treatment, with and without CS completed (single time-point) HRQoL ...

Introduction: Children with adrenal insufficiency requiring hydrocortisone rely on compounded adult medication. This study aimed to evaluate the absorption, palatability and safety of Alkindi® (hydrocortisone granules in capsules for opening).Methods: The phase 3 study was an open-label, single-dose study in a total of 24 children (aged 0–6 years) with adrenal insufficiency. Fasted children were given a single dose of Alkindi&#1...

The overproduction of ACTH, in conditions such as Congenital Adrenal Hyperplasia (CAH) leads to significant morbidity. Current treatment with glucocorticoids does not adequately suppress plasma ACTH, resulting in excess adrenal androgen production. At present, there is no effective medical treatment that would directly block ACTH action. Such a therapy, especially one that can be orally administered, would be of great clinical value allowing a ‘block and replace’ tre...

Parathyroidectomy is the only definitive cure for primary hyperparathyroidism (PHPT). The standard for pre-operative localisation of parathyroid pathology at our institution is both a (99m)Tc-sestamibi SPECT/CT (sestamibi) and neck ultrasound scan (USS). The aim of this audit was to assess the accuracy of this standard pre-operative imaging.Methods: Retrospective data was gathered from all parathyroidectomies performed at St Thomas’ Hospital between...

Parathyroid hormone is involved in calcium homeostasis through interactions with vitamin D. Because intact and truncated forms of PTH vary in their biological activity, assays that can accurately quantify the ratio of intact hormone to its fragments are of increasing significance in the diagnosis of endocrine, renal and bone diseases. Vitamin D and its metabolites circulate tightly bound to vitamin D-binding protein (DBP). Because DBP concentrations are altered in pregnancy, l...

Parathyroid hormone is involved in calcium homeostasis through interactions with vitamin D. Because intact and truncated forms of parathyroid hormone (PTH) vary in their biological activity, assays that can accurately quantify the ratio of intact hormone to its fragments are of increasing significance in the diagnosis of endocrine, renal and bone diseases. Vitamin D and its metabolites circulate tightly bound to vitamin D-binding protein (DBP). Because DBP concentrations are a...

Pregnancy complicated by pre-existing or gestational diabetes is associated with increased risk of maternal and fetal mortality and morbidity. The most common complication, macrosomia, occurs during the third trimester of pregnancy as a result of abnormal placental growth and increased transfer of nutrients to the fetus. We have previously demonstrated using an explant model of human placenta, that statins have the potential to limit placental growth. In this study we tested t...