Endocrine Abstracts

Background: The Short Synacthen Test (SST) is the most popular test of adrenal insufficiency (AI) worldwide. The current SST protocol at Sheffield Children’s Hospital (SCH) recommends measurement of serum cortisol at baseline, then 30- and 60-minutes post stimulation. A peak cortisol of >429nmol/l constitutes a pass. Our practise has evolved to consider results between 350 and 429nmol/l as “borderline” and these patients may be treated with stress dosing ste...

A 22-year old female is followed at our department because of genetically confirmed autoimmune polyendocrine syndrome type 1 (APS-1). This was diagnosed at the age of 9 and in this patient characterized by autoimmune hypoparathyroidism, autoimmune hepatitis, autoimmune gastritis and premature ovarian insufficiency. Throughout childhood and puberty, the hypoparathyroidism was treated with moderate doses of calcium citrate (~3g/d) and calcitriol (~1.5µg/d), nevertheless res...

Introduction: Diabetes is a chronic condition causing morbidity and mortality globally, with a growing economic burden on healthcare systems. In the UK, 1 in 14 people have diabetes, with type 2 accounting for 90% of cases (1). Complications from poorly controlled diabetes are associated with increased socioeconomic costs and a reduced quality of life. Research has shown education and self-management are crucial in helping diabetic patients achieve metabolic control (1). Smart...

Objective: Anaplastic thyroid carcinoma (ATC) and primary thyroid lymphoma (PTL) are two highly aggressive malignancies of the thyroid, both leading to a rapidly enlarging neck mass. Fine-needle aspiration cytology (FNAC) is generally performed as the primary examination for diagnosis in thyroid pathology but shows low sensitivity in diagnosing ATC or PTL. Non-diagnostic FNACs are usually followed by core-needle biopsy (CNB) or diagnostic surgery. As sensitivities of up to 100...

Background: Measurement of salivary glucocorticoids is gaining popularity as it offers a non-invasive collection technique, enabling sampling in the community or home environment, allowing tailored capture of steroid circadian rhythm and improved patient experience. Current popular salivary collection methods cannot be used in very young children due to choking and the requirement for active participation. There is little data on saliva stability during home collection.<p ...

Background: Limited data support concerns that corticosteroid use in pregnancy, for maternal health reasons, can suppress the neonatal Hypothalamic-Pituitary-Adrenal (HPA) axis. We sought to determine if neonates born to mothers on high-dose steroids are at risk of adrenal suppression.Methodology: Our tertiary neonatal unit guidance advises that babies born to mothers receiving ≥7.5 mg/day prednisolone for 28 consecutive days in the 3rd trimester u...

Defects in any of the four functional domains of the androgen receptor (AR) (resulting from loss-of-function or gain-of-function mutations), may affect androgen action. Specific AR splice variants have been reported in women with PCOS (Wang et al, PNAS 2015 112 4743). In this study we sought to identify AR splice variants in granulosa-lutein (GL) cells of women with and without PCOS and to assess their functional significance. GL cells were ...

Aim: To investigate the relationship of arterial stiffness with short- and long-term parameters of glycemic control and glycation in patients with type 1 diabetes.Methods: Cross-sectional study at a tertiary care centre including 54 patients with type 1 diabetes free from known CVD. Arterial stiffness was assessed with carotid-femoral pulse wave velocity (cf-PWV). Current level and 10-years history of HbA1c was evaluated, and skin advanced glycation end-...

Background: The reserve pool of primordial follicles (PMF) is finely regulated by molecules implicated in follicular growth or PMF survival. Anti-Müllerian Hormone (AMH), produced by granulosa cells of growing follicles, is known for its inhibitory role in the initiation of PMF growth. We observed in a recent in vivo study that injection of AMH into mice seemed to induce an activation of autophagy, a cytoplasmic lysosomal-dependent degradation system, which is im...

Chronic stress is a pervasive concern in the modern society. A long-term hyper activation of the hypothalamic-pituitary-adrenal (HPA) axis leads to elevated amounts of stress hormones [e.g. ACTH and glucocorticoids (GCs)]. This can incur maladaptation that eventually contributes to mental illness, cardiovascular dysfunctions, diabetes, cancer and autoimmune diseases. Emerging key players for stress adaptation of the HPA axis are stem/progenitor cell populations. In this study,...