Endocrine Abstracts

Aim: To audit the current congenital hypothyroidism (CHT) management practice in our centre.Standards: Guidelines published by UK Newborn Screening Policy and Standards in 2005 and ESPE in 1999.Method: Retrospective audit from 2006 to 2010. The list was compared with the regional newborn screening lab to ensure data collection was complete.Results: Thirty cases were referred to the unit giving local incidence...

A decrease in insulin sensitivity (IS) is associated with increasing visceral adiposity. An inverse correlation has been demonstrated between Intramyo-(IMTG) and intrahepatocellular triglyceride (HCTG) concentrations and IS. Patients with AA have reduced IS but IMTG and HCTG content has not been studied.Eight patients with AA (IGF-I >ULN, median 1.83×ULN (range1.16–4.38) ((6 M), median age 39.5 (range 23–66) years, median BMI 30.6(23.5...

Background: Testosterone replacement therapy has been shown to produce a wide range of benefits for men with hypogonadism with studies showing improvement in libido, bone density, muscle mass, body composition, mood, cognition, and erythopoiesis. The risks associated with testosterone replacement therapy are less well characterised and there is a lack of larger randomised trials. One recognised risk is polycythaemia. The aim of this study is to assess the frequency of polycyth...

Background: Polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD) are both associated with the metabolic syndrome and are each associated with increased cardiovascular risk. Endothelial function, an early feature in the development of atherosclerosis, has been shown to be abnormal in both PCOS and NAFLD.The aim of this study was to determine if NAFLD conferred additional cardiovascular risk compared to PCOS alone.<p class="ab...

Background: Obesity is associated with increased insulin resistance, type 2 diabetes and increased cardiovascular risk leading to atherosclerosis. Bariatric surgery has been shown to improve some of these factors in obese patients with glucose intolerance. A form of bariatric surgery is the Roux-en-Y procedure which can result in greater weight loss and restriction with less malabsorption than other procedures (such as the bilious-pancreatic diversion); but the effect of some ...

Objectives: To examine the effect on weight change of diet/lifestyle advice to maintain/achieve a healthy weight in an unselected PCOS population.Methods: All overweight patients attending the Reproductive Endocrine clinic with PCOS are routinely given lifestyle advice for weight loss by their consultant, offered referral to see a dietician and, when clinically appropriate, prescribed orlistat. Clinical notes were reviewed for 50 consecutive patients wit...

We describe the case of two patients who presented with non-mechanical bowel obstruction as a consequence of an underlying, undiagnosed Phaeochromocytoma. The first patient was referred in to the surgical team by his GP with signs and symptoms of small bowel obstruction. He described abdominal pain, distension and vomiting and had not opened his bowels for a week. The X-ray supported the clinical diagnosis and he went on to have an abdominal CT scan. The scan did not identify ...

The majority of adult GH replaced patients reach target IGF1 levels using established injection devices. However, a small but significant cohort of these patients fail to achieve these intended goals. This can be manifested as either a failure to improve (biochemically or symptomatically) despite escalating GH doses, or large variations in IGF1 measurements despite steady GH dosing.The Easypod® device has a memory chip which allows record...

A 21-year-old man presented with 2 months history of weight gain, acne, hirsutism, lethargy, and muscle weakness. Examination revealed that he was cushingoid in appearance, had pustular acne and proximal myopathy. Initial 24 h urinary free cortisol was significantly raised at 5320 nmol/day (10–147), with raised ACTH of 120 ng/l (<47). He failed to suppress his cortisol on the low dose dexamethasone suppression test (baseline 708 nmol/l and 48 h 706 nmol/l). Urinary an...

Background: The insulin stress test (IST) is accepted as the gold standard investigation of the hypothalamio-pituitary–adrenal axis (HPA). The short synacthen test (SST) has been advocated as an alternative to the IST. Fatigue can be a common presenting symptom of patients suffering from abnormalities in the HPA axis.Methods: We audited the results of ISTs following failed SSTs for the assessment of patients who present with symptoms of fatigue. We ...