Endocrine Abstracts

Context: Prolactinomas are the most common functioning pituitary adenomas & it is recognised that gender has an influence on presentation and management of this condition.Objective: To examine the effects of gender on presentation and response to treatment in a large cohort of adults with confirmed prolactinoma (MRI performed and macroprolactin excluded).Design & patients: This retrospective cohort study design used an elec...

11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inactive glucocorticoid to their active form (cortisone to cortisol in humans, 11-dehydrocorticosterone (11-DHC) to corticosterone in mice), and is dependent upon the presence of cofactor NADPH generated by the enzyme hexose-6-phosphate (H6PDH) for its activity. The 11β-HSD1/H6PDH system is implicated in the pathogenesis of the metabolic syndrome by generating tissue specific glucocorticoid excess. The ...

6-Phosphogluconate dehydrogenase (6PGDH) is the third enzyme of the oxidative phase of the pentose phosphate pathway. The cytosolic form of this pathway is well characterised, but the details and significance of the endoplasmic reticulum (ER) version are only beginning to be understood. We have previously identified hexose-6-phosphate dehydrogenase (H6PDH), which catalyses the first two steps of this pathway within the lumen of the ER, as a pivotal regulator of ER reductases s...

Glucocorticoids are highly detrimental to skin integrity and function both when used locally for anti-inflammatory treatments and during conditions of raised systemic concentrations such as Cushing’s syndrome. Many of the adverse effects of glucocorticoids on skin are also symptoms associated with natural intrinsic aging and extrinsic photoaging.Locally, glucocorticoid availability is regulated independently of circulating levels by 11β-hydroxy...

A 19-year-old, female of West African descent presented with a 5 months history of thyrotoxicosis. The GP had commenced carbimazole. She had continuing clinical and biochemical thyrotoxicosis TSH <0.01 (0.3–5.5 mU/l), FT4 68.0 (9–20 pmol/l) and FT3 18.9 (3.4–5.6 pmol/l). Thyroid antibodies were present at elevated titre and technetium uptake scanning showed toxic diffuse hyperplasia with an uptake function of 37%, confirming Graves&#146...

Radioactive iodine (RAI) has been in use for more than 60 years with satisfactory results RAI and safe profile, there has been a different outcome of treatment in different ethnic groups. We assessed the demographic features and clinical outcome of a Jordanian and British cohorts of patients treated with RAI.Methods: Hyperthyroid patients who opted RAI as a primary therapy and those who had relapse after treatment with antithyroid drugs (ATD) or h...

Background: Hypertension, obesity and hyperlipidemia are key interlinked features of both metabolic syndrome and cardiovascular disease. Numerous studies have suggested that green tea may reduce blood pressure by activating endothelial nitric oxide synthase and reducing total cholesterol by disrupting the production of apo B and synthesis of chylomicrons and thus have cardio-protective effects. The aim of this pilot study was to investigate the effects of increasing the consum...

Primary hypothyroidism and hypoadrenalism may occur concomitantly as part of autoimmune endocrine syndromes. Thyroxine replacement without steroid replacement can precipitate fatal adrenal crisis in this subgroup of patients. We report two patients with autoimmune primary hypothyroidism presenting with acute adrenal crises after commencing thyroxine replacement.Case 1: A 36-year-old patient with type 1 diabetes for 15 years was admitted with vomiting, ab...

Background and objective: Widespread use of highly active anti-retroviral therapy (HAART) has led to a decrease in morbidity and mortality with this infection. HAART is also associated with body fat redistribution, insulin resistance and dyslipidemia, well known risk factors for cardiovascular disease. The prevalence of fat redistribution in studies ranges from 11 to 83%. The objective of this study was to look at changes in body composition in HIV infected men and to determin...

Although glucocorticoids (Gc) are used to treat a range of pathologies, an individuals response to therapy varies considerably. There is a distinct correlation between certain cell types and steroid sensitivity. Aberrant glucocorticoid receptor (GR) function is well-characterised in lymphoid malignant cells but not small cell lung cancer (SCLC) (DMS79) or osteosarcoma (U2OS) cell lines, which are both Gc resistant.Previously we have shown reduced GR cont...