Endocrine Abstracts

Background: Acute adrenal insufficiency is a medical emergency and patients at risk of adrenal crisis should be treated immediately with glucocorticoid replacement. Our aim was to ensure there were safety alerts in place for health care professionals managing steroid dependent patients, to highlight their risk of adrenal insufficiency, and therefore prevent delays in life saving treatment.Methods: Review of the electronic documentation of all the steroid...

Introduction: Vitamin D deficiency is known to cause adverse outcomes in pregnancy and has shown to have an association with Gestational Diabetes Mellitus (GDM)Aim: To evaluate the relationship between GDM and Vitamin DMaterials and Methods: In a retrospective study we explored the Vitamin D levels (Sufficient >50nmol/l - G1, Insufficient 25-50nmol/l - G2, Deficient <25nmol/l - G3), GTT results, diabetes status and pregnanc...

Background: Hyponatraemia is the most common electrolyte abnormality encountered in hospitals and has been independently associated with increased morbidity and mortality1. An appropriate work-up with guideline-based investigations and management is, therefore, crucial to allow accurate diagnosis and optimisation of patient care.Case Presentation: A 49-year-old with no significant past medical history presented with 2 weeks of persistent nause...

Background: Falls are a significant health problem and major burden on healthcare services. Falls are typically associated with ageing-related frailty, but diabetic peripheral neuropathy, postural hypotension and hyponatraemia are recognised risk factors for falling that might be independent of ageing-related factors. We undertook a study to assess the prevalence of these independent risk factors in patients admitted to hospital following a fall.Methods:...

GPR56 is an adhesion G-protein coupled receptor (GPCR), which we have shown to be the most abundant GPCR in mouse and human islets. The extracellular N-terminal domain of adhesion GPCRs contains a tethered agonist, buried within the GPCR autoproteolysis-inducing domain. Synthetic peptides mimicking tethered agonist sequences can activate a variety of adhesion GPCRs including GPR56. Here we investigated the effect of a GPR56 tethered agonist peptide, P7, on β-cell function...

Background: Short synacthen test is used to assess adrenal function by injecting 250 μg of synacthen (tetracosactide) and measuring cortisol at baseline and subsequently after 30 and 60 min of the injection. In our hospital the cut-off for a normal test is a peak cortisol of 480 nmol/l or an increment of 200 or more from the baseline value.Methodology: We reviewed the results of 50 short synacthen tests performed in our hospital within the last year...

Hyponatraemia is a very common electrolyte abnormality with varied presenting features depending on the underlying cause. The authors report the case of a 75 years old, previously fit, gentleman who presented with weight loss, lethargy, and blackouts. He was admitted to the hospital repeatedly under the general physicians over an 8 month period.Investigations revealed persistent hyponatraemia (serum sodium 113–120 mmol/l, serum osmolality 258 mOsm/k...

A 59-year-old gentleman presented with a 6-month history of painless, progressive lower limb weakness. There was no history of trauma or weight loss although he had been suffering night sweats. He had been bed bound for 4 weeks prior to admission. He was an insulin-dependent type 2 diabetic.Examination revealed marked symmetrical wasting of the leg muscles with reduced power (3/5) and absent reflexes and plantar reflexes were up-going. He was in urinary ...

Background: We present an interesting case of a 56 year old male who, during pre–operative work up, was found to have a very low HbA1C 3.1% (10 mmol/mol). The patient was also noted to have mild thrombocytopenia, raised bilirubin and alanine aminotransferase and moderate splenomegaly on CT scan, with otherwise normal appearance of remaining abdominal viscera. His past medical history included alcohol excess (60–80 units/week), he was not diabetic and was taking Asp...

Background: Cushing’s syndrome is defined as a hormonal disorder resulting from elevated serum cortisol leading to specific physical and biochemical abnormalities that might be detrimental to life itself. Majority is caused by steroid intake while endogenous sources although representing only a minority of patients often lead to delay in diagnosis. Ectopic ACTH syndrome considered a rare entity are usually found as small cell lung cancer and carcinoid tumors. Rare types o...