Endocrine Abstracts

Background: There is currently no agreed consensus for the optimization and titration of mineralocorticoid (MC) therapy in patients with primary adrenal insufficiency (PAI).Objective: To measure serum (sFC) and urine (uFC) fludrocortisone levels and explore their relationship with biochemically and clinically important variables (including treatment compliance) in order to evaluate their usefulness as markers to guide the MC replacement titration.<p ...

Section 1: Case history: A 30 year-old female patient with a background of symptomatic primary hyperparathyroidism diagnosed in 2008 and a history of two failed neck surgeries, was reviewed in clinic complaining of persistent symptoms of hypercalcaemia. Previous pre-operative neck imaging had failed to localise a parathyroid adenoma and the patient had undergone two neck explorations by an experienced ENT surgeon; one which removed thymic tissue and the other which removed a m...

Introduction: Previously published UK Cancer Registry data showed incidence of Neuroendocrine Neoplasms rising between 2001 and 2015. This was higher than had been thought (Genus et al.). We report more recent data with more accurate coding (ICD-O-3).Aim: To analyse National Cancer Registration and Analysis Service (NCRAS) data on Neuroendocrine Neoplasias (NENs) in England including years 2015–2017.Methods: Public He...

We present a 66 year old man with a metastatic small bowel neuroendocrine tumour managed with resection of primary in 2011 and subsequent somatostatin analogue therapy. In 2018 disease progressed requiring right ureteric stenting due to extrinsic nodal compression. Three weeks later he presented with sweats, pyrexia and elevated inflammatory markers. Multiple blood and urinary cultures were clear. CT imaging, MRI spine and echocardiogram did not identify a source of sepsis. Ur...

A genome wide meta-analysis by the CORtisol NETwork (CORNET) consortium1 has identified genetic variants spanning the SERPINA6/SERPINA1 locus on chromosome 14 associated with changes in morning plasma cortisol and predictive of cardiovascular disease (Crawford et al, Unpublished). SERPINA6 encodes Corticosteroid Binding Globin (CBG) which binds most cortisol in blood and influences delivery of cortisol to target tissues. We hypothesised th...

Introduction: Late-night salivary cortisol assessment is an important element when investigating suspected Cushing’s syndrome (CS). The goal of medical therapy is achieving a mean (of 5 samples during a single day) serum cortisol (serumF) of 150–300 nmol/l (Cushing Day Curve [CDC]). Metyrapone is an 11β-hydroxylase inhibitor elevating levels of 11-deoxycortisol causing conventional immunoassay (IA) to overestimate SerumF; a problem obviated by LC–MS/MS. We ...

Metabolic syndrome and its hepatic manifestation, non-alcoholic fatty liver disease (NAFLD), are increasing in prevalence. Steroid hormones are established regulators of metabolic phenotype. 5β-reductase (AKR1D1) is highly expressed in human liver, inactivating steroid hormones, including glucocorticoids and androgens. The human AKR1D1 gene contains 9 exons; six splice variants have been identified and three lead to functional protein isoforms (AKR1D1-001, -0...

Background: Adipose tissue dysfunction could partially explain the well-demonstrated association between obesity and survival in breast cancer (BC). Oestrogen and glucocorticoid concentrations and their respective activation enzymes, oestrogenic 17β-hydroxysteroid dehydrogenases (17βHSDs) and aromatase, and 11βHSD1 are increased in adipocyte hyperplasia and hypertrophy, supporting the hypothesis of a potential role for locally generated steroids in obesity-assoc...

Background: Neonatal cortisol assessment is indicated in suspected adrenal insufficiency.Aims/objectives: Review of neonatal cortisol assessment within our Trust over seven years, to analyse trends, indications, outcomes; and relationships between gestational age (GA), birth weight (BW) and cortisol assessment.Methodology: From cortisol results on neonates (≤30 days age) between 2012–2018 (inclusive) we identified random...

Reproductive timing strongly influences the fitness of the individual. While most vertebrates rely on photoperiodic changes to induce seasonal reproduction, the arctic ground squirrel (AGS) naturally undergoes reproductive maturation in a photoperiod-independent manner. In addition, males spontaneously activate their reproductive axis during hibernation, but the timing of reproduction is sensitive to external cues. We are using electron microscopy to examine, define, and measu...