Endocrine Abstracts

Introduction: The availability of the body’s most abundant amino acid, glutamine is compromised in obesity-associated diabetes. This may impair glucose metabolism by increasing hepatic insulin resistance, oxidative stress and the development of nonalcoholic fatty liver disease (NAFLD).Objective: Evaluate the effects of free and dipeptide (DIP, L-alanyl-L-glutamine) forms of L-glutamine on glucose metaboli...

TSHoma is rare, with an incidence of 1 per million, and <1% of all pituitary tumours. We reported a case involving a 49-year-old female who was first referred to our endocrine unit in 2006 with excessive lethargy and abnormal TFT’s. She was thought to have thyroid hormone resistance for several years until 2015 when she reported having persistent symptoms and further investigation suggested an alternative diagnosis.Results: Ft4=41.6 pmol/l, TSH=...

Serum or plasma human chorionic gonadotropin (hCG) immunoassays are a cornerstone in diagnosis and monitoring of pregnancy [1]. Although these assays show very satisfying performance, pathophysiological (e.g., menopause induced pituitary secretion of hCG, familial hCG syndrome, exogenous hCG injections) and analytical (e.g., interference of heterophilic antibodies or anti-hCG antibodies, lack of specificity of older assays) determinants may rarely cause false positive results ...

Testosterone reduces myocardial ischaemia in men with coronary artery disease (CAD) and improves symptoms and exercise capacity in men with congestive heart failure (CHF), effects proposed to be due to testosterone-induced vasodilatation. Isolated vessel studies suggest this occurs via a calcium antagonistic action upon voltage-gated Ca2+ channels but this has yet to be investigated directly.We therefore employed patch clamp methodology to stu...

Cyclophosphamide is an alkylating agent used in the treatment of malignant and autoimmune diseases. Severe hyponatraemia is a serious electrolyte disorder with life threatening neurological sequelae. We report a case of recurrent severe, symptomatic hyponatraemia that developed in a 61 year old female with systemic vasculitis and Sjogrens syndrome following low-dose cyclophosphamide.Case report: A 61 year old lady, with ANA positive systemic vasculitis p...

Background: Corticosteroid Binding Globulin (CBG) binds >85% of plasma cortisol and controls the circulating free cortisol pool. Proteolytic cleavage by neutrophil elastase is proposed to reduce CBG binding affinity and increase free cortisol availability to inflamed tissues. The CORtisol NETwork (CORNET) consortium found that genetic variation at a locus spanning SERPINA1 (encoding alpha-1 antitrypsin, A1AT, the endogenous inhibitor of neutrophil elastase) and SE...

A 69-year-old lady with a history of autoimmune diabetes mellitus and primary autoimmune hypothyroidism presented to the Specialist Diabetes Clinic with a significant inexplicable variation in her capillary blood glucose. She had been undergoing investigations with the gastroenterologists for nausea, vomiting, and weight loss. Despite extensive investigations including: oesophageal–gastro-duodenoscopy, CT–thorax, abdomen, pelvis scanning, and gastric emptying studies...

Adrenocortical carcinoma (ACC) is a rare malignant tumour arising from the adrenal cortex, with an estimated annual incidence of one to two patients per million. Ectopic ACCs are extremely rare. They are believed to arise from cortical fragments arrested during embryologic migration and have been found close to the adrenal gland or along the path of gonadal descent. The majority of ACCs are sporadic, however, ACC has been linked with genetic disease processes, including multip...

Non-islet cell tumour hypoglycaemia (NICTH) is a rare paraneoplastic phenomenon and there is limited guidance regarding different treatment modalities.We present two cases of NICTH focusing on the combined methods used to control hypoglycaemia.The first involves an 89-year-old gentleman diagnosed with a pelvic leiomyoma in 2003. For several years, he had experienced recurrent collapses which briefly improved following tumour emboli...

Background: PPI are known to diminish the intestinal absorption of L-T4, which is commonly ingested as tablets of L-T4 sodium salt. However, a liquid formulation is available (Tirosint, oral solution, IBSA Farmaceutici Italia s.r.l., Italy), in which the hormone is solubilized in 28.8% ethyl alcohol. One ml of this formulation (=28 drops) contains 100 mcg L-T4 sodium salt in 243 mg ethanol. Because this formulation contains L...