Endocrine Abstracts

Glucocorticoids (GCs) act through the glucocorticoid receptor (GR) to regulate immunity, energy metabolism, and tissue repair. The inactive GR is held in the cytoplasm in a multi-protein complex, which upon ligand binding undergoes a conformational change. Activated GR translocates to the nucleus to regulate gene expression (over hours), but some effects occur more rapidly. GCs inhibit cell migration through an uncertain mechanism. We now show a very rapid effect, and surprisi...

Introduction: Immune mediated cases of severe insulin resistant diabetes are very rare. We report responses to immunosuppression with rituximab in two patients.Case 1: A 31 year old black African female, BMI 22.84 kg/m², was referred with new onset diabetes, diagnosed shortly following a miscarriage. She had weight loss, acanthosis nigricans, nocturnal hypoglycaemia and severe hyperandrogenism . She was on an insulin pump and required >1000 units in...

Background: Recent NICE guidance recommends radioactive iodine as the first line treatment for relapsed thyrotoxicosis as it reportedly produces better control than long-term anti-thyroid drugs (ATDs).However, almost all studies of long-term ATDs relapse occurs after discontinuation of a medication. We present a retrospective analysis of efficacy of ATDs. Methods: Data of all patients with hyperthyroidism, attending Endocrinology clinic at Morriston Hosp...

Aim: In light of recent publications - could a lower cortisol cut off value of ~350 nmol/l be used to safely rule out adrenal insufficiency (AI) compared to current local guideline cutoff value of either a baseline or 9am cortisol of 420 nmol/l? If so could this potentially help reduce the number of Co-syntropin stimulation tests (CST) performed?Background: Current local guidelines recommend a cortisol cut value of 420 nmol/l to rule out adrenal insuffic...

Introduction: Water deprivation testing (WDT) is considered the gold standard test in differentiating between craniogenic diabetes insipidus (DI), nephrogenic DI and primary polydipsia. However, it requires day case admission for monitoring of sodium and osmolality. Copeptin, derived from pre-provasopressin, is secreted in an equimolar amount with arginine vasopressin and has a potential role in facilitating the diagnosis of DI and reducing the need for WDT. Copeptin was gradu...

Case history: A 35-year-old woman with known hypertriglyceridaemia presented with a one day history of abdominal pain, vomiting and fever. She was 14 weeks pregnant having conceived spontaneously following a period of infertility. She had discontinued her lipid-lowering medication and was managed with diet alone. On examination, she was pyrexial, tachycardic (HR=100 bpm), normotensive (BP=111/71 mmHg), oxygen saturation was 96% on air and she had a tender distended abdomen. A ...

Background: There are gaps in our understanding of the impact of conditions that affect sex development, such as DSD and CAH, on the parent and patient.Aims: The project aimed to explore whether patient reported outcomes (PRO), assessed by standardised questionnaires, could be integrated within routine paediatric endocrine clinic visits.Methods: Previous validated questionnaires were used to develop a parent Self-Report qu...

Graves’ orbitopathy (GO) is a serious, progressive eye condition seen in patients with autoimmune thyroid disease. GO is characterized by inflammation and swelling of soft orbital tissues. Adipose tissue produces cytokine mediators called adipokines. The present study focuses on the relationship between serum levels of selected adipokines in patients with GO, comparing them with the control group, and uniquely describes the effect of high-dose systemic corticosteroids (HD...

Objective: We present a case of hypertriglyceridemia induced acute pancreatitis (HTG-AP) and concurrent diabetic ketoacidosis (DKA) as a first presentation of Diabetes Mellitus in an adult patient. This uncommon triad has been previously described in the literature, however, it is rare to be observed in a previously undiagnosed patient with diabetes. The purpose of this poster is to describe the potential mechanisms for this and discuss management strategies.<p class="abst...

Introduction: We offer patients needing glucocorticoid replacement in primary and secondary adrenal insufficiency the choice of either once daily prednisolone or thrice daily hydrocortisone. A recent European study found no difference between prednisolone and hydrocortisone users in several markers, including glucose, weight, body mass index (BMI), systolic and diastolic blood pressure and waist circumference, although they did suggest an increase in cholesterol and low densit...