Endocrine Abstracts

A 70-year-old female presented with general lethargy and a two day history of painful muscle twitching and paraesthesia in her right hand. No other symptoms were reported. Past medical history included hypertension, hypothyroidism and she had recently been diagnosed with Type 2 diabetes. Examination was unremarkable.The overall biochemical picture was that of a hypokalaemic alkalosis with hypocalcaemia and hyperglycaemia: Na+140 mmol/l, K...

Introduction: Symptoms of hypothyroidism in childhood include tiredness, poor growth, weight gain, dry skin and constipation. Whilst muscular manifestations including myalgia, muscle weakness, aches and cramps, stiffness and delayed tendon jerk relaxation are common, rhabdomyolysis has also rarely been reported.Case presentation: An 11-year-old female presented to her GP with a history of tiredness and poor growth. Initial blood tests performed by the GP...

Epigenetic dysregulation may be one mechanism underpinning the link between early life conditions and later cardiometabolic risk. In animal models, environmental manipulations including modified maternal diet change DNA methylation and offspring phenotype. Manipulations altering the epigenetic state reverse the phenotype suggesting causality. We have previously reported higher blood pressure (BP) and cortisol in an adult cohort whose mothers were advised to eat a high-protein,...

The anti-natriuretic properties of growth hormone (GH) are well established. GH deficiency (GHD) results in salt and water depletion and studies confirm that replacement leads to sodium and vasopressin-mediated water retention, in patients with intact posterior pituitary function.We report the case of a 20-year-old male patient with septo-optic dysplasia, fixed cranial diabetes insipidus (DI) and an abnormal thirst threshold. He first presented after bir...

Cabergoline is a dopamine agonist that may be used as primary or adjunctive therapy for acromegaly. Although one study suggested biochemical control may be achieved in a substantial proportion of patients (Abs et al, JCEM 1998), it is still commonly perceived to be a relatively ineffective treatment, possibly on account of inadequate dosing.We performed a retrospective case notes review of 9 consecutive acromegalic patients to determine the effectiveness...

Mechanisms underlying the association of low birth weight with the metabolic syndrome in adults remain poorly understood. Epidemiological studies suggest that obesity is not programmed by early life events, but amplifies the risks of intra-uterine growth retardation. We have explored the effects of dietary obesity in rats in which features of the metabolic syndrome have been programmed by prenatal dexamethasone.16 pregnant Wistar rats were treated with d...

Introduction: Primary aldosteronism (PA) accounts for 5-10% of patients with hypertension. Approximately 40-50% of cases are bilateral, usually managed using mineralocorticoid receptor antagonists (MRAs). Recent literature suggests a higher risk of renovascular disease and cardiovascular events in PA patients treated medically, compared to those with essential hypertension. This excess risk is mitigated in individuals with unilateral disease managed surgically...

Case history: A 59 year old Afro-Carribbean male with a 25 year history of cardiac enlargement and hypertension, on multiple anti-hypertensives, presented with increasing breathlessness and several years of markedly reduced exercise tolerance. He was intolerant of spironolactone and eplerenone. His past medical history included hypertersion, obstructive sleep apnoea, Steven-Johnson syndrome secondary to allopurinol, thyrotoxicosis treated with radio-active iodine, monoclonal g...

A 60 year old gentleman with a history of renal stones presented 5 years ago with left sided flank pain. A CT of his renal tract showed an unexpected metastatic deposit in the left iliac crest. Cross-sectional whole body imaging, performed to locate the primary, also identified an expansile soft tissue mass in the T8 vertebral body and a predominantly cystic looking left sided thyroid nodule. He proceeded to have an iliac crest biopsy which was consistent with metastatic folli...

A 69-year-old retired pharmacist was referred to our endocrine clinic with an incidental finding of hypokalaemia noted during recent spinal fusion surgery. He has been hypertensive for 6 years. His blood pressure was well controlled on Diltiazem 240 mg and Doxazosin 4 mg, but required 8 tablets of SandoK daily to maintain normokalaemia. His past medical history includes type 2 diabetes, diabetic retinopathy, chronic kidney disease, hypercholesterolaemia and benign prostatic hy...