Endocrine Abstracts

Introduction: Growth hormone (GH)-deficiency in adults is associated with a range of adverse outcomes that improve with GH replacement. Pituitary adenomas and their treatment account for a large proportion of patients with adult GH-deficiency. However, safety fears have arisen due to the mitogenic effect of excess GH on pre-malignant colonic polyp formation in individuals with acromegaly. This, along with anecdotal suggestions of pituitary tumour recurrence, has prompted furth...

A 61-year-old was diagnosed with CLL in 1986 but received no active treatment until 2006, when the WCC became elevated and bone marrow biopsy showed a dense B cell infiltrate. Despite initial treatment with chemotherapy there was disease progression, hence started on Alemtuzumab (Campath) on 24/5/2010. This was stopped on 18/6/2010 because of recurrent neutropenic sepsis. He was readmitted on 18/7/2010 because of left eye cellulitis and hyponatremic with serum sodium of 122 mm...

Serum parathyroid hormone (PTH) and other parameters are measured post-parathyroidectomy to assess cure. A persistently raised serum PTH may indicate an unsuccessful procedure. However, vitamin D deficiency is increasingly recognised in the general population, and may be a cause of raised PTH post-surgery (secondary hyperparathyroidism). Persistently elevated post-operative PTH may continue to stimulate bone turn over and bone loss post-surgery. Our aim was to determine whethe...

We recently demonstrated that fetal programming changes induced by a maternal low protein diet (MLP) that lead to the development of hypertension in the rat offspring were associated with increased expression of the AT1b angiotensin receptor (AT1b) and reduced methylation of its promoter in the adrenal gland. Previous findings have suggested that overactivity of the maternal pituitary–adrenal axis in pregnancy results in overexposure of the fetus to glucocorticoids which ...

Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer. Given dramatic improvements in survival rate (>80%), long term quality of life is of rising concern. Skeletal complications including osteonecrosis (ON) are being reported more frequently, affecting up to 38% of children treated for ALL though the pathogenesis is unclear.The purpose of this study is to examine possible mechanisms causing ON. We hypothesize that polychemotherapy ...

Background: Chromogranin A and B (CgA, CgB) are widely used as markers of neuroendocrine tumour (NET) disease. However, the sensitivity of the test is variable and the value of CgB measurement is unclear. We thus sought to review 3 years of CgA and CgB requests made in our hospital.Methods: CgA and CgB were measured at the Hammersmith Hospital. Case notes were reviewed in each of these patients.Results: There were 520 tests perform...

Two patients presented to us with polyuria and polydipsia.Case 1– A 34 year old gentleman was referred with polyuria, polydipsia, diffuse headaches and poor sleep. Initial plasma and urine osmolality were 306 and 272 milliosmol/kg respectively. Water deprivation test demonstrated normal concentrating ability. Starting urinary osmolality was 788 milliosmol/kg, rising to 877 milliosmol/kg. MRI pituitary was normal. Hypertonic saline infusion test prod...

A 35-year-old woman was seen at the medical obstetric antenatal clinic with gestational diabetes (GDM) and new-onset hypertension during the second trimester of her first pregnancy. She was well, with no prior medical history. Blood pressure of 120/80 had been recorded at her first antenatal visit. Throughout the pregnancy, GDM was managed successfully with diet alone: HbA1c always <5.8%. Methyldopa was initiated for persistent hypertension at 18 weeks gestation, and labet...

In addition to its central role in the control of thyrocyte growth and function, the TSHR is expressed during the differentiation of mesenchymal precursors. To explore further, we have developed an in vitro model in which TSHR activation is achieved by introducing constitutively active (M453T, L629F) TSHR, using retroviral vectors.We aimed to investigate the effect of TSHR activation on body composition, via the production of TNFα and express...

The active form of vitamin D, 1,25-dihydroxyvitamin D3 (1,25D3) is a potent antiproliferative/immunomodulatory steroid hormone with many applications outside calcium homeostasis. This is particularly true in the placenta which can generate 1,25D3 locally via the enzyme 1alpha-hydroxylase (CYP27b) in both trophoblast and decidua. We have investigated the potential function of 1,25D3 across gestation using human tissue obtained after l...