Searchable abstracts of presentations at key conferences in endocrinology

ea0026s8.2 | The biological clock and metabolism | ECE2011

Circadian clock regulation of glucocorticoid synthesis

Kiessling S , Eichele G , Oster H

Under non-stressed conditions adrenal glucocorticoid (GC) secretion shows strong circadian rhythms with blood levels peaking around wake-up time (i.e. in the morning in humans and at the beginning of the night in nocturnal rodents). These diurnal variations are primarily regulated by rhythmic activation of the hypothalamic–pituitary–adrenal (HPA) axis and the secretion of ACTH from the pituitary. While circadian HPA axis activity is ultimately controlled by the circa...

ea0026p276 | Pituitary | ECE2011

Late development of resistance to cabergoline in a giant macroprolactinoma with aggressive carvenous sinus and spheinodal bone invasion

Mlawa G , Deshmukh S , Nasruddin A , Sandeman D

Background: Dopamine agonists (DA) are used as the first-line trearment in patients with macroprolactinomas. Late resistant to DA(cabergoline) therapy may occur. Patient with resistant macroprolactinoma may end up receiving a relative high dose of DA. These patients should be advised to take up radiotherapy option as earlier as possible to avoid the need of high dose dopamine agonist. We present a 63-year-old man who presented in 1999 with visual loss,due to giant macroprolact...

ea0026p505 | Bone/calcium/Vitamin D | ECE2011

Insulin sensitivity and bone mineral density in primary hyperparathyroidism

Gianotti L G , Tassone F T , Pellegrino M P , Cesario F C , Baffoni C B , Magro G M , Croce C G C , Borretta G B

Introduction: Recent data suggest a reciprocal influence between bone and energy metabolism. Mediators have been identified as osteocalcin (OC), which stimulates insulin (IRI) secretion and activity and IRI as bone anabolic factor. Primary hyperparathyroidism (PHPT) stimulates bone turnover, induces osteoporosis and is associated with increased IRI resistance. A positive relationship between OC and IRI sensitivity has been found in PHPT, but no data exist on the relationship b...

ea0026p571 | Cardiovascular endocrinology and lipid metabolism | ECE2011

D-Lys-GHRP-6, an antagonist of ghrelin receptor type 1a, did not antagonize the effect of acylated ghrelin but antagonized the effect of unacylated ghrelin on the growth of HECa10 murine endothelial cell line

Melen-Mucha G , Polowinczak-Przybylek J

Ghrelin is expressed in endothelial cells but its precise role remains unknown. Some authors treat ghrelin as an endogenous regulator of angiogenesis.The aim of this study was to examine the direct effect of human acylated and unacylated ghrelin and rat acylated ghrelin applied alone or together with D-Lys-GHRP-6, an antagonist of ghrelin receptor type 1a, on the growth of murine endothelial cell line HECa10 assessed by Mosmann method i...

ea0019p51 | Clinical practice/governance and case reports | SFEBES2009

Intestinal neurofibromatosis and subclinical Cushing’s syndrome

Malik I , Panahloo A , Chong WH , Bano G

A 55-year-old gentleman was referred to surgeons for screening colonoscopy in view of family history of bowel cancer. His mother, maternal aunt and two cousins had history of bowel cancer. When seen by the surgeons, he gave 4-month history of intermittent abdominal bloating and rectal bleeding. His past medical history included a recent diagnosis of hypertension, a chronic history of facial neuralgia and history of excision of numerous facial skin tags. He was on amlodipine 5 ...

ea0019p89 | Clinical practice/governance and case reports | SFEBES2009

Transient secondary hypoadrenalism after a single intra-articular steroid injection-a case report

Alfitori G , Mahmood M , Malik S

A 39-year-old man was referred to our department with an incidental finding of low blood glucose. He had presented to rheumatology with non-traumatic left knee pain and swelling. He had a longstanding history of obstructive sleep apnoea and hiatus hernia. He had not been taking any medications. Examination was unremarkable apart from tender left knee with an effusion. A diagnosis of reactive arthritis was made. An incidental finding of low blood glucose (2.7 mmol/l-normal 3.4&...

ea0019p108 | Clinical practice/governance and case reports | SFEBES2009

Case of persistent mild hypocalcaemia? Carbamazepine induced osteomalacia

Natarajan G , Foster M , Zacharia S

A 41-year-old female was diagnosed with generalised seizures in 1984 and her EEG showed excess slow wave activity in the temporal region. She was commenced on carbamazepine. In 2005 she was diagnosed to have a bipolar affective disorder for which olanzapine was added.She was found to be hypocalcaemic with corrected calcium of 2.08 mmol/l in 2005 after sustaining a right undisplaced distal radial fracture following a seizure. She was empirically commenced...

ea0019p165 | Endocrine tumours and neoplasia | SFEBES2009

Adrenal insufficiency in post chemotherapy patients: an often missed diagnosis.

Kalathil S , Simon G , Kar P

A 75-year-old gentleman was admitted with symptoms of lethargy, abdominal pain, severe nausea and vomiting in January 2008. He had solid transitional cell carcinoma of the bladder, diagnosed in May 2005, when he initially presented with microscopic haematuria. He had further undergone radical cystoprostatectomy and an ileal conduit. The histology showed aggressive tumour (G3pT3a) with vascular invasion but no metastasis. Follow-up CT scans done 9 months later showed a 3.5 cm l...

ea0019p255 | Pituitary | SFEBES2009

Successful treatment of a combined GH/TSHoma using SOM230

Dixit K , Higham C , Brabant G

Case: A 44-year-old lady was diagnosed with Acromegaly (IGF-1 of 1315 ng/ml, prolactin 498 mu/l). She was also thyrotoxic clinically and biochemically with T4 29 pmol/l (normal 9-26), total T3 3.24 nmol/l (normal 0.9–2.2) but high TSH of 3.50 mu/l (normal 0.35–3.5). Further work-up with TRH testing and α-subunit measurement confirmed a TSHoma. Pituitary MRI scan showed a macroadenoma displacing optic chiasm and extending into cavernous sinu...

ea0019p260 | Pituitary | SFEBES2009

Hypoglycaemia during the insulin stress test – how low do we go?

Lockett H , Twine G , Flanagan D

Introduction: The insulin stress test (IST) used to assess the hypothalamic–pituitary–adrenal (HPA) and growth hormone axes requires blood glucose to fall below 2.5 mmol/l. This level of hypoglycaemia is considered safe for selected patients but blood glucose levels below this are associated with increasing risk. We reviewed the depth and length of hypoglycaemia in a cohort of patients undergoing IST.Method: Between October 2004 and 2008, 138 I...