Endocrine Abstracts

FGFs and T3 are required for skeletal development. Activating mutations of FGF receptor-1 (FGFR-1) and FGFR-2 cause craniosynostosis, whilst FGFR-3 is a negative regulator of chondrocyte proliferation and activating mutations cause achondroplasia. Childhood hypothyroidism causes delayed ossification and growth retardation, whereas thyrotoxicosis accelerates bone development, induces premature growth plate and skull suture closure and causes short stature and craniosynostosis. ...

T3 is essential for normal skeletal development. Childhood hypothyroidism causes delayed bone formation, whereas T3-excess accelerates growth and epiphyseal closure. Fibroblast growth factors (FGFs) act via receptor tyrosine kinases (FGFRs) to inhibit chondrocyte proliferation, matrix production and skeletal maturation. Dimerisation of FGFRs and their functional interaction with FGFs requires heparan sulphate proteoglycans (HSPGs). We recently showed that T3 induces FGFR-1 exp...

A 71 year old obese lady was noticed to have acromegalic facies and bilateral carpal tunnel syndrome, increasing ring and shoe size, but no sweats or headaches. Random IGF-1 was raised (39.1nanomol per litre). Following oral glucose tolerance test (OGTT) fasting glucose was normal but impaired at 2hours (4.8 and 9.6millimol per litre respectively), growth hormone (GH) suppressed from a baseline of 3.8microunits per litre to 2.2microunits per litre. Following thyrotropin releas...

There is increasing reliance on published consensus criteria for clinical decision-making in states of GH excess and deficiency. NICE eligibility criteria for GH treatment include a peak GH response <9 mU/L during an ITT. To determine the adequacy of GH assay performance for diagnosing GH deficiency (GHD), we have assessed the variability in 101 UKNEQAS reported results from a single sample with a value close to 9.0 mU/L. For all laboratories (n=101) median GH was 11.1 mU/L...

Spironolactone (Sp) is an aldosterone-antagonist diuretic, that is traditionally used in the treatment of hirsutism due to its antiandrogenic effects. Sp can inhibit ovarian and adrenal biosynthesis of androgens, compete for the androgen receptor in the hair follicle, and directly inhibit 5alpha-reductase activity. The steroid suppressive effects are so variable that the receptor-blocking action is considered the most important mechanism. It is probable for this reason that co...

Angiogenesis, which is tightly regulated in health and disturbed in many diseases, is inhibited by glucocorticoids. Local glucocorticoid availability within the vessel wall is determined by the pair of enzymes 11beta-hydroxysteroid dehydrogenase type 1 and 2 (11HSD-1 and 2) that catalyse the interconversion of active glucocorticoid (corticosterone in mice, cortisol in humans) with inactive 11-dehydrocorticosterone or cortisone. We hypothesized that regeneration of active gluco...

A 59-year-old lady presented with 2 days of increasing confusion, hallucinations and drowsiness. Her family reported lethargy, weight gain and changing appearance over several months.On examination she was profoundly hypothyroid with typical coarsened facial features and dry skin. She had pulsus paradoxus, BP 120/70mmHg and Glasgow coma scale was 11/15. She was transferred to our care.Free thyroxine was <3.0pmol/L and TSH 30.8mu...

A 62 year old lady presented to the clinic with hirsutism, virilisation and temporal balding. Her past medical history included type 2 diabetes, hypothyroidism, ischaemic heart disease and peripheral vascular disease. Her body mass index was 30 kilograms per metre squared and she had mild cliteromegaly. Her serum testosterone was 3.6 nanomols per litre.She had a high dose dexamethasone suppression test and CRH test to exclude Cushings Syndrome or Disease...

Short stature in thalassemia major: multiple aetiologies.A 24 year old Asian male with beta-thalassemia major was referred with symptoms of tiredness, weight gain, muscle weakness and depression. He had been treated elsewhere with blood transfusions, desferrioxamine and had undergone a splenectomy. He was known to have underlying cardiac dysfunction and was diagnosed to have hypogonadotrophic hypogonadism at the age of 17 years and primary hypothyroidism...

Erratic release of insulin accounts from periodic nature of the symptoms in insulinoma. Islet-amyloid polypeptide has been demonstrated in human insulin producing tumours- insulinoma. Presence of amyloid tissue has been demonstrated in pancreatic islets in patients with diabetes mellitus. Impaired islet function is a feature of diabetes mellitus. Hyperglycaemia, as in diabetes, enhances amylin secretion. Presence of insulinoma has been documented in past but insulionoma presen...