Searchable abstracts of presentations at key conferences in endocrinology

ea0007p98 | Endocrine tumours and neoplasia | BES2004

Diagnosis - 'query acromegaly'

Hordern S , Banu G , Nussey S

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...

ea0007p168 | Neuroendocrinology and behaviour | BES2004

Variability in GH assays undermines the value of consensus criteria for the diagnosis of adult GH deficiency and acromegaly

Pokrajac-Simeunovic A , Wieringa G , Ellis A , Trainer P

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...

ea0007p211 | Steroids | BES2004

Spironolactone interference in the immunoassay of androstenedione

Honour J , Tsilchorozidou T , Conway G

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...

ea0007p213 | Steroids | BES2004

Local regeneration of glucocorticoids by 11betaHSD-1 within the vessel wall modulates angiogenesis

Small G , Dover A , Hadoke P , Walker B

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...

ea0007p272 | Clinical case reports | BES2004

Myxoedema coma with pericardial effusion and respiratory arrest in a 59-year-old woman

Mackay E , Kennedy A , Dalzell G , Atkinson A

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...

ea0007p287 | Clinical case reports | BES2004

Post menopausal virilisation

Smeeton F , Bano G , Nussey S

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...

ea0007p303 | Clinical case reports | BES2004

Short stature in thalassemia major: multiple aetiologies

Jha S , Bano G , Nussey S

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...

ea0006p13 | Clinical case reports | SFE2003

Surgical treatment for insulinoma and disappearance of type 2 diabetes mellitus

Garg R , Patankar A , Jones G , Agarwal A

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...

ea0006p32 | Endocrine tumours and neoplasia | SFE2003

TITLE: Acquired prolactin deficiency (APD) reflects residual pituitary function after treatment for Cushing's disease

Mukherjee A , Murray R , Teasdale G , Shalet S

OBJECTIVE: To investigate the association between APD, treated Cushing's disease and severe hypopituitarism.METHODS: Fifty-seven patients (42 female), in remission after treatment for Cushing's disease, were studied. The cohort comprised 13 patients with, and 44 without APD. APD was defined as a serum prolactin persistently below the detection limit of the assay. Age and gender did not significantly differ between sub-groups.RESULT...

ea0006p33 | Endocrine tumours and neoplasia | SFE2003


Zachariah S , Bano G , Nussey S

Case: A GP with autoimmune hypothyroidism presented with a phaeochromocytoma during labour at the age of 36 y. A left adrenalectomy confirmed the diagnosis and a basal cell carcinoma was also removed. She had a history of Dupuytren's lesions of both soles and palms starting in her teenage years and multiple keratosis. There was no family history of any endocrine or skin disorder. At 41y, a benign breast lump was removed and also a gastrointestinal spindle cell stromal tumour (...