Endocrine Abstracts

Background: Hyponatraemia is one of most common electrolyte abnormalities in acutely ill elderly patients. Severe hypothyroidism is often associated with hyponatraemia. The mechanism of hyponatraemia in hypothyroidism is not fully understood. It is suggested that hypothyroidism induces hyponatraemia either by inappropriate release of ADH or by decrease in GFR. Regardless of the mechanism, the net effect is impairment of water excretion. We report a case of severe hypothyroidis...

Background: Before synthetic cortisone was introduced, patients with Addison’s disease prolonged their lives by maintaining a high salt intake and taking plant based containing preparations affecting steroid metabolism. We report the case of someone who discovered this regime for herself.Case report: A 42 year old lady presented with a four week history of decreased energy, malaise, and postural dizziness. She was hyponatraemic (plasma sodium 126 mm...

Hyponatraemia is the commonest electrolyte abnormality in hospitalised patients. It is often seen in patients with complex medical problems and in the critically ill. We determined the outcome for patients identified to have hyponatraemia over a one month period.Methods: We reviewed all in-patients with severe hyponatraemia, defined as serum sodium <125 mmol/l (135–146) at Hope Hospital during April 2005. Patients were identified retrospectively...

An important issue for all endocrinologists involved in management of non-functioning pituitary adenomas (NFAs) not treated surgically at initial presentation is the frequency and duration of follow-up neuroimaging. Previous studies have described tumour enlargement in less than 15% of microadenomas (<1cm diameter) with macroadenomas (1cm diameter or more) showing a greater propensity for growth. With improvements in neuroimaging techniques we felt that it was timely to rev...

IntroductionPituitary macroadenoma requires extensive endocrine investigations to diagnose any evidence of hormone excess or deficiency. As a part of routine investigation, IGF-1 is frequently used to exclude growth hormone excess. Here we report 3 cases of pituitary macroadenoma, who had a normal pre-operative IGF-1 but post-operatively developed biochemical evidence of growth hormone excess.CasesWe report 3...

IntroductionWe have previously demonstrated profound effects of hormone replacement treatment (HRT) in post-menopausal women on the IGF-system. HRT is widely used to prevent osteoporosis. The IGF-system has been implicated in bone formation. IGFBP-4 and IGFBP-5 are known to be important in modulation of IGF activity in bone. In this larger study we have examined the effects of HRT on circulating IGFBP-4 levels.MethodOral conjugated equine estrogen (CEE) alone or in...

OBJECTIVE Recent studies have shown the benefits of insulin sensitising agents such as Metformin in the treatment of infertility and hirsuitism in PCOS. However not all women with PCOS are insulin resistant. Within a clinic population of women referred for treatment of hirsuitism, we examined the utility of fasting insulin/glucose measurement in identifying which women were insulin resistant.DESIGN We evaluated an outpatient clinic group of 25 PCOS pati...

Introduction: Substrate accumulation, energy deficiency or complex molecule defects characterize inherited metabolic disorders (IMDs), accounting for their multi-system manifestations. One important aspect of this is endocrinopathy, which is relatively common but underestimated in IMDs, presenting in childhood following diagnosis or sometimes a presenting symptom in adults where there is multi-system or multi-gland involvement. Endocrinopathies may be secondar...

Introduction: Type 2 diabetes mellitus (T2DM) frequently associates with increasing multi-morbidity/treatment complexity. Some headway has been made to identify genetic and non-genetic risk factors for T2DM. However longitudinal clinical histories of individuals both before and after diagnosis of T2DM are likely to provide additional insight into both diabetes aetiology/further complex trajectory of multi-morbidity.Methods: This study utilised diabetes p...

Introduction: The androgen receptor (AR) mediates the peripheral effects of testosterone. The main mechanism of action for the AR is direct regulation of gene transcription. Available evidence suggests that the number of CAG repeats in exon-1 of the AR gene is negatively correlated with transcriptional activity of the AR and that CAG repeat number links to mortality rate in T2DM men. The aim of this analysis was to determine the association between CAG repeat number and all ca...