Endocrine Abstracts

Neonatal salt wasting can present in neonates with a life-threatening state of hyponatraemia, hyperkalaemia, dehydration and metabolic acidosis. The differential diagnosis of neonatal salt wasting includes congenital adrenal hyperplasia (CAH) most commonly due to 21-hydroxylase deficiency, pseudohypoaldosteronism (PHA), X-linked adrenal hypoplasia congenital (AHC) and aldosterone synthase defects. Diagnostic work up should include serum measurement of ACTH, Cortisol, 17OH-prog...

A 13 year old female presented with a two day history of abdominal pain and vomiting which responded to analgesia. Pelvic ultrasound showed complex ovarian cysts and a pre-pubertal uterus. Initial blood tests were consistent with hypergonadotrophic hypogonadism (LH 31.5 U/l, FSH 14.3 U/l and oestradiol <70 pmol/l) and karyotype was 46 XX. Bone age was slightly delayed (measured 12.4 years, chronological age 13.7 years). On referral to paediatric endocrinology, the patient ...

Background: Gigantism is a rare condition with accelerated growth in childhood when the epiphyseal plates are not fused. Most cases are due to growth hormone (GH) secretion from a pituitary adenoma. Rarer causes of GH-related gigantism include somatotroph hyperplasia as part of McCune-Albright syndrome, Carney complex, X-linked acrogigantism or ectopic GHRH production.Case presentation: An 18-year-old male with c.249_252delGTCT;p.I85Sfs MEN1 mut...

Introduction: There is increasing emphasis on stringent glycaemic control (HbA1c <48 mmol/mol) within the first year of diagnosis for all types of diabetes, to preserve metabolic memory and reduce future risk of sub-optimal diabetes outcomes. Retrospective data collected on two previous annual cohorts of children and young people (CYP) with diabetes revealed only 9% achieved the HbA1c < 48 mmol/mol target at 12 months post diagnosis despite initial HbA1c improvement un...

Objective: Obese PCOS have poor IVF outcomes. The aim of this study was to evaluate the impact of weight reduction with metformin alone or in adjunct with liraglutide on oocyte maturity and embryo quality in infertile obese PCOS population.Design/participants/main outcome measure: A 12-week prospective randomized study was conducted with 40 infertile PCOS (30.77±3.742 aged years, BMI 36.69±3.51 kg/m2, mean ± SD) who had been pre...

Background: Currently there are no evaluated diabetes teaching packages for primary school age children which meet their learning needs, styles and are delivered by trained educators. Sheffield children’s Hospital produced and tested, as a randomized controlled trial (RCT), the KICk-OFF course for 11–16 year olds. This 5-day course based on carbohydrate counting and insulin dose adjustment showed significant improvement in HbA1c (9 mmol/mol, 0.8%) for those with poor...

Objective: Incidentally discovered adrenal masses (‘incidentalomas’) are found in 2% of the population. Adrenalectomy is necessary only in a small proportion of such subjects as outlined by the relevant ESE/ENSAT guideline1. However, uncertainty exists over the need for removal of lesions between 4 and 6 cm and those with low lipid content on CT scanning (found in 20% of benign adenomas). Our centre tends to offer surgery for all adenomas >4 cm.<p ...

Craniopharyngioma is a rare benign pituitary tumour that occurs in children and adults. Recurrence rates are high (up to 90%) but factors underpinning this are unclear, particularly in cases of childhood onset. We aimed to investigate factors that may influence subsequent recurrence rates in childhood onset craniopharyngiomas in patients attending our centre. A retrospective study of patients followed up at the Oxford Late Effects of Childhood Cancer service was conducted. Pat...

Background: Metformin is widely used for treatment of gestational diabetes mellitus. Metformin is considered safe in pregnancy but crosses the placenta. The limited available data of follow-up of children exposed to metformin in utero suggests potential for increased adiposity but mechanisms are unknown. As placental DNA methylation has been linked to later obesity and metformin causes global DNA methylation changes in cancer cell lines we hypothesised that this may be a candi...

We present a case of 71-year-old gentleman who presented with bitemporal hemianopia in 2008 with pituitary apoplexy compressing the optic chiasm. Prolactin was 55287MU/l, with deficiency of all other anterior pituitary hormones. He underwent transphenoidal adenectomy (TSA). Prolactin was 35633MU/l post-operatively and cabergoline was commenced. Histology was consistent with a lactotroph adenoma with MiB-1 index of 3–5%. Visual fields recovered and prolactin was normal unt...