Endocrine Abstracts

A 37-year-old woman presented with a short history of left arm pain. X-ray indicated a lytic lesion of the scapula. Calcium was elevated at 3.25 mmol/l (normal 2.2–2.6) with parathyroid hormone (PTH) 936 pg/ml (5–70). Upon questioning she reported nocturia, polydipsia and dyspepsia. Magnetic resonance imaging revealed brown tumours in the scapula, clavicle and hand. A superior parathyroid adenoma was excised with normalisation of calcium. Bone biopsy of the scapular ...

Postural orthostatic tachycardia syndrome (PoTS) reflects a disturbance of autonomic function leading to a myriad of clinical features. Subcutaneous octreotide injections and intramuscular long acting preparations of octreotide have been used in the treatment of PoTS. However, inconvenience of frequent injections, side effects and theoretical overexposure, as well as cost of the intramuscular preparation, makes them far from ideal.We present a case of un...

A 45-year-old man who works as a psychotherapist was referred with an incidental finding of a rudimentary uterus and bilateral pelvic gonads on pelvic computerized tomogram and magnetic resonance imaging. This was performed for investigation of abdominal pain which has since settled. As far as he is aware he was born without complications and developed normally through childhood. He progressed through puberty uneventfully with voice changes by 13 years and shaving by 16 years....

Fetal growth restriction is associated with abnormal placental cell (cytotrophoblast) proliferation. Using an explant model of human first trimester placenta, we have demonstrated that the IGFI and -II stimulate proliferation in cytotrophoblast and are probably essential for normal placental growth. IGF activates signalling through both Akt and ERK, so the regulation of these pathways in placenta is important for normal pregnancy outcome. The tissue contains high levels of mic...

Pregnancy complications such as pre-eclampsia and intrauterine growth restriction are associated with abnormal placental cell (cytotrophoblast; CT) proliferation and apoptosis. The mechanisms regulating these events are unclear however altered levels of IGFs have also been reported in these conditions. Using an explant model of human first trimester placenta we have shown that both IGF-I and –II act through IGF1R mediated signalling pathways to enhance CT proliferation, d...

Introduction: Coeliac disease (CD) is associated with an increased risk of osteoporosis. The aim of this study was to determine the efficacy and relevance of screening for osteoporosis in CD and to determine possible risk factors in the coeliac population. There has been no conclusive study concerning the efficacy of such screening programmes to date.Method: All Coeliac patients who attended a 2003 Coeliac clinic were reviewed by questionnaire, clinical ...

The liver performs essential functions including the control of blood nutrient levels; the synthesis of many blood proteins; the metabolism of bile components and the conversion of ammonia to urea for excretion by the kidney. Impaired urea synthesis is often the cause of coma and death in patients with liver failure. The only treatment for liver failure at present is transplantation.Stem cells may be a promising future resource for the treatment of acute...

Concerns on the noncomparibility of intact parathyroid hormone (iPTH) methods have recently been voiced (Cantor T et al; Clin Chem 2006, 52, 1771–6). It is therefore important that any new iPTH immunoassays are thoroughly validated before routine use. We describe performance characteristics for an iPTH immunoassay on the ARCHITECT 8200i analyser as compared with iPTH measurement on the Diasorin LIAISON platform. Potassium EDTA plasma samples (n=80) we...

IGF-I and -II influence cytotrophoblast proliferation by activating the type-I IGF receptor (IGF1R) in first trimester human placenta. Ligand access to receptors is regulated by IGF binding proteins (IGFBPs) 1-6. In humans, the most abundant IGFBPs at the maternal-fetal interface are IGFBP-1 and IGFBP-3; we hypothesised that these IGFBPs function to regulate the effects of IGFs in the placenta and used our placental explant model, in which proliferation and differentiation are...

A young female presented concerned that she may have Addison’s disease. She had noted increasing pigmentation and reported her sister had died from undiagnosed Addison’s disease. She was hypotensive, with no postural drop in her blood pressure. She was hyponatraemic and hyperkalaemic. An initial 250 μg Synacthen test performed in the afternoon gave a baseline cortisol of 258 nmol/L and a 30 minute cortisol of 291 nmol/L. In view of this, the Synacthen test was r...