Endocrine Abstracts

A 26-year-old woman presented to the Endocrine clinic with features of Cushing’s syndrome (CS). Investigations revealed a non-suppressible cortisol in low dose Dexamethasone suppression test with a suppressed ACTH, and two positive 24-hour urine cortisol collections, indicating CS. CT imaging revealed a left adrenal adenoma of 3.4 cm. Following a left adrenalectomy, she was discharged on once daily Prednisolone 3 mg. She was well for a year except for one occasion where s...

Ovarian aging is a naturally occurring physiological process, marked by dynamic changes in ovarian function and hormone secretion. Ovarian ageing is associated with several co-morbidities, including; osteoporosis, diabetes, cardiovascular disease and impaired cognitive function, therefore, understanding the physiological processes regulating this is imperative for identifying novel treatment modalities. A key endocrine regulatory of ovarian function is the heterodimer glycopro...

Pancreatic neuroendocrine tumours (PNETs) may occur as part of the multiple endocrine neoplasia type 1 (MEN1) syndrome, or as a non-familial isolated endocrinopathy. Current medical treatments for PNETs are largely ineffective in preventing tumour progression, so there is a need for better therapies, which will develop from an improved understanding of the mechanisms driving PNET tumorigenesis. Cytokine-driven inflammation has been implicated in the development and progression...

A 24 year old gentleman presented following an episode where he became ‘sleepy’ and disorientated whilst driving and had to pull over. He was confused and lethargic and paramedics found blood glucose of 2 mmol/l. He gave a 3-week history of extreme lethargy, nausea, epigastric discomfort, blurring of vision and constant hunger. He denied recent weight changes and had no significant past medical/family history. Biochemical evaluation was as follows; Laboratory glucose...

Introduction: Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women and polycystic ovaries are characterized by excess ovarian stroma that has implications for disordered follicle development in PCOS. The factors contributing to proliferation and increased density of stroma remain unclear but local overproduction of androgens may be involved.Aim: To examine differential expression of genes that regulate key proteins that comprise ...

Peripartum hyponatraemia is an under-recognised complication of labour and poses a risk to both mother and baby. It is typically caused by water intoxication for physiological reasons and population health trends around water intake. We have recent experience of managing 2 patients with severe symptomatic hyponatraemia. Both patients had increased their oral intake of fluid during labour as well as receiving intravenous fluids. Dilutional hyponatraemia was found to be the unde...

Pituitary apoplexy is a rare but life threatening condition if not diagnosed and treated promptly. Common causes include hypertension, head trauma, major surgery, dynamic pituitary tests, anticoagulant use and pregnancy. In pregnancy, hyperplasia and hypertrophy of the lactotroph cells increase pituitary volume by 45% returning to original size at 6 months post-partum. Pituitary apoplexy is uncommon in pregnancy and an underlying adenoma is usually the cause. Very few...

Introduction: Flash glucose monitoring is increasingly used in the management of T1DM. Although the FreeStyle Libre reduces the overall burden of conventional self-monitoring of blood glucose, capillary glucose should be checked at times of Libre-predicted extreme hypo/hyperglycaemia.Methods: Consenting FreeStyle Libre users completed a structured questionnaire via phone interview. Users reported incidence of extreme hypo/hyperglycaemia (indicated by LO/...

Purpose: Patients with Cushing’s disease (CD) experience a wide range of physical and psychosocial health impacts. This can have a profound effect on patient’s quality of life (QOL), impairing areas such as body image, personal relationships and work performance. The CushingQoL is a valid and reliable disease-specific patient-reported outcome (PRO). When using a PRO in an interventional context it is critical to understand whether reported change is clinically meanin...

Sixty six year old gentleman was referred to clinic with hypercalcaemia. He suffered with low mood, “funny turns”, nocturia and loose stools with urgency to open bowels. He appeared tanned but no increase pigmentation in skin folds. There was no palpable lymphadenopathy or neck lump. The calcium levels were around three with low normal PTH of 3.7 (2.8 on repeat). He had not developed any complications like osteoporosis, fracture or renal stones secondary to hypercalc...