Endocrine Abstracts

A 37-year-old Nigerian lady was referred to the endocrinology clinic with worsening dyspnoea, weight loss, poor sleep and palpitations over the preceding few months. She had a past history of depression treated with citalopram. She was clinically and biochemically thyrotoxic with a TSH <0.01 μ/l [0.4–5] and free T4 49.3 pmol/l [9–19]. TSH receptor antibodies were positive. She was commenced on carbimazole 40 mg once daily and propranolol 40 mg twi...

Prostate cancer (PC) growth is androgen-dependent, hence, the mainstay for treatment is hormone-ablation therapy using anti-androgens, and/or androgen-deprivation therapies. Unfortunately, after a median time of 18 months, the cancer reappears in an androgen independent form, termed castrate-resistant PC (CRPC), which is largely fatal. To date, many molecular mechanisms have been suggested to be responsible for persistent AR signalling in CRPC. AR variants (AR-Vs), short forms...

Background: Children with brain tumours are known to be at risk of late neuroendocrinopathies due to anatomical and treatment disturbances to central pituitary function.Aims: To provide a descriptive analysis of a cohort of children with such tumours, referred to the late-effects neuroendocrine service at UCLH. It aims to describe the types of tumour, treatment and current endocrine morbidity of this cohort.Methods: Cases were iden...

Introduction: The period of adolescence is a difficult time for most people and is the time when transition from the paediatric diabetic service to the adult occurs; therefore a smooth transition is essential. The National Service Framework for Diabetes identified transition from paediatric care to adult as an area where protocols could support better care. Placing emphasis on the transition services may help in ensuring effective long-term control and health improvement.<...

Coordinated interaction between the immune and neuroendocrine systems is of key importance in regulating the host's response to inflammation and anoxic stress. Adenosine, released under such conditions in high concentration, modulates a number of inflammatory processes and can regulate the activity of the hypothalamo-pituitary-adrenal (HPA) axis. Although adenosine receptors (ARs) have been described in the pituitary gland, the distribution of the receptor subtypes (A1, A2A, A...

Introduction: Primary hyperparathyroidism is usually caused by a parathyroid adenoma (80-85%), occasionally by primary parathyroid hyperplasia (10-15%), and rarely by atypical parathyroid tumor (APT) or carcinoma (<1%). APT reflects parathyroid neoplasm of uncertain malignant potential which poses a challenge for differential diagnosis with parathyroid carcinomas. Most patients exhibit strong symptomatology of hypercalcemia at presentation shared with the benign causes of ...

Introduction: Primary hyperparathyroidism may be sporadic or occur as part of a genetic predisposition. Inactivation of CDC73 tumour suppressor gene can cause hyperparathyroidism-jaw tumour (HPT-IJ) syndrome, parathyroid carcinoma or familial isolated hyperparathyroidism (FIHP).Case details: We report a 26 year old gentleman, previously fit and well who was found to have hypercalcemia on a routine testing. Renal ultrasou...

Introduction: Prior to 2015 there was no pathway for adrenal masses. An Adrenal MDT was started to discuss all the adrenal nodules (except for suspected phaechromocytoma and adrenal carcinoma) to improve the service for this cohort of patients. This audit is a review of the impact of this intervention.Methods: Data was collected between April 2016 and March 2016 for all adrenalectomies performed at East Sussex Hospitals Trust. Data was collected from the...

Case History: Case 1: A 37-year-old lady with relapsing-remitting multiple sclerosis was initiated on Alemtuzumab and symptoms of sweats and heat intolerance arose. Hyperthyroidism was confirmed with free T4 30.1 pmol/l (12–22) and suppressed TSH. Symptoms settled without antithyroid medication and within 2 months T4 had fallen to 10.2 pmol/l with TSH 6.95 mIU/L. After a further 6 weeks T4 was 9.8 with TSH 20.35 and levothyroxine was initiated. Anti-TPO was raised at 442 ...

A 60-year-old woman presented to the endocrine clinic with significant hirsutism and male-pattern baldness, progressive since the menopause 5 years earlier. She was otherwise fit and well. Testing revealed an elevated serum testosterone of 14.2 nmol/L. A CT scan revealed a large malignant 19 cm mass arising from the left adnexa, a large fibroid uterus and 2 small masses in the left kidney. Other abdominal organs were normal with no visible ascites. With the presumption of mali...