Endocrine Abstracts

Non-islet cell tumour hypoglycaemia (NICTH) is a rare paraneoplastic phenomenon and there is limited guidance regarding different treatment modalities.We present two cases of NICTH focusing on the combined methods used to control hypoglycaemia.The first involves an 89-year-old gentleman diagnosed with a pelvic leiomyoma in 2003. For several years, he had experienced recurrent collapses which briefly improved following tumour emboli...

Anti-inflammatory salicylates improve insulin sensitivity, however the mechanism remains unclear. We have observed down-regulation of the glucocorticoid regenerating enzyme 11β-hydroxysteroid dehydrogenase 1 (11βHSD1) by salicylates in cultured adipocytes and in human adipose tissue after oral salsalate therapy, consistent with known transcriptional regulation of 11βHSD1 by pro-inflammatory cytokines. Since inhibition of 11βHSD1 improves insulin sensitivity...

Initial follicle growth results in a number of distinct morphological changes, such as cuboidalisation and proliferation of the granulosa cells (GC) as well as an increase in oocyte size.Cell adhesion molecules and intercellular junctions play a pivotal role in changes in cell shape. We hypothesize that change in GC shape is key, and that increased understanding of changes in cell adhesion and associated junctions will provide insight into the regulation...

In rodents and other mammals, it is well established that the production of certain TGF-β members including Gdf9 and Bmp15 by oocytes is important for follicle development to proceed. It is believed that these growth factors form part of a short loop paracrine system to regulate gene expression in neighbouring follicle cells. We propose that one aspect of this feedback loop may involve the genomic modulation of TGF-β antagonists in granulosa cells by oocyte-secreted ...

A 72-year-old gentleman was diagnosed with primary hyperparathyroidism in 2005. He had 6 admissions in a year with hypercalcaemia refractory to treatment with conventional agents. On each admission he was treated with intravenous pamidronate and fluid resuscitation. This resulted in an average stay of 16 days and an average cost of £4800 per admission.A single parathyroid adenoma was diagnosed on sestambiscan. He was not considered fit for surgery d...

Background: Pleuro-pulmonary inflammatory fibrotic syndrome is a rare but recognised complication of dopamine agonist (DA) therapy in Parkinson’s disease. Here, we describe a case of asymptomatic pulmonary fibrosis, presumed secondary to DA therapy, in a patient treated with cabergoline for an invasive macroprolactinoma.Case report: A 47-year-old previously fit man was admitted as an emergency with a 3 days history of headache followed by collapse. ...

Activation of the G-protein coupled receptor GPR54 (AXOR12, OT7T175) by peptide ligands (kisspeptins) encoded by the Kiss-1gene is central to acquisition of reproductive competency in mammals. Administration of exogenous kisspeptins stimulates GnRH release from hypothalamic neurons in several species including humans. To confirm that kisspeptins are the natural agonist of GPR54 in vivo and to determine if these ligands have additional physiological functions, we ...

Human studies indicate that local glucocorticoid (GC) generation within osteoblasts plays a critical role in various bone diseases. Human osteoblasts express the enzyme 11b-hydroxysteroid dehydrogenase type 1 (11b-HSD1) that converts inactive GCs (cortisone, dehydrocorticosterone) to their active counterparts (cortisol, corticosterone). This activation capacity critically depends on expression of a cofactor generating enzyme hexose-6-phosphate dehydrogenase. Enzyme expression ...

Background: There is evidence to suggest an association between hypothyroidism (overt and subclinical) and cardiovascular disease. It is unclear whether the set-point of the thyroid axis, within the normal range, may be related to vascular risk.Methods: We have reanalysed the data from the original Whickham study to assess BP in the entire cohort and its relationship to serum TSH within the reference range (0.3–6.0 mIU/L). Multivariate stepwise line...

Background: Type 1 diabetes is a chronic condition with significant implications on the child, the family and the health services. Management of this condition in a refugee child is fraught with further challenges.Methods: In this observational case report, we discuss the challenges in the management of a 10-year-old Somalian boy, with type 1 diabetes for the past few years, who presented with Diabetic ketoacidosis.Table 1 illustra...