Endocrine Abstracts

Acute adrenal insufficiency, also termed adrenal crisis, is a life-threatening endocrine emergency due to a lack of production of the adrenal hormone cortisol (and also aldosterone in primary adrenal insufficiency). Patients with both primary (PAI) and secondary adrenal insufficiency (SAI) are at risk of adrenal crisis. PAI is caused by loss of function of the adrenal gland itself resulting in both glucocorticoid and mineralocorticoid deficiency. SAI is caused by alterations i...

Diarrhoea is a common symptom in patients with neuroendocrine tumours (NETs), especially metastatic small bowel NETs. Diarrhoea substantially impairs quality of life, as increased frequency of bowel moments with associated urgency, cause social embarrassment and constrain diet and the ability to leave the house. Diarrhoea, with associated electrolyte disturbance, was a major cause of premature death in patients with NETs prior to the advent of medical therapies. It is importan...

Sweating in the absence of any physiological precipitant can be extremely distressing and unpleasant. Primary hyperhydrosis, usually affecting the palms of the hands, soles of the feet and the axillae, usually presents in teenage years and is managed by dermatologists. Secondary hyperhydrosis usually develops later in life, is more generalised and may be associated with flushing. The differential diagnosis is very long and includes systemic illness (such as lymphoma and chroni...

Iodine is an essential component of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) which play a crucial role in brain and neurological development. The ideal dietary allowance of iodine recommended by World Health Organisation (WHO) is 150 μg of iodine per day which increases to 200–250 μg/day in pregnancy. Severe iodine deficiency may be associated with impairment in the psycho-neurological outcome in the progeny because bot...

Background: Thyrotropinomas (TSHomas) have traditionally been considered a rare, albeit important cause of thyrotoxicosis. However, a recent report suggests their prevalence may be 2–3 times higher than previously suspected. In addition, although early case series described a predominance of invasive macroadenomas, recent findings (including in our own cohort of 40 patients) confirm that microadenomas are being increasingly diagnosed, and the clinical/biochemical phenotyp...

Traumatic Brain Injury (TBI) is a devastating neurological emergency, usually resulting in transient or permanent neurological dysfunction. It is the most common cause of death and disability in young adults in industrialised countries and is a major public health problem. Although anatomical pituitary damage following TBI was first recognised as long ago as 1918, evidence of hormonal dysfunction in both the acute and chronic phases following TBI had only been studied in detai...

Accurate diagnosis of thyroid dysfunction is dependent on understanding hypothalamic–pituitary–thyroid (HPT) axis physiology and the pathophysiology that can affect this classical endocrine feedback loop. Even minor perturbations of thyroid status, which may be imperceptible to the patient and clinician, can significantly alter the relationship between circulating thyroid hormone (TH) levels and pituitary TSH such is the finely-tuned nature of the axis.<p class="...

Cushing’s syndrome (CS), is the prolonged exposure to excess cortisol within the body and has a significant negative prognostic impact if left untreated. There are several screening tests available for CS: urinary free cortisol (UFC), overnight dexamethasone suppression test (oDST), and late night salivary cortisol test (LNSC).This audit evaluated the screening of patients for CS by the Manchester Royal Infirmary (MRI), in 2012 against guidelines pr...

Although life expectancy is increasing, deterioration in many tissues with age can substantially impair quality of life. Muscle loss and weakness, decreased bone density leading to fractures, insulin resistance leading to diabetic complications and cognitive decline increase substantially with age. These features are also seen in patients treated with high doses of glucocorticoids raising the possibility that glucocorticoids could be involved in the ageing process. However, ci...

Most Europeans take drinking milk for granted; it’s the everyday consumption of an everyday drink. But for most adult humans, indeed, for most adult mammals, milk is very far from an everyday drink. Milk is something that we have specifically evolved to be able to consume in the relatively recent past. The ability to digest the sugar in milk is called Lactase Persistence and Darwin’s engine of evolutionary change, natural selection, has probably worked harder on this...