Endocrine Abstracts

Cardiac arrhythmias in thyrotoxicosis are usually seen as sinus tachycardia and atrial fibrillation but conduction abnormalities in the form of heart blocks do occur in rare instances. We present here four hyperthyroid patients with complete heart blocks. Cases 1 and 2 are young women diagnosed with Graves’ disease who both experienced syncope and were seen to have 3rd degree atrio-ventricular block. Case 3 is a young woman who presented with palpitations, fever and short...

Hypophosphataemic rickets with hypercalciuria (HHRH) is a rare autosomal-recessive condition, typically reported in consanguineous families. Milder forms, with less significant hypophosphataemia, present with hypercalciuria and nephrolithiasis, without bone disease and may be underdiagnosed. The underlying pathophysiology is due to mutations in the SLC34A3 gene, which encodes a sodium-phosphate transporter in the proximal renal tubules. Our patient, a 13-year-old Caucasian gir...

Prostate cancer development and progression depend on androgen signaling through the androgen receptor (AR). Recent evidence indicates the continued presence of intratumoral dihydrotestosterone (DHT) during androgen deprivation therapy drives prostate cancer recurrence through the activation of AR. There are ongoing efforts to identify drugs that target AR and enzymes that catalyze the synthesis of testosterone and DHT. Temporary remediation of prostate cancer by surgical or m...

Tolvaptan is an ADH antagonist licensed for the treatment of the syndrome of inappropriate ADH secretion (SIADH). We describe the case of a patient with severe symptoms due to refractory SIADH who was successfully treated with tolvaptan. A 35-year old patient developed a chordoma involving the pituitary gland and optic chiasm and was treated with surgery, radiotherapy and gamma knife therapy. After several years, she developed recurrent, severe, symptomatic hyponatraemia due t...

Skeletal muscle is the principal site for insulin-stimulated glucose disposal but its ability to utilise glucose is diminished by insulin resistance associated with obesity and consequent elevations of free fatty acids (FFAs). Chronic sub-clinical inflammation, characterized by increased macrophage infiltration into obese adipose tissue is a hallmark of the insulin resistance syndrome. However, little is known about the potential role of muscle macrophages in mediating local e...

Dietary fat has been correlated with obesity since it induces the proliferation and differentiation of pre-adipocytes. However it has become clear that the effect of fat on human health depends on the composition and the nature of fatty acids. Arachidonic acid (AA) is a major omega-6 polyunsaturated fatty acid (PUFA) with a controversial role in adipocyte differentiation. We investigated the effect of a brief AA exposure on pre-adipocyte differentiation. We show that a short t...

Hypopituitarism is a recognised complication of pituitary and hypothalamic pathology. It can also be a consequence, less commonly, of traumatic brain injury. It has never been described in patients following recovery from a cardiac arrest. We present a case history of hypopituitarism following successful cardiopulmonary resuscitation for a ventricular tachycardia (VT) cardiac arrest. A 51 year old patient with known prolonged QT (Romano ward) syndrome and chronic obstructive a...

Background: Male sex, cigarette smoking, young age, severe thyrotoxicosis, large goitre and marked or persistent elevation of TRABs are consistently reported as predictors of relapse following withdrawal of thionamides in Graves’ disease. Early recurrence rates are commonly quoted at 50% but the definition of early recurrence varies widely across the literature. AIM We sought to determine the best clinical predictors of recurrent thyrotoxicosis and whether these would per...

Dietary fat has been correlated with obesity since it induces the proliferation and differentiation of pre-adipocytes. Now it has become clear that the effect of fat on human health depends on the composition and the nature of fatty acids. Arachidonic acid (AA) is a major omega-6 polyunsaturated fatty acid (PUFA) with a controversial role in adipocyte differentiation. We investigated the effect on pre-adipocyte differentiation after a brief exposure to AA.<p class="abstext...

Introduction: The psychiatric consequences of inoperable Cushing’s syndrome can be difficult to manage medically. Etomidate, an imidazole derived anaesthetic agent, inhibits cortisol synthesis and may be useful in this circumstance.The case: A 57-year-old woman presented with symptoms and signs of hypercortisolism. She gave a history of recent onset intermittent right sided stabbing chest pain and worsening breathlessness.Two ...