Endocrine Abstracts

Introduction: Van Wyk-Grumbach syndrome was first described in 1960 in patients presenting with long standing juvenile hypothyroidism, delayed bone age and precocious puberty. Literature review indicates only few cases reported in males compared to females. We are reporting this case in a male patient who presented with short stature.Case: A 7.25-year-old boy was referred for endocrine opinion due to short stature. He had not grown over the last 18 month...

Introduction: Bedside blood ketone measurement has often been used in the management of diabetic ketoacidosis. However there is no available data on its reliability in the evaluation of hypoglycaemia in children. We aimed to assess the reliability of bedside ketones (beta-hydroxybutyrate (BHB)) in the evaluation of hypoglycaemia in children.Methods: We collected data on 20 children who had paired measurement of bedside and lab BHB at the end of a control...

Introduction: Congenital hyperinsulinism (CHI) is a rare genetic disorder that is characterised by persistent hypoglycaemia in infants and children. We are reporting a rare case of diffuse CHI who was also found to have hypopituitarism and several other congenital anomalies. A similar association has not been reported in literature.Case: A female baby was born at 42 weeks gestation with a birth weight of 4.185 kg (1.72 SDS). She suffered shoulder dystoci...

Introduction: We present a case which highlights the complexities of managing hyperthyroidism.Case report: An 81 year old man complained of irritability, insomnia, diarrhoea, shortness of breath and weight loss. Past medical history includes type II diabetes, atrial fibrillation (AF), hypertension, gallstone pancreatitis requiring cholecystectomy (2005). Clinically, he was in fast AF and right heart failure. On examination he had a tremor; normal sized t...

Omega-3 polyunsaturated fatty acids modulate the risk factors for metabolic syndrome via multiple mechanisms. However, their underlying mechanisms on insulin resistance and type 2 diabetes are still unknown. Here, we report that Odontella aurita, a microalga rich in the omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA), prevents high saturated fat diet induced insulin resistance and inflammation in the liver of Wistar rats. High fat diet (HFD), given for 8 weeks, ...

FGF21 has recently emerged as a major regulator of metabolism and energy utilisation. FGF21 administration confers multiple metabolic benefits on insulin sensitivity, blood glucose, lipid profile and body weight in rodents and primates. FGF21 acts through a receptor complex consisting of FGF receptors (FGFR 1, 2, 3 or 4) and a co-receptor βKlotho (KLB), crucially required for FGF21 signaling. Although FGFRs are widely expressed, KLB is predominantly expressed in adipose t...

Background: In steroid dependent patients the knowledge of steroid dose change during illness and stress is of paramount importance.Objectives: i) To assess patient’s knowledge of steroid management during acute illness and stressful condition. ii) To evaluate whether there is a relation between patient knowledge and admission with documented adrenal crisis. iii) To improve medical access to information about patients on steroid at Emergency Departm...

Toll-like receptor 4 (TLR4) has a critical role in innate immunity, and the activation of inflammatory pathways plays an important role in the induction of insulin resistance. Indeed, we have recently demonstrated that TLR4 is implicated in resistin-induced inflammation and insulin resistance in the hypothalamus.1 We have also shown that TLR4 is up-regulated in the hypothalamus of mice fed a high-fat diet. Here, we aim to decipher the molecular mechanisms implicated...

Introduction: A significant number of patients are intolerant of anti-thyroid drugs (ATD) and thyroidectomy remains the only treatment option available to patients who decline radioiodine as definitive therapy. As patients with poorly controlled thyrotoxicosis are at risk of developing thyroid storm, optimal pre-operative control of hyperthyroidism is essential. Rapid thyroid blockade (RTB) with the contrast agents sodium ipodate and iopanoic acid were attractive treatment opt...

Introduction: Congenital Hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in neonates, infants and children with an incidence of 1/25000-1/50000 live births. HNF4A and HNF1A mutations lead to maturity onset diabetes of the young (MODY 1 and 3 respectively) with a potential for causing CHI in the newborn period. Whilst HNF4A mutations causing CHI is well known, reports on CHI due to HNF1A mutations are very limited.</...