Endocrine Abstracts

Diabetes arising in young adulthood has a wide differential diagnosis, including autoimmune and genetic causes as well as young onset type 2 diabetes (YT2D). Specific features may be associated with each of these groups, but they cannot be differentiated from YT2D by mode of presentation. Family history, clinical characteristics and laboratory investigations provide complementary strategies to help dissect different known aetiologies.We studied 268 UK Ca...

Introduction: Our current local management guidelines for Graves’ Disease (GD) in children and young people (CYP) do not include routine screening for coeliac disease (CD). However, ad hoc testing of patients in this cohort pointed to a high incidence of positive tissue transglutaminase (TTG) results.Aims/Objectives: 1. To determine the incidence of CD in patients in our service diagnosed with GD. 2. To establish if...

Introduction: Pseudohypoparathyroidism is a rare group of heterogenous disorders. PHP1b consists of renal resistance to PTH in the absence of other physical or endocrine abnormalities and is associated with reduced 1,25-OH vitamin D synthesis, increased phosphate secretion and hypocalcaemia. Despite calcium and vitamin D replacement many patients still have chronically elevated PTH.Case description: A 31-year-old white female presented with symptoms of t...

Synthetic glucocorticoid administration during pregnancy reduces birth weight and increases disease risk in the offspring. This study investigated whether increasing maternal natural corticosterone levels, by endogenous stress or exogenous administration, alters fetal amino acid supply in the mouse.C57BL6/J dams (n=82) were exposed to daily restraint and subcutaneous saline injection (stress) or given corticosterone (cort, 82±11 &#...

Introduction: Methodological differences in the immunoassay measurement of cortisol are apparent when reviewing External Quality Assessment scheme data. A bimodal distribution is often observed, particularly for samples from female subjects. It has been postulated that some immunoassays are inefficient at removing cortisol from its binding proteins and therefore have the potential to under-recover from female samples. We investigated the results obtained from two immunoassays ...

Introduction: There has been much interest recently in measuring both salivary cortisol and cortisone due to the presence of 11β-hydroxysteroid dehydrogenase type 2 enzyme in the salivary glands. This enzyme facilitates the conversion of cortisol to cortisone; hence the concentration of cortisone in saliva may also be of interest. Studies have shown recently that salivary cortisone and cortisol are good markers of serum free cortisol status.Methods:...

The measurement of plasma renin activity is required in a number of clinical situations, in particular screening for primary aldosteronism (PA) and monitoring mineralocorticoid replacement therapy. PA is a treatable cause of hypertension and has an estimated prevalence of up to 20% amongst resistant hypertensives. Consequently, recent guidelines now recommend screening for PA in all patients groups with a high prevalence of PA. At present, the most reliable method of screening...

Introduction: It has been recognised in EQA schemes in Europe and America that the reproducibility between labs using LC–MS for testosterone analysis is not optimal for this technique. We decided to conduct a calibration exercise to investigate the variability seen between labs.Methods: Aqueous and matrix matched serum samples were sent to labs participating in the NEQAS testosterone scheme. The labs were asked to measure these samples blind using t...

Saliva contains the free unbound fraction of testosterone, which has been shown to correlate with the free circulating serum testosterone, and may better reflect the physiologically active form. Recently, measurement of free testosterone has gained international recommendations for the diagnosis of hypogonadism in the ageing male. Saliva collection is a non-invasive technique, offering more flexibility to the patient, e.g. the collection of samples at home. Liquid chromatograp...

Generalised resistance to glucocorticoid is a rare familial or sporadic disease with partial target tissue insensitivity to glucocorticoids. Compensatory activation of the hypothalamo–pituitary–adrenal axis occurs with raised andrenocorticotrophic (ACTH) hormone levels and increased synthesis of adrenal steroids. The phenotype varies from asymptomatic to excess glucocorticoid, mineralocorticoid and androgenic effects.A 20-year-old female was fo...