Endocrine Abstracts

Introduction: Hypocalcemia in post-operative hypoparathyroidism responds to oral vitamin D and calcium replacement. We describe a case of persistent symptomatic hypocalcemia and hypothyroidism despite oral replacement and management with supervised weekly supplementation.Case history: A 56-year-old lady had total thyroidectomy for multinodular goitre. Persistent post-operative hypoparathyroidism and hypothyroidism necessitated replacement with calcitriol...

History: A 27-year-old woman with a background of HIV presented to the GUM department with sudden onset of weight gain (approximately five stones over 3 months). She had been started on kaletra (Lopinavir with Ritonavir) for her HIV, about 11 months previously, while she was on fluticasone (seretide) for her asthma. Clinically, she had a cushingoid appearance with extensive purplish striae marks over her abdomen and arms. Her Seretide was stopped and changed to ventolin- due t...

Background: Infants born small for gestational age (SGA) usually show catch-up growth during the first few years of post-natal life. However, some infants remain small and little is known about the factors governing their growth failure. IGF-I receptor mutations account for a minority of cases therefore we have initiated an assessment of signalling molecules downstream of the receptor.Method: Skin biopsies were obtained with local ethics approval from he...

Thyroid hormone (TH) regulation of hypothalamic function has been extensively investigated. It is driven, in part, by the presence of deiodinase enzymes in tanycytes surrounding the third ventricle converting T4 to active T3. Retinoic acid (RA), the transcriptionally active form of Vitamin A, has not previously been considered to be an important part of hypothalamic regulation. Data presented here highlights novel parallels between the TH and RA synthetic...

Topical glucocorticoid therapy causes adverse effects in human skin including a reduction in dermal fibroblast proliferation and extracellular matrix protein secretion (e.g. collagen 1) and epidermal thinning – effects paralleled in photoexposed and elderly skin. These cause reduced wound healing rates and a loss of elasticity with increased fragility and transepidermal water loss – signs also typical of Cushing’s syndrome characterised by raised circulating cor...

We have collected an extensive record of more than 8000 patients with a thyroid carcinoma over the years 1946–2005. In all cases, the diagnosis was done by the histology examination carried by a pathologist. Those records were classified by their dimension and the extent of the thyroid gland. This classification is used as a basis for the treatment decision. Tumors of the bigger size needs radiotherapy with I 131 whereas the smaller tumors are subject of observation and r...

Background: Most patients consulting an endocrinologist for hypercalcemia suffer from primary hyperparathyroidism. Rarely, toxic vitamin D levels can also induce hypercalcemia while suppressing parathyroid hormone (PTH) levels. Infantile hypercalcemia can be caused by mutations in CYP24A1 (24-hydroxylase), which are inherited in an autosomal recessive manner (1). This enzyme is responsible for the inactivation of 25-OH-vitaminD (25-OHD) and 1,25(OH)2vitaminD3</...

Adrenal suppression and iatrogenic Cushing’s secondary to concomitant inhaled steroid and itraconazole is a potentially common and serious drug interaction. A 55 year old patient with bronchiectasis and asthma developed an exacerbation of allergic bronchopulmonary aspergillosis (ABPA). He had been on inhaled fluticasone for over 2 years. He was commenced on itraconazole. The patient was on holiday 6 weeks after itraconazole was commenced when he noted that his face had be...

Background: Transient Receptor Potential (TRP) channels are expressed in many epithelial cells and respond to mechanical or osmotic stress by initiating a number of calcium-dependent mechanisms. The human serum and glucocorticoid regulated kinase (hSGK) is one such calcium-dependent protein found in the kidney. Stimulated by cell shrinkage, this volume-regulated kinase stimulates sodium transport. Aberrant absorption of sodium has been implicated in the development of hyperten...

Animal studies suggest that circulating IGF-1 concentrations are influenced by hypoxia. To test whether a similar situation pertains in humans we related cord IGF-1 concentrations to cord pH in the babies of 1650 Caucasian mothers delivering at term. All pregnancies were singleton and antenatal growth and uterine blood flow was assessed at 20 and 32 weeks gestation. Hypoxia was chronic if associated with preeclampsia in non-smokers and acute based on cord pH. Effects of cigare...