Endocrine Abstracts

Renalase is a recently discovered flavin adenine dinucleotide (FAD)-dependent oxidase, predominantly secreted into the circulation from the kidney and regulates catecholamine degradation and metabolism. Renalase gene is also present in heart muscle, skeletal muscle and liver cells in humans, and in mouse testicles. Four isoforms of renalase gene has been identified in humans (hRenalase1 to hRenalase4), however only hRenalase1 is detected in human blood suggesting that hRenalas...

Introduction: Extrapulmonary manifestations of tuberculosis can cause a diverse range of atypical presentations, depending on the system involved. Involvement of lymph nodes, pleura, central nervous system and bone are some of the organs that are well-described in the literature. This leads to a diverse range of presentations which can misguide diagnosis unless there is a high index of suspicion. Endocrinological manifestations are rare, but can occur uponhaematogenous dissemi...

Cabergoline has long been used to treat prolactinomas for symptomatic, radiological and biochemical resolution of pituitary tumours. As clinicians we are well-versed at screening for physical side effects, but are we holistic enough? We present two cases illustrating the damaging social consequences of cabergoline treatment for prolactinomas.Case 1A 49-year-old married father of two presented with a seizure in April 2018. MRI showe...

Introduction: Hyponatraemia is the commonest electrolyte disturbance occurring in 15–20% of inpatients (1), with significant clinical implications if mismanaged. We conducted a retrospective audit of our current management of hyponatraemia in our 1000 bedded trust.Method: Data of patients with severe hyponatraemia (Na<125 mmol/l) admitted to hospital over 4 weeks (Aug 2011) was collected. Twenty randomly selected cases were reviewed focusing on ...

Introduction: Insulinomas are the most common, functioning, pancreatic neuro-endocrine tumours. The minority of patients <10% who present with metastatic disease have a median survival of <2 years.We present a case of a gentleman with a 30 years history of Multiple Endocrine neoplasia type 1 (MEN1), which highlights the various modalities of treatment and the challenges from his progressive disease and marked symptomatic hypoglycaemia.<p clas...

Lithium increases retention of Iodine-131 in the thyroid gland and inhibits thyroid hormone release following radioactive iodine (RAI) administration. However, outcomes of studies of the effects of lithium on the efficacy of RAI are conflicting. The aim of this study was to assess whether adjuvant lithium increases the efficacy of RAI treatment in hyperthyroidism. A retrospective cohort study was performed of 204 hyperthyroid patients (163 Graves’ disease, 26 toxic multin...

Introduction: Congenital hyperinsulinism (CHI) is a rare condition of dysregulated insulin secretion causing hypoglycaemia. Oral Diazoxide is used as first line therapy for CHI. In those who are Diazoxide unresponsive, subcutaneous Octreotide is used as second line treatment. Octreotide has recognised side effects of biliary stasis. Additionally, we report hepatitis as a complication of Octreotide therapy in a child with CHI.Case report: A neonate with C...

Introduction: Congenital hyperinsulinism (CHI) is characterised by abnormally regulated and excessive insulin secretion by pancreatic β cells. First line management includes an oral suspension of Diazoxide but a standardised formulation is not universally employed. Anecdotal evidence suggests that different formulations can alter the management of glucose levels. Lack of glucose control can lead to permanent brain damage and adversely affect neuro development.<p class...

Cardiovascular disease and diastolic hypertension are major causes of morbidity in Cushing’s although left ventricular failure is more rarely described. There are three other cases of documented dilated cardiomyopathy with subsequent left ventricular failure.Thirty-five year old lady who presented with obesity and striae was found to have a suppressed ACTH, elevated cortisol (914 post dexamethasone suppression test) and a right adrenal adenoma (on C...

In humans, androgen synthesis crucially depends on the enzyme CYP17A1 expressed in adrenals and gonads. The 17,20 lyase activity of CYP17A1 catalyses the key step in human androgen biosynthesis, the conversion of 17-hydroxypregnenolone to the universal sex steroid precursor dehydroepiandrosterone (DHEA). For its catalytic activity, CYP17A1 requires electron transfer from P450 oxidoreductase (POR). Mutations in CYP17A1 and POR are known to disrupt human androgen s...