Endocrine Abstracts

Congenital Hyperinsulinism (CHI), a common cause of persistent hypoglycaemia in infancy can be associated with feeding problems (FP). The extent of FP in CHI is not known. The commonest genetic cause of CHI is mutations in ATP-sensitive potassium (K+ATP) channel genes (ABCC8 and KCNJ11).Aims: To define FP in CHI patients presenting to a regional centre, in relation to medication and K+ATP ...

Background: The BTA guidelines for the use of thyroid function tests recommend the measurement of TSH receptor antibodies (TRAb) when investigating hyperthyroidism of uncertain aetiology, in suspected Graves’ ophthalmopathy and in pregnant women with Graves’ disease. An in-house TSH receptor autoantibody ELISA assay (TRAb) was introduced in 2008. This study has audited the assay performance and evaluated its clinical usefulness in a tertiary centre.<p class="abst...

Objective: To evaluate whether patients with congenital adrenal hyperplasia (CAH) have been successfully transitioned to adult endocrine care.Methods: All patients with CAH who had attended the paediatric adrenal clinic at RMCH and were currently between 16 and 30 years of age were identified. Current status of adult endocrine care was recorded.Results: Sixty-eight patients were identified. There was inadequate information on 16 pa...

In severe CHI which is unresponsive to medical therapy, pancreatic resection is undertaken to prevent further hypoglycaemia from dysregulated beta-cell insulin secretion. Traditionally, 95% subtotal pancreatectomy has been the surgery of choice (Lovvorn et al. 1999), with associated risks of post-operative complications such as lifelong diabetes and malabsorption. Since the introduction of 18F-DOPA PET-CT imaging, clinicians have been able to effectively differentia...

Objective: The adipocytokine visfatin, expressed in abdominal adipose tissue (AT) is thought to mimic insulin activity. However, whilst central adiposity is closely related to insulin resistance (IR) and T2DM, visfatins’ role in the development of these conditions remains unclear.Method: We investigated circulating visfatin levels in non-diabetic (ND) and diabetic (T2DM) subjects and in T2DM patients pre- and post- rosiglitazone (RSG) treatment. We ...

Introduction: Compared to ethnically European men, Pakistani origin men living in the UK have a lower circulating total and free testosterone level, corresponding with greater central adiposity and higher insulin resistance. Within a South Asian group we have now examined the effect of migration to the UK on male testosterone level.Methods: Circulating testosterone concentration was measured by automated immunoassay in 97 Gujarati males resident in India...

Mutation of the GPR54 receptor is associated with a failure of reproductive function. The endogenous neuropeptide agonist for GPR54, kisspeptin, potently stimulates the hypothalamic-pituitary-gonadal (HPG) axis in rodents and primates.Objective: The present study was designed to determine the effects of elevating circulating kisspeptin levels on LH, FSH and testosterone in male volunteers.Method: Study (i) Volunteers were infused w...

Increased hypothalamic-pituitary-adrenal (HPA) activity in the fetus is a consistent event across different animal species, including the human. Fetal HPA activation contributes both to maturation of organ systems required for extra-uterine life and provides the trigger for the birth process. Precocious activation of the fetal HPA axis, for example in response to an adverse intrauterine environment or periconceptual undernutrition may result in increased incidence of preterm b...

IntroductionLithium remains a first-line treatment for several mental disorders.Hypercalcaemia has been associated with long-term lithium treatment, yet it is often unrecognized. The manifestations of hypercalcaemia can develop insidiously and mimic psychiatric disturbances.CasesCase Report 1 – A 53-year-old Caucasian gentlemen referred by his GP following routine bloods with an adjusted calcium of 3.46 ...

Paradoxical severe hypercalcemia is a rare phenomenon observed in some patients in delayed phase following rhabdomyolysis. We present a case of 33-year-old male who developed severe hypercalcemia following successful treatment of rhabdomyolysis. Patient was admitted with agitation and disinhibition, was intubated in A&E due to metabolic acidosis (pH 6.7), hyperkalemia (K+ 7.3 mmol/l), lactic acidosis (23 mmol/l), and pyrexia (40°C). Toxicology screening shown presence...