Endocrine Abstracts

A 79-year-old female patient, with a background history of hypertension and ischaemic heart disease was brought by ambulance to hospital with near collapse episode associated with capillary blood glucose (CBG) of 2.1 mmol/l. Her regular medications include Ramipril, clopidogrel and atorvastatin. She had no history of diabetes. While inpatient, it was observed that majority of low capillary blood glucose readings (CBG) were late night or early mornings. At venous glucose of 1.9...

A 57-year-old gentleman presented with bilateral painless submandibular swelling, and flu like symptoms. A biopsy from the enlarged submandibular gland showed chronic sclerosing sialadenitis with lymphocytic infiltration. Immunohistochemistry showed plasma cells positive for CD79a and IgG4, and a combination of CD4 and CD8 positive lymphocytes. IgG4 levels were significantly raised (3.16 g/l, NR <1.3 g/l). A diagnosis of IgG4 syndrome was made. Chest and abdominal CT imagi...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Many SSTs at Royal Bournemouth Hospital (RBH) are undertaken externally to the Bournemouth Diabetes and Endocrine Centre (BDEC). There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply. A 0900 h cortisol or random cortisol on acutely unwell patients can be sufficient ...

Background: Short Synacthen tests (SSTs) are used to assess adrenal function by injecting tetracosactide and measuring blood cortisol after 30 and 60 min. Accuracy of timing helps enable successful interpretation of results. A SST is an invasive test although it is normally well tolerated. There is an increasing cost-implication for undertaking SSTs exacerbated by recent problems with Synacthen supply.Method: We undertook a retrospective audit of 333 pat...

Introduction: Guidelines for the use of GH in GH deficient adults were issued by the UK National Institute for Clinical Excellence (NICE). To assess current practice in relation to these guidelines, a review of patients receiving GH treatment was performed. The aims were to i) assess if adults with GH deficiency met NICE criteria for GH therapy and ii) identify reasons for initiating or continuing GH treatment if NICE criteria were not met.Methods: Retro...

Primary pigmented nodular adrenal disease (PPNAD) is a form of bilateral adrenocortical hyperplasia characterised by small to normal sized adrenal glands containing multiple small cortical pigmented nodules1. It may occur independently, but 90% of cases are a manifestation of the Carney complex. Most cases of PPNAD are diagnosed before age 30, and are the result of a germline mutation in PRKAR1A or PDE11A, leading to upregulation of cAMP signalling. It is a cause of...

Introduction: The human masculinisation programming window (8–14 weeks of gestation) sees testis-derived androgen drive the foetus towards a male phenotype. However, there are few systematic studies of human foetal gonad development.Aim: To conduct a pilot analysis of the foetal gonadal proteome at the end of the masculinisation programming window (13–14 weeks of gestation).Methods: Twenty-eight electively terminated foet...

Background: Patients with Cushing’s syndrome (CS) in remission often suffer from impaired quality of life and cognitive dysfunction. Mental fatigue is characterized by mental exhaustion which appears especially during sensory stimulation or following mentally strenuous tasks. Other typical features are long recovery time for restoration of mental energy, irritability, impaired memory and concentration and sensitivity to stress, light and noise. The primary aim of this stu...

Tolvaptan (a V2 receptor antagonist) is licensed for correction of hyponatraemia in patients with SIADH at an initial dose of 15 mg od. Data in oncology patients with SIADH suggest 7.5 mg can safely and effectively increase sodium levels where 15 mg can on occasion lead to too rapid a correction. Recommendations suggest a repeat sodium taken at 4–6 h. We retrospectively assessed the safety and efficacy of intermittent out-patient dosing with 7.5 mg tolv...

Carney complex (CNC) is rare autosomal dominant disorder, which was firstly described as a combination of manifestation of myxomas, spotty skin pigmentation and endocrine overactivity in 1985. This condition affects many organs and varies in clinical manifestation. The presence of at least two clinical signs is considered as pathognomonic with regard to a sporadic form of CNC, and an evidence of at least one sign with simultaneous manifestation of CNC in any of first degree re...