Endocrine Abstracts

Ketosis-prone, Jamaica (J) type diabetes is an uncommon form of diabetes described in a sub-population of mainly Afro-Caribbean patients who often present acutely with diabetic ketoacidosis (DKA) but during follow up demonstrate clinical, metabolic, and immunologic features of Type II diabetes. We present such a case.A 37-year old Afro-Caribbean man with a family history of Type II diabetes presented with polyuria, polydipsia and weight loss. He was over...

Background and aims: Subjects with primary (PAI) and secondary adrenal insufficiency (SAI)/hypopituitarism have an increased cardiovascular mortality for reasons that are unclear. Arterial stiffness is an independent risk factor for increased cardiovascular mortality. We sought to measure arterial stiffness in subjects with AI and aimed to identify which factors might account for any increase observed.Methods: Ethical approval was obtained for this study...

Background: CB1 antagonism has potential benefits in the metabolic syndrome, with effects mediated through central orexigenic mechanisms and peripheral action on adipose tissue. We have previously demonstrated the inhibitory effects of CB1 inactivation on preadipocyte proliferation and now extend these studies to in vitro adipogenesis.Aims: To compare the effects of CB1 agonism and antagonism on differentiation in both preadipocyte cell lines and ...

Neuroendocrine tumours of the GI tract originate from enterochromaffin cells. Somatostatin analogues are the mainstay drugs for therapy in these cancers as they ameliorate symptoms and lower hormone secretion, but only in 30–70% of patients. Such tumours are also associated with angiogenesis which has been used as a prognostic indicator; adenosine, the major regulator of angiogenesis, is released by enhanced degradation of ATP, during cellular stress, damage and hypoxia.<...

Background: Chromogranin A and B (CgA, CgB) are widely used as markers of neuroendocrine tumour (NET) disease. However, the sensitivity of the test is variable and the value of CgB measurement is unclear. We thus sought to review 3 years of CgA and CgB requests made in our hospital.Methods: CgA and CgB were measured at the Hammersmith Hospital. Case notes were reviewed in each of these patients.Results: There were 520 tests perform...

Dehydroepiandrosterone (DHEA) is an adrenal sex steroid whose levels decline during normal aging. Epidemiological studies demonstrate inverse correlation between circulating DHEA-sulphate and body fat mass while DHEA administration in elderly subjects reduces visceral and subcutaneous fat accumulation. Although previous studies have shown that some effects may be mediated via DHEA-induced inhibition of white pre-adipocyte proliferation, mechanisms remain unknown. Furthermore, ...

A 14 year old girl, with a family history of MEN1, presented with secondary amenorrhoea and weight gain. Biochemical investigation revealed raised 24-hour urinary free cortisol excretions (1455, 1190, 614 nmol/24 hours; normal <290) and failure of cortisol suppression following 48 hours of low dose (0.5 mg qds) dexamethasone (199 nmol/l to 202 nmol/l). High dose dexamethasone administration (2 mg qds) for 48 hours resulted in further suppression of serum cortisol to 49 nmo...

A 40 year old gentleman presented with dramatic weight loss and a rash in the perineal area spreading to involve his face, trunk, legs and feet. Initial investigations demonstrated a normocytic anaemia with no evidence of thyroid disease or diabetes. Occasional diarrhoea prompted subsequent investigations including upper GI endoscopy, duodenal biopsy, pancreatic exocrine testing and barium follow-through studies which were normal. His 24 hour urinary 5-hydroxyindoleacetic acid...

Introduction: The biochemical diagnosis of acromegaly is based on elevated plasma growth hormone (GH) that fail to suppress after an oral glucose load. Elevated insulin like growth factor 1 (IGF1) supports the diagnosis. Traditionally GH level of less than 2 miliunits per litre rules out acromegaly. With advent of recent sensitive GH assays, lower levels of GH are increasingly being recognized. We describe a case of acromegaly which differed from the traditional presentation.<...

We present two patients who were originally diagnosed with polycystic ovarian syndrome (PCOS). A 23 year old was referred with deteriorating hirsutism. Her menstrual cycle was reported as entirely regular following the menarche at age 13. Examination revealed her to be obese with a body mass index of 33 and hirsute, with a Ferriman and Gallway score of 19. She had a typical PCOS appearance on trans-vaginal ultrasound scan. Additional investigations in endocrine clinic revealed...