Endocrine Abstracts

We report two cases of hypernatraemia with reset osmostat and pituitary dysfunction.A 35-year-old male was referred with Graves’ thyrotoxicosis associated with hypokalaemic periodic paralysis and an incidental serum sodium 154 mmol/l. He complained of polyuria and nocturia but denied excessive thirst and was otherwise well. Height was 193 cm with BMI 29.5. He had gynaecomastia and sparse body hair. He had a small 6 ml right testicle (originally und...

A forty-three year old woman (SR) presented to her GP in 2004 with persistent back pain. Following MRI, an incidental right adrenal mass was discovered. Laparoscopic adrenalectomy was performed in the private sector and histology was consistent with a phaeochromocytoma. No further biochemical investigations were performed at that stage. Six years later, her fourteen year old daughter presented with a solitary neck lump. Fine needle aspiration was inconclusive and subsequent le...

Introduction: Leptin is a pro-inflammatory cytokine and excess leptin in obesity may induce autoimmune disease. The suppressors of cytokine signalling (SOCS) are negative regulators of cytokine signalling and therefore a target for therapy. SOCS3 modulates leptin actions but there is no data regarding other SOCS proteins and leptin signalling.Aim: To develop a bioassay and examine the actions of SOCS proteins on leptin signalling.M...

QLS-H is a new, weighted QoL questionnaire developed for patients with hypopituitarism. We evaluated QLS-H data from UK patients in the HypoCCs International surveillance study, and compared results with a sample of the general UK population (n=1090).The QLS-H questionnaire was administered at baseline and at yearly intervals. Scores were corrected for age and gender differences, and expressed as Z-scores based on UK-specific reference ranges. Using this...

For many animals anticipation of future changes in environmental conditions is a critical adaptation for survival. Seasonal changes in reproductive activity, body weight and adiposity, metabolism and coat condition are examples of such adaptive physiology. Clearly each of these involves neuroendocrine control. The environmental cue that triggers these changes is photoperiod, which is translated into the hormonal signal, melatonin, a product of the pineal gland. A considerable ...

The development of the growth hormone antagonist, Pegvisomant, is a story of modern drug design. The original observation was by John Kopchick, who noted that transgenic mice with a mutation in the third alpha helix of the GH molecule had a dwarf phenotype. This is the basis for the site 2 mutation (G120K) in the GH molecule that blocks GH signaling. At the same time the Genetech group of James Wells had characterised the crystal structure of the GH/receptor complex demonstrat...

In January 2023 a Medicines Supply Notification (MSN) was issued by the Department of Health and Social Care (DHSC) regarding a shortage of Norditropin (somatropin) products. The MSN recommended that all patients on Norditropin FlexPro 10mg pens and NordiFlex pens (all strengths) be changed to Omnitrope SurePal. Each patient affected by the shortage needed to be informed of the issue, a new prescription issued, and training provided on the new device. Affected patients were id...

Background: Cortisol is an essential stress hormone and deficient patients suffering a systemic inflammatory response (SIR) will rapidly die if not replaced. However, controversy remains on the definition for a normal adrenal response in critically ill patients. We investigated cortisol status in patients undergoing coronary artery bypass surgery (CABG), surgery frequently associated with a SIR, varying in severity from sub-clinical, to life-threatening....

Background: The current screening test for adrenal insufficiency (AI) involves patients attending hospital for an “early” morning serum cortisol sample, generally taken some considerable time after the child has woken. This risks missing the morning cortisol peak, leading to false positive results. It requires venepuncture, which is unpleasant for children. Saliva collection is non-invasive, simple and can be undertaken on waking at home, providing a...

Background: Primary hyperaldosteronism (PHA) typically manifests as resistant hypertension, hypokalaemia and metabolic alkalosis. We present a case of PHA who subsequently exposed type 4 renal tubular acidosis (RTA) after surgical intervention.Case history: A 62 year old man underwent investigation for chronic resistant hypertension, which had failed to respond to titration of three antihypertensive agents including Perindopril, Amlodipine and Doxazosin....