Endocrine Abstracts

Background: Adrenocorticotrophic hormone (ACTH) measurements can help determine the cause of adrenal insufficiency (AI), but AI is diagnosed using peak cortisol levels following Synacthen stimulation, not ACTH levels. ACTH levels are high in primary and low in secondary and tertiary AI. Primary AI is rare in childhood. At Sheffield Children’s Hospital (SCH) ACTH is measured as part of screening for AI, paired with an early morning cortisol, and at baseline (0 minutes) as ...

A preterm baby was born at 23 weeks + 2 days gestation. She was managed on our tertiary care neonatal unit and remained ventilated for most of her stay. During her admission, she had recurrent episodes of clinically suspected NEC which were medically managed. Her feeds were discontinued on numerous occasions due to bilious aspirates, vomiting and abdominal distention. Given the patient’s clinical condition, a contrast study of the gastrointestinal tract was done using an enteral iodina...

A 50 years old man was seen in the Endocrine clinic with elevated calcium (2.80 mmol/l, normal 2.20-2.60) and Parathyroid hormone (10.7 pmol/l, normal 1.6-6.9) levels. His medical background includes Alport Syndrome, Renal Allografts (1st 1990, 2nd 2000 and 3rd 03/11/2005), and Osteopenia on DEXA scan in February 2020. He did not have any renal stones in the past. There was no family history of hypercalcemia. He was on Vitamin D 1000 Units daily (Vitamin D 55 nmol/l, normal 50...

Introduction: TSH-secreting pituitary adenomas (TSHomas) are rare pituitary tumours treated primarily with surgery; in cases of surgical failure, somatostatin analogue (SSA) or radiotherapy are further options. SSAs are rarely used as monotherapy; if responsive and in the absence of radiotherapy, the requirement of life-long medical treatment, is unknown. Herein, we present a patient with a TSHoma who remains in remission three years after SSA withdrawal.<p class="abstext"...

Introduction: The optimal management approach for incidental non-functioning pituitary microadenomas (micro-NFAs) is unclear. We aimed to capture current UK practice and identify changes following a 13-year interval.Methods: Two surveys on micro-NFAs were conducted in 2009 and 2022 (advertised by Society for Endocrinology). Hormonal/imaging evaluations were explored.Results: 2022: 150 clinicians participated. At baseline, ≥14...

Hypoparathyroidism causes severe hypocalcaemia and defective skeletal metabolism. Treatment with calcium and vitamin D supplementation can cause kidney failure whilst native parathyroid hormone (PTH) requires repeated injections and causes renal impairment paralleling high peak and low trough PTH levels. A long-acting PTH, providing constant physiological levels, is needed. LA-PTH, a hybrid of PTH and PTH related peptide, prolongs cAMP responses via altered receptor mechanisms...

Introduction: Leptin is a 16-kDa peptide hormone secreted by adipose tissue and acts as a sensor for energy stores. It feedsback at the hypothalamic arcuate nucleus to suppress appetite. Leptin treatment has been highly effective in suppressing appetite in the rare cases of leptin-deficient obesity and improving the metabolic profile in congenital generalised lipodystrophy. These patients require 2.5–10 mg once daily recombinant leptin treatment. We hypothesised that prol...

Objectives: Addison’s disease diagnostic and management challenges in Africa are not well documented. We aimed to identify the specific needs of patients with established Addison’s disease, across Africa.Methods: An online survey of a large pool of medical practitioners was undertaken. The questionnaire covered patient demographics, aetiology, therapy and limitations of diagnosis and treatment.Results: Of the 36,203 recip...

Background: The UK acromegaly register reported that <60% of acromegalics on medical therapy had controlled disease (1). Pegvisomant, a growth hormone antagonist (GHA), controls disease in >95% cases, but is not cost-effective and requires high dose daily injections (2). We have developed a fusion technology for making a cost-effective long-acting GH molecule (3), and generated a GHA by linking mutated growth hormone to its binding protein (GHBP).<p class="abstext"...

Background: The UK acromegaly register reported that <60% of acromegalics on medical therapy had controlled disease (1). This is because many patients do not respond to somatostatin therapy. Pegvisomant, a growth hormone antagonist (GHA), controls disease in >95% cases, but is not cost-effective and requires high dose daily injections (2). There is therefore an unmet need for a cost-effective GHA. We have developed a fusion technology for making a cost-effective long-a...