Endocrine Abstracts

The glucocorticoid receptor is constitutively expressed and fundamental to life. Activity of GR is partially governed by interacting partners whose actions skew the frequency with which GR produces meaningful transcriptional outcomes. Moreover, the tissue-specific actions of GR are themselves defined, with binding patterns being distinct in various tissue types. These features mean full molecular understanding of this steroid hormone receptor remains incomplete. As glucocortic...

A 43-year-old gentleman with no known medical illnesses presented with progressive abdominal distension and pain. This happened following a fall from 2-metre height with direct impact on his abdomen. On examination he had signs of abdominal peritonism and was managed as a trauma case. He was haemodynamically stable. CT of his abdomen showed suspected large pancreatic haematoma, consistent with significant pancreatic injury with no evidence of active haemorrhage or pancreatitis...

Introduction: Thyroid dysfunction is one of the commonest endocrine disorders with hypothyroidism being the most common thyroid dysfunction in the elderly population[1]. An elderly patient with thyroid dysfunction can be asymptomatic, or present with non-specific symptoms, making biochemical testing of thyroid function useful and essential. We reviewed the screening rate and prevalence of thyroid dysfunction in older medical patient patients admitted to an Irish sec...

Background: Increased endogenous post-prandial GLP-1 release is a key mediator of improved glycaemic control following Roux-en-Y gastric bypass (RYGB) surgery. GLP-1 receptor agonists (GLP-1 RA) augment glucose-stimulated-insulin-release and suppress glucagon release, and do not usually cause hypoglycaemia. The use of GLP-1 RA have been shown to be safe for patients requiring additional glycaemic control following RYGB. We present a case of severe recurrent fasting nocturnal h...

Case history: A 22-year-old woman presented with a week’s history of abdominal pain and constipation. further history revealed episodes of tachycardia during childhood but no cause at that time was identified. On examination she had a sinus tachycardia, her abdomen was mildly tender and the rest of her clinical examination was completely unremarkable, including blood pressure, and there were no clinical findings consistent with Addisonian crisis.Inv...

Africo Caribbean gentleman was referred to our endocrine department for management of secondary hypertension. He initially presented to his doctor with headache and he was found to be hypertensive with systolic BP of 200 mmHg and hypokalaemia. A renal MRI showed a right adrenal mass, 2.9×2.4 cm, and echocardiogram showed moderate left ventricular hypertrophy and diastolic dysfunction. He had normal 24 h excretion of metanephrines and free cortisol. An aldosterone renin ra...

Introduction: Misdiagnosis of secondary hypocortisolaemia can have profound consequences on a patient’s life. Due to contraindications the gold standard dynamic diagnostic test of cortisol reserve – the insulin tolerance test (ITT) – may not always be suitable. Here we examine the diagnostic accuracy of the second line dynamic tests: the overnight metyrapone test (OMT), short synacthen test (SST) and glucagon stimulation test (GST).Patient...

Background: Hyperprolactinaemia is common in patients presenting with polycystic ovary syndrome (PCOS). Recent studies suggest that each condition has an independent aetiology, hence appropriate investigation of hyperprolactinaemia in the context of PCOS is required, for which separate treatment may then be provided. Appropriate investigation includes a serum macroprolactin screen, a specific drug history for drug-induced hyperprolactinaemia (DIH), blood tests to exclude secon...

Introduction: Chemerin is a pro-inflammatory adipokine, which has been shown as a mediator between obesity and metabolic syndrome (MetS). The aim of this study was to evaluate the associations of chemerin with insulin resistance and the effects of lifestyle interventions on circulating chemerin levels in Chinese obese children.Methods: A cross-sectional study was conducted among 225 obese children (101 with MetS and 124 without MetS) and 119 lean control...

Introduction: Insulin stress test (IST) has long been the gold standard for testing the hypothalamus-pituitary–adrenal (HPA) axis. There are concerns about the safety of IST as hypoglycaemia can give rise to various symptoms including seizure and coma although this is rarely seen in clinical practice. Hyperinsulinaemic hypoglycaemic clamp is a common research procedure used to induce hypoglycaemia in a step-wise fashion to study the effect of hypoglycaemia.<p class="a...