Endocrine Abstracts

CIDEC is a lipid droplet-targeting protein that promotes triglyceride accumulation and inhibits lipolysis. CIDEC is regulated by peroxisome proliferator-activated receptor γ (PPARγ). Previous studies demonstrate that CIDEC down-regulation is involved in TNFα-induced lipolysis. Here, we focus on the signalling pathway to clarify the mechanism of TNFα-mediated CIDEC down-regulation. CIDEC is significantly decreased in subcutaneous adipose tissue in obese subj...

Introduction: We report a patient with hypercalcaemia secondary to parathyroid hormone related peptide (PTHrp) from metastatic oesophageal cancer and co-existing primary hyperparathyroidism.Case report: A 52-year-old lady was admitted to the hospital with a 2-week history of right scapula pain, reduced appetite and weight loss.Blood test revealed an adjusted calcium of 3.99 nmol/l (NR 2.1–2.55 nmol/l), PTH of 147 ng/l (NR 15&#...

Introduction: Hypoglycaemia in a non-diabetic patient is not a common condition and is often a diagnostic challenge.Case report: A 78-year-old gentleman was admitted to hospital by paramedics when his neighbours found him unresponsive. He had a background history of primary hypothyroidism. Capillary blood glucose reading done on site was 1.0 mmol/l. He received intravenous glucose which resulted in prompt recovery. All other vital signs were normal.<...

Introduction: Hypercalcaemia is a frequent complication of breast cancer with bony metastasis. There is also an increase incidence of primary hyperparathyroidism among patients with breast cancer. We report a patient with breast cancer presenting with hypercalcaemia secondary to both parathyroid hormone- related peptide (PTHrP) from liver metastasis and possibly co-existing primary hyperparathyroidism.Case report: A 53 year old woman, with a history of r...

When investigating patients for possible Cushing’s, repeat testing should be considered despite initial negative results if there is a high index of suspicion. We report a case of a patient whose initial tests for Cushing’s yielded conflicting results; cyclical Cushing’s Disease was diagnosed following persistent testing. A 40 year-old lady (BMI 38.0 kg/m2) was seen in the obesity clinic with a 12-month history of weight gain. She had clinical feature...

Introduction: Hypoglycaemia is a common event encountered in patients with type 1 diabetes usually due to an imbalance between diabetic therapy, activity level and dietary intake.Case: We report a case of a 31-year old lady with 20-year history of type 1 diabetes on basal-bolus regimen of insulin, who presented with a 2 month history of secondary amenorrhoea and recurrent disabling hypoglycaemia despite significant reduction in insulin doses. Clinical ex...

Patients with acromegaly have characteristic clinical features of soft tissue overgrowth. Both somatic and metabolic features of acromegaly are secondary to excess GH secretion and high circulating levels of insulin-like growth factor 1 (IGF1). However, an acromegaloid phenotype associated with severe insulin resistance is occasionally seen in the absence of biochemical hallmarks of acromegaly (insulin-mediated pseudoacromegaly). Here we present a case of ‘insulin-mediate...

Introduction: Meningitis is a recognized complication of the treatment of pituitary adenoma. It is usually considered as a peri-operative problem but does need to be considered as a potential complication at other points in the treatment pathway. We present two patients with meningitis where the link to pituitary pathology was originally unrecognized.Case report:Patient 2: 41 years old lady, presented with a history of nasal drip u...

Introduction: Turner Syndrome is a chromosomal disorder that is characterized by short stature and gonadal dysgenesis, affecting 1 in 2500 female live births. It is associated with a wide variety of conditions that could lead to significant morbidity and mortality if not followed up and managed appropriately. A multidisciplinary approach is important in the management of these patients. This audit aims to review the current practice of a specialist Turners Syndrome clinic in a...

Background: Short Synacthen Tests (SSTs) are integral to the diagnosis of Adrenal Insufficiency (AI). A 30-minute stimulated cortisol value is assessed against local assay dependent thresholds to ascertain or exclude the diagnosis. A diagnosis of AI is a life changing event requiring the initiation of life long glucocorticoid replacement therapy for survival. Glucocorticoid replacement is associated with long term morbidity and mortality, including an increased risk of diabete...