Endocrine Abstracts

Background: Increased circulating bile acids may contribute to improved glucose control and augmented secretion of the gut hormones peptide tyrosine tyrosine (PYY) and glucagon-like peptide-1 (GLP-1) observed post-prandially in patients following bariatric surgery. Oral bile acids could represent a non-surgical means of improving glucose tolerance after a meal.Aim: To investigate the effects of a single oral dose of ursodeoxycholic acid (UDCA) and chenod...

Background: GLP-1/glucagon dual agonists are being developed as treatments for obesity due to their combined effect of reducing food intake while increase energy expenditure. Though the effect of the dual agonist on carbohydrate and lipid metabolism is well studied, little is known about the effects on protein metabolism. This study aimed to examine the acute and chronic effects of the GLP-1/glucagon dual agonist on amino acid metabolism.Methods: The lon...

Objective: Agranulocytosis is a rare but severe side effect of thionamide use in patients with hyperthyroidism. Treatment involves cessation of offending drug, treatment of sepsis, and the use of haematopoietic growth factors. Most patients recover uneventfully, and rarely present with further complications after treatment of the acute episode. We present a case report of suppurative lymphadenitis after treatment with granulocyte-stimulating factor (GCSF) and recovery from car...

Introduction: Disturbances in menstruation and fertility are often reported in women with chronic kidney disease (CKD), particularly in women undergoing dialysis treatment (CKD stage 5). Prolactin (Prl) seems to play a major role in this pathomechanism. However, there are only very few data on the gonadal axis and the androgen status in postmenopausal women with mild to moderate renal failure and in dialysis patients. Therefore, we prospectively studied the sex hormone profile...

Background: While psychiatric disturbances are well-documented manifestations of hypothyroidism, initiation of levothyroxine (LT4) therapy can also present in a similar manner.Case: A 34-year-old Filipino with Hashimoto’s thyroiditis consulted for signs and symptoms of hypothyroidism. Thyroid function tests were severely deranged, and an electrocardiogram revealed high grade atrioventricular block. Twenty-four hours after a full replaceme...

Introduction: Obstructive sleep apnoea (OSA) is common and frequently found in patients with obesity and type 2 diabetes mellitus. This case report shows the infrequently documented link between OSA and type 1 diabetes and highlights the need to confirm the type of diabetes especially in complex and atypical cases.Case report: A 44-year-old gentleman, with a BMI of 34, was diagnosed with type 2 diabetes and was treated with metformin and given lifestyle ...

Introduction: The recommended strategy for glycemic control among critically ill is i.v. insulin adjusted via a standardized insulin protocol. Critical to its success is acceptance of the implementing staff. In our hospital, we adapted and modified the Yale insulin infusion protocol (IIP). Evaluation of medical staff experience has not yet been done.Objectives: To evaluate medical staff experience and acceptance of the IIP through a survey and focused gr...

Introduction: The short synacthen test (SST) is commonly used to assess the hypothalamic pituitary adrenal (HPA) axis in clinical practice. We evaluated the underlying clinical conditions pre-empting the request for a SST in a general medical ward and the adequacy of clinical follow up of patients with suboptimal responses to the test.Methods: All patients with suboptimal SST results (30 min cortisol level 450–540 nmol/l) performed in the Acute Asse...

Background: Primary hyperparathyroidism (PHPT) and familial hypercalcaemic hypocalciuria (FHH) can both present with hypercalcaemia, but their management and prognosis are quite distinct. The 24 h urine calcium: creatinine clearance ratio (CCCR) is used to distinguish FHH from PHPT, where patients with FHH have a CCCR of <0.01. This study compares the use of a spot urine sample to measure CCCR with the gold-standard 24-h urine CCCR.Objective: To eval...

A 36-year-old man, presenting to his GP with severe intermittent headaches, was found to have a blood pressure of 210/110 mmHg. He had been diagnosed with familial adenomatous polyposis (FAP) in early childhood, and had had a total colectomy with ileo-rectal anastamosis at the age of 17. Routine surveillance CT imaging the following month revealed an incidental finding of bilateral adrenal masses (right 4×2 cm, left 2.7×2.9 cm).On assessment in...