Endocrine Abstracts

Phaeochromocytomas (PCC) and paragangliomas (PGL) are rare tumours derived from the sympathetic or parasympathetic paraganglia. They characteristically secrete catecholamines (noradrenaline/adrenaline/dopamine), which are metabolised to the metanephrines (normetadrenaline/metadrenaline/3-MT respectively). These tumour markers can be detected in acidified 24-h urine collections as first-line investigative tests. Plasma 3-MT has been characterised as a biomarker of metastatic PG...

A 31-year gentleman presented with a four day history of anxiety and confusion. Over several months, he had noticed red eyes and a ‘stomach-ache’. A collateral history revealed a previous episode of confusion and concern about excessive alcohol intake. He denied any current medication. On examination, he had bilateral conjunctivitis. Investigations demonstrated severe hypercalcaemia of 3.54 mmol/l (NR 2.15–2.6 mmol/l). He was treated with intravenous fluids and ...

Hyperaldosteronism is a significant cause of secondary hypertension, but there are often delays in obtaining the diagnosis. The recent BES publication of Guidelines for the investigation and management of this condition represent a move to standardise the work-up of these patients.We present an audit of cases, dating back to 2000, with confirmed biochemical hyperaldosteronism (on the basis of plasma aldosterone/renin activity ratio or lack of aldosterone...

Pancreatic polypeptide (PP) is a 36 amino acid peptide, secreted from the endocrine pancreas. Previous work has shown that peripheral administration of PP inhibits food intake in rodents and humans. However, PP has a short circulating half-life that limits its use as an anti-obesity agent. Determining the mechanisms involved in the physiological breakdown of PP will allow the rational design of long-acting analogues with greater clinical utility in the treatment of obesity. PP...

A 30-year-old lady was transferred to our hospital at 37 weeks of pregnancy. Hypertension was noted at 24 weeks of gestation and managed with methyldopa and labetalol. Despite treatment, BP was labile with a systolic of 90–220 and diastolic of 50–129 mmHg. She reported occasional palpitations but not chest pain or shortness of breath. The patient had a history of migrainous headaches but not hypertension prior to pregnancy. Her brother had previously had an operation...

Primary hyperparathyroidism (HPT) in pregnancy is an uncommon phenomenon, mostly occurring in the 2nd or 3rd trimester. HPT in pregnancy may cause complications affecting both the mother (renal stones, pancreatitis) and fetus (neonatal tetany, seizures, intra-uterine growth retardation and preterm labour). We report two recent cases that highlight the potential risks.Results: The patients, 37 and 35 years old at presentation respectively, both presented ...

Prednisolone is widely prescribed in the UK, whereas prednisone is used instead for the same indications in the United States. Both have utility as anti-inflammatory agents and for use as glucocorticoid replacement therapy at lower doses. Oral prednisone is converted to prednisolone by first pass hepatic metabolism by 11 beta HSD-1. This study was undertaken to compare the bioavailability of prednisone against prednisolone. To determine the conversion of prednisone to predniso...

Background and Aim: Type 2 diabetes mellitus (T2DM) disparately affects ethnic groups. Prevalence is higher in Asian and Black ethnicities, and these patients suffer increased rates of some diabetes-related complications. Bariatric surgery is an effective treatment for T2DM and can lead to complete diabetes remission. The aim of this study was to assess if T2DM remission rates at 1-year following bariatric surgery vary between different ethnicities.Metho...

Background: Dexamethasone significantly improved outcomes in patients requiring supplementary oxygen and in ventilated patients with COVID-19 in the RECOVERY trial. Consequently, dexamethasone is now routinely used in these patients. However, dysglycaemia is commonly associated with steroid use and is an established risk factor for poorer outcomes in COVID-19. In this study, we aimed to elucidate the effect of dexamethasone use in patients hospitalised with COVID-19 in a real-...

Background: Non-alcoholic fatty liver disease (NAFLD), encompasses hepatic steatosis alone (NAFL), steatohepatitis (NASH), NAFL/NASH with fibrosis and cirrhosis. Severe fibrosis and cirrhosis are associated with increased risk of morbidity and mortality (due to cardiovascular events, end-stage liver failure and cancer). Postmenopausal women are a high-risk group of patients that have worse outcomes, but the specific factors that place them at higher risk are incompletely under...