Endocrine Abstracts

Chronic fatigue syndrome (CFS) is a common and disabling problem; although most likely of biopsychosocial origin, the nature of the pathophysiological components remains unclear. Most studied has been the hypothalamic-pituitary-adrenal (HPA) axis; although the quality of many studies is poor, the overall balance of evidence points to reduced cortisol output in at least some patients, with some evidence that this is linked to symptom production or persistence. However, there is...

Objectives: To define clinical and metabolic factors associated with severe hypoglycaemia (SH) in affected individuals with Type 1 diabetes (T1DM).Methods: Individuals with T1DM and SH (defined as hypoglycaemia requiring third party intervention within the preceding 12 months) were characterised to include screening for other underlying autoimmune disease (coeliac serology, short synacthen and thyroid function tests); a questionnaire to evaluate underlyi...

Subcutaneous heparin is commonly used for prophylaxis of deep vein thrombosis. Heparin induced hypoaldosteronism can lead to hyperkalemia and natriuresis. These side effects are more common in elderly, renal insufficient and diabetic patients. We present a case with heparin induced hyperkalemia in a patient with diabetes.An 85 year old lady with insulin dependent diabetes mellitus of 32 years duration with peripheral neuropathy was admitted under the vas...

Hypothalamic GnRH neuronal dysfunction is a frequent cause of hypogonadotrophic hypogonadism (HH) in women with secondary amenohrroea. However, the entity is poorly characterized in men, possibly due to lack of a sensitive equivalent clinical marker of the condition.A 40-year-old man presented with a 7-year history of progressive lack of energy, loss of libido, decreased sexual function, and loss of morning erections. Puberty had occurred normally and h...

Introduction: Nephrogenic diabetes insipidus is caused by a deficiency in the action of anti-diuretic hormone, and can be life threatening if not treated appropriately. Lithium is a commonly used mood stabiliser in psychiatry and is known to cause NDI in around 12% of patients. It has been reported in the literature that severe hyperglycemic state may trigger symptomatic lithium-induced NDI in patients who had been on prolonged lithium therapy.Case: We r...

Cutaneous and subcutaneous metastases are very rare in well differentiated neuroendocrine tumours with a handful of case reports available to date. Head & neck and bronchial NET seem to show this feature most commonly. Such metastases can be very painful and display allodynia (pain occurring on exposure to non-painful stimuli), even if growing very slowly. We describe the case of a young patient who underwent surgical resection of a typical bronchial NET who developed pain...

Background: Glutamic acid decarboxylase 65-kilodalton isoform (GAD65) antibody is a known to be present in inhibitory interneurons and pancreatic islet β-cells. Arino et al suggests that high levels of GAD65 present with neurological symptoms should prompt physicians to screen patients for occult cancer. The literature also suggests high GAD65 antibodies have been associated with various malignancies; although large studies are lacking. This research focuses on i...

A 43-year-old female presented to the endocrine clinic with a 6-month history of polyuria and polydipsia. Investigations revealed a raised prolactin and a water deprivation test confirmed cranial diabetes insipidus. Subsequent pituitary MRI showed a likely pituitary microadenoma which however on further radiology review was thought to represent a hypothalamic/stalk lesion measuring up to 5 mm. She was commenced on intranasal desmopressin and cabergoline initially. Repeat MRI 2...

Aims and objectives: This study was undertaken to look at the agreement between the hologic database (HD) based on NHANES bone mineral density (BMD) data in Caucasians and the ICMR database (ICMRD) published in 2010 in defining normal and subnormal BMD in subjects with or without hip fracture and to arrive at a BMD cut off which has a high sensitivity of predicting fracture.Materials and methods: A cross sectional study of 3098 subjects (men-341 and wome...

Introduction: In the year 2010, the Indian Council of Medical Research (ICMR) has published a normative data for mone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) scanning. However, its impact on the diagnosis of osteoporosis when compared to currently used Caucasian database has not been analysed.Objectives: To study the effect of the newly generated ICMR database (ICMRD) on the diagnosis of osteoporosis compared with the Hol...