Endocrine Abstracts

A 70-year-old woman was referred to the endocrine clinic with recently diagnosed diabetes mellitus and poorly controlled systemic hypertension. At presentation she had clinical features of Cushing’s syndrome including central obesity, Cushingoid facies and marked proximal myopathy. BP was 220/190. Initial biochemistry revealed plasma sodium 140 mmol/l, potassium 3.6 mmol/l and creatinine 82 mmol/l. Overnight 1 mg dexamethasone suppression test revealed cortisol 1148 mmol/...

Introduction: The diagnosis of Cushing’s syndrome (CS) requires a screening test of high sensitivity, followed by biochemical evaluation aiming to identify the aetiology of hypercortisolism. The high-dose dexamethasone suppression test (HDDST) with the corticotropin-releasing hormone (CRH) test is commonly used for the differential diagnosis of ACTH-depended Cushing’s syndrome. However, the diagnostic utility of the HDDST has been questioned.Ai...

We report the management of 16 predominately elderly patients (12 female: 2 male; mean age at presentation 73.8 years, range 48 to 85 years) presenting with massive goitres. Seventy-five percent had significant co-morbidities. Fifteen had multinodular goitres and 1 Reidel’s thyroiditis. Four goitres were confined to the neck; 6 were intra-thoracic and 6 had both neck and intra-thoracic goitres. Five had symptoms of compression; 9 were thyrotoxic and 2 hypothyroid. Mean fo...

A 79-year-old lady presented with a 6 months history of confusion and slurred speech and was found to have recurrent spontaneous hypoglycaemia (plasma glucose 1.3, 1.8 and 2.6 mmol/l). Pituitary and adrenal function were normal, and raised insulin (102 pmol/l) and C-peptide (630 pmol/l) levels confirmed the diagnosis of insulinoma, which was identified as a solitary 2 cm mass in the head of pancreas. Treatment with diazoxide 100–150 mg tds led to normalisation of g...

Iodothyronamines are endogenous trace amines which are putative products of thyroid hormone decarboxylation by Aromatic Amino acid Decarboxylase (AADC). 3-Iodothyronamine (T1AM) has been shown to have profound effects on rodents in vivo, including reductions in body temperature, blood pressure and cardiac output, alongside a switch from carbohydrate to fat utilisation. It is possible that T1AM induces some of these effec...

Recent evidence suggests that endogenous glucocorticoids (GC) may be suppressed by adipocyte-derived leptin and elevated by dietary acidity. Therefore we examined whether these factors might be predictors of potentially bioactive free glucocorticoids independently of adrenocortical activity.Body composition, plasma cortisol, plasma leptin, 24-h urinary excretion rates of net acid (NAE) reflecting daily diet-dependent acid load, total nitrogen, urinary fr...

Melanocortin receptors (MCR), which belong to the superfamiliy of G protein-coupled receptors (GPCR), are preferentially coupled to Gs proteins and play a major role in the regulation of energy homeostasis. In line with this notion, mutations in the MC4R gene are the most frequent monogenic cause of severe obesity in human beings. Recently it has been shown that the MC4R receptor undergoes, similar to most GPCR, GPCR kinase (GRK) and arrestin-mediated ligand-promoted receptor ...

Background: Obesity pandemic continues to grow and currently bariatric surgery is the only interventional method proved to induce significant long-term weight reduction. The number of bariatric surgery has doubled in USA over the past decade. We present a case of adult onset nesidioblastosis, post gastric bypass.Case Summary: A 50 years old female who is 2 years status post Roux-en-Y gastric bypass was admitted to the hospital with a documented hypoglyce...

5 α-reductase deficiency is a rare autosomal recessive condition of male psuedohermaphroditism, resulting from mutations of the type 2 isoenzyme 5 α-reductase, crucial in conversion of testosterone to dihydrotestosteroneCase report: Baby P is a full term baby, a product of a consanguineous marriage. The baby had ambigous genitalia with a clitoris, minimal glans tissue at the apex of the labial folds, gonads in the labioscrotal folds and a ureth...

Clinical outcome and Implications for training in thyroid surgery in a district general HospitalAuthors: Rajashekhar Rao, Kanagaraj Marimuthu, and Paul ThomasObjective: To assess the volume of work outcome and training opportunity in adistrict general Hospital and compare with the BAES recommendationsMethods: Retrospective study, Patients identified by theatre records, pathology<p c...