Endocrine Abstracts

Case history: A 38-year-old woman presented with blepharospasm, cramping of the hands, and paraesthesia primarily affecting the face and hands. Symptoms had been present for 10 years but had been progressive over the previous 12 months. Symptoms were consistent with neuromuscular instability. Hypocalcaemia and elevated Parathyroid hormone (PTH) were confirmed. Past medical history was notable for anorexia nervosa in remission. Family history was non-contributary. Hypocalcaemia...

Background: Prednisolone is the most commonly prescribed exogenous glucocorticoid(GC) and its use is frequently associated with the development of iatrogenic Cushing’s Syndrome. Once administered, prednisolone is rapidly converted to inactive prednisone by renal 11β-hydroxysteroid dehydrogenase type 2(11β-HSD2) and subsequently reactivated by 11β-HSD1. We have shown previously that 11β-HSD1 inhibition(with the selective 11β-HSD1 inhibitor, AZD4017...

Introduction: Hypophysitis (Hp) is a serious adverse effect (AE) of Immune check-point inhibitor (ICI) therapy in malignancy. We evaluated 6 yeas of clinical expereince with ICI against the recent ESE CPG 2023 which provides practical guidance on the management of this condition based on up-to-date evidence.Methods: A quality improvement project (QIP) included all patients with ICI-Hp (n=17) referred to a dedicated Endocrine-ICI clinic (January ...

Background and aims: HNF1A-MODY causes monogenic diabetes with a lean, insulin sensitive phenotype. Altered glucocorticoid (GC) metabolism has been implicated in the pathogenesis of type 2 diabetes (T2D) and inhibitors of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) which regenerates active cortisol from inactive cortisone have been trialled as a therapeutic approach. 11β-HSD1 is down-regulated in hepatocytes from Hnf1a knock-out mice but the role...

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is reported to be common in patients undergoing bariatric surgery, but the diagnostic accuracy of non-invasive NAFLD biomarkers to stage disease and track progress longitudinally has not been assessed.Methods: 274 patients undergoing bariatric surgery were included in the study. Intra-operative liver biopsies were taken from 163 patients and histologically graded using t...

Idiopathic intracranial hypertension (IIH) is a condition of unknown aetiology characterised by raised intracranial pressure, chronic headaches and blindness. Akin to polycystic ovary syndrome (PCOS), IIH patients are almost exclusively obese females of reproductive age. A distinct androgen excess profile has been noted in PCOS. Here, we aimed to delineate androgen metabolism in IIH compared to PCOS and simple obesity.Women w...

Background and aims: HNF1A-MODY causes monogenic diabetes with a lean, insulin sensitive phenotype. Altered glucocorticoid (GC) metabolism has been implicated in the pathogenesis of type 2 diabetes (T2D) and inhibitors of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) which regenerates active cortisol from inactive cortisone have been trialled as a therapeutic approach. 11β-HSD1 is down-regulated in hepatocytes from Hnf1a knock-out mice but the role...

Introduction: Non-Alcoholic Fatty Liver Disease (NAFLD) is reported to be common in patients undergoing bariatric surgery, but the diagnostic accuracy of non-invasive NAFLD biomarkers to stage disease and track progress longitudinally has not been assessed.Methods: 274 patients undergoing bariatric surgery were included in the study. Intra-operative liver biopsies were taken from 163 patients and histologically graded using t...

Idiopathic intracranial hypertension (IIH) is a condition of unknown aetiology characterised by raised intracranial pressure, chronic headaches and blindness. Akin to polycystic ovary syndrome (PCOS), IIH patients are almost exclusively obese females of reproductive age. A distinct androgen excess profile has been noted in PCOS. Here, we aimed to delineate androgen metabolism in IIH compared to PCOS and simple obesity.Women w...

The prevalence of metabolic syndrome and its hepatic manifestation, non-alcoholic fatty liver disease (NAFLD), continues to escalate. Glucocorticoids (GCs) and bile acids (BAs) are established regulators of metabolic phenotype. 5β-reductase (AKR1D1) is highly expressed in human and rodent liver, where it inactivates steroid hormones and catalyses a fundamental step in BA synthesis. We have previously demonstrated that AKR1D1 modulates hepatic GC availability and GC recept...