Endocrine Abstracts

A 76-year-old lady with a background of Crohn’s disease (ileostomy in 1991) was referred to endocrinology in March 2022. Her 9-am cortisol level was <50 nmol/l, with a sodium of 130 mmol/l. These were done as she reported tiredness, lethargy and dizziness since November 2021. She had also lost 7 lb of weight. No evidence of hyperpigmentation. She had then been empirically started on hydrocortisone (10 mg-morning, 5 mg-afternoon and 5 mg-evening) pending evaluation of ...

Objective: Highlight hypertrophic pulmonary osteoarthropathy (HPOA) and partial HPOA as a cause for raised bony alkaline phosphatase (ALP).Case: We report the case of a 59-year-old lady who was referred to the endocrine clinic with 2 years history of bilateral leg pain and raised bony ALP. She denied any other symptoms. She had no past medical history. She was not on any regular medications and she has never smoked. Apart from mild tenderness over both l...

Reactive hypoglycaemia is usually mild, often presents with non-specific symptoms and may be difficult to distinguish from neuropsychiatric illnessThe diagnosis should be considered when these symptoms are related to eating. We present a severe case of idiopathic hypoglycaemia which responded dramatically to the alpha-glucosidase inhibitor acarbose.A 25 year old woman presented with a nine year history of intermittent thirst, feeling hot, distal paraesth...

In ovine placenta, binucleate cells (BNCs) are formed from trophectodermal uninucleate cells and produce placental lactogen (PL) and pregnancy associated glycoproteins (PAGs). BNC numbers cells are stable throughout most of pregnancy, yet fall abruptly just before term (Wooding et al., 1994), at a time when endogenous fetal cortisol levels are rising. This study looked at the effect of abolishing the normal prepartum cortisol rise by fetal adrenalectomy on the BNC population i...

A 60-year-old woman presented to the endocrine clinic with significant hirsutism and male-pattern baldness, progressive since the menopause 5 years earlier. She was otherwise fit and well. Testing revealed an elevated serum testosterone of 14.2 nmol/L. A CT scan revealed a large malignant 19 cm mass arising from the left adnexa, a large fibroid uterus and 2 small masses in the left kidney. Other abdominal organs were normal with no visible ascites. With the presumption of mali...

Differentiated thyroid cancer (DTC) is common in female patients of reproductive age and generally has a good prognosis and so many patients may become pregnant following treatment. Progression of DTC during pregnancy has been reported and may relate to thyroid stimulation by human chorionic gonadotropin (hCG). Until recently suppression of thyrotropin (TSH) by supraphysiological doses of levothyroxine was indicated for all patients following thyroidectomy and radioiodine abla...

Parathyroid hormone (PTH) secretion maintains extracellular calcium (Ca2+o) homeostasis under the control of the calcium-sensing receptor (CaR). Supra-physiological pHo changes (±1 pH unit) significantly alter CaR activity in a heterologous expression system. Interestingly, metabolic acidosis and hyperparathyroidism are concomitant in both ageing and chronic kidney disease. Therefore, here we examined whether smaller, pathophysiological pH...

Exposure to soy isoflavones (ISO), abundant in soy protein infant formula, during early postnatal life has benefits to bone health in female mice. Moreover, exposure during the first 10 or 21 days of life has been shown to interfere with structural development of female reproductive organs and results in heavier body weight. The study objective was to compare if shorter exposure to ISO, during the first 5 vs 10 days of life, results in lesser adverse effects on ovarian and ute...

Our patient presented at the age of 29 years with headaches and galactorrhoea and was found to have a prolactin level of more than 3000 mu/L. Her other pituitary function was normal. MRI pituitary showed 2×2 cm lesion with suprasellar extension and some distortion of the optic chiasm. She was started on Cabergoline 0.5 mg twice weekly for a presumed macroprolactinoma. Visual testing was normal. The repeat MRI four months after initiation of dopamine agonist therapy showed...

A 19 year old girl presented at 39 weeks gestation with headache and blurring of vision. MRI showed an enhancing pituitary mass measuring 1.2 cm maximum height, extending suprasellarly and distorting the optic chiasm. Visual field testing showed bilateral constriction. 0900 h cortisol was 502 nmol/l, thought to be relatively low for the stage of pregnancy and FT4 was 9.3 pmol/l suggesting TSH deficiency. Prolactin was appropriately raised for the gestational age at 4951 mU/l.<...