Endocrine Abstracts

Introduction: The first multi-center randomised trial looking at the efficacy and safety of Insulin Aspart, a faster acting insulin which aims to mimic endogenous prandial insulin action, was published in May 2019. We report our experience of using Insulin Aspart in the Norfolk and Norwich University Hospital children’s diabetes clinic.Methods: Children and young people with type 1 diabetes seen the Norfolk and Norwich paediatric diabetes service (t...

Background: UK South Asians (SA) are at risk of vitamin D deficiency (VDD, defined as 25-OH vitamin D <25 nmol/l) and insufficiency (VDI, 25-OH vitamin D 25–49 nmol/l), which increases the risk of metabolic bone disease. As VDD and VDI are often asymptomatic, many individuals will be unaware of this metabolic abnormality. As there is little information on how to detect VDD/VDI in the community, we wished to investigate if they were identified more effectively using ei...

Objective: To evaluate the outcome of preoperative therapy with ketoconazole (KTZ) and/or metyrapone (MTP), in previously untreated CS patients who later underwent surgery.Design and methods: A total of 62 CS patients (85% ACTH-dependent), who have been treated with steroidogenesis inhibitors prior to surgery in our centre between 1983 and 2010, were retrospectively studied. T0 and t1 defined visit at baseline and at the end of medical treatment, respect...

Introduction: Significant hyponatraemia (serum sodium <128 mmol/l) is a potentially modifiable cause of prolonged hospital length of stay (LOS). By correcting euvolaemic hyponatraemia more rapidly than imposed fluid restriction, vasopressin receptor-2 antagonists may be useful adjuncts to existing treatments.Aim: To explore the potential clinical utility of vasopressin antagonists by describing the frequency and nature of hyponatraemia typically enco...

Introduction: The Gli-family of zinc-finger transcription factors regulates the Sonic Hedgehog (Shh) signalling pathway, critical for normal CNS development. Gli2 is essential for early pituitary and ventral forebrain development in mice, with mutations described in humans with holoprosencephaly (HPE), isolated hypopituitarism (HP) and cranial/midline facial defects. SHH mutations have been associated with phenotypes including HPE but not HP, despite murine studi...

Background: Prolactin concentration is frequently measured as part pituitary function assessment, however there is little published data regarding result interpretation.Objective: To compare serum prolactin concentrations in children with isolated GH deficiency (IGHD), multiple pituitary hormone deficiency (MPHD) and septo-optic dysplasia (SOD).Methods: Patients were assigned to the appropriate study group based on the results of t...

Case: A 73-year-old lady presented with hyponatraemia six days post-transphenoidal surgery for a non functioning pituitary macro-adenoma. Peri-operatively she developed diabetes insipidus requiring short term desmopressin whilst on the neurosurgical ward. At post-operative presentation she complained of weakness, confusion and nausea; sodium 125 mmol/l, serum osmolality 268 mOsmol/kg, urine osmolality 474 mOsmol/kg. Over the next few days she became symptomatically worse and h...

Aims: Recent evidence suggests that Growth Hormone Deficiency (GHD) may be associated with cognitive impairment in adults. These findings are supported by neurobiological studies documenting the presence of GH receptors in many regions of the brain, including the hippocampus and the prefrontal cortex. However to date no comprehensive investigation of the cognitive sequelae of growth hormone deficiency in children has been undertaken. We aimed to determine the effect of GHD on ...

Endogenous hypercortisolism and chronic glucocorticoid (GC) therapy reduce bone mass, increase central fat mass, alter adipokines and enhance cardiovascular risk. Surgery (pituitary, adrenal or for ectopic ACTH) can control hypercortisolism in 90% of patients in experienced hands, and is often followed by inhibition of the adrenal axis, requiring substitution therapy with GC for months or years. We have been interested in learning on long-term outcome of ‘cured’ CS p...

In cases of ret-oncogene positive Medullary Thyroid Carcinoma (MTC), national guidelines advocate screening of 1st degree relatives with the Pentagastrin Stimulation Test (PST) to identify those with C-cell hyperplasia, and therefore at risk of MTC. Prophylactic thyroidectomy is recommended in those with positive tests. We highlight the difficulties of quantifying risk in the relatives of a ret-negative patient.A 30 year-old man presented with a tender n...