Endocrine Abstracts

TSH receptor antibody (TRAb) assays are highly sensitive and specific for the diagnosis of Graves’ disease. TRAb can minimise need for additional radiological modalities such as ultrasound and isotope scan in excluding other causes of hyperthyroidism. The relapse rates of hyperthyroidism following a course of anti- thyroid drugs (ATDs) remains disappointingly high at between 50-70%. TRAb levels at diagnosis and at the completion of a course of ATDs can be useful in predic...

Efficacy and Safety of High Dose Testosterone Therapy in Partial Androgen InsensitivityS. Bandyopadhyay, W.A.Watson, C. M.Park, P. Abraham, S. Philip, S. Acharya , J.S. Bevan. Department of Endocrinology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN.INTRODUCTION: There have been few reports of the efficacy and safety of high dose androgen therapy in men with partial androgen insensitivity (PAI). We report on the responses of a p...

Glucocorticoids (GCs) are prescribed for their anti-inflammatory and immunosuppressive properties. However, they have significant side-effects including a decline in muscle mass and function which has similarities to age related sacropaenia. Within skeletal muscle 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts 11-dehydrocorticosterone (11DHC) to active corticosterone (CORT) amplifying local GC action. We hypothesise that 11β-HSD1 mediated intramyoce...

The pathophysiological effects of glucocorticoid (GC) excess (Cushing’s syndrome) are similar to the aging phenotype. As such, we hypothesise that age-related changed in body composition (central obesity, reduced bone density, reduced muscle mass and skin thinning), and resultant chronic disease (type 2 diabetes, osteoporosis, sarcopenia and heart disease) may be caused by increased GC exposure with age. However, circulating GC’s show little change with advancing age...

Glucocorticoids (GC), such as prednisolone, are widely prescribed for their anti-inflammatory and immunosuppressive properties. However, they have significant side-effects including insulin resistance and hepatic steatosis. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts 11-dehydrocorticosterone (11DHC) to active corticosterone (CORT) and thus amplifies local GC action. We hypothesise that enhanced local GC regeneration of exogenously administered GCs by ...

Background: The global prevalence of metabolic syndrome (MetS) characterized by type 2 Diabetes (T2D), obesity, and cardiovascular diseases, has reached alarming proportions worldwide. The prevalence is rapidly increasing among all the age groups due to calorie dense food intake and sedentary lifestyle. Beta adrenergic receptors (β ADRs), are known for its role in thermogenesis, lipolysis and glucose metabolism. Ceasrine et al., 2018, reported that pancreas-speci...

This 46 year old lady with no significant past medical history was referred urgently to the Endocrine Investigation Unit with a 9 month history of increasing lethargy and gradual weight loss of around 5 kg. Two months prior, she had been diagnosed with subclinical hypothyroidism and after commencing Levothyroxine, quickly lost another 5 kg in weight over a period of 6 weeks and had postural dizziness with systolic BP readings between 80 and 90 mmHg. She was having a normal men...

Background: Following the RECOVERY study, dexamethasone is prescribed for patients requiring inpatient treatment of Covid. Cases of new and atypical diabetes have been reported during this pandemic. The risk of steroid induced hyperglycaemia is well recognised but other metabolic sequelae less so. We present a patient who developed severe hypernatraemia following commencement of dexamethasone.Case Report: A 44-year-old man (unvaccinated) was diagnosed wi...

Flash glucose monitoring has increased dramatically in patients with diabetes since the introduction of the FreeStyle libre 2 (FSL) incorporating hypoglycaemia predictive features and an alarm system. A 31-year-old lady, gravida 2, para 1 presented at 26 weeks’ gestation following a car accident where she fractured clavicle and navicular. She reported blurred vision and subsequent collapse whilst driving (with her daughter as a passenger) prior to the accident. Paramedics...

Identifying the cause of hypercortisolism is vital in ensuring the correct treatment plan for a patient. I present the case of a patient in whom the desmopressin test, as an adjunct to the CRH test, proved helpful in determining the cause. A 27 year old man who initially presented with weight gain, abdominal striae and sweating was admitted with low mood, anxiety and suicidal ideation. Tests showed elevated 24 hour urinary cortisol (highest 1446 nmol/24 hours), random cortisol...