Endocrine Abstracts

In March 2020, the world went into covid lockdown. Students, trainees and consultants were all called to the front-line, working additional and highly stressful shifts. Amongst the numerous negative consequences of the pandemic, teaching fell by the wayside. All conferences and educational meetings were cancelled. Initially there seemed no time or mechanism to continue teaching. However, on the 27th April 2020, one month into the first lockdown, I presented the first ‘Ale...

Adipocytes are important metabolic buffers and endocrine regulators of energy expenditure and satiety. Adipocyte dysfunction, either genetic or as observed in acquired obesity, is linked to hallmarks of the metabolic syndrome. I will discuss novel translational regulators of adipocyte function and focus on the role of the proteasome for cellular protein quality control, ER stress, and maintenance of healthy brown and white adipocytes in obesity, diabetes, and atherosclerosis i...

Background: Oncogenic osteomalacia is a paraneoplastic syndrome that occurs in the context of an FGF23 secreting tumour. We describe a case of a 42 year old gentleman who presented with this rare cause of hypophosphataemia.Clinical Case: This gentleman presented with a history of multiple fragility fractures, and generalised bone and muscular pain. His biochemistry showed: serum phosphate 0.52 mmol/l (reference range 0.80-1.50 mmol/l), adjusted calcium 2...

This case series compared the efficacy of long acting basal Insulin, Insulin Degludec compared to Insulin Glargine in adolescent paediatric patients. There were seven patients in total aged 14 to 18 years. Changes in HbA1c, BMI and reduction in nocturnal hypoglycaemic episodes were compared in all seven patients. Insulin Degludec showed a decrease in HbA1C levels, particularly in patients who had HbA1C higher than 48 mmol/mol on Insulin Glargine. There was a 2.4% decrease in H...

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency can have multiple effects on growth, sexual development, fertility and overall health. Sub-optimal adherence to treatment regimens during adolescence and puberty can have lifelong consequences. We present the case of 20-year-old male who was diagnosed at birth. His parents are first cousins, and his two siblings also have CAH. Initial treatment comprised hydrocortisone and fludrocortisone and administration ...

Hypothalamic amenorrhea is a diagnosis of exclusion. It accounts for 30% of cases of secondary amenorrhoea in women of reproductive age. It is caused by abnormal signalling between the hypothalamus and the pituitary gland due to deficient pulsatile secretion of GnRH. This reduced secretion of GnRH leads to levels of LH and FSH that are insufficient to maintain full folliculogenesis and normal ovulatory ovarian function, with consequent oestrogen deficiency. There are many caus...

Hyponatraemia is the most common electrolyte abnormality encountered in clinical practice and second most common endocrine referral. Acute severe hyponatremia is potentially life-threatening and must be treated promptly and aggressively. SIADH, Cortisol deficiency, Liver Disease, Heart disease, certain medications and excess alcohol intake can frequently lead to hyponatremia. We present a case of 41 year old male known to have alcoholic liver disease and depression who present...

Introduction: Prolactinoma are the commonest functioning pituitary tumors. Pressure symptoms such as headache and visual field defect are common in patients with macroprolactinoma. Early investigation and intervention can deter permanent visual impairment, pituitary apoplexy and panhypopituitarism.Case vignette: 27-year-old lady presented to ophthalmologist with two months history of headache with visual impairment on the right side. She was found to hav...

A 32-year-old female was referred with abnormal thyroid function tests after investigation for nonspecific joint symptoms and exhaustion in 2010. Initial biochemistry showed TSH 0.03 mU/l(0.2-5), Free T4 75 pmol/l(9-24). At her endocrine appointment she reported loose stools, tremors, exertional dyspnea and a peculiar sensation in neck in keeping with thyrotoxicosis. Since puberty, she had problems acquiring weight. Repeat thyroid function demonstrated TSH <0.01 mU/land Fr...

Case history: 21-year-old male presented in November 2006 with visual loss, headaches and fatigue. No previous past medical history. Visual field testing confirmed a left temporal hemianopia with right temporal upper quadrantanopia.Investigations: Brain imaging revealed a large macroadenoma with suprasellar and lateral extension. Hormone testing demonstrated abnormalities in TSH 5.13 mU/L, Free T4 7.1 pmol/l, random Cortisol 64nmol/l and Testosterone 2.3...