Endocrine Abstracts

Background: Letrozole is a potent aromatase inhibitor licensed for use in women with breast cancer. It is also used by body builders for reduction of gynecomastia when taking anabolic steroids. Supply for this unlicensed use is readily available through internet. Testosterone production is regulated by negative feedback of estrogen on the pituitary. The use of letrozole can therefore cause supraphysiological levels of testosterone in men. We present such a case.<p class="a...

Background: Primary Hyperparathyroidism is mainly produced by an adenoma and it is mostly a benign condition. Most of the patients are asymptomatic. We present a case of ectopic parathyroid cyst presenting with this condition.Case: A 76 yr female presented with new onset confusion, abdominal pain, vomiting, diarrhoea and dehydration. She was currently being treated for a urinary tract infection. Investigations showed acute kidney injury with creatinine 3...

Objectives: Increasing use of scanning has led to a significant increase in detection of adrenal incidentalomas. The American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons have issued guidelines for evaluation of adrenal incidentalomas in 2009. We audited our current practice at Royal Shrewsbury Hospital against the 2009 guidelines.Method: Retrospective audit of patients found to have adrenal masses on imaging st...

Loss of muscle mass is associated with ageing and several degenerative pathological conditions which limit movement and critically impair quality of life. One key regulator of muscle mass is myostatin which inhibits muscle growth. In circulation, myostatin is bound to follistatin-like 3 (FSTL3) in an inactive complex. FSTL3 is a natural, soluble regulator of myostatin along with follistatin (FST) and myostatin propeptide. In the FSTL3 gene deleted mouse (FSTL3 KO), however, to...

Background: Acute adrenal insufficiency leads to potentially life threatening crises if increases in steroids are delayed or insufficient. The patient is central to early increases in dosage and informing Healthcare Professionals of their steroid-dependency.Methods: To assess adequacy of information given to cortisol deficient patients we performed an audit of case notes documentation. The audit was performed over four weeks, involving 32 patients from t...

Background: Primary hypoadrenalism with bilateral adrenal enlargement is a relatively rare condition. We present four such patients. Case 1: 60 year old male presented with malaise, weight loss and hyponatremia. Short synacthen test was abnormal and ACTH was raised (309 ng/L). CT adrenals showed bilateral adrenal enlargement with uniform texture and low attenuation with no change in repeat CT. FNAC of adrenal gland showed infarcts. Further tests confirmed antiphospholipid anti...

It is becoming increasingly clear that stem cell function and differentiation state are affected by the physical environment of the stem cell, and the stem cell’s physical properties – or physical phenotypes. Physical phenotypes include how the cell responds to forces in its environment and its subcellular structure. This presentation will be primarily focused on subcellular structure, or structural phenotype. I will present two different techniques to quantitatively...

Background: We describe a 64-year-old lady with past medical history of Thalassaemia Trait and Hypertension, who was presented with Cushing’s syndrome.Clinical presentation: This patient was admitted with severe bi-basal pneumonia in February 2010 and treated successfully. But unfortunately her symptoms persisted with increasing facial swelling in end of May 2010, therefore, a staging CT was arranged and found incidental 6×5 cm left adrenal mas...

Glucocorticoids (GCs) are steroid hormones, products of the hypothalamic–pituitary–adrenal axis. Synthetic GCs, such as dexamethasone, have been widely used in the treatment of inflammatory diseases like rheumatoid arthritis or asthma, but their long-term use causes severe side effects (osteoporosis, diabetes, hypertension, etc). The ligand-bound GC receptor (GR) can activate gene expression via binding to GC response elements (GREs), a mechanism known as transactiva...

5alpha-Reductase 1 (5aR1) catalyses A-ring reduction of glucocorticoids and androgens. We previously demonstrated that transgenic disruption of 5aR1 predisposes male mice to fatty liver and insulin resistance when challenged with a high-fat diet. Here, we have dissected the contributions of androgens and glucocorticoids to the metabolic phenotype using 2 models of enzyme inhibition (trangenesis and pharmacology).Female 5aR1−/− mice (KO) and w...