Endocrine Abstracts

Introduction: We present a case of Dunnigan Kobberling type of lipodystrophy in a young female.Case report: A 25-year-old woman presented with hirsuitism, secondary amenorrhoea, increase in neck size and reduction in breast size. On examination she had moon like facies, broad neck, small breasts and well defined male pattern musculature. Testosterone and lutenising hormone were marginally raised, serum alanine transminase was raised. Overnight dexamethas...

Introduction: Recent trials suggest that using ergot-derived dopamine agonists such as cabergoline in the treatment of Parkinson’s disease is associated with an increased risk of valvular heart disease. However, the dose of cabergoline used to treat hyperprolactinaemia is considerably less than that used in Parkinson’s disease.Study design: A cross-sectional study; forty four patients, who received cabergoline for at least 6 months, underwent t...

41 year old male presented in 1992 with 2 years history of blurring of vision, headaches, dizzy spells. Had Right supratemporal visual field defect, pituitary MRI which showed cystic pituitary lesion. Had TSS in May 1992 and histology showed Rathkes pouch cyst. Post operatively developed DI and started on DDAVP.SST,TRH and GnRH tests were normal. Persisted retro orbital head aches, developed nasal and temporal field loss. MRI in Sept 1992 showed large intrasellar recurrence of...

A 75-year-old lady presented with hypertension, weight gain, ankle oedema and proximal myopathy. She had clinical features of Cushing’s syndrome. Blood pressure was 180/99 mmHg. Her visual fields were normal. Investigations confirmed Cushing’s syndrome with high 24-hour free urinary cortisol levels (2264 nmol/l and 3295 nmol/l; normal range 40–305) and a high serum cortisol level following overnight dexamethasone suppression test (serum cortisol 1,550 nmol/l). F...

Fasting blood glucose is key to diagnosing diabetes, whilst the Oral Glucose Tolerance Test (OGTT) is a valuable adjunct when diagnosis is borderline or inconclusive. The OGTT is often used to detect early changes in glucose tolerance and predict a likely path to overt Diabetes Mellitus for example in gestational diabetes.A 42 year old female, referred to the Endocrine services for episodes of symptomatic hypoglycaemia. Past medical history included pylo...

The novel somatostatin receptor agonist SOM230 (pasireotide) binds with high affinity to somatostatin receptors sst1, sst2, sst3 and sst5. Acting principally through the latter, it inhibits basal and CRH-stimulated ACTH secretion from the AtT20 mouse corticotroph cell line and ACTH release from a proportion of human corticotroph adenomas both in vitro and in vivo. Data suggesting an additional antiproliferative effect has led to SOM230 being explored as a potenti...

Glucocorticoids (GCs) are potent anti-inflammatory agents, but a variable therapeutic response occurs. We have used microarray analysis to explore the basis for inter-individual differences in the GC sensitivity of a healthy volunteer population, and identified genes predictive of response to GCs. Three such discriminating genes were then selected to be investigated for their potential to interact with the Glucocorticoid Receptor (GR). These are the Bone Morphogenetic Protein ...

Hepatic A-ring reduction of glucocorticoids is enhanced in obesity, perhaps contributing to compensatory activation of the hypothalamic-pituitary-adrenal axis and adrenal androgen excess. One pathway activated is the formation of tetrahydro metabolites by two sequential steps catalysed by 5beta-reductase (5bR) followed by 3alpha-hydroxysteroid dehydrogenases (3HSD). However, regulation of these enzymes is understood poorly. 5bR and 3HSD are also involved in the conversion of c...

Case history: We present a 40 year old female admitted with hyperglycaemia, polyuria, polydipsia and weight loss of 6 kg over a 1 month period. She had no night sweats or change in bowel habit. There was no personal or family history of malignancy or diabetes mellitus. She denied any alcohol, cigarette or illicit drug use. She took no prescription or OTC medication. On examination, she was jaundiced with pale mucous membranes. The rest of systemic examination was normal. Capil...

A 77 year old female was admitted two weeks after an out-patient CT Pulmonary Angiogram showed a subsegmental pulmonary embolism and retrosternal goitre. History was of ten days of confusion, breathlessness, diarrhoea and reduced intake. On admission, she was febrile, tachypnoeic and in new, rate controlled, AF. Burch-Wartofsky Point Scale: 45, this being highly suggestive of a thyroid storm. TFTs were normal one year prior. Thyroid USS showed a multi-nodular goitre. She was c...