Endocrine Abstracts

Background: Thyroid disease in pregnancy is common with hypothyroidism predominating.Objectives: To determine the aetiology of thyroid disease in patients attending an antenatal thyroid clinic, their baseline biochemical and therapeutic characteristics as well as subsequent management.Subjects/setting: 114 women with a mean 31 years (±5) age were seen by a consultant endocrinologist in the antenatal thyroid clinic, between Sep...

Aim: To investigate the relationship between baseline and stimulated cortisol responses in relation to the habitual time of rising and time of test.Method: The self-reported habitual rising time and time of cortisol testing were recorded in 63 consecutive patients (47F, 17M, age 18–94) undergoing standard stimulation testing with tetracosactide (SynActhen) 250 μg i.v. In total, 75 tests were analysed. A normal response was defined as a 30 min p...

Ipilimumab, pembrolizumab, and nivolumab – novel immune checkpoint blockade drugs – are increasingly used in the treatment of metastatic melanoma and other cancers. Ipilimumab is an anti-cytotoxic T-lymphocyte antigen 4 (CTLA4) MAB and the first drug shown to improve overall survival in metastatic melanoma. Hypophysitis is a widely described side-effect linked with both lymphocytic inflammation and a direct toxic effect on the pituitary in mouse studies, but has been...

Hypertension is the most commonly recognised cardiac manifestation of a phaeochromocytoma. There are however a variety of other cardiac presentations including arrhythmias and the increasingly reported Takotsubo cardiomyopathy. We present the case of a female patient presenting acutely to the general medical take who was found to have cardiac arrhythmias and transient left ventricular dysfunction.The initial presentation was breathlessness, chest pain, s...

Background: Elevated morning plasma cortisol is associated with multiple cardiovascular risk factors in metabolic syndrome. Epidemiological studies have also reported a positive association between plasma cortisol and coronary heart disease (CHD), although not all estimates are statistically significant (OR 1.10 (95% CI 0.97 to 1.25)) (Davey Smith et al. Circulation 2005). Importantly, observational studies are unable to infer causality and results may be confounded.<...

Introduction: Islet transplantation (ITx) is a therapeutic option for patients with Type 1 diabetes. However there is attrition of graft function and the majority of patients require exogenous insulin injections and/or further transplants, within five years. Mouse models help elucidate mechanisms of islet graft failure and the NOD/Lt-scid IL2rγnull (NSG) mouse is useful to study human islet engraftment but few published studies exist. As diffe...

Introduction: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, which may relate to enhanced sympathetic nervous system (SNS) activation. The cerebral pathways involved in this process are not known.Aims: i) To compare SNS activation in response to isometric forearm contraction (IFC) in patients with PCOS and controls. ii) To identify and compare the neuronal signatures of this response.Methods: 15 ...

Background: The lipid profile of healthy adults in northern Nigeria is scarcely reported in literature. Yet, hospital records show increasing frequency of dyslipidemia-related illnesses like CVA, MI, and peripheral vascular diseases in practice. We aim to report the pattern of lipid abnormalities in a rural population in Kano, Nigeria.Methods: A population screening of apparently healthy adults resident in sub urban community in Kano was undertaken over ...

Canrenone and mifepristone (RU486) are respectively mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) antagonists commonly used to block or displace steroid for clinical pharmacological or research purposes. The aim of this study was to develop and validate a sensitive, quantitative assay for the combined analysis of glucocorticoids (cortisol, cortisone, corticosterone, and 11-dehydrocorticosterone), mineralocorticoids (aldosterone), canrenoate, and mifepristone...

Adrenal incidentaloma’s are a common clinical dilemma with increasing utilisation of cross-sectional imaging modalities. The aims of management include i) exclusion of possible malignancy and ii) identification of hormonally active lesions. Our unit has adopted AACE guidelines, including a screen for adrenal androgen hypersecretion. This audit aimed to review the utility of such an approach. We identified case notes of 100 consecutive adrenal incidentaloma’s referred...