Endocrine Abstracts

Glucocorticoids are highly detrimental to skin integrity and function both when used locally for anti-inflammatory treatments and during conditions of raised systemic concentrations such as Cushing’s syndrome. Many of the adverse effects of glucocorticoids on skin are also symptoms associated with natural intrinsic aging and extrinsic photoaging.Locally, glucocorticoid availability is regulated independently of circulating levels by 11β-hydroxy...

Introduction: Hyperthyroidism may mimic many conditions, and there is potential for under-diagnosis if testing is considered only in patients presenting with classical symptoms.Aim: To describe the range of presentations in patients found to have hyperthyroidism and referred from primary care.Method: Consecutive patients diagnosed with hyperthyroidism and referred to the endocrine clinic between Jan 2009 and Nov 2009 were studied. ...

Audit standard: All patients should receive written and verbal advice about the risk of neutropenia associated with the use of anti-thyroid drugs. Compliance rate 100%.Our Endocrinology Department has a detailed patient information sheet that is provided to the patients at the time of initiation of anti-thyroid drugs.Background: Recently, a patient was admitted with neutropenia secondary to the use of carbimazole. She did not know ...

Introduction: The incidence of primary hyperparathyroidism (PHPT) is ~3.5/100 000 per yearThe incidence is on the rise due to increase in ‘routine biochemical testing’Has been thought to be a ‘relatively harmless’ disorder.Some patients tend to undergo surgery, while others are conservatively treated and most followed up for a short period before discharge from follow up.Aims:<l...

Introduction: Hypocalcaemia is a rare presentation of thyrotoxicosis. We describe a patient with severe life-threatening hypocalcaemia and suggest pathogenic mechanisms.Case report: A 66-year old lady with long-standing insulin-treated type 2 diabetes presented acutely with generalised weakness and a collapse at home. Prior to admission, she had been treated for an infected neuro-ischaemic plantar ulcer with broad-spectrum antibiotics. She had developed ...

Recent investigations have suggested that 11ß-hydroxysteroid dehydrogenase-1 (11ßHSD1) activity influences development of atherosclerotic lesions and that pharmacological inhibition of this enzyme may have therapeutic benefits. Whilst these findings have been attributed to glucocorticoid metabolism, 11ßHSD1 also inter-converts 7-oxysterols (oxidized products of cholesterol which may promote atherogenesis). This study investigates whether metabolism of 7-oxystero...

Introduction: In a recent 16-week Phase II study in patients with de novo, persistent or recurrent acromegaly, pasireotide effectively controlled GH and/or IGF-I levels in 56% of patients, and reduced tumor volume by >20% in 39% of patients. We present preliminary 6-month results from the ongoing extension phase of this study.Methods: This extension study enrolled patients who achieved biochemical control (GH ≤2.5 μg/l and normalize...

Renal impairment and electrolyte disorders in hypothyroidism are frequently subtle and rarely observed in clinical practice. Case reports have noted the association but it is rarely found in textbooks. We describe a case of new onset renal dysfunction secondary to hypothyroidism. A 54-year-old male was referred to renal clinic with new renal failure. He described a 3 weeks history of sudden onset peri-orbital, facial and generalised leg swelling and associated muscle ache and ...

Cortisol is regenerated from cortisone by 11βHSD1 reductase in cells from VAT. Mice overexpressing 11βHSD1 in adipocytes have more glucocorticoids in the portal vein (PV) and hepatic insulin resistance. In humans, hepatic vein (HV) sampling during D4-cortisol tracer infusion confirmed substantial splanchnic cortisol generation, and indirect modelling suggested major contributions from both liver and VAT. PV sampling in dogs, however, did not reveal cortisol release f...

Introduction: Aminoglycoside exposure may result in hypomagnesemia, hypocalcaemia and hypokalemia. We describe a case of severe hypomagnesemia due to gentamicin therapy.Case report: A 46-year-old lady presented with ‘pins and needles’ and muscle cramps two weeks after being treated with gentamicin for biliary sepsis. Trosseau and chovstek signs were positive. Investigations showed hypokalemia, hypocalcaemia and hypomagnesemia (0.25 mmol/l (0.74...