Endocrine Abstracts

An 87 year old lady with a background of longstanding cognitive impairment was referred to our service with biochemical evidence of primary hyperparathyroidism. The patient had past medical history of type 2 diabetes mellitus, osteoporosis, hypothyroidism, ischaemic heart disease and primary hyperparathyroidism (under observation in a neighbouring health board). There was no pharmacological cause for cognitive impairment identified. Following acute admission after a fall with ...

Increased intake of sodium is postulated to be controlled by aldosterone-sensitive cells in a select region of the adult mouse brain, the nucleus of the solitary tract (NTS). These cells express the enzyme 11β-hydroxysteroid dehydrogenase type 2 (HSD2) which inactivates glucocorticoids, allowing selective activation of mineralocorticoid receptors by aldosterone. However in the developing brain, HSD2 is widely expressed to protect against adverse glucocorticoid action, whi...

Introduction: We present a case which highlights the complexities of managing hyperthyroidism.Case report: An 81 year old man complained of irritability, insomnia, diarrhoea, shortness of breath and weight loss. Past medical history includes type II diabetes, atrial fibrillation (AF), hypertension, gallstone pancreatitis requiring cholecystectomy (2005). Clinically, he was in fast AF and right heart failure. On examination he had a tremor; normal sized t...

Background: Craniopharyngiomas are rare tumours with an annual incidence of 0.5–2/100 000. Though benign they still represent a management challenge because of morbidity that includes pituitary hormone deficiency, visual impairment, adipsia and morbid obesity. We retrospectively assessed the outcomes of craniopharyngioma patients in our centre over a 10-year period.Methods: All children (n=16) diagnosed with craniopharyngioma and treated in t...

Introduction: Patients with diabetes mellitus are known to have increased mortality and morbidity from influenza and pneumococcal disease. The Department of Health recommends that these children, along with other high risk patients, receive yearly influenza vaccination and additional immunisations against invasive pneumococcal disease. We audited the uptake of these additional immunisations in our patients.Method: Retrospective audit of all patients with...

Background: The National Institute for Clinical Excellence (NICE, 2002) suggests that measurement of quality of life (QOL) is necessary to assess the efficacy of GH treatment (GHT). A pilot study (Sheppard 2006) showed a greater improvement in QOL over the first 6 months of GHT for patients with acquired GH deficiency (AGHD) compared with idiopathic GH deficiency (IGHD).Method: In view of this, a longitudinal research study was set up to measure changes ...

We investigated ACTH-induced hypertension in mice by studying renal function in vivo and by analysing renal gene expression by microarray and RT PCR methods. During two weeks sc infusion with Synacthen, mean blood pressure in adult male mice increased (89±5 vs 110±2 mmHg), and plasma corticosterone, adrenal weights and drinking rate increased by 5, 2 and 2.5-fold respectively (P<0.01); renal mass was unaffected. Greater mineralocorticoid activity wa...

Central cholinergic defects, as well as cognitive impairments, have been reported in humans with non-insulin-dependent diabetes mellitus (NIDDM). The levels of acetylcholine are partly controlled by the activity of acetylcholinesterase (AChE) which breaks it down. We have previously reported evidence for abnormal AChE activity in the skeletal muscles of the obese diabetic (ob/ob) mouse which provides a model for NIDDM. The aim of the present study was to investigate the levels...

Aldosterone and glucocorticoids stimulate sodium transport by the renal tubule, which is important for blood pressure homeostasis. Corticosteroid excess and/or abnormal steroid hormone activity within the kidney can cause hypertension. Circulatory and urinary steroid concentrations can be measured routinely but steroid concentrations at a tissue and cellular level are largely unknown, and the kidney remains a “black box”. Mass spectrometry imaging (MSI) permits local...

Blood pressure homeostasis is regulated via renal sodium reabsorption by aldosterone and glucocorticoids, although the role of glucocorticoids is less clear. High-salt diets lead to suppression of aldosterone in plasma, but changes in available ligands for the mineralocorticoid and glucocorticoid receptors in kidney subregions are unknown. Hypothetically, high-salt intake modifies aldosterone and corticosterone amounts in specific kidney subregions. Kidney cryosections from ma...