Endocrine Abstracts

Glucocorticoids are by far the most effective anti-inflammatory therapy for asthma (and many other inflammatory diseases). Glucocorticoids bind to glucocorticoid receptors in the cytoplasm and translocate to the nucleus, where they interact as dimers with glucocorticoid response elements in the promoter region of steroid-sensitive genes to switch on transcription of anti-inflammatory genes, (such as MKP-1). This involves binding of GR to coactivator proteins and acetylation of...

An 82 year old man was admitted to hospital with lethargy, anorexia and back pain. His past medical history included chronic lymphocytic leukaemia and hypertension. Blood tests revealed a serum sodium of 115 mmol/l and potassium of 5.4. His irbesartan was discontinued and sodium rose to 126 prior to discharge. 9 am cortisol was 408 nmol/l. He was readmitted to hospital 6 days later with hyponatraemia (116 mmol/l). A short Synacthen test was performed which showed a flat respon...

61 year male presented with productive cough and was noted to have persistent hypokalaemia. On examination he had an elevated blood pressure; previously not known to be hypertensive and significant proximal myopathy in his lower limbs. He also had central obesity. In October 2018 he had a left parotid swelling. He had left parotidectomy and left neck dissection. The histology was an adenocarcinoma. In the following year he had cough, and shortness of breath, which on investiga...

A 71-year-old gentleman was referred for investigation of bilateral enlarged adrenals first discovered after presenting with subacute bowel obstruction. A CT scan of his abdomen revealed the left adrenal was 8×5 cm, the right 3 cm. No other abnormalities were detected.The patient was otherwise well. No other medical history was volunteered. On examination, he was of short stature (height 1.47 m) with a normal pattern of pubic and axillary hair. Bloo...

Patients on long term prednisolone therapy have suppression of their hypothalamo-pituitary-adrenal (HPA) axis. The short synacthen test (SST) is routinely employed to assess the viability of the HPA axis. However, as this test examines only adrenal function it may fail to identify those patients with secondary adrenal insufficiency. The overnight metyrapone test (OMT) may be a better test as it examines the whole HPA axis.We have compared the responses t...

A 53-year-old gentleman was seen following a recent diagnosis of type 2 diabetes in May 2009. He had suffered a subarachnoid haemorrhage in 1993 and remained under the local tertiary centre after developing secondary hypogonadism treated with testosterone replacement. The cause had never been established.The patient had previously been diagnosed with seronegative HLA B27 arthropathy and in December 2008 was admitted with acute cardiac failure and atrial ...

A 53-year-old gentleman was seen following a recent diagnosis of type 2 diabetes in May 2009. He had suffered a subarachnoid haemorrhage in 1993 and remained under the local tertiary centre after developing secondary hypogonadism treated with testosterone replacement. The cause had never been established.The patient had previously been diagnosed with seronegative HLA B27 arthropathy and in December 2008 was admitted with acute cardiac failure and atrial ...

Introduction: The obesity epidemic is growing at an alarming rate. The body volume index (BVI) scanner is a novel machine that produces a true scale 3D body image of the whole body within 6 s and may have a role in the management of obesity.Method: In a pilot study, we set out to assess the impact of BVI scanning on weight loss during a standard weight loss programme in overweight subjects. Forty-three subjects were given standard dietary and lifestyle a...

We report a case of a 20-year-old male with a clinical profile of Gorlin-Goltz syndrome with delayed puberty. This 20-year-old man had learning disablitiy, macrocephaly and multiple jaw cysts. His other clinical features included agenesis of the carpus callosum, obesity and multiple cutaneous lesions suggestive of angiolipomata. His pubertal development was delayed although a LHRH test done at the age of 16 showed a normal response. Radiological features included macrocephaly,...

This 55-year-old gentleman presented to endocrine clinic following an episode of septicaemic shock complicating benign prostatic surgery one year previously. He subsequently developed symptoms of lethargy, palpitations, lightheadedness, peripheral weakness and loss of libido, which had developed after this episode. Routine biochemistry and ambulatory electrocardiography measurements were normal.Endocrine testing revealed:: - Undetectable gonadotrophins (...