Endocrine Abstracts

Objective: To highlight an unusual cause of hyperinsulinaemic hypoglycemiaMethods: Case Report: Results or Case PresentationA previously healthy and fit 52 year old gentleman of Asian descent presented with recurrent severe neuroglycopenic hyperinsulinemic hypoglycemic symptoms, suggestive of insulinoma. On several occasions he was confirmed to have severe hypoglcaemia with venous blood glucose values ranging between 1.5 and 2.7 mm...

Hypoparathyroidism post-thyroidectomy is a recognised complication and treated with calcium supplements, vitamin D, and rather recently with recombinant human parathyroid hormone therapy (teriparatide). We report a case of a 68-year-old female who developed refractory hypocalcaemia and hypomagnesaemia following thyroidectomy for a multinodular goitre. Her management was complicated by inflammatory bowel disease, surgically treated with an ileostomy in situ. Post-opera...

Introduction: Extrapulmonary manifestations of tuberculosis can cause a diverse range of atypical presentations, depending on the system involved. Involvement of lymph nodes, pleura, central nervous system and bone are some of the organs that are well-described in the literature. This leads to a diverse range of presentations which can misguide diagnosis unless there is a high index of suspicion. Endocrinological manifestations are rare, but can occur uponhaematogenous dissemi...

Background: The UK Acromegaly Register contains data for 2700 patients. IGF-1 and random growth hormone (GH) measurements are used for disease monitoring. The registry reference laboratory (RRL) uses the Immunodiagnostic systems (IDS)-iSYS immunoassay platform for GH and IGF-1. The RRL uses age- and sex-specific reference ranges for IGF-1. We compared IGF-1 and GH results fromlocal laboratories to those of the RRL (pre-defined as the Gold standard) to determine the extent of d...

A counter-regulatory rise in GC levels is important to the inflammatory response, that when impaired is associated with high mortality in inflammatory states. 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) regenerate’s intracellular glucocorticoids (GC), amplifying their actions, and has been postulated to play a role in the development of inflammation-associated arthritis, obesity and myopathy. Pro-inflammatory cytokines (e.g. TNF-α) increase expressio...

Introduction: The aetiology of obesity-related nephropathy (ORN) is uncertain but may involve hyperfiltration and systemic inflammation.Aims: To define ORN using novel urinary biomarkers that can identify damage to specific regions of the nephron.Methods: Clinical data, blood and urine samples were collected from a consecutive series of 22 patients attending a weight-management clinic (excluding those with diabetes), and from a con...

Fasting of Holy month of Ramadan may be beneficial for patients with Type-2 diabetes but patient education and advice is of paramount importance to offset any effect from changing of dietary habits and treatment schedule. We conducted a questionnaire study few weeks before, during Ramadan and few weeks after Ramadan 1424 H/ 2004. A cross sectional random sample of patients with diabetes attending our services was analyzed. 50 patients mean age 65 yeas (20–83), (median, ra...

Background: Prostate cancer is the second leading cause of cancer-related deaths in men worldwide. A marker of poor survival in prostate cancer patients is the loss of the tumor suppressor gene PTEN (phosphoinositide-3-phosphatase). Deletion of PTEN occurs in approximately 40% of prostate cancer patients, and is associated with early biochemical recurrence, metastatic potential, and androgen-independence. Androgen-deprivation-therapy (ADT) remains the princip...

The commonest cause of hypercalcaemia is primary hyperparathyroidism (PHPTH). The diagnostic work up includes paired blood samples for serum corrected calcium, parathyroid hormone (PTH) and vitamin D levels. But in young patients, rare genetic conditions could be contributing towards hypercalcaemia and hence could produce a diagnostic challenge. We report hypercalcaemia work up in two young females where genetic tests were required.Case 1<p class="ab...

Hypercalcaemia due to primary hyperparathyroidism (PHPTH) is fully curable by parathyroidectomy. Occasionally recurrent hypercalcemia presents as a results of either residual adenoma, recurrent disease or an ectopic parathyroid gland. The most challenging cases are those with ectopic glands which are not identified on usual surgical neck exploration. We present a similar case that went through multiple surgeries for recurrent hypercalcemia. A 79-year-old lady initially was dia...