Endocrine Abstracts

Background: Adrenal incidentalomas are common amongst the general population, incidence increases with age. Radiological and biochemical assessment of all lesions >1 cm is standard practice to determine appropriate future management, as per current European guidelines. We report the experiences of a recently formalised adrenal multi-disciplinary pathway in a large UK teaching hospital, where all adrenal incidentalomas are referred and systematically assessed.<p cl...

Measurement of steroid metabolites in urine by gas chromatography-mass spectrometry remains the gold standard for biochemical diagnosis of steroidogenic disorders. In the UK, three laboratories offer steroid profiling for routine clinical testing, with the Supraregional Assay Service at King’s College Hospital being the largest and experiencing increased demand year-on-year for testing. In this study, we used our profiling database to audit 2021 workload. By direct compar...

A 51 year old female patient presented in 2000 with a 7 month history of diarrhoea and weight loss. Bloods revealed hypokalaemia (1.9). Infection and malabsorption screen negative, but patient remained hypokalaemic despite maximum iv and oral replacement. No abnormality was found endoscopically. Fasting gut hormone profile showed raised Vasoactive Intestinal Polypeptide (VIP) >400 (NR <30). CT scan confirmed 5cm mass in body of pancreas, no metastatic disease. Response...

The endometrium is a complex tissue with luminal and glandular epithelial cell layers supported on a multicellular stromal compartment; in women the inner (luminal) portion of the tissue breaks down and is shed during menstruation. The endometrium is exquisitely sensitive to the actions of sex steroids (oestrogens, progestogens and androgens) produced in ovarian and other extra gonadal tissues and delivered via blood vessels that rapidly develop and mature within the tissue (e...

Introduction: Oestrogen receptors (ER) are essential for reproductive function and fertility. ER46 is a 46 kDa truncated isoform of full length ERα (ER66) that binds oestradiol (E2) and can signal via nuclear or membrane-initiated signalling pathways. ER46 has been detected in breast cancer cell lines but expression in endometrial tissues has not been documented. The aims of this study were a) to determine whether endometrial cells express ER46, and b) to investigate a po...

Background: Many patients require IV insulin during their critical illness. Maintenance of insulin in St James’s Hospital ICU is governed by a local protocol. At the time of ICU discharge, IV insulin therapy is often stopped. Transitioning from IV to subcutaneous insulin is often done with endocrinology input. If this is unavailable inappropriate insulin dosing may increase the risk of hypo-/hyperglycaemia.Aims: To reduce the number of episodes of h...

Endometriosis is a chronic incurable hormone dependent condition characterized by growth of endometrial tissue in sites outside the uterus: 30–40% of women with endometriosis have sub/infertility however the underlying cause is unknown. We have previously demonstrated that steroid-induced differentiation of endometrial stromal cells (hESC) (decidualisation) is associated with increased expression of metabolic genes that are thought to be essential to support the implantin...

AMP-activated protein kinase (AMPK) acts as a sensor and regulator of cellular energy homeostasis. Once activated, AMPK influences a number of responses including inhibition of anabolic pathways and the switching-on of catabolic pathways. Regulation of AMPK, which responds to an increase in the AMP/ATP ratio, could have an important role in chondrocyte function particularly in response to hormones and to stress such as occurs in osteoarthritis. Therefore, we sought to investig...

Oestrogen receptor (ER) activity has a wide spectrum of functions in the human body, including the development, growth and maintenance of the reproductive system. There are two ER subtypes, ERα and ERβ. The latter exists as multiple splice variants (ERβ1, ERβ2 and ERβ5) some of which lack a steroid ligand-binding domain. ERs act as steroid-ligand activated transcription factors. Epidermal growth factor (EGF) acting via the MAP kinase pathway has been s...

A number of candidate genes have been investigated as susceptibility loci for the development of Graves' disease. Those which appear to be consistently associated with disease include the HLA and the CTLA-4 gene regions. Polymorphisms of the VDR gene have been shown to increase susceptibility to autoimmune diseases including type 1 diabetes, multiple sclerosis, and Crohn's disease. Recently, an association has also been reported between the VDR gene and autoimmune thyroid dise...