Endocrine Abstracts

Until recently it was usual to discharge teenagers with TS to primary care once final height had been attained in the paediatric setting. It is now clear that adults with TS benefit from dedicated TS clinics in order to optimise health care for this commonly neglected group. In adult life there is a great deal of preventable morbidity in TS which lies within the endocrine remit: osteoporosis, hypothyroidism, obesity, diabetes, hyperlipidaemia and hypertension. Other disorders ...

Reproductive endocrinology spans the interface between ‘mainstream’ endocrinology, paediatric endocrinology and gynaecology, with excursions into genetics and psychology. This subspecialty is a fertile ground for clinical research. The field of Turner syndrome – ‘Turnerology’ – is a perfect example of where an endocrinologist has a lot to contribute with knowledge of oestrogen physiology, diabetes, osteoporosis as well as cardiovascular disease, g...

The action of insulin acting as a co-gonadotrophin in women with PCOS has long been a focus of research. In western populations, a key environmental effect on PCOS is through the obesity epidemic. The resulting insulin resistance has direct effects on the clinical manifestation of PCOS with serum insulin showing positive associations with BMI, serum testosterone, AMH and variably with ovarian volume. AMH is a particularly interesting marker of PCOS with respect to insulin as d...

Once induction of puberty has been completed the options for sex steroid hormone replacement change to take in to account long term health outcomes and the issues of transition from pediatric to adult care. With regard to the late stages of development, some thought has to be given to the fact that bone mass continues to increase to reach a peak at about the age of 25. It may not be until the age of 18 that meaningful bone density results can be obtained. For those who are slo...

Women with a 46XY karyotype comprise a heterogeneous group who differ not only in their diagnostic category and anatomy but also in their journey from paediatric to adult services. Transition care should be an individualised process covering past experiences, current medical and surgical needs and future prospects is required for optimal wellbeing. A multidisciplinary team is helpful in providing this care and liaison with supports groups (for instance the AISSG) is essential ...

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All women with early onset oestrogen deficiency have an increased risk of cardiovascular disease regardless of aetiology, be it premature ovarian failure, hypopituitarism or Turner Syndrome. The fact that oestrogen deficiency in young women increases CVD risk appears to be in conflict with the adverse effects of oestrogen replacement on cardiovascular morbidity in postmenopausal women. One explanation for this paradox is that oestrogen may slow atherogenesis in young women whi...

It is often said that the transition from paediatric to adult care should be seamless. At the same time, the first visit to an adult clinic is a time to stop, take stock and reorganise. Clinicians must be aware of the importance of this first visit in overcoming the disillusionment that often is felt by an individual as they leave the cosy world of a paediatric service and move into the busy, fragmented world of adult care. However thoroughly a child coming up for transfer is ...

Background: Auto-immune pancreatitis (AIP) is a rare chronic inflammatory disease, characterised by raised serum levels of IgG4, which may mimic pancreaticobiliary malignancy, and is noted to have an IgG4-positive plasma cell infiltrate on pancreatic histology. Extrahepatic manifestations in liver, kidneys, and retroperitoneum, are increasingly recognised.We present a case of extrapancreatic manifestation of AIP in the pituitary gland causing lymphocytic...

Objectives: The syndrome of CAIS is the result of loss of function mutations of the androgen receptor. Women with CAIS present with primary amenorrhea, absent uterus and 46XY karyotype. Little is known about the long term natural history of this condition, in particular the risk of heart disease in adults. Here we report on biochemical risk markers in a group of women with CAIS compared to a control group with ovarian failure who were matched for their use of exogenous oestrog...