Endocrine Abstracts

A 51-year-old woman with no significant past medical history presented with left flank pain, accelerated hypertension, progressive deterioration in renal function and left sided pleuritic chest pain. CTPA revealed pulmonary oedema and left adrenal haemorrhage. Urinary catecholamines were marginally elevated (24 h Urinary Metadrenalines 7.58 μmol/24 h) raising the possibility of an underlying phaeochromocytoma. Short synacthen test showed a sub-optimal response (0 min cort...

Cofactors of the nuclear hormone receptors are crucial in regulating their transcriptional activity. The glucocorticoid receptor (GR) is a member of the nuclear hormone receptor superfamily, involved in the regulation of metabolism, inflammation and stress–responses and many GR cofactors are known, including p300. Here, we identify a new cofactor for GR: TTC5/Strap, tetratricopeptide repeat domain 5/ stress–responsive activator of p300. Strap is a TPR motif containin...

The aldosterone synthase gene encodes the final step in the production of aldosterone. The aldoststerone synthase gene is polymorphic and variants within the gene and the regulatory region have been associated with hypertension and a phenotype of relatively higher level of aldosterone and its metabolites. However to date; none of the polymorphisms in the regulatory region of CYP11B2 have been shown to alter transcription. Seven novel polymorphisms in the promoter region of CYP...

The use of high doses of the ergot-derived dopamine receptor agonists such as cabergoline for treatment of Parkinson’s disease has been associated with increased prevalence of echocardiography detected cardiac valve disease. Whether smaller doses of cabergoline used for treating endocrine disorders causes similar valvular abnormalities is not yet conclusively established.We conducted echocardiographic screening of 35 adult endocrine patients on curr...

Introduction: A Mucocele is a collection of mucus enclosed by sinus epithelium within the paranasal sinuses. The pathogenesis is debated but a history of nasal obstruction, nasal surgery, nasal polyps or trauma is common but not universal. Mucoceles can erode local bone structure and invade the orbits. Four cases of sphenoidal mucoceles presenting with headache, 1–15 years post trans-sphenoidal pituitary surgery have previously been reported. We present two cases of front...

Background: Hypopituitarism is an important sequela of traumatic brain injury (TBI) in adults. In paediatric practice, however, there are concerns that it may be under-recognised. Symptoms may be mistaken for post-concussion syndrome, which may result in delayed investigation and diagnosis. Furthermore, predictors of post-traumatic hypopituitarism (PTHP) in children have not been consistently identified. As normal pituitary function is required for growth, serial growth monito...

Introduction: Dopamine Agonists are important in the management of endocrine disorders such as acromegaly and hyperprolactinaemia. Recent studies have shown that Cabergoline used in high doses to treat Parkinson’s disease is associated with cardiac valve fibrosis.Methods: We identified patients on long term high-dose cabergoline for the management of acromegaly. The following data was analysed: demographic data, duration of treatment, cumulative dos...

Background: Hyponatraemia is one of most common electrolyte abnormalities in acutely ill elderly patients. Severe hypothyroidism is often associated with hyponatraemia. The mechanism of hyponatraemia in hypothyroidism is not fully understood. It is suggested that hypothyroidism induces hyponatraemia either by inappropriate release of ADH or by decrease in GFR. Regardless of the mechanism, the net effect is impairment of water excretion. We report a case of severe hypothyroidis...

We report the case of a 26 year old man who presented to his GP with infertility; biochemical investigations revealed elevated serum free thyroid hormones (FT4 41 pmol/l (12–22); FT3 13.4 pmol/l (2.8–7.1); and a normal TSH (2 pmol/l (0.27–4.2). He was referred to the endocrine department.On examination, he was found to be clinically well though thin (BMI 18), anxious and tremulous. His heart rate was 110 bpm and blood pressure was normal. ...

A 57 year old Caucasian woman complained of severe back pain and arthralgia of large joints. Her arthralgia gradually got worse and she also noticed proximal muscle weakness. Blood tests showed normal CRP but elevated alkaline phosphatase of 521 iu/l with normal Gamma GT. Phosphate was low at 0.75 mmol/l with normal corrected calcium of 2.6 mmol/l. A DEXA scan suggested osteoporosis (Spine T −2.5). Isotope bone scan revealed increased activity in the right tibia and plai...