Endocrine Abstracts

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...

The link between thyrotoxicosis and coronary artery disease is complex with associations between therapy and vasculitis, as well as thyroid hormone excess and coronary artery spasm described. We present a 37-year-old female with a one-year history of Graves thyrotoxicosis treated with Propylthiouracil, who presented acutely with chest pain and a left hemiparesis. Typical electrocardiography changes and elevation of Troponin T confirmed a recent myocardial infarction, and CT sc...

A 14 year old girl, with a family history of MEN1, presented with secondary amenorrhoea and weight gain. Biochemical investigation revealed raised 24-hour urinary free cortisol excretions (1455, 1190, 614 nmol/24 hours; normal <290) and failure of cortisol suppression following 48 hours of low dose (0.5 mg qds) dexamethasone (199 nmol/l to 202 nmol/l). High dose dexamethasone administration (2 mg qds) for 48 hours resulted in further suppression of serum cortisol to 49 nmo...

A 40 year old gentleman presented with dramatic weight loss and a rash in the perineal area spreading to involve his face, trunk, legs and feet. Initial investigations demonstrated a normocytic anaemia with no evidence of thyroid disease or diabetes. Occasional diarrhoea prompted subsequent investigations including upper GI endoscopy, duodenal biopsy, pancreatic exocrine testing and barium follow-through studies which were normal. His 24 hour urinary 5-hydroxyindoleacetic acid...

We report the case of a 53 year old woman with a history of refractory focal epilepsy with complex partial and secondary generalised seizures. She has been on multiple anti-epileptic drugs since childhood. At 42 years of age she was referred to the Endocrinology Department complaining of capital hair loss and hirsutism. At this time her epilepsy was controlled on phenytoin and carbamazepine.A diagnosis of congenital adrenal hyperplasia (CAH) was made, wi...

Pro-opiomelanocortin (POMC) is endoproteolysed by prohormone convertase-1 (PC1) to ACTH within the secretory pathway in pituitary cells, where the regulation of ACTH release is essential for mediating the stress response. However POMC is present in the human circulation, indicating that not all POMC is processed. This suggests that regulation of trafficking and processing of POMC are important in determining ACTH release. To investigate this, we analysed steady-state release o...

Annexin-1 (Anx-1), a 37 kDa protein, is a member of the super-family of Ca2+and phospholipid-binding annexin proteins and acts as a mediator of glucocorticoid (GC) action in the host defence and neuroendocrine systems. In the anterior pituitary Anx-1 is expressed mainly by folliculostellate (FS) cells and mediates the early-delayed feedback inhibition exerted by GCs on the release of ACTH and other pituitary hormones.The stress responsiveness ...