Endocrine Abstracts

Background: The incidence of gestational diabetes appears to be rising, likely related to the increasing prevalence of overweight/obesity in the general population, and the trend of increasing maternal age. However, it must be remembered that some women newly diagnosed with diabetes in pregnancy have latent type 1 diabetes; GAD (glutamic acid decarboxylase) antibody measurement may be useful in cases with atypical features. We present two such cases.Case...

The differential diagnosis of diabetes insipidus includes psychogenic polydipsia and a water deprivation test is sometimes difficult to perform due to patient’s confusion, compliance or extreme thirst. We present a simple, cost effective alternative to the water deprivation test.67-year-old male was admitted with a 3 week history of polyuria, polydipsia and extreme thirst. On systemic enquiry he complained of left sided pleuritic chest pain for few ...

Patients with significant hypercalcaemia unrelated to primary hyperparathyroidism have suppressed or undetectable levels of Parathyroid Hormone (PTH). We present a case where the hypercalcaemia was not due to primary hyperparathyroidism yet the PTH was elevated.82 year old male was admitted with 2 weeks history of lethargy, vomiting, increased frequency of micturiton, light headedness and confusional state. Past medical history included Type 2 diabetes, ...

We present a complex case of basal skull prolactinoma presenting with CSF rhinorrhoea and without elevated prolactin. Our case is a 41 year woman who presented 2 years ago with streptococcal meningitis and CSF rhinorrhoea. Initial imaging suggested right sphenoid tumour eroding the skull base involving structures in anterior and middle cranial fossa. After the tumour was biopsied by ENT team, she developed signs of recurrent meningitis, therefore referred to neurosurgery. She ...

Background: Adrenal incidentalomas are discovered unexpectedly and with increasing frequency on cross-sectional imaging acquired for reasons unrelated to adrenal dysfunction. Whilst the majority are non-functioning, literature suggests there is an increased risk of malignancy for adrenal incidentalomas above 4 cm. American guidelines advising resection of all incidentalomas above 4 cm were established without strong evidence whilst European guidelines adopt a more pragmatic ap...

Morvan’s syndrome is a rare autoimmune disease characterised by peripheral nerve hyper excitability, CNS symptoms and autonomic dysfunction which can mimic other endocrine presentations with symptoms including hyperhidrosis, weight loss, neuromyotonia and insomnia. Morvan’s is associated with malignancy, in particular thymomas, suggesting paraneoplastic aetiology. This case is the first to associate Morvan’s with renal carcinoma and proposes insulin like growth ...

Morvan’s syndrome is a rare autoimmune disease characterised by peripheral nerve hyper excitability, central nervous system symptoms and autonomic dysfunction which can mimic other endocrine presentations with symptoms including hyperhidrosis, weight loss, neuromyotonia and insomnia. Morvan’s is associated with malignancy, in particular thymomas, suggesting a paraneoplastic aetiology. This case is the first to associate Morvan’s with renal carcinoma and proposes...

GnRH neurons are vital for reproductive competence. These neurons originate mainly in the nasal epithelium and migrate to the preoptic region of the hypothalamus during foetal development. Defective migration may result in Hypogonadotropic Hypogonadism (HH), a condition in which puberty is never or only partially achieved.Little is known about the molecular ontogeny and regulation of GnRH neurons. Their anatomical localisation and small numbers (about 10...

A 70-year-old woman was referred to the endocrine clinic with recently diagnosed diabetes mellitus and poorly controlled systemic hypertension. At presentation she had clinical features of Cushing’s syndrome including central obesity, Cushingoid facies and marked proximal myopathy. BP was 220/190. Initial biochemistry revealed plasma sodium 140 mmol/l, potassium 3.6 mmol/l and creatinine 82 mmol/l. Overnight 1 mg dexamethasone suppression test revealed cortisol 1148 mmol/...

We carried out a series of experiments to identify common principles underlying the temporal organization of diverse circadian rhythms in endocrine and other functions in humans. Profiles of rhythms in plasma hormone levels, body temperature, and arousal state were measured while subjects remained at rest in continuous dim ( < 1 lux) light, after they had been exposed to artificial 'days' and 'nights' of different lengths. Subjects gave written informed consent for their pa...