Endocrine Abstracts

The current paradigm for management of acromegaly includes surgery as primary treatment regardless of whether or not this is likely to be curative. There is increasing evidence that somatostatin analogue medical therapy may produce shrinkage of growth hormone producing pituitary tumours. This study tests the hypothesis that primary medical therapy may produce clinically significant tumour shrinkage prior to surgery.Eleven treatment naïve subjects wi...

Background: Growth hormone (GH) excess is associated with increased insulin resistance (IR). Lanreotide autogel (Autogel) reduces GH-levels effectively in patients with active acromegaly. However, the effect of somatatostatin analogues on IR and (-cell function (HOMA %B) is complex and unpredictable. Our study prospectively monitored IR and related metabolic parameters in acromegalics treated with Autogel.Methods: Nine patients (P) with active acromegaly...

A 35-year-old woman was seen at the medical obstetric antenatal clinic with gestational diabetes (GDM) and new-onset hypertension during the second trimester of her first pregnancy. She was well, with no prior medical history. Blood pressure of 120/80 had been recorded at her first antenatal visit. Throughout the pregnancy, GDM was managed successfully with diet alone: HbA1c always <5.8%. Methyldopa was initiated for persistent hypertension at 18 weeks gestation, and labet...

Classical congenital adrenal hyperplasia (CAH) usually presents at birth with ambiguous genitalia or adrenal failure. Non-classical forms can present later with precocious puberty or may only present, in early adult life, with hyperandrogenism and amenorrhoea.An 86 year old lady presented with a toxic confusional state, male pattern balding and hirsuitism. Little history was available. The provisional diagnosis was an androgen secreting tumour, however, a history taken fro...

The cortisol day curve has been advocated in the assessment of glucocorticoid replacement therapy in adrenal failure but remains controversial.Objective: To determine the validity of this test within our practice.Method: A retrospective analysis using endocrine laboratory dataset.Results: 102 inpatient cortisol day curves from 76 patients were analysed. The serum cortisol was checked at 5 time points (pre and 1 hour post morning dose, before midday dose, pre and po...

Little is known about the place of insulin-like growth factors (IGFs) in preantral follicle development, although there is considerable evidence that IGFs are important in antral folliculogenesis. In the rat, isolated large preantral follicles developed better when cultured in vitro in the presence of IGF-I than without (Zhao et al 2001). In the same study, reverse transcriptase polymerase chain reaction identified mRNA for IGF-I and the type I receptor in the granulosa/theca ...

Background: Primary hyperparathyroidism is the commonest cause of hypercalcemia. Current guidelines advise to rule out familial hypocalciuric hypercalcemia (FHH) when evaluating hypercalcemia. It is widely considered that FHH is associated with low urine calcium creatinine clearance ratio (CCCR). However, low CCCR can also occur in Primary hyperparathyroidism.Case: A 30 years lady presented with hypercalcemia and high parathyroid hormone (PTH). She had a...

Background: Hypothalamus pituitary adrenal axis (HPA) dysfunction is associated with serious morbidity and mortality. Its symptoms can be non-specific. Objective diagnosis depends on clinical suspicion and confirmed on assessment of early morning cortisol or dynamic assessment of cortisol secretion. The cosyntropin or short synacthen test (SST) has emerged as the most common test to assess the HPA. The insulin stimulation test (IST) is the traditional ‘gold standard’...

Background: Myasthenia gravis and thyroid disease can sometimes create diagnostic confusion because the two may have similar clinical features and may also co-exist in the same individual.Case: A 68 years male, was seen in the Neurology clinic with drooping of his left eyelid, first noticed 8 months prior, worse in the evenings. There were no other complaints. He had history of type2 diabetes, and Graves’ disease. On examination, he appeared to have...

Understanding how pancreatic beta-cells develop during human development is essential to advance current protocols aimed at developing insulin-producing beta-cells in vitro and highlight therapeutic targets for diabetes treatment. Identifying the single-gene mutations which result in individuals developing diabetes in the first 6 months of life (a condition called neonatal diabetes) has the potential to give unique insights into the genes regulating human beta-cells w...