Endocrine Abstracts

Background: Glucagon (GST) is used as an alternative to insulin (ITT) to diagnose GH deficiency (GHD) and adrenal insufficiency (ACTHd). However the peak cortisol response to diagnose adrenal insufficiency varies (550, and 500 nmol/l), has been extrapolated from adults undergoing intraoperative stress and not fully validated.Aim: To determine the peak cortisol ‘cut off’ level which most accurately predicts clinically significant adrenal insuffi...

Introduction: Glucocorticoid replacement therapy uses twice or thrice daily regimens of hydrocortisone (HC) with variable distribution of the dose over the day. Deconvolution analysis determines the mass of hormone that needs to be secreted to attain a particular serum concentration. We have used this methodology to determine the amount and distribution of cortisol over a 24 h period.Methods: Seventy-nine adults (41M) aged 60–74 years and 30 childre...

Introduction: Delivering an equitable service is one component defining a quality service. Various factors impact on diabetes control including health beliefs and socioeconomic pressures. To determine the role played by ethnicity and/or deprivation we audited access to insulin treatment regimens and overall diabetes control in our clinic population of children and young people with type 1 diabetes mellitus (CYPT1DM).Methods: Three hundred and twenty-five...

Introduction: Neonatal diabetes mellitus is a rare condition with an estimated incidence of 1 in 400 000 live births in the UK population. Half of these cases will have permanent neonatal diabetes mellitus (PNDM). We report a homozygous missense mutation (R397L) in the glucokinase (GCK) gene which is associated with PNDM, in an infant from a consanguineous Asian family.Case report: The baby was born with a birth weight of 1.68 kg at 38 weeks gesta...

In humans Growth Hormone Receptor (GHR) transcripts exist in two isoforms, the full-length (GHRfl) or exon 3 deletion isoform (GHRd3). Individuals with the GHRd3 isoform are associated with an increased response to recombinant human GH. The d3/fl-GHR polymorphism does not influence adult height. However, an association with the d3/fl-GHR polymorphism has been found with antenatal growth especially in small for gestational age (SGA) infants. H...

Background: Premature pubic hair development, with or without manifestations of androgen production, is a common clinical presentation. Premature adrenarche (PA) needs to be differentially diagnosed from congenital adrenal hyperplasia (CAH) and may be associated with early development of puberty.Aim: To study the characteristics at presentation, endocrine profile and outcome of patients who presented with premature pubic hair development. We studied retr...

Introduction: The Autoimmune Polyendocrinopathy Syndromes (APS) comprise 4 clinical subtypes (1–4), APS type 1 is an autosomal recessive disorder caused by mutations in the AIRE (Autoimmune Regulator) gene. It should include at least 2 of the following 3 major criteria: chronic mucocutaneous candidiasis (CMC), hypoparathyroidism (HPT) and adrenal insufficiency (AI) although 50% of patients develop all 3 features, usually before the age of 20 years. In addition, there are ...

Background: Holoprosencephaly (HPE) is a brain malformation that results from a defect in the patterning of the forebrain. Children with the most severe forms of HPE have endocrine deficits, in addition to neurologic and visual impairment. Forebrain abnormalities and pituitary hormone deficiencies are also part of the clinical spectrum of septo-optic dysplasia (SOD).Aim: Describe the spectrum of endocrinopathies in children with HPE and compare their cha...

Background: Adrenal insufficiency is a well-recognised feature of congenital adrenal hyperplasia (CAH).CAH is commonly treated with oral steroid replacement, taken 2–3 times a day, at doses that aim to reproduce normal diurnal variation. Though acceptable for most patients, this does not control others, resulting in high levels of 17-hydroxyprogesterone-acetate (17OHP), ACTH, and the need for increased doses of steroid replacement, with associated c...

Background: Congenital adrenal hyperplasia (CAH) is a recessively inherited deficiency of cortisol production associated with life-threatening adrenal crisis, accelerated growth and excess virilising hormone production, which may result in girls being incorrectly assigned as boys at birth. Newborn screening for CAH has not been introduced in the UK, reflecting concerns about false positive diagnoses, as well as inconsistent information about disease frequency and severity. A n...