Endocrine Abstracts

Glucocorticoids have profound effects in development, altering cell proliferation, differentiation, migration and network formation. It has been shown that the developing fetus is protected from high maternal glucocorticoid levels by the presence of 11beta-HSD2 in the placenta and if this enzyme is inhibited, programmed changes of adult health are observed (hypertension, hyperglycaemia, insulin resistance). The developing brain is a sensitive target for glucocorticoids and hen...

Aim: To determine if inpatient hypoglycemia management in our trust is compliant with NICE guidelines and understand the conundrums in documentation and treatment of the hypoglycemic episodes.Method: Retrospective audit on all patients admitted in Huddersfield Royal Infirmary who had hypoglycemic episode(s) in March 2021 which were picked up by wireless-enabled central capillary blood glucose monitoring system (cobas)1.R...

Introduction: The reason for weight gain is multifactorial. Effective intervention can only be incorporated if the underlying cause is evaluated correctly. Here we present a lady with Addison’s disease who gain significant weight and was helped to lose weight using a novel approach.Case-Report: 42 year-old lady was referred to our weight-management service as she was unsuccessful in losing weight. Detailed evaluation in the obesity clinic revealed t...

Introduction: Radioactive iodine (RAI) is an effective and widely used treatment for thyrotoxicosis. Post-radioiodine thyrotoxicosis is a well-known side effect of RAI. This is usually mild and easily controlled mostly with beta blockers but sometimes needs anti-thyroid drugs (ATD).Aim of the study: To assess the incidence and predictors of post-radioiodine thyrotoxicosis.Methods: Retrospective analysis of 86 patients who had RAI t...

Increased intake of sodium is postulated to be controlled by aldosterone-sensitive cells in a select region of the adult mouse brain, the nucleus of the solitary tract (NTS). These cells express the enzyme 11β-hydroxysteroid dehydrogenase type 2 (HSD2) which inactivates glucocorticoids, allowing selective activation of mineralocorticoid receptors by aldosterone. However in the developing brain, HSD2 is widely expressed to protect against adverse glucocorticoid action, whi...

Background: Chronically elevated brain glucocorticoid (GC) levels impair cognition. In rodents, raised GC levels prior to lipopolyaccharide (LPS) administration potentiate neuroinflammation although GC suppresses neuroinflammation if administered after LPS. 11β-hydroxysteroid dehydrogenase-1 (11β-HSD1) activity can increase intracellular GC levels, including in the brain, without alteration in circulating levels. 11β-HSD1 deficiency/inhibition protects against a...

Background: Hypercortisol states present a diagnostic conundrum. Other conditions such as cyclical and subclinical Cushings pose additional challenges. We report a complex clinical presentation of thymoma with coexisting subclinical Cushing’s.Case report: A 65-year-old man presented to chest clinic with breathlessness and anterior mediastinal mass on CXR. CT scan demonstrated a 7.5 cm probable thymoma and bilateral adrenal masses of varying sizes up...

Background: Elevated TSH with raised free T4 (fT4) presents a diagnostic challenge. Symptomatically they vary across the spectrum of thyroid status. We report cases with these dilemmas.Case 1: Seventy four year old was referred with 5 years of TSH ranging between 4.9–7.9 mIU/l (0.2–4.0), fT4 18.5–27 pmol/l (9.0–19) and free T3 (fT3) 4.5–12 pmol/l (2.5–5.7). Thyroid perox...

In addition to their essential role in fetal lung development, glucocorticoids promote late-gestation maturation of the fetal heart as shown by severe functional impairment, structural disorganisation and transcriptome immaturity in fetal hearts of glucocorticoid receptor-deficient (GR-/-) mice. Here we use primary fetal mouse cardiomyocytes (E16-E17.5) to investigate whether these effects of glucocorticoids result from direct actions of GR and whether they are independent of ...

Introduction: Optimising management of diabetes in school is critical especially with more children being commenced on intensive insulin regimens. Partnership between families, school and caregivers is essential to enhance safety and satisfaction with the educational experience for students.Methodology: We gathered information on facilities in schools for children with T1D from our district hospital by telephonic questionnaire. The questions related to p...