Endocrine Abstracts

Introduction: The short Synacthen test (SST) is a popular diagnostic investigation for adrenal insufficiency (AI). Cannulation and blood sampling are required making it invasive, time-consuming and resource-intensive. Salivary cortisol is a well-established alternative to serum sampling. We have developed a non-invasive alternative to the 1 μg SST, using a novel formulation of Synacthen (with a nasal drug enhancer, chitosan) given nasally and utilising saliva to measure t...

Introduction: 85% of cases of primary hyperparathyroidism are caused by a parathyroid adenoma. These are usually small in size, in the range of 70 mg to 1 g. Those weighing more than 2 g are classified as ‘giant adenomas’. Few adenomas weighing more than 30 g have been described in the literature. Here we present one such case.Case report: A 52-year-old female presenting with lethargy was found to have a corrected calcium of 3.15 mmol/l with a ...

Introduction: A 2009 BSPED survey revealed that 90% use a low dose Synacthen test (LDST) and 44% had noticed increased referrals of asthmatic children prescribed inhaled corticosteroids (ICS). Approximately 21% of UK children have asthma of whom 70% are prescribed ICS (10% at ‘high dose’). There is an increasing need for a simple, less invasive, alternative to the LDST to evaluate their adrenal function. We are developing a non-invasive LDST, with Synacthen administe...

Medullary thyroid cancers (MTC) account for about 5% of thyroid cancers. The biochemical hallmark of MTC is the secretion of calcitonin (CT). CT levels are both a key feature of pre-operative diagnosis and post-operative follow up. CT screening in a cohort of over 10 000 patients with thyroid nodular disease has demonstrated that a positive CT test has a higher diagnostic sensitivity and specificity for MTC than fine needle aspiration (FNA). They may also secrete carcinoembryo...

Introduction: Successful treatment for childhood-onset Hodgkin lymphoma (HL) has highlighted long-term effects of therapy. We review endocrinopathy in HL survivors attending a hospital follow-up clinic and consider, together with published data, appropriate disease screening and monitoring.Method: Retrospective review of notes and investigations from survivors of childhood HL ≥5 years from diagnosis.Results: Forty-four subjec...

Audit standard: All patients should receive written and verbal advice about the risk of neutropenia associated with the use of anti-thyroid drugs. Compliance rate 100%.Our Endocrinology Department has a detailed patient information sheet that is provided to the patients at the time of initiation of anti-thyroid drugs.Background: Recently, a patient was admitted with neutropenia secondary to the use of carbimazole. She did not know ...

The G protein-coupled receptor (GPCR), follicle stimulating hormone receptor (FSHR) plays a critical role in ovarian function and reproduction, with multiple functions in follicle growth, maturation, survival, and steroid hormone production. Yet how FSH/FSHR mediates these pleiotrophic physiological roles remains unknown. Numerous studies indicate GPCRs can regulate and diversify their actions through receptor-receptor association and the formation of dimers/oligomers. Moreove...

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...

Localized transitions in chromatin structure accompany nuclear receptor binding events in mammalian cells. These remodeling processes are critical to determine the binding landscape for steroid receptors (SRs) in cancer cells. Multiple reports indicate that steroid receptors (ER, GR, AR, PR) can regulate the binding patterns for each other, particularly during cancer progression. Elucidation of the mechanisms by which these ‘chromatin opening’ processes occur is cent...

Hyponatremia is the commonest electrolyte abnormality presenting to Medical Admissions and when acute, severe and symptomatic, is associated with high mortality. The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common underlying disorder in hospitalised patients with euvolaemic hyponatraemia and is a complication of many clinical conditions and drug therapies.We discuss the cases of two patients...