Endocrine Abstracts

Background: Immunotherapy with checkpoint inhibitors (CPI) {CTLA4 and PD-1 inhibitors} have significantly improved outcomes and survival rates in patients with a number of cancers. In the UK, Ipilimumab and Nivolumab are approved for the treatment of advanced malignant melanoma. These are often long term therapies and are associated with immune mediated endocrinopathies.Case: A 70 year old male presented to the Medical Admissions Unit with a history of l...

An 87 year old lady with a background of longstanding cognitive impairment was referred to our service with biochemical evidence of primary hyperparathyroidism. The patient had past medical history of type 2 diabetes mellitus, osteoporosis, hypothyroidism, ischaemic heart disease and primary hyperparathyroidism (under observation in a neighbouring health board). There was no pharmacological cause for cognitive impairment identified. Following acute admission after a fall with ...

Background: Vitamin B12 (B12) deficiency is associated with obesity and was recently shown to trigger lipid accumulation in the adipose tissues and liver. The body is capable of synthesizing fatty acids (FAs) endogenously via de novo lipogenesis in the liver. However, dysregulated levels are associated with adverse consequences in subjects. We therefore assessed B12 regulation of de novo fatty acid synthesis and the profile of various FAs in hepatocytes.<...

Background: Pituitary carcinoma is extremely rare and constitute only 0.1−0.2% of all pituitary tumors. Diagnosis is on evidence of metastasis, although these criteria has been challenged. Majority of pituitary carcinomas are functioning tumours, usually secreting ACTH (42%) or prolactin (33%). Common sites of metastasis include the brain, spinal cord, leptomeninges, bone, liver, lymph nodes and lung. Mean survival after detection of metastasis is around 1−2 years....

The active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) is abundant in decidua but its role in placental development is unclear. We hypothesized that decidual 1,25(OH)2D promotes placentation in early-pregnancy via actions on trophoblastic cell invasion. Using trophoblastic JEG3, BeWo and HTR8 cells we showed that 1,25(OH)2D has no effect on trophoblastic cell proliferation and migration in plasticware culture. However, in Matrigel t...

ATR-101 is a selective Acyl-CoA: cholesterol acyltransferase 1 (ACAT1) inhibitor in development for the treatment of diseases of the adrenal cortex including rare endocrine diseases, such as congenital adrenal hyperplasia (CAH) and Cushing’s syndrome (CS), and in adrenocortical carcinoma (ACC). ATR-101 has been shown to inhibit adrenal steroidogenesis at low doses and cause apoptosis at high doses. To better understand the adrenal-specific effects of ATR-101, in vivo<...

Background: The University Teaching Hospital Trust has a regional neuroendocrine tumour (NET) service that requires a database exclusively for NET patient information. UK and Ireland NET Society (UKINETS) guidelines for gastroenteropancreatic (GEP) NETs recommend plasma Chromogranin-A (Cg-A) and 24 h urinary 5-hydroxyindoacetic acid (24 h Ur 5-HIAA) as baseline investigations. This audit investigated both guideline adherence and the value of these tests in making the diagnosis...

Introduction: Bariatric surgery is now a common surgical procedure for weight management recommended by NICE. Complications such as dumping syndrome, micronutrient deficiencies are well documented in the literature. Here we discuss a lesser reported complication of adrenal insufficiency and its management in five patients following gastric bypass surgery.Case reports: All patients presented with one or more of the following symptoms: sweating, anxiety, w...

Introduction: Idiopathic Pituitary atrophy is rare cause of pan hypopituitarism. Various hypotheses were proposed to identify aetiology of idiopathic pituitary atrophy. Still definite cause is not known. There are very few reported cases of pituitary atrophy. We present a case of pituitary atrophy that required complete replacement of pan hypopituirsm to alleviate her symptoms.Case report: About 64 year lady was referred for evaluation of hyponatraemia a...

Introduction: Insulinoma is a neuroendocrine tumour derived from the pancreatic islet cells producing excessive amounts of insulin. It can be seen at every age but mostly seen in females above age 50 years old. Because of nonspecific symptoms 20% of cases are misdiagnosed primarily. Major symptoms and signs are related to hypoglycaemia and become significant due to exercise and fasting. This case reveals the diagnostic difficulty due to hypoglycaemia unawareness.<p class="...