Endocrine Abstracts

Introduction: Tight metabolic control reduces the risk of microvascular complications in individuals with type 1 diabetes (T1DM). Multiple studies have shown improvements in quality of life (QOL) in children following the introduction of continuous subcutaneous insulin infusion (CSII) but metabolic outcomes have been more variable. This audit looked at metabolic parameters at long-term follow up in children and adolescents using CSII over 3 years.Methods...

Introduction: Congenital Adrenal Hyperplasia (CAH) carries a high risk of morbidity and mortality in undetected affected infants and has an estimated incidence of 1:15 000 based on newborn screening programmes internationally. This project aimed to identify cases and mode of diagnosis of CAH in the Republic of Ireland (ROI) to establish the case if any for screening.Methods: (i) A retrospective questionnaire was sent to all consultant paediatricians in R...

Introduction: Congenital hypothyroidism (CHT) has a reported incidence of 1:3500 in Caucasian populations. Early detection by newborn screening and appropriate L-thyroxine treatment leads to normal or near-normal neurocognitive outcome.The National Newborn screening programme (NNP) was established in Children’s University Hospital, Temple St. in 1979. This study aimed to ascertain the incidence of congenital hypothyroidism in the Republic of Ireland...

Obesity is associated with decreased hepatic reactivation of glucocorticoids (Gc) by 11β-hydroxysteroid dehydrogenase type 1 (11HSD) and increased metabolism of glucocorticoids by hepatic A-ring reductases, which may contribute to activation of the hypothalamic-pituitary-adrenal axis. Androgen action encourages central obesity and increased metabolic complications, possibly by altering Gc metabolism.This study investigates the role of gonadal androg...

Section 1: Case History: We present the case of a 52-year-old found female found collapsed at home with a three-week history of polyuria, polydipsia and lassitude on a background of primary hypothyroidism and non-insulin-dependent diabetes. On examination, she was hypothermic at 32°C, hypotensive (blood pressure 90/60 mmHg), newly oliguric, and had a Glasgow coma scale (GCS) of 9/15. A diagnosis of severe diabetic ketoacidosis (DKA) was made on admission. <p class="ab...

Primary CNS lymphoma (PCNSL) accounts for 0.85% - 2.0% of primary brain tumours. PCNSL arises in periventricular regions of the corpus callosum, with hypothalamic involvement less commonly. While cases have been reported in the literature, cranial diabetes insipidus (CDI) secondary to PCNSL is a rare phenomenon. We present this case series of three patients from our institution diagnosed with CDI and panhypopituitarism in the context of PCNSL.Cases: 1. 3...

Reproductive morbidity is increased in women with diabetes, including a higher prevalence of polycystic ovary syndrome, hypothalamic amenorrhoea and premature ovarian failure. Routine discussion of reproductive and menstrual dysfunction for women with diabetes remains a peripheral feature of clinical consultations. Here we aimed to determine women’s own reproductive care experience. We surveyed women of all ages attending routine diabetes care using a detailed clinical qu...

Ectopic ACTH syndrome is a rare condition occurring in five to ten percent of ACTH dependent hypercortisolism. We present the case of a fifty eight year old gentleman who presented with severe hyperosmolar hyperglycaemic state (blood glucose fifty seven mmol/l) and acute decompensated heart failure associated with elevated liver enzymes. Liver ultrasound followed by computed tomography of thorax abdomen and pelvis showed a lung tumour with liver metastases. Clinical suspicion ...

Lipodystrophy represents a broad spectrum of disorders, subdivided depending on aetiology (congenital or acquired) or the extent of adipose tissue absence (generalised or partial). A lack of adipose tissue results in systemic insulin resistance and ectopic fat deposition, which predisposes patients to metabolic syndrome and associated conditions such as non-alcoholic fatty liver disease and diabetes mellitus. Additionally, severe hyperinsulinaemia can generate ovarian androgen...

First line screening for pheochromocytoma, as recommend by Endocrine Society guidelines, is to determine plasma free or urinary fractionated metanephrines. We routinely offer the latter. Although negative results rule out pheochromocytoma, it is not uncommon to see borderline results which require further investigation. In this situation we have historically relied on the measurement of plasma catecholamines in the clonidine suppression test (CST). Plasma metanephrines, howeve...