Endocrine Abstracts

Pseudohypoparathyroidism type 1b is a disorder of calcium metabolism resulting from renal resistance to PTH, the genetic basis caused by abnormal imprinting and thus expression of the gene encoding the Gs alpha-subunit (GSα) of the stimulatory G protein.For patients with PHP 1b, pregnancy raises issues regarding management of calcium and vitamin D homeostasis as well as more difficult aspects such as genetic counselling.<p class="abst...

A 70 yr old man presented with an episode of syncope and complaints of leg weakness. He was hypogonadal with coarse facial features and a marked proximal myopathy. Hypopituitarism was confirmed biochemically: serum FT4 7.7 pmol/l (9.7-25.7), TSH 1.65 mIU/l (0.05-5.00), FSH 1.8 IU/l (1.6-18.0), LH 1.0 IU/l (2.0-18.0), testosterone 1.13 nmol/l (5.70-28.8) and 9am cortisol 122 nmol/l. Treatment with hydrocortisone and thyroxine was commenced. Further investigation revealed elevat...

Aim: Anti-thyroid treatment with carbimazole or propylthiouracil is the first-line treatment for autoimmune thyrotoxicosis in the UK. Following 12–18 months treatment there is a significant relapse rate (at least 50%). This study analysed the demographics and clinical features of 100 patients with relapsed thyrotoxicosis to examine which variables are predictive of relapse.Methods: This retrospective study included adult patients identified using ou...

Case history: A 26 year old female with severe gastro-oesophageal reflux disease was seen in our service for assessment prior to roux-en-Y gastric bypass (RYGB) surgery for this condition. She had additional history of obesity, hypertension, insomnia, cholecystectomy for gallstones and anxiety-depression. At age 18 her weight was 85 kg, BMI 28 kg/m2. She gained 40 kg over the subsequent 8 years and in clinic was 123 kg, BMI 41.1 kg/m2 with a gynaecoid pat...

Background: Bariatric surgery is considered the most effective tool to manage the growing pandemic of obesity related health disorders. Lack of regular surveillance following bariatric procedures can put patients at risk of developing serious micro-nutritional deficiencies and related complications.Case report: A 51-year-old lady presented to the bariatric services in 2015 with long standing neurological symptoms including memory and cognitive impairment...

Introduction: Primary hyperaldosteronism (PHA) accounts for 5–13% of all hypertension and up to 20% of resistant hypertension. Aldosterone producing adenomas (APA) account for 60% of PHA and surgical resection in these patients can be curative. There is no consensus on the need for and duration of follow-up after adrenalectomy. This study assessed the immediate effect of unilateral adrenalectomy for APA on the serum potassium, renin and aldosterone levels. Acute effects o...

Introduction: Gestational diabetes mellitus (GDM) is an important co-morbidity of pregnancy, with insulin resistance a key contributor in its underlying pathology. Relaxin is a hormone considered crucial for mediating adaptations deemed vital for maintenance of pregnancy. Evidence has suggested that levels of plasma relaxin may be positively correlated with insulin sensitivity. This led us to hypothesize that relaxin may play a role in the pathogenesis of insulin resistance in...

Opioid analgesia impairs gonadal function in healthy men and women. Methadone, a synthetic opioid is used in opioid addicts to prevent relapse due its longer-lasting effects and is known to cause hypogonadism. Little data exists on the prevalence of this and the mechanism through which this occurs.Men (n=147), mean age 36.2 years (S.D 7.2) attending a drug-treatment rehabilitation centre for methadone maintenance therapy had early m...

Introduction: Antiphospholipid syndrome (APS) is the association of anti-cardiolipin antibodies and venous & arterial thrombosis. APS accounts for <0.5% of cases of hypoadrenalism. We present a series of 5 such cases occurring at our institution plus a further patient identified with unilateral adrenal haemorrhage. Case 1 presented with nausea, vomiting and weight loss. Lupus anticoagulant positive. Commenced aspirin 300 mg. 6-weeks later represented with dehydration, ...

The management of childhood obesity has evolved from hospital led treatment to community-based programmes. This is an audit reviewing the impact of the active children eating smart (ACES) programme for overweight/obese children on the dietetic department in the Royal Hospital for Sick Children; Glasgow. A retrospective audit was carried out of referrals to the dietetic department. Clinic lists for dietetic appointments in 2008 and 2010 were identified and reviewed. In 2008 and...