Endocrine Abstracts

Background: The autoimmune thyroid diseases, primary autoimmune hypothyroidism (AH) and Graves’ hyperthyroidism (GD), represent the most prevalent endocrine disorders. Although clinically distinct, they share several genetic susceptibility loci, many of which remain unidentified.TIGIT (T cell immunoreceptor with immunoglobulin and ITIM domains), expressed on the surface of T-cells, interacts with CD-155 on dendritic cells to form an alternative cost...

Background: Idiopathic intracranial hypertension (IIH) predominantly affects obese women of childbearing age. IIH is characterised by increased intracranial pressure (ICP) which results in visual loss and disabling headaches. ICP dis-regulation results from imbalance of cerebrospinal fluid (CSF) production rate (at the choroid plexus epithelial cells) and drainage. Treatments for IIH are limited but weight loss is established as disease modifying.Glucago...

ACTH is a 39 amino acids polypeptide which stimulates adrenocortical steroid production. The N-terminal segment of ACTH(1–24) is biologically active and the C-terminal is considered to have greater antigenicity. In one previous (‘RoSA’) and one current (‘RADS2’) clinical trial synthetic ACTH (zinc tetracosactide; depot synacthen) was administered to autoimmune Addison’s disease (AAD) patients to stimulate adrenocortical regeneration. 4/13 RoSA pat...

A 61-year-old lady presented with rapid onset of lethargy and reduced mobility with inability to use stairs over 1 month. Prior to this, she was fit and well and was a lifelong non-smoker. At presentation, she was overweight and had evidence of skin bruising and severe proximal myopathy of her legs. A midnight cortisol was >1710 nmol/l with a corresponding ACTH of 610 nmol/l confirming ACTH dependent Cushing’s syndrome. Serum potassium was 2.6 mmol/l and a new diagnos...

Management of newly-diagnosed non-functioning pituitary adenomas (NFPAs) has evolved over the last decade. Whilst surgical debulking remains the mainstay of treatment for patients presenting with compressive disease, the use of pituitary irradiation has declined, with greater emphasis on observation or further surgical debulking. We aimed to compare outcomes of treatment for NFPAs at our institution since 2004 with older management strategies.We reviewed...

Reproductive disorders in males that manifest at birth (cryptorchidism, hypospadias), or young adulthood (low sperm count, lower testosterone levels, testicular cancer) may share a common origin and constitute a ‘testicular dysgenesis syndrome’ (TDS). Normal reproductive tract development is programmed by androgens within the ‘masculinisation programming window’ (MPW, e15.5–e18.5-rats; ~8–14 weeks’ gestation-humans). In rats, TDS disorders ca...

Introduction: We submit a rare presentation of round blue cell pituitary tumour complicated by cranial diabetes insipidus following transphenoidal surgery.Case history: 47-year-old lady with severe headache was diagnosed with a 10 mm non functioning pituitary macro adenoma. Initial plan for conservative management was revised as she developed sixth cranial nerve palsy, bi temporal hemianopia and rapidly enlarging pituitary tumour to 20×18×19 mm...

Background: Immune responses to self-peptides should not generally occur. However, four of 12 autoimmune Addison’s disease (AAD) patients developed adverse reactions immediately after synacthen injections, following repeated subcutaneous synacthen injections during a clinical trial (RoSA study). We wondered if these adverse effects were due to the production of anti-synacthen (ACTH1–24) antibodies.Methods: We evaluated the presence o...

Background: The need for improved glycaemic control in children with type 1 diabetes in Scotland is well recognised; DIABAUD 3 identified that only 9.7% achieved the national HbA1c target.Aim: To evaluate whether a change from three times daily injection regimen to a basal bolus regimen with carbohydrate counting at diagnosis will result in an improvement in immediate and longer term glycaemic control.Method: We included children &...

Corepressors and coactivators mediate thyroid hormone receptor-dependent repression and transactivation of positively-regulated target genes respectively, but their role in negative regulation is not understood.A 4 years old boy was born at 31 weeks. He was jittery at birth, with neonatal respiratory distress. Childhood features included poor weight gain, heat intolerance, tachycardia and hyperactivity. Ongoing problems are low frequency hearing loss, po...