Endocrine Abstracts

A 48-year-old non-smoking female was seen in the chest clinic for cough and breathlessness on a background of asthma type symptoms for 20 years. Her cough was exacerbated by inhalers, productive of yellow sputum and intermittent streaks of blood. On examination, her lungs were clear but coughed continuously with an unusual duration of five minutes. Pulmonary function test showed an obstructive picture. CT scan showed bronchiectasis with multiple small nodules scattered through...

A 42-year-old female had extensive neurological investigations (normal MRI brain, EEG, NCS). A low CSF glucose triggered endocrine referral. She had a history of ill health/fatigue since 19 years when she had a viral illness with seizure-like episode and transient wheelchair dependance, with no formal diagnosis made. She had recurrent symptoms including fatigue, myalgia and weakness, with some relation to hunger and fasting.Physical examination revealed ...

Loss of muscle mass is associated with ageing and several degenerative pathological conditions which limit movement and critically impair quality of life. One key regulator of muscle mass is myostatin which inhibits muscle growth. In circulation, myostatin is bound to follistatin-like 3 (FSTL3) in an inactive complex. FSTL3 is a natural, soluble regulator of myostatin along with follistatin (FST) and myostatin propeptide. In the FSTL3 gene deleted mouse (FSTL3 KO), however, to...

Objective: Gestational diabetes mellitus occurs in 2–9 percent of all pregnancies. It is associated with substantial maternal and perinatal complications which can all be reduced if it is diagnosed. In UK 65% of pregnant complicated by diabetes involve gestational diabetes. Professional bodies disagree about whether to recommend routine screening, selective screening or no screening of gestational diabetes. The NICE guidelines are in progress and are expected by end of 20...

Background: Considerable overlap of IGF-I levels exists between normal subjects and those with severe GHD determined by conventional testing of GH status. Recognised factors influencing IGF-I status in GHD patients include age, gender, timing of onset of GHD and exogenous oestrogen therapy, but these do not fully explain the GH/IGF-I discordance in severe GHD. The primary structures of prolactin and GH are similar. Effects of hypoprolactinaemia are not well described in humans...

Although prolactin is well recognised as a cytokine, effects of hypoprolactinaemia on biological endpoints are not well described in humans. In-vitro and clinical studies suggest an influence on humoral and cell mediated immunity and autoimmunity. We studied basal and stimulated immune function in panhypopituitary adults with and without prolactin deficiency and age and gender matched healthy controls. The study was approved by hospital and local research ethics committees. Ni...

Adult growth hormone replacement is currently given by daily sc injections in the vast majority of children and adults treated for growth hormone (GH) deficiency. In recent years, sustained-release preparations of GH have been developed; the preparations available so far maintained therapeutic GH concentrations for approximately 14 days, but were characterised by a dominant early release, which resulted in high supraphysiological early GH peaks, and a rapid decline thereafter....

OBJECTIVE: To quantify the extent of change in total body water (TBW) and nature of its relationship with changes in body composition, measured by direct methods, during physiological GH replacement in severely GHD adults.METHODS: Thirty (16 female, age range 17-65 years) severely GHD adults were studied. Patients with diabetes insipidus, cardiovascular or renal disease requiring diuretic therapy were excluded. Patients with other pituitary deficits had ...

OBJECTIVE: To determine whether the quality of life improvement, observed with long-term physiological GH replacement, is correlated with favourable changes in body composition or total body water (TBW) measured by direct methods.METHODS: Thirty (16 female, age range 17-65 years) severely GHD adults were studied. Patients with diabetes insipidus, cardiovascular or renal disease requiring diuretic therapy were excluded. Patients with additional pituitary ...

OBJECTIVE: To investigate the association between APD, treated Cushing's disease and severe hypopituitarism.METHODS: Fifty-seven patients (42 female), in remission after treatment for Cushing's disease, were studied. The cohort comprised 13 patients with, and 44 without APD. APD was defined as a serum prolactin persistently below the detection limit of the assay. Age and gender did not significantly differ between sub-groups.RESULT...