Endocrine Abstracts

The cell surface calcium receptor (CaR) in the parathyroid gland plays a central role in the regulation of serum calcium homeostasis. Activation and inactivation mutations in the CaR lead to chronic hypocalcemia and hypercalcemia states (Brown, EM. Mutations in the calcium-sensing receptor and their clinical implications. Horm Res 1997 48 199–208). Type 11 calcimimetics are a novel class of compounds that directly reduce PTH secretion from the parathyroid ce...

Phosphate is an essential ion for mineralization of bone. Hypophosphatemia leads to rickets and osteomalacia whereas hyperphosphatemia promotes ectopic calcification in soft tissues. FGF23 is a polypeptide hormone secreted by bone that regulates serum phosphate concentration. It acts on kidney to decrease phosphate reabsorption, and 1,25-dihydroxy vitamin D secretion which in turn reduces phosphorus absorption by the gut. Its action on the renal tubule appears to require PTH a...

PHP has four serious complications: urinary calcium stone disease; nephrocalcinosis; high-turnover metabolic bone disease; and hypercalcemia. Medical management is reserved for patients who are asymptomatic or who have failed, refused or are unfit for surgery. Aims of medical management are to prevent increase in severity of disease and to ameliorate and prevent the disease complications.Prevention of increase in severity includes regular follow-up, ensu...

Introduction: The ultimate goal of a diabetes transition service is to provide coordinated, uninterrupted and developmentally appropriate healthcare, which promotes skills in decision-making, communication, autonomy, and self-care, with an essential component required to achieve this, being adequate resourcing.Methods: Data from Yorkshire and South West London CYP diabetes networks were collected via questionnaire. The primary focus was to ascertain whic...

Introduction: Phytoestrogens are derived from plants that are structurally and functionally similar to oestrogens. Their health benefits are widely extolled, although excessive consumption in children may cause adverse effects.Case 1: A 5.7-year old female presented with a one-month history of breast development and a 3-day history of vaginal bleeding. Prior to presentation, she was taking a health drink containing fennel and sesame seeds, in addition to...

Omnitrope is a biosimilar growth hormone (GH) preparation with a lower acquisition cost than other GH preparations. We switched adult patients with growth hormone deficiency treated with Genotropin (n=14, age 59.2±13.7 [mean±SD] yrs, 8 male) to Omnitrope at an equivalent dose. There followed titration visits every month for 3 months then visits every 3 months until 9 months. GH dose (0.5±0.0 vs 0.5±0.0 mg [mean±SD],...

Introduction: The 1 μg low dose short Synacthen tests (LDSST) and the glucagon stimulation tests (GST) have been suggested to be safer alternatives to the insulin induced hypoglycaemia stress test. The aim of this study was to compare the peak plasma cortisol concentration in response to a LDSST followed 60 min later by a GST in children undergoing investigation for short stature.Methods: We retrospectively studied 38 patients (19 female, 19 male) w...

Introduction: The prenatal treatment of Congenital Adrenal Hyperplasia (CAH) with Dexamethasone (Dex) is effective at minimising virilisation in affected females. Treatment is initiated with Dex at 20 mcg/kg per day (max 1.5 mg/day) as soon as pregnancy is confirmed and continued to term in affected females only. There are concerns regarding neurocognitive difficulties in children exposed to prenatal Dex, but no reports of late intra-uterine deaths (IUD) attributed to prenatal...

Patients with persistent PHPT after parathyroidectomy (PTX) or contraindications for PTX often require chronic treatment for hypercalcemia, representing an unmet medical need. In an open-label, single-arm study in the US and EU, 17 patients underwent a variable length titration phase (maximum 16 weeks) with a maintenance phase (MP) of up to 3 years. Patients were eligible if they had (1) persistent PHPT following PTX or were considered contraindicated for PTX, and (2) serum ca...

Introduction: Acute renal failure (ARF) is a rare but life-threatening complication of severe diabetic ketoacidosis (DKA) in children.Aim: To characterise the presentation, treatment and clinical course of children with DKA complicated by severe ARF requiring renal support.Method: Retrospective notes review of patients aged <16 years admitted in 2011–2016 to 3 UK regional paediatric intensive care units (St George’s H...