Endocrine Abstracts

Background: The melanocortin system is known to be involved in hypothalamic regulation of energy balance, which is implicated in reproductive success. However, the peripheral role for melanocortin receptor (MCR) signalling in the reproductive system has not been described. During a clinical trial of repeated high dose tetracosactide (ACTH1–24) injection, four of nine premenopausal women with Addison’s disease developed menstrual disturbances. We wondered i...

Background: The plasticity of adrenal cortex suggests the presence of adrenocortical stem cells (ACSC) but the exact in vivo identity of ACSC remains elusive. A few studies have demonstrated the differentiation of adipose or bone marrow-derived mesenchymal stem cells (MSC) into steroid-producing cells. We therefore investigated the direct isolation of MSC from human adrenal cortex.Methods: Adrenals were obtained as discarded surgical material. S...

A 54-year-old lady presented with malaise, weakness, and constipation. She was found to be mildly hypercalcaemia (adjusted calcium 2.68–2.76 mmol/l; reference range 2.12–2.60 mmol/l) and was referred to local endocrinology services. Her PTH was 79 ng/l (range 10–60) and a diagnosis of primary hyperparathyroidism was made. Imaging to localise a parathyroid source was negative. She was referred to the endocrine surgeons at the Royal Victoria Infirmary, Newcastle, ...

We present two patients with significant hypokalaemia initially attributed to liquorice use.Case 1: A 52-year-old engineer was noted to have a potassium level of 2.5 mmol/l (3.5–5.3 mmol/l) at a Well Man check-up. He had no significant past history, and took no medications. He was normotensive. The patient reported regular liquorice use. The hypokalaemia corrected with supplementation equivalent to 48 mmol K+ daily, and with cessation of ...

Introduction: The association between fatigue, functional status and subclinical hypothyroidism (SCH) remains unclear. The available data is not consistent, and this is likely to be due to selection bias in studies recruiting patients from clinic rather than unselected community populations. Only population surveys looking at prevalence of fatigue and functional status in SCH are likely to provide the answer.Objective and Methodology: We compared the pre...

Male hypogonadism is characterised by sexual dysfunction, loss of muscle bulk, central obesity, fatigue, mood and sleep disturbances, osteoporosis and anaemia. Although these features are associated with low serum testosterone concentration, not all men with a low serum testosterone are definitively hypogonadal, and there is a large symptom overlap with obesity and non-endocrine illness. Importantly, testosterone replacement therapy may not be appropriate for men with mild, fu...

Postoperative hypocalcaemia is usually transient; we present a case report of persistent symptomatic hypocalcaemia following elective thyroid surgery; its challenging pharmaceutical management including the successful use of a novel therapeutic agent. A 56 yr old woman with known type 2 diabetes, morbid obesity (treated with gastric band), and benign intracranial hypertension underwent total thyroidectomy for a multi-nodular goitre, following which she became symptomatic with ...

Sialic acid acetylesterase (SIAE) has been found to be essential for the maintenance of immune tolerance in mice by negatively regulating B lymphocyte antigen receptor signalling. Recently, numerous rare heterozygous loss-of-function germline variants and a homozygous functionally defective variant of the SIAE gene (M89V) have been identified as conferring a strong genetic susceptibility to several autoimmune disorders, including T1DM and rheumatoid arthritis. We performed a c...

After adrenal insufficiency is confirmed by synacthen testing, lifelong steroid replacement is expected. We report a case of apparent reversal of adrenal insufficiency. Case details: a 66-year-old man was referred for oral pigmentation, and a random cortisol level of 184 nmol/l. He reported a 2-year history of tiredness, nocturia, dry mouth and reduced libido. There was no dizziness, salt-craving, or weight loss. He denied taking any form of steroid or over-the-counter drugs. ...

Background: Thyroid hormone replacement is one of the most commonly prescribed and cheapest treatments for a chronic disease. There have been recent changes in community prescribing policies in many areas of the UK that have changed patient access to necessary medications.Aim: To provide a picture of thyroid hormone usage in the UK and to survey patient opinion about current community prescribing policies for levothyroxine.Methods:...