Endocrine Abstracts

An 88 year-old male was referred to Endocrine Clinic with abnormal thyroid function test (TFT); free T4:fT4: 36.9pmol/L (NR:11-23) and a normal TSH:2.51mU/L (NR:0.35-5). Atrial Fibrilation was diagnosed recently and was on Apixiban and Bisoprolol. He had history of prostate cancer, hypertension, oesophagitis, cervical spondylosis, splenectomy and CKD3. He felt well apart from slight heartburn. He was a retired motor engineer. He had no family history of thyroid disease and nev...

Aims: To define and identify patients who have ‘failed’ parathyroidectomy by a single surgeon. To explore common features of these cases to refine our pathways.Methods: This case note review began with a retrospective audit of 123 patients having neck exploration from January 2009 to May 2014. The dataset of clinicopathological information obtained from the electronic Trust records, was interrogated to identify patients fulfilling the following...

Background: Hydrocortisone replacement for primary adrenal insufficiency (PAI) is targeted to mimic circadian endogenous cortisol secretion. Nevertheless, patients on stable treatment report impairments in quality of life. The brain is a major target area for cortisol considering it high density of glucocorticoid receptors and previous studies in patients treated for Cushing’s disease (CD) suggest that hypothalamic-pituitary-adrenal axis dysregulation is related to cognit...

Background: Type 2 diabetes (T2D) and hypercortisolism associated with Cushing’s syndrome (CS) share clinical characteristics such as hypertension, dyslipidaemia, hyperglycaemia, and obesity. Several studies have recorded a relatively high prevalence of hypercortisolism in T2D, which may have therapeutic implications. The aim of this systematic review and meta-analysis was to assess the prevalence of hypercortisolism in T2D patients.Methods: Origina...

Introduction: Glucokinase-MODY (Maturity onset diabetes of the young) results from heterozygous mutations in the GCK gene, impairing its enzymatic activity. GCK acts as a glucose sensor in the pancreatic beta cell and regulates insulin secretion. We describe two cases of MODY due to a GCK gene mutation not described until now.Clinical Case: A 63-year-old male is followed in our hospital for 30 years due to diabetes mellitus (DM). He was diagnose...

Background and aims: Maternal BMI and weight gain are associated with maternal and fetal complications in gestational diabetes (GD), but their relative contribution is not clearly defined. Our aim was to determine the influence of BMI and weight gain in the evolution of GD.Material and methods: Multicenter, retrospective study of women diagnosed with GD at the medical centers of the Portuguese Group for the Study of Diabetes and Pregnancy in 2011. We use...

Evidence from studies in goats1, sheep2 and mice3 suggests that the kisspeptin cells of the arcuate nucleus generate the signal that causes the pulsatile secretion of GnRH. This effect may be due to action of kisspeptin on GnRH terminals in the median eminence3,4. We conducted studies on sheep to test the hypothesis that kisspeptin cells of the arcuate nucleus (ARC) and/or the glutamate cells of the hypothalamus pulses of GnRH secret...

Introduction: Chronic somatotropin (ST) hypersecretion has systemic effects. It can cause important structural and functional cardiovascular (CV) changes, which can result in increased morbidity and mortality.Case report: A 48-year-old, male. followed by cardiology since 2005 for dilated cardiomyopathy (DCM) (Ecocardiography: moderately dilated left ventricle with globular appearance. Severely impaired global systolic function - LVEF 25%. Right cavities ...

Introduction: Differentiated thyroid cancer (DTC) prognosis is usually favorable, even when metastatic radioiodine avid disease is present. Radioiodine-refractory disease, usually a sign of higher aggressiveness, can be detected by 18F-FDG-PET/CT. There is a reverse relationship between iodine and FDG accumulation in thyroid cancer lesions, the so-called ‘‘flip-flop’’ phenomenon: when thyroid cancer cells dedifferentiate they tend to lose the...

Introduction: Hyponatremia is the most common hydroelectrolytic disturbance in clinical practice. Multiple causes exist for its occurrence, being the etiological diagnosis sometimes complex. In patients with suprasellar tumours it is even harder due to several confounding factors. Management of these patients is difficult as it conflicts with chemotherapy-associated hyperhydration protocols. We present a case that exemplifies this.Clinical case: Four yea...