Endocrine Abstracts

A number of different cell types contribute to the cellular architecture of fat tissue. While the fat cell is making important functional contributions to the systemic metabolic well-being, several additional cell types contribute a supportive role to bestow maximal flexibility on the tissue with respect to many biosynthetic and catabolic processes. The adipocyte has morphed into a cell type whose complexity we only start to appreciate. We now understand that: 1) the contribut...

Introduction: Pats with Klinefelter Syndrome (KS) have elevated morbidity and mortality due to several reasons. Yet, there is no connection between KS and male-to-female sex change.Case: A 74-year-old man was sent for endocrine work-up prior to surgery due to gynecomastia. The patient had lived as a man-to-woman transgender for many years. He was told not to qualify for a transgender surgical approach when he was 55 years old. He took estradiol substitut...

We present a case of discordant pituitary biochemistry which resolved after discontinuing a commercially available combination vitamin supplement. A 35 year-old man presented following an episode of headache and dizziness, preceding collapse and possible seizure activity. Investigations revealed deranged pituitary function: TSH 0.02 mU/l (0.35-5.50), fT4 3.6 pmol/l (10.0-20.0), 9 am cortisol 18 nmol/l (200-500), testosterone >52 nmol/l (8.4-28.7), FSH <0.3 U/l (1.0-18....

Introduction: Foot disease in diabetes is associated with significant morbidity and mortality. Diabetic foot disease requires complex care with input from a range of healthcare professionals. Scottish Intercollegiate Guidelines Network guideline 116 recommends that all patients with diabetes and foot ulceration are seen at a multidisciplinary foot clinic. Our aim was to assess the impact on patient outcomes of introducing a multidisciplinary foot clinic within NHS Fife.<p ...

There have been several case reports over the years of hypopituitarism occurring after cerebral oedema caused by diabetic ketoacidosis (DKA). The case reports have ranged from a single hormone defect to a more extensive loss of hormone production. What is not reported in the literature so far is what happens to these patients and their hormone deficiencies in the longer term.This is a case report of a young man who presented with DKA aged twelve who rapi...

Background: Primary hyperaldosteronism (PA) is a prevalent, but underdiagnosed syndrome. Diagnosis and treatment have been relatively constant since the development of the latest Endocrine Society guidelines in 2016.Study objective: Baseline characteristics, treatment and follow-up of subjects with PA referred for adrenal venous sampling (AVS) in a tertiary hospital since 2009 are presented.Results: Thirty five subjects (M/F: 17/18...

Background: Primary hyperaldosteronism (PA) is a prevalent, but underreported syndrome. Diagnostic procedures and treatment options have been relatively constant since the development of the latest guideline of the Endocrine Society in 2016.Study objective: To clinically and biochemically describe subjects with PA who underwent a salt infusion test (SIT) or an adrenal venous sampling (AVS) in a tertiary hospital since 2009 and provide an overview of thei...

Introduction: ‘Primary Aldosteronism Detection, Diagnosis and Treatment Guidelines’ from the Endocrine Society (2008) recommend the use of the aldosterone- renin ratio (ARR) to detect primary aldosteronism (PA) in patient groups with high prevalence of PA. The guidelines suggest cut-offs specific to assay type and measurement units. The department of Clinical Chemistry and Metabolic Medicine at RLBUHT recently moved to a direct renin method (iSYS, Immunodiagnostics) ...

Normal ageing is accompanied by increased organismal frailty, reflecting organ specific functional decline, with an associated increase in the likelihood of disease. The immune system undergoes significant decline with age, termed immunesenescence, which results in increased susceptibility to infection and reduced vaccination responses. Significant changes in the hormonal milieu also occur with age and it is clear that age-related changes in adrenal hormone secretion can impos...

The UKPDS study has shown that, intensive lowering of blood sugar and blood pressure decreases the risk of micro vascular complications in individuals with type 2 diabetes. The Steno-2 study has shown that target driven, long-term intensive treatment in patients with type 2 diabetes and microalbuminuria reduces the risk of cardiovascular and micro vascular events by about 50%.We investigated the effect on the 10 years absolute CHD risk of our type 2 diab...