Endocrine Abstracts

Background: Guidance on pubertal-induction in hypogonadal adult men is sparse. For adolescent boys, in whom delay is usually constitutional, treatment is typically initiated with pulsed low-dose IM testosterone (T); the dose being progressively increased if/when it becomes clear that endogenous gonadotrophin secretion is not being initiated. In teenagers with organic hypogonadism, the aims are to recapitulate the normal tempo of puberty over 2–3 years and optimise linear ...

Background: Hypocalcaemia is a common electrolyte disorder and it can occur following parathyroidectomy or thyroidectomy. It has been suggested that some post-operative hypocalcaemic crises may reflect severe vitamin D deficiency and vitamin D supplementation may have a protective effect.Objectives: To establish the prevalence of severe post-operative hypocalcaemia (as defined by the requirement for i.v. calcium gluconate) following parathyroid surgery a...

Hypothesis: Exogenous kisspeptin-10 (Kp10) enhances pulsatile LH. Research strategy: A first-in-man dosing study of kp10 was first performed. Healthy volunteers and hypogonadal patients were subsequently infused with kp10. Dose titration study Rapid increases in LH with clear dose-dependency (P<0.0001) were observed in healthy men (n=6), with the 0.3 and 1 µg/kg doses being maximally stimulatory (P<0.01). Effect of sex-steroid milieu: LH respo...

Background: Multiple sclerosis (MS) is associated with low ambient ultraviolet B (UVB) light in childhood and in utero (relative risk of developing MS is 1.2 for those born in spring). Besides, the MS-linked HLA-DRB1 allele interacts strongly with vitamin D in vitro, and vitamin D levels are lower in MS patients. Fatigue and musculoskeletal aches/pains are prominent symptoms in both MS and vitamin D deficiency. Moreover, having any chronic disease may predispose to stay...

A 64-year-old lady presented with weight gain, tiredness, palpitations and tremor. She had no goitre and no other extra thyroidal manifestations. Both TSH and thyroid peroxidase antibodies (>1300) were elevated and she was treated by her GP with Thyroxine 50 mcg daily. She felt a lot worse on this, so it was discontinued and a full thyroid hormone profile was checked (see Table 1) which prompted referral; to Endocrinology.Other pituitary hormone leve...

Introduction: Congenital adrenal hyperplasia (CAH) is an inherited disorder, most commonly caused by enzymatic deficiency of 21-hydroxylase (CYP21A2). The non-classic or late-onset form is one of the most common autosomal recessive diseases in women, but the diagnosis is only rarely made in men unless they happen to present with testicular or adrenal masses or infertility.Case report: A 65-year-old man presented with recurrent episodes of postural dizzin...

A 44-year-old man referred with erectile dysfunction was found to have hypogonadotrophic hypogonadism (HH), but otherwise apparently normal anterior pituitary function (LH 1.6 & FSH 2.7 IU/l; T 3.4 & cortisol 516 nmol/l; PRL 103, GH 5.5 & TSH 2.8 mU/l; f-T4 13, f-T3 4.8 & f-T 128 pmol/l; ferritin 103 ug/l). He appeared normally virilised, with central obesity (BMI 36 kg.m−2, collar size 46 cm) and symptomatic sleep apnoea (SA). MRI showed a rig...

Conventional intramuscular preparations of testosterone esters are associated with wide fluctuations in serum testosterone (T) levels following administration, even when a lower dose (100 mg) is injected every 7–10 days, let alone 250 mg every 2–3 weeks. Depot Testosterone undecanoate [TU -Nebido] is a newly available option for androgen replacement. The possibility of achieving stable therapeutic serum T levels over a period of months is its principal attraction. Da...

IntroductionTrue resistance to cabergoline in patients with hyperprolactinaemia has only rarely been reported. We describe a patient with macroprolactinoma who initially responded to cabergoline, but then developed a progressive increase in PRL levels.Clinical caseA 78-year-old male presenting with headache and left temporal hemianopia was found to have a macroprolactinoma with suprasellar/cavernous sinus ext...

Phaeochromocytomas (PCC) are rare neuroendocrine tumours of chromaffin cells that are characterised by autonomous production of catecholamines. Fundamental to the detection and diagnosis is the biochemical confirmation of excessive catecholamine production by the measurement of plasma or urinary catecholamines and metanephrines. Recently, plasma metanephrines have been shown to provide a high diagnostic sensitivity for the detection of catecholamine secreting tumours and unlik...