Endocrine Abstracts

Rationale: Over the last 20 years, granulocyte colony-stimulating factor (GCSF) has become a recognized therapy in the treatment of patients suffering from neutropenia. Current therapies require daily injections of GCSF to stimulate stem cell production and response to treatment is often unpredictable as GCSF is rapidly cleared. A number of approaches to reducing GCSF clearance have been tried mainly through conjugation with another moiety. The technologies already being emplo...

Langerhan cell histiocytosis (LCH) is a rare; incidence 1.8/100 000. It affects bone, skin, and pituitary but can involve any organ. Diabetes insipidus (DI) is reported in 15–50% of patients, and anterior pituitary dysfunction in 5–20%. We describe a patient whose diagnosis was delayed because of the challenge in making a tissue diagnosis.A 42-year-old female presented in 2010 with sudden onset deafness and vertigo then 1 year later developed D...

Introduction: Generously supported by IPSEN)-->Insulin tolerance test (ITT) is considered as the gold standard assessment for hypothalamic–pituitary–adrenal axis (HPA) integrity. Short synacthen test (SST) is a relatively simple, low-cost and well tolerated first line test of HPA despite concerns regarding accuracy. The glucagon stimulation test (GST) is often used as an alternative to the ITT. Although less reliable, it is...

A 60-year-old woman was referred with a 14 mm right adrenal mass on a contrast CT abdomen whilst being investigated for left iliac fossa pain and increased bowel frequency. She reported a 2-year history of anxiety attacks, poor sleep, excessive sweating and weight loss. She had hypertension, asthma and recurrent vasovagal syncope and had previously undergone an open cholecystectomy. Her medications included Lansoprazole, Salbutamol, Losartan, Citalopram and Diltiazem. Systemic...

We report two cases of hypernatraemia with reset osmostat and pituitary dysfunction.A 35-year-old male was referred with Graves’ thyrotoxicosis associated with hypokalaemic periodic paralysis and an incidental serum sodium 154 mmol/l. He complained of polyuria and nocturia but denied excessive thirst and was otherwise well. Height was 193 cm with BMI 29.5. He had gynaecomastia and sparse body hair. He had a small 6 ml right testicle (originally und...

Background: Functional hypogonadotrophic hypogonadism (FHH) occurs in the context of any chronic disease including obese patients with type 2 diabetes (T2DM) and/or metabolic syndrome. FHH is reversible with resolution of the underlying disease process. Reported benefits of bariatric surgery include improvements in lipid profile, blood pressure and resolution of T2DM. Here we report reversal of FHH and T2DM with bariatric surgery-associated weight loss.C...

Background: Hypogonadotropic hypogonadism in apubertal males is commonly due to constitutional delay; permanent gonadotropin deficiency becomes more likely with older age at presentation, cryptorchidism and non-reproductive defect, e.g. anosmia. All forms of testosterone induce pubertal development, though short-acting IM preparations are associated with extraphysiological excursions of serum testosterone and are increasingly unavailable. Long-acting testosterone undecanoate I...

Introduction: Thyroid eye disease (TED) is a visually disabling and cosmetically disfiguring condition. There is a paucity of research on the psychosocial impact of TED. One of the aims of this research is to improve understanding of the extent and type of psychosocial distress experienced by TED patients.Method: 77 patients with TED were recruited (53 female, 24 male; aged between 25 and 73 years, average age=47.6±11.6 yrs; 58% Caucasian). Particip...

High-resolution peripheral computed tomography (HR-pQCT) (XtremeCT, Scanco) obtains three-dimensional images of the distal radius with a resolution of 82 microns, which enables detailed study of the microarchitecture of cortical and trabecular bone. Better description of the microarchitectural changes in bone with ageing will improve understanding of which preventative and therapeutic interventions are most likely to be effective.The aim of this study wa...

The short Synacthen test (SST) is used to evaluate adrenal glucocorticoid secretion in response to synthetic ACTH (also known as tetracosactide or Synacthen). Traditionally, after a baseline cortisol and ACTH, two plasma cortisol samples have been taken after i.v. or i.m. administration of Synacthen 250 μg, one at 30 min and one at 60 min. However practice varies and some physicians only take one cortisol measurement at 30 min.Hypothesis: A protocol...