Endocrine Abstracts

Objective: The incidence of childhood obesity and type 2 diabetes has reached epidemic proportions. Glucocorticoid excess causes central obesity and diabetes mellitus as seen in Cushing’s syndrome. The 11beta-hydroxysteroid dehydrogenase type 1 enzyme (11beta-HSD1), which is predominantly expressed in liver and adipose tissue, regenerates active cortisol from inactive cortisone. Altered 11beta-HSD1 may cause tissue-specific Cushing syndrome with central obesity and impair...

Case: A 69 year old man was diagnosed with poorly differentiated pancreatic adenocarcinoma with liver metastases in November 2017 and received FOLFIRINOX chemotherapy followed by Gemcitabine. This stabilised his disease and chemotherapy was stopped in March 2020. In April 2021 he presented with a 3-4 month history of tiredness; intermittent confusion, especially in the early morning; the discovery that food resolved his symptoms, albeit temporarily; and accompanying significan...

Introduction: Polycystic Ovary syndrome (PCOS) is a metabolic disorder associated with increased cardiovascular disease risk. Exercise is an effective treatment strategy to manage symptoms and reduce long-term health risk. High-intensity interval training (HIIT) has been suggested as a more efficient exercise mode in PCOS; however, it is not clear whether HIIT is superior to moderate intensity steady state exercise (MISS).Methods: We synthesized availabl...

Introduction: There is a clinical need to develop novel and better biomarkers to monitor patients with neuroendocrine neoplasms (NENs). Our aim was to identify and track plasma circulating cell free tumour derived DNA (ctDNA) in a cohort of patients using a personalised, patient specific approach.Materials and methods: 35 serial plasma samples were collected from 9 patients with metastatic NENs (6 small intestinal and 1 each of lung, ovarian, and pelvic;...

Benign Ethnic Neutropenia (BEN) is a common form of neutropenia defined as an absolute blood neutrophil count (ANC) of < 1.5 x 109/l, usually observed in Afro-Caribbeans. These patients are not at increased risk of infection despite their neutropenia, unless they are on medications which can cause neutropenia. Amongst these drugs antithyroid medications are known to cause agranulocytosis defined as ANC of <500/μl. We report a case of 24 years old male w...

Background: The phaeochromocytoma of the adrenal gland scaled score (PASS) is used for histological reporting of phaeochromocytomas as a surrogate marker of malignant potential. A PASS score of ≥4 (of a maximum of 20) suggests an aggressive tumour and hence the importance of lifelong careful follow-up. However, the utility of the PASS score has been questioned recently due to the discordance between PASS score and clinical outcomes.Aim: To review t...

Glucagon like peptide-1 (GLP-1) is derived from selective cleavage of the preproglucagon (PPG) molecule synthesised in intestinal L-cells. The physiological action of GLP-1 is most commonly recognised as a peripherally released incretin, but a subset of neurons in the lower brainstem, the PPG neurons, also express GLP-1. The majority of PPG neuronal cell bodies are located in the nucleus of the solitary tract and their axons project to numerous sites throughout the CNS. Many o...

Context: Phaeochromocytomas are rare, but potentially fatal, neoplasms. The diagnosis and localization of phaeochromocytoma can be challenging and recently there has been some debate regarding the role for adrenal venous sampling (AVS). The utility of AVS in this setting is hampered by a lack of normative value data for adrenal vein catecholamine concentrations and the reliability of lateralization ratios. We sought to address these concerns by analyzing AVS catecholamine conc...

Introduction: RAMPs (receptor activity-modifying proteins) are single-pass transmembrane accessory proteins required for appropriate signalling of the G-protein coupled receptors; CRLR (Calcitonin receptor like receptor) and CTR (Calcitonin receptor). There are three forms of human RAMPs known as, RAMP1, 2 and 3. RAMP3 heterodimerises with CRLR or CTR to form a high affinity receptor for the peptide hormones adrenomedullin and amylin, respectively. However, the exact mechanism...

Measurement of urinary free cortisol (UFC) in overnight, early morning and 24h sample collections are often used to assess potential effects of inhaled or intranasal corticosteroids (ICS) on the HPA axis. In the present study the effects of single inhaled doses of fluticasone propionate (FP), Budesonide (Bud), Triamcinolone acetate (TAA)(molar equivalence; 1750, 1600 and 1600 micrograms respectively) and placebo on UFC excretion was investigated in 13 healthy male subjects. UF...