Endocrine Abstracts

A 55year old man with neurofibromatosis type 1 and hypertension presented with a 1 month history of recurrent falls. Examination revealed an unsteady gait with poor co-ordination, impaired joint position sense and a positive Romberg’s test, with no other abnormal neurological findings.An MRI spine revealed an expanding intramedullary lesion T8-L1 with a differential diagnosis of an ependymoma, astrocytoma and intradural extra medullary schwannoma.</...

Subclinical Cushing’s syndrome (CS) has not been adequately characterised and the natural history is unknown. We report two cases of subclinical CS that presented as perforated duodenal ulcers (DU) and in both cases the disease rapidly progressed to overt CS.Case 1A 60-year-old women presented with perforated DU requiring laparotomy and repair. Abdominal CT scanning demonstrated a right adrenal mass 4.2 cm. There were no clini...

It has been postulated that ACTH might modulate its own secretion by a negative feedback loop and we have recently found that the ACTH receptor (MC2R) is present in both normal and tumorous human corticotrophs. In this study we investigated the expression of the ACTH receptor in mouse and rat pituitary tissue as well as mouse pituitary tumour (AtT20) cells and studied the effect of Synacthen (ACTH [1-24]) on ACTH secretion, cAMP release and cell proliferation in AtT20 cells. M...

Nausea and vomiting is common in pregnancy. Severe symptoms with metabolic upset (hyperemesis gravidarum) occurs in 0.2 percent of pregnancies, We present 2 cases of primary hyperparathyroidism in pregnancy. Both women (19 & 34y) presented in the 1st trimester of pregnancy with lethargy, vomiting, thirst and headache. Serum calcium and parathyroid hormone concentrations were elevated:2.69 milli mole per litre (2.18 to 2.47 ) PTH 20.5 pica mole per litre (1.1 to 6.9 ); 3.28...

A 32 year old Indian woman presented with a spontaneous patella fracture. Serum alkaline phosphatase was 3694 units per litre, calcium was 3.12 millimoles per litre and phosphate 0.81 millimoles per litre. Serum PTH concentration was >150 picomoles per litre and the 25-hyroxyvitamin D3 concentration was 7 nanomoles per litre. She was found to have a 5 cm parathyroid adenoma. A 44 year old Somalian woman presented to the rheumatology clinic with a 2 year history of aching in...

BackgroundDiabetes is a multi-systemic disorder and psychosocial stress is a contributor for glycaemic derangement and resulting complications. Covid-19 has bought psychological stress and restriction of activity for many. Psychological risk factors such as anxiety and depression have been associated insomnia and fluctuations in BP and blood sugar values. Shavasana and other relaxation techniques have long been shown to reduce the stress. This relaxation...

Background: Neuroendocrine tumors (NETs), also known as carcinoid, comprise a heterogeneous group of malignancies that arise from neuroendocrine cells throughout the body, most commonly originating from the gastrointestinal tract and lungs. Lung NETs originate from pulmonary neuroendocrine cells (PNECs) that occur as individual cells or small clusters, accounting for approximately 25% of primary lung neoplasms. Lungs NETs can be classified into four subtypes: well-differentiat...

Individuals with chronic hypoparathyroidism sometimes receive suboptimal care with high frequency of unplanned hospitalisation and iatrogenic harm. In 2015 the European Society for Endocrinology published evidence base consensus guidelines on the management of chronic hypoparathyroidism. Using these consensus recommendations as audit standards we worked with the Society for Endocrinology and Parathyroid UK to conduct a national audit of management of chronic hypoparathyroidism...

A 33 year old white European patient presented at 32 weeks gestation with a three day history of severe epigastric pain radiating to left flank with vomiting. She had pre-existing hypertension, controlled with labetalol. On admission, her BP dropped from 170/100mmHg to 90/70mmHg. Abdominal examination revealed epigastric tenderness without peritonism. There were no Cushingoid features. An abdominal ultrasound scan was normal. An MRI scan showed a bulky left adrenal gland, with...

Background: Free androgen index (FAI) is used to estimate free testosterone concentrations in patients undergoing investigation for polycystic ovarian syndrome (PCOS). However, it’s not widely used for diagnostic purpose due to lack of consensus in the literature. We present an appraisal of biochemical data from patients referred to a hyperandrogenaemia clinic with a view to establish an in-house cut-off for the diagnosis of hyperandrogenaemia in PCOS.<p class="abstex...