Endocrine Abstracts

The Competency Framework for Adult Endocrine Nursing was launched at the Society for Endocrinology (SfE) BES conference in March 2013 and was made available to Endocrine nurses and Endocrine centres in the UK. It was also made accessible via the SfE website. Questionnaires were sent out 6 months later to audit its use.Results: 80.4% of nurse respondents had heard of the document and 69.6% had read it. 100% of those who had read it found it easy to use an...

Background: Radioactive iodine (RAI) therapy is well-established in the management of benign thyroid disorders associated with thyrotoxicosis, but the optimal dose remains controversial. Guidelines recommend 500–800 MBq, though it is thought that Graves’ thyrotoxicosis may respond more readily to lower doses (400–600 MBq).Methods: We studied all local cases receiving RAI over four calendar years (2010–2013; n=447). Demographi...

Background: Vertebral Fractures (VF) are recognized as an important aspect of bone health in children and adolescents. The clinical utility of vertebral fracture assessment (VFA) using dual-energy X-ray absorptiometry (DXA) has not been evaluated in the paediatric population.Method: VFA was performed independently by two non-radiologist observers, in 165 patients (77M/88F) as part of their investigation for low bone mineral density. Lateral thoracolumbar...

Background: Recombinant human GH (rhGH) may improve bone mass in paediatric inflammatory bowel disease (IBD).Objective: To investigate rhGH on bone and body composition in paediatric IBD.Method: Bone biomarkers were evaluated in 12 children, 11CD (10M), median age 14.4 year (8.9, 16.2) who received rhGH (0.067 mg/kg per day) as part of a 6 months RCT. Eight received rhGH for 24 months and had DXA evaluation. Results were reported a...

Background: Childhood-onset GH deficiency (CO-GHD) is perceived to be a cause of low bone density and osteoporosis in adulthood. Data on bone mass and body composition of GH-treated adolescents with CO-GHD at final height are inconsistent.Aims: To compare size/height corrected parameters of bone mass and body composition in adolescents with CO-GHD at final height.Method: Review of CO-GHD treated patients at final height between 200...

Introduction: Adrenal insufficiency (primary/secondary) is a rare and potentially life-threatening condition which can be easily overlooked. Patient awareness and management of problems is critical and central to effective treatment. The NICE Clinical Knowledge Summaries for patients identifies and recommends critical areas that require attention in adrenal insufficiency. In particular, patients should:i) Realize the need for lifelong glucocorticoid repl...

This is a case of a 49 year old obese Caucasian female who was referred to an endocrinology clinic for investigation of Cushing’s syndrome, based on raised blood pressure and cushingnoid facies. The patient had underlying schizophrenia and was stable on clozapine. Her blood pressure was 150/99 mmHg on bendrofluoriomethiazide and candesartan. Her 24 hour urinary free cortisol was normal but 24 hour urinary free noradrenaline was elevated at 835 nmol (76–561) with norm...

Type 1B pseudohypoparathyroidism is characterised by renal resistance to parathyroid hormone in the absence of other endocrine or physical abnormalities. We present a 36-year-old lady with pseudohypoparathyroidism diagnosed aged seven following seizures with hypocalcaemia, hyperphosphataemia, elevated alkaline phosphatase, elevated parathyroid hormone (PTH) at 700 pg/mL (<120) and no cyclic AMP response to bovine PTH. There was no family history or diagnostic phenotypic fe...

Hyperinsulinism in Infancy (HI) is a potentially-lethal condition of neonates and during early childhood. For many years the pathophysiology of this disorder was unknown. Recent advances in genetics, histopathology and molecule physiology have now revealed the causes of HI in a large cohort of patients. This review focuses upon the relationship between the basis of HI and current treatment options. From defects in ion channel subunit genes to lesions in the control of pancreat...

ATP-evoked signalling events are known to promote release of insulin from pancreatic beta-cells in a Ca2+-dependent manner. In rodent beta-cells and insulin-secreting cell lines, this is mediated by purinergic receptors and there is evidence for the involvement of both P2X and P2Y subtypes. Here,we have used human insulin-secreting cells to examine the expression of purinoceptors in control and disease tissue. Intact islets and isolated beta-cells were obtained from...