Endocrine Abstracts

Introduction: Hypercalcemia due to parathyroid-hormone-related-peptide (PTHrP) is rare in neuroendocrine tumours.A 63-year-old lady initially presented to ENT surgeons with symptoms of reflux, dysphagia, and weight loss. Past medical history included hysterectomy eight years previously for uterine prolapse. There was no family history of note. Investigations revealed corrected calcium was elevated at 2.94 (2.1–2.5) mmol/l. ALP: 184 (30–135) U/l...

Introduction: The benefits of growth hormone (rGH) replacement during the transition from childhood to adulthood are well established. In adulthood rGH dose is optimized by titrating to serum IGF-I concentration. The use of non-specific IGF-I reference ranges may result in erroneous assessment of IGF-I concentration and inappropriate rGH dosing.Methods: IGF-I methods and reference ranges across 9 UK centres were reviewed. Immulite IGF-1 results for a 12 ...

Glucocorticoids (GCs) are used extensively in the treatment of inflammatory disease. Unfortunately, as GC act on virtually every organ system they also carry a broad range of serious side-effects which limits their clinical use.The structure of the bound GC strongly impacts the final conformation of the glucocorticoid receptor (GR) and thereby dictates downstream events. Designing drugs with different GR binding properties therefore offers a plausible ro...

A 45-year-old woman presented with a 6-week history of constipation and generalised abdominal pains. Blood biochemistry revealed a corrected serum calcium of 4.99 mmol/l, phosphate 0.82 mmol/l, and intact parathyroid hormone (i-PTH) of 0.2 pmol/l (normal range 1–6.1 pmol/l). Serum parathyroid hormone related peptide (PTH-rP) was 5.3 pmol/l (normal range <1.8 pmol/l). Computed tomography demonstrated an 11.0×11.6 cm ovarian tumour with cystic and solid areas and h...

Aims: Our aim was to explore factors related to the acute presentation of diabetic keto-acidosis (DKA) in patients with Type 2 diabetes mellitus (T2D), and to identify any predictors for severity of DKA in T2D.Methods: This was a retrospective study based on acute medical admissions presenting to the Royal Berkshire Hospital during 2008. Criteria for inclusion included a confirmed diagnosis of DKA (defined by a plasma glucose level >11.1 mmol/l, keto...

Objective: A descriptive study to summarize the experience on diagnosis of NET using various imaging modalities.Methods: Imaging was reviewed for 25 patients between 2002 and 2009 (22 MEN-1, 3 sporadic insulinoma). Of 13/25 had elevated fasting gut hormones. CT, MRI, endoscopic ultrasound (EUS), somatostatin receptor scintigraphy (SRS) and angiography were reviewed. (CT, MRI examined with arterial enhancement).Results: Most frequen...

Background: Pleuro-pulmonary inflammatory fibrotic syndrome is a rare but recognised complication of dopamine agonist (DA) therapy in Parkinson’s disease. Here, we describe a case of asymptomatic pulmonary fibrosis, presumed secondary to DA therapy, in a patient treated with cabergoline for an invasive macroprolactinoma.Case report: A 47-year-old previously fit man was admitted as an emergency with a 3 days history of headache followed by collapse. ...

We present a rare case of acute falciparum malaria complicated by hypocalcaemia while having normal renal function.Case: A 64 year old African lady presented with a 2 week history of lethargy, weakness and oliguria. She had returned from Malawi a fortnight previously and had not taken antimalarial prophylaxis. Her malaria screen was positive for Plasmodium falciparum and she was commenced on quinine. On day 5 of her admission she developed perioral pares...

A 39 yr-old female with a past medical history of a non-metastatic ductal breast carcinoma, presented to hospital with a two-week history of vomiting and dizziness. Clinical examination was essentially normal apart from pigmentation of her mastectomy scar, palmar creases and buccal mucosa. Investigations revealed a plasma sodium (Na) 102 mmol/l, potassium 4.9 mmol/l, plasma osmolality 219 mOsm/kg, urine osmolality 173 mOsm/kg and urine Na 36 mmol/kg. She was treated with fluid...

In numerous tumour types, including those of pituitary origin, gene silencing is frequently mediated through inappropriate methylation of CpG islands. In studies designed to identify novel methylated sequences we used a technique termed arbitrarily primed methylation sensitive PCR (MsAP-PCR) to identify DNA in its hypermethylated forms. The technique relies on cutting the DNA, with methylation sensitive restriction enzymes, prior to PCR amplification. In a similar way in which...