Endocrine Abstracts

A 21-year-old man presented with 2 months history of weight gain, acne, hirsutism, lethargy, and muscle weakness. Examination revealed that he was cushingoid in appearance, had pustular acne and proximal myopathy. Initial 24 h urinary free cortisol was significantly raised at 5320 nmol/day (10–147), with raised ACTH of 120 ng/l (<47). He failed to suppress his cortisol on the low dose dexamethasone suppression test (baseline 708 nmol/l and 48 h 706 nmol/l). Urinary an...

Background: The insulin stress test (IST) is accepted as the gold standard investigation of the hypothalamio-pituitary–adrenal axis (HPA). The short synacthen test (SST) has been advocated as an alternative to the IST. Fatigue can be a common presenting symptom of patients suffering from abnormalities in the HPA axis.Methods: We audited the results of ISTs following failed SSTs for the assessment of patients who present with symptoms of fatigue. We ...

Insulin induced hypoglycaemia is a life threatening complication in T1DM. Sub-optimal counter regulatory response, with hypocortisolemia, threatens the recovery from insulin induced hypoglycaemia. We present a 28-year-old man with polyglandular autoimmune syndrome type 2 and life threatening hypoglycaemia, whose severe hypoglycaemic events were improved following introduction of CSII.The patient was diagnosed with Addison’s disease in 2000 and T1DM ...

A 17-year-old female was referred to the adult endocrine clinic with a history of primary amenorrhoea. She was short in stature with a height below the 4th centile for her age. Her BMI was 24 kg/m2 with a weight below the 25th centile and there was delay in bone-age 2 years.She had an interesting past medical history of late-onset central nocturnal hypoventilation from the age of 8 years when she presented with apnoeic episodes and weight gain...

Context: Prolactinomas are the most common functioning pituitary adenomas & it is recognised that gender has an influence on presentation and management of this condition.Objective: To examine the effects of gender on presentation and response to treatment in a large cohort of adults with confirmed prolactinoma (MRI performed and macroprolactin excluded).Design & patients: This retrospective cohort study design used an elec...

Copeptin is a stable AVP marker and stoichiometrically released with AVP. It closely reflects changes in water balance. Its stimulation in severe stress has recently has been suggested for the early diagnosis of myocardial infarction but clear definition of the physiological variability is necessary. Here, we studied the pulsatile and circadian variation in healthy individuals and compared copeptin to cortisol rhythms.Copeptin levels were sampled every 2...

Considerable dichotomy exists in the phenotype of adults with severe GHD of childhood (CO-GHD) and adult-onset (AO-GHD). Those with CO-GHD show immaturity. Adults with partial GHD (GH insufficiency (GHI), peak GH 3.1–7.0 μg/l) show a similar, but milder phenotype to adults with severe GHD. Whether a similar dichotomy relating to timing of onset is observed in CO-GHI and AO-GHI adults is not known.We studied 24 adults with GHI (CO-GHI n=1...

Polycystic ovary syndrome (PCOS) is associated with insulin resistance. Abnormally low glucose transporter 4 (GLUT4) expression has been shown in adipocytes from subjects with PCOS1 and skeletal muscle from type 2 diabetics2. Although GLUT4 expression is mostly restricted to classic insulin target tissues such as skeletal muscle, cardiac muscle and adipose, we have found it in granulosa cells (GCs) of mice3. Glucose uptake and metabolism by GCs...

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. It is characterized by hyperandrogenism, which results primarily from excess androgen production by ovarian theca cells (TCs). Obesity contributes to androgen excess in PCOS and previous studies in vitro using bovine TCs have shown that adiponectin (production of which is inhibited in PCOS) is a repressor of P450c17 activity. However, little is known about expression of adiponec...

Initial follicle growth results in a number of distinct morphological changes, such as cuboidalisation and proliferation of the granulosa cells (GC) as well as an increase in oocyte size.Cell adhesion molecules and intercellular junctions play a pivotal role in changes in cell shape. We hypothesize that change in GC shape is key, and that increased understanding of changes in cell adhesion and associated junctions will provide insight into the regulation...