Endocrine Abstracts

Introduction: Thionamides are the mainstay of management of thyrotoxicosis but can be associated with adverse effects like agranulocystosis, hepatitis and vasculitis. While radioactive iodine and thyroidectomy can be utilized in such scenarios, they were not timely available during the COVID pandemic. We present our experience of using cholestyramine as monotherapy.Case Series: Our series consists of four females. Graves’ disease was the underlying ...

Measurement of steroid metabolites in urine by gas chromatography-mass spectrometry remains the gold standard for biochemical diagnosis of steroidogenic disorders. In the UK, three laboratories offer steroid profiling for routine clinical testing, with the Supraregional Assay Service at King’s College Hospital being the largest and experiencing increased demand year-on-year for testing. In this study, we used our profiling database to audit 2021 workload. By direct compar...

Intro/Aims: Maternal obesity is a major risk factor for the development of first onset of diabetes in pregnancy, also known as gestational diabetes mellitus (GDM). Recent studies also indicate that non-alcoholic fatty liver disease (NAFLD) is an independent predictor of GDM. Sulforaphane (SFN) is a well-known dietary activator of the redox-sensitive transcription factor Nrf2, with reported anti-adipogenic and NAFLD ameliorating effects in non-pregnant obese rodent models. In t...

The incidence of maternal obese and/or gestational diabetic (GDM) pregnancy are increasing globally, with ~10-20% of mothers classified as obese and/or GDM within the U.K. Both obese and GDM pregnancy are associated with increased risk of cardiometabolic disease, with mothers and their children at greater risk of developing later-life Type 2 diabetes, obesity and/or cardiovascular disease. Higher adiposity in pregnancy leads to increased inflammation, which may be countered by...

Section 1: Case history: 75 year old female diagnosed with Grade 1 pNET (Ki-67 index 70%) in 2018. Treated with subtotal pancreatectomy but 8 months post-surgery a follow up scan showed new liver metastases, at which point she was commenced on lanreotide. 3 months later she presented with an 8 week history of episodic weakness, sweating and confusion consistent with hypoglycaemia. These episodes initially improved with eating but had become more severe and unresponsive to carb...

Colorectal cancers (CRC) represent 9.4% of all cancers, with about 42 000 new UK cases per year. Current treatment involves surgical resection followed by radio- and chemo-therapy. 5-Fluorouracil is the standard post-operative chemotherapy although tolerance is poor due to dose-limiting toxicities and drug-resistance. New treatment strategies are therefore sorely needed. One emerging chemotherapeutic option is to target oestrogen metabolism. Our novel work rev...

Oestrogen quantification in serum is challenging as concentrations are low, especially in men and post-menopausal women. Additionally, oestrogens do not ionise readily and structure similarities can lead to cross-reactivity and reduced specificity, especially with immunoassay. Full characterisation of oestrogen metabolism and its role in disease progression has therefore not been fully investigated. We aimed to develop and validate a liquid chromatography mass spectrometry met...

Gas chromatography–mass spectrometry (GC–MS) has been used for urinary steroid analysis for over 50 years. The process of hydrolysis to release steroids from their conjugates is routinely performed using commercially available snail Helix-Pomatia sulfatase (HP). However, as this is a naturally occurring enzyme its production process results in batch variation and so each batch requires experimental validation to adjust for the difference in efficiency of the enzymati...

Advancements in medical care have significantly improved survival rates following major traumatic injury. An understanding of the hormonal, inflammatory and metabolic changes that occur following trauma is still evolving but it is clear that they impact significantly upon patient prognosis. To date, studies that have examined trauma-induced changes in steroid metabolism have analysed samples taken from patients post-hospital admission, culminating in marked variability in the ...

Background: Over the past decade there has been increased recognition of the dangers associated with inpatient management of diabetes insipidus (DI) and omission of desmopressin leading to hypernatremia. In May 2009 a patient died from diabetes insipidus mismanagement in a London hospital. An NHS England patient safety alert was issued in 2016 highlighting this risk.Method: Inpatients with a serum sodium of 155 mmol/l or greater were prospectively identi...