Endocrine Abstracts

A 43 year old hypertensive lady was referred to a surgical team at a tertiary oncology centre for consideration of completion thyroidectomy following removal of a nodule the histology of which had shown medullary thyroid carcinoma. She was reviewed in the cancer Multi-Disciplinary Team meeting; surgery was deferred until she had been reviewed in the endocrine clinic.There was no known family history of MTC or other endocrine abnormality; however the pati...

Type 1 diabetes mellitus is usually believed to present acutely and it is assumed that metabolic decompensation is sudden.We present 3 cases of asymptomatic type 1 diabetesCase1A 28 year old asymptomatic gentleman moved to a new surgery and glycosuria was noted as part of routine screening , no ketonuria., body mass index 21, no past medical illness or any family history of diabetes. His fasting blood glucose...

Introduction: Vitamin D deficiency is increasingly being recognized as a widely prevalent metabolic disorder in temperate climates with various systemic manifestations. However topical, it is important to exclude tumour induced osteogenic osteomalacia as a possible aetiology in severe vitamin D deficiency when other risk factors (vegetarian diet, ethnicity, etc.) are absent. Early diagnosis of malignant tumours could be life saving and their resection may make this vitamin D r...

Introduction: Hip fractures are the most serious osteoporotic fractures and difficult to prevent them without a precise knowledge of the causative factors. The risk factors, which precipitate hip fracture in elderly may vary according to the local customs and practices. Indian data on risk factors for hip fractures are scant. The present study was undertaken to assess the various risk factors leading to femoral neck fracture in postmenopausal women and also to define the thres...

Background and objective: Widespread use of highly active anti-retroviral therapy (HAART) has led to a decrease in morbidity and mortality with this infection. HAART is also associated with body fat redistribution, insulin resistance and dyslipidemia, well known risk factors for cardiovascular disease. The prevalence of fat redistribution in studies ranges from 11 to 83%. The objective of this study was to look at changes in body composition in HIV infected men and to determin...

Androgens and estrogens are transported bound to the sex hormone binding globulin (SHBG). SHBG is believed to keep sex steroids inactive and to control the amount of free hormones that enter cells by passive diffusion. Contrary to the free hormone hypothesis, we demonstrate that megalin, an endocytic receptor in reproductive tissues acts as a pathway for cellular uptake of biologically active androgens and estrogens bound to SHBG. In line with this function, lack of receptor e...

Metallothioneins (MT) are cystein-rich intracellular proteins which exert anti-apoptotic effects by protecting cells against oxidative stress and DNA damage. Previously, expression of MT in normal and neoplastic thyroid tissue has been demonstrated. However, the thyroidal regulation of MT expression is widely unsettled. Thus, we investigated the expression of MT isoform 1 in human thyroid carcinoma cells (FTC-133-TSHR) upon stimulation with thyrotropin (TSH). Using quantitativ...

Background: Gastric reduction duodenal switch involves restrictive and mal-absorptive aspect, removing approximately 70% of stomach and most of the duodenum. Surgical alteration leading to malabsorption of macronutrients is achieved with varying results of weight loss but resulting nutritional side effects are under-recognised. Issues in nutritional complication leading to neurological complications like peripheral neuropathy are increasingly recognised. We discuss a case of s...

Background: Bariatric surgery has contributed to a large spectrum of presentations of hypoglycaemia. Dumping syndrome caused by food reaching the duodenum rapidly is associated with abdominal pain, bloating and diarrhoea as well as vasogenic symptoms of tachycardia and flushing. Hypoglycaemia may occur as a late sign of dumping 1–3 hours after a meal. In contrast, post-gastric bypass reactive hypoglycaemia is thought to result from discordance between blood glucose circul...

Adrenal insufficiency is not commonly associated with a finding of bilateral enlarged adrenal gland when diagnosed in late adulthood. Various cases in the literature to date seem to indicate that the combination of these two findings may be suggestive of adrenal lymphoma. Our patient was initially referred to Gastroenterology with weight loss, nausea and early satiety from where he was referred for a whole body computed-tomography (CT) scan as part of a screen for malignancy. ...