Endocrine Abstracts

Hyponatraemia occurs in 14% of hospitalised patients. Our data shows that plasma sodium concentrations < 130 mmol/l occur in 8% of patients with traumatic brain injury (TBI) and in 6% of patients undergoing hypophysectomy. The causes of hyponatraemia in neurosurgical patients include SIADH, cerebral salt wasting (CSW), diuretic therapy, intravenous fluids, and glucocorticoid deficiency.The greatest diagnostic challenge is to distinguish between SIADH ...

Introduction: Hashimoto’s thyroiditis is the most common cause of acquired hypothyroidism in children and adolescents affecting ten time more females than males. Diagnosis is based on clinical features and antibodies against thyroid peroxidase (TPO) or thyroglobulin (TG). Addison’s is an autoimmune disease resulting in primary adrenal insufficiency. It is extremely rare in children and easily misdiagnosed. Levothyroxine may precipitate adrenal crisis in individuals w...

A 58-year-old male was admitted through the emergency department with symptomatic severe euvolemic hyponatremia. Biochemistry was consistent with SIAD (plasma sodium (pNa) 107 mmol/l, plasma osmolality 230 mOsm/kg, urine sodium 36 mmol/l, urine osmolality (UOsm) 638 mOsm/kg, 0900 h plasma cortisol 484 nmol/l and thyroid function tests normal). Chest X-ray was normal but CT thorax confirmed a lung mass suspicious for malignancy. As the patient had symptoms of cerebral irritatio...

Craniopharyngioma (CP) is associated with considerably higher mortality and morbidity than pituitary adenomas. The tumours are rare, but present a considerable management challenge. In addition to the endocrine and mass effects which are common to all tumours arising from the region of the pituitary fossa, the site, size, and sometimes the treatment of CP, dictate that the endocrinologist must also manage hypothalamic complications. Endocrinologists are aware of the high frequ...

Hyponatraemia is the commonest electrolyte abnormality in clinical practice; epidemiological data would suggest that SIAD is the commonest cause of hyponatraemia, and it is particularly important in patients undergoing neurosurgery, in whom SIAD is common. Recent data has shown that even mild hyponatraemia (plasma sodium 125–135 mmol/l) is associated with gait instability, falls, fractures, osteoporosis and increased mortality. This has led to the recognition that correct...

Bisphosphonates are powerful inhibitors of bone resorption and have become blockbuster drugs in the treatment of metabolic bone diseases. Enormous progress has been made over the last few years in understanding exactly how bisphosphonate drugs act at the molecular level. After targeting bone and selective internalisation by osteoclasts, nitrogen-containing bisphosphonates potently inhibit FPP synthase. Inhibition of this enzyme disrupts the flux through the mevalonate pathway,...

Environmental endocrine-disrupting chemicals (EDCs) are exogenous chemicals that perturb hormones and their actions. In our laboratory, we are studying how early life exposures to EDCs affect the developing brain and lead to behavioral dysfunctions in exposed individuals and their descendants across generations. To do this, pregnant rats are fed one of three treatments: the weakly estrogenic commercial polychlorinated biphenyl (PCB) mixture, Aroclor 1221 (A1221, 1 mg/kg); vinc...

Optimal in-patient glycaemic control improves morbidity and mortality in in-patients with diabetes1. The National Inpatient Diabetes Audit (NaDIA) is an annual snapshot audit of diabetes inpatient care in England and in Wales. We performed a similar audit in Our Lady of Lourdes Hospital, Drogheda (OLOLHD, 363 in-patient beds) on 26/01/2022 and 08/10/2020. Data from all adult in-patients with diabetes were gathered using a standard proforma. Data from the OLOLHD 2022...

Introduction: Hen corticosteroids are utilised for their anti-inflammatory properties, adrenocortical atrophy may result. Abrupt steroid withdrawal or intercurrent illness can precipitate acute adrenal crisis. We report two cases of adrenal crisis which resulted from withdrawal of immunosuppressive steroid therapy.Case report: i) A 74-year-old gentleman was admitted with hypotension (BP 80/40), severe hyponatremia (Na:118 mmol/l) and acute renal failure ...

Permanent pan-anterior hypopituitarism is a rare complication of bacterial sinusitis, with only six cases reported worldwide. However, all were reported before the advent of MR imaging and most did not have what is now regarded as gold standard evaluation of pituitary function. Also, all previous cases noted an interval of months between resolution of sinusitis and development of hypopituitarism. We report two cases of previously healthy Caucasian adults who developed pan-ante...