Endocrine Abstracts

Background: There is limited data on the use of Denosumab for hypercalcaemia in patients with primary hyperparathyroidism (PHPT). We describe a case of severe hypercalcaemia in a critically ill patient with COVID, on a background of mild PHPT prior to hospital admission.Case report: Seventy-seven-year-old gentleman with mild hypercalcaemia dating back to 2019, was referred to endocrinology with hypercalcaemia (adjusted calcium 4.02 mmol/l) and associated...

Introduction: Acute adrenal insufficiency (adrenal crisis) is a life-threatening condition caused by glucocorticoid deficiency. Patient and carer education is key in the prevention, early identification and prompt management of this condition. We assessed the knowledge of adrenal insufficiency/crisis in patients with adrenal and pituitary disease to evaluate the strengths and weaknesses of local ‘sick day’ education processes.Methods: We utilis...

The mineralocorticoid receptor (MR) is primarily involved in osmoregulation in mammals, with additional roles of brain-behaviour implicated. However, the understanding of this role is limited, partly due to the mortality of MR-knockout mice due to impaired Na+ reabsorption. Many steroidogenesis pathways and hormone receptors are highly conserved in zebrafish, providing a great potential to become a high-throughput model for translational endocrine research. My proje...

Background: Primary hyperparathyroidism (PHP) is the commonest cause of hypercalcaemia, with an annual incidence rate (AIR) of 4/100 000 and peak age incidence of 50–60 years. Our hospital serves a population with age ≥18 of around 500 000. A corrected calcium (cCa) ≥3.00 mmol/l is a critical phoning limit in our biochemistry laboratory.Aim: To assess the incidence of hypercalcaemia in the community, the referral pattern of hype...

A 73-year-old female with previous tuberculosis, primary hypothyroidism, depression and caecal cancer was referred to Endocrinology when interval CT scanning reported a 2.5 cm adrenal mass, stable in size over 4 years. No symptoms or signs of hormonal production were noted. Screening tests were abnormal: post-1 mg dexamethasone cortisol was 98 nmol/l, 24-h urinary free metadrenaline was elevated tenfold (3256 nmol/24 h, range 0–350) to a concentration reported to have hig...

Background: Three 5α-reductase (5α-R1-3) isoenzymes are described. In humans, 5α-R2 deficiency (5α-R2D) causes pseudohermaphroditism and 5α-R3 neurological defects. The role of 5α-R1 is not clear. Urine steroid profiling (USP) by GC–MS can compare 5α-reduction activity based on excretion of 5α- and 5β-reduced metabolite ratios. Finasteride predominantly inhibits 5α-R2. USP in these patients shows concordance with 5α-R...

Introduction: Diabetes insipidus can complicate up to 1 in 30 000 pregnancies and has a variety of causes, some that predate the pregnancy and others that begin during gestation. In addition, women can experience diabetes insipidus de novo in pregnancy through the actions of placental vasopressinase, which causes accelerated degradation of vasopressin. This form of diabetes insipidus may be associated with increased complications of pregnancy, including pre-eclampsia. M...

Introduction: Epidemiological evidence suggests that vitamin D (25(OH)D3) deficiency is an acquired risk factor for tuberculosis (TB). Lack of sunshine during the winter reduces 25(OH)D3 levels markedly, but darker skin pigmentation reduces 25(OH)D3 synthesis in African and Asian populations wherever they live.Aims: To examine 25(OH)D3 deficiency and its associations in TB patients in a regional population.Methods: Serum 25(OH)D3 c...

Experimental, clinical and/or epidemiological evidence points to a role for prolactin (PRL) in the promotion of benign and malignant tumors of the breast and the prostate. However, therapies reducing PRL levels (dopamine agonists) are currently not considered for the treatment of these pathologies. Dopamine agonists only target PRL secretion from the pituitary, while recent observations suggest that the involvement of autocrine PRL is perhaps even more relevant than circulatin...

A 31 year old female with no prior history of thyroid disease presented to hospital four days after 2nd dose Pfizer vaccination with fever, myalgia, neck discomfort and chest pain; which was relieved by sitting forwards. A small goitre and tachycardia were noted on physical examination. CXR and echocardiogram were normal. ECG revealed sinus tachycardia. Troponin T was elevated (32 ng/l, normal <5). Free T4 was raised (26.6 pmol/l, reference 10-22) with an undetectable TSH ...