Endocrine Abstracts

Introduction. As for many minor metabolites of steroids, no authentic standard is commercially available for 18-OH-THA. This compound is the principal urinary metabolite of 18-hydroxycorticosterone, a putative intermediate in the synthesis of aldosterone and of diagnostic value in screening for hypermineralocorticoidism. Since de novo synthesis is time-consuming and expensive, we tested the possibility of using beta-cortol, which produces an ion at m/z 457 in common wit...

A 60 year old nurse presented to the emergency department with palpitations, itchy skin, shortness of breath, diarrhoea, insomnia, weight loss and feeling hot /clammy. She felt her symptoms were in keeping with the menopause although she had been amenorrhoeic for six years. Thyroid function tests revealed fT4 73 pmol/land TSH <0.01 mIU/lhaving been normal six months previously. She was started on carbimazole 40 mg/day and was seen urgently in clinic. She reported to feelin...

Case History: A 27 year-old lady, seven weeks gestation presented to ED during her second pregnancy with abdominal pain, vomiting, constipation and hyponatraemia (Na = 114mmol/l). She had attended twice earlier during her pregnancy with presumed hyperemesis gravidarum. Because urinary sodium was elevated at 181mmol/l, dehydration was deemed unlikely and she was initially treated as SIADH with 1.2L fluid restriction and 2.7% 200mls of hypertonic saline. Sertraline was held. Rep...

Development of a functional human lung requires regulation of cell growth, proliferation and differentiation in specific germ layer compartments. Important endocrine regulators of respiratory development include glucocorticoid (GC) steroids and the potent synthetic GC betamethasone is commonly used antenatally to treat the deficits of very preterm human birth. Previous studies with conditional mouse knockouts of the glucocorticoid receptor (GR) gene have established the mesenc...

Primary hyperparathyroidism (PHP) during pregnancy is associated with high risk of maternal, foetal and neonatal mortality. Maternal and foetal complications have been reported in 67 and 80% of cases respectively. Guidelines for the management of PHP in adults exist, but there is no clear consensus regarding optimal management of PHP during pregnancy. We describe a case of PHP managed conservatively during pregnancy, resulting in the delivery of a healthy baby.<p class="ab...

Thyroid cancer has an annual incidence of 0.2–5 per million children representing 3% of all childhood tumours. We describe the presentation, histopathology and treatment of four patients in a regional paediatric surgical and endocrine unit over the past 15 years.Three of four cases are female with 1 male. Age of diagnosis ranged from 6 to 15 years. All had an elevated thyroglobulin at presentation with normal thyroid function tests. Three underwent ...

Ulceration is a common and severe complication of diabetes affecting 15% of the 200 million patients with diabetes worldwide. A significant proportion of these chronic wounds fail to respond to conventional treatment, hence major amputation is a feared outcome of diabetes. More than 60% of non-traumatic amputations in the western world are performed in the diabetic population. There exists a growing need for effective therapeutic agents to improve healing in these wounds.<...

Introduction: We have developed a highly sensitive LC–MS assay in an attempt to improve the measurement of salivary testosterone in female samples.Methods: A 200 μl saliva sample, calibrators or QC were mixed with 10 μl working internal standard (0.1 μg/l) and 1 ml of methyl tert-butyl ether (MTBE). Vortex mixed for 4 min and frozen at −80 °C (1 h). Unfrozen organic layer was transferred to a glass tube and evaporated. The ...

TSH-secreting pituitary adenomas are rare and the optimal investigation and management is uncertain.A 42-year-old lady presented with a three-month history of three stone weight loss, palpitations, heat intolerance and tremor. Her sister was being treated for Graves’ disease. Visual fields were intact.Thyroid function tests showed free T4 concentration 29.5 pmol/l (9.0–19.0) and TSH concentration 3.672 mU/l (0....

Background: Osteoporosis leads to significant morbidity and disability through an increased susceptibility to fracture. Post-menopausal females are a high-risk group. A fracture liaison service model has been proposed as a method to maximise initiation of treatment for secondary prevention following a fragility fracture.Aim: To compare practice in two fracture units to guidelines contained in the National Institute for Clinical Excellence (NICE) Technolo...