Endocrine Abstracts

Background: True cyclical Cushing's syndrome is rare and usually due to an ACTH-secreting corticotrophinoma. We describe a man with cyclical Cushing's syndrome of 15 years duration who had unexpected pituitary immunohistopathology.Clinical details: A 22-year-old man presented in 1986 with clinical features of Cushing's syndrome & urinary free cortisols up to 1800 nmol/24h, but normal low-dose DXM suppression, & normal pituitary and adrenals on CT. He was then lost ...

Background/Aims: Prognosis in midgut carcinoid tumours (MGCs) is difficult to predict. Studies of traditional clinical parameters give conflicting results. This is a large retrospective survival analysis of both clinical and biochemical data collected at diagnosis before treatment.Methods: Sequential cases of MGCs were identified using a database in Belfast from 1978. Clinical notes and pre-treatment plasma Neurokinin A (NKA) concentrations, were reviewed for each patient ...

Efficacy and Safety of High Dose Testosterone Therapy in Partial Androgen InsensitivityS. Bandyopadhyay, W.A.Watson, C. M.Park, P. Abraham, S. Philip, S. Acharya , J.S. Bevan. Department of Endocrinology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN.INTRODUCTION: There have been few reports of the efficacy and safety of high dose androgen therapy in men with partial androgen insensitivity (PAI). We report on the responses of a p...

The high survival rate for patients with differentiated thyroid carcinoma (DTC) declines markedly in those with bony metastases. We compare the management of two patients with large dominant pelvic metastases.Case 1 63 year old man with R hip pain. Investigation revealed a 10cm lesion in the R hemi pelvis and subsequent imaging and biopsy revealed a 9th rib lesion and metastatic follicular DTC. He underwent 131 I ablation of the normal thyroi...

Introduction: Women with turner syndrome (TS) have an increased risk of aortic dissection at young age. Bicuspid aortic valve (BAV) and aortic dilatation, both associated with TS, are risk factors. Preliminary studies suggested that cardiac MR (CMR) perfoms better than transthoracic echocardiography (TTE) for evaluating BAV and aortic dilatation, probably related to the frequent chest abnormalities in TS.Aim: To evaluate the ability and comparability of ...

Non-healing foot ulcers are a major complication in diabetic patients. Mesenchymal stem cells (MSCs) are known to promote angiogenesis with improved wound healing. Orbsen Therapeutics has identified a novel antibody (CD362+) which can be used to prospectively FACS-isolate CD362+CD45− MSC from human bone marrow with enhanced MSC/MNC purity ratios of up to 1/4. Excellagen matrix was used to seed the cells as biomaterials are well reported t...

Introduction: Fibroblast growth factor 23 (FGF23) excess is the cause of chronic hypophosphatemia in rare conditions such as X-linked hypophosphataemic rickets (XLHR) and tumour-induced osteomalacia (TIO), but animal studies indicate that the effect of FGF23 on serum phosphorus is dependent on the presence of parathyroid hormone (PTH). In this case series of rare disorders with abnormalities in renal phosphorus handling, we sought to explore the relative roles of PTH and FGF23...

The insulin signalling system including the insulin receptor tyrosine kinase (IRTK) is evolutionarily ancient and appears in the first multicellular organisms (Cnidarians). The Drosophila melanogaster genome contains seven genes for insulin-like peptides (ILPs) that are expressed in neurosecretory cells in a highly tissue- and stage-specific pattern, DILP1-7. There is however only one IRTK (dIR). This system is important in the regulation of metabolism, growth, reprod...

Introduction: The clinical features and complications of Cushing’s syndrome result from chronic excess of circulating cortisol, typically quantified by 24-h urinary free cortisol (UFC). LCI699 is a potent inhibitor of 11β-hydroxylase. Since 11β-hydroxylase catalyzes the final step of cortisol synthesis, LCI699 is a potential new treatment for all forms of Cushing’s syndrome.Methods: Adult patients with mild-to-severe Cushing’s di...

Thymic carcinoma is a rare but aggressive cause of ectopic ACTH secretion, with fewer than 100 reported cases.Hypokalaemic alkalosis was found in a 38 year old woman who presented with a 2-week history of leg swelling, fatigue and dyspnoea. She was not obviously Cushingoid.ACTH-dependent Cushing's Syndrome was confirmed biochemically: urinary free cortisol (UFC) >8500nmol/day and serum cortisol 4060nmol/l, (no suppression on 8...