Endocrine Abstracts

Hyponatraemia is associated with an increase in morbidity and mortality, prolonged hospital stays and poor assessment and management. Two audits were performed looking at acute medical unit (AMU) admissions with sodium <130 mmol/l, before and after the introduction of a protocol and regular endocrine nurse specialist ward visits, 3 months apart (58 patients in April and 99 in July 2013).Hyponatraemic patients were older than the AMU population (>...

Thyroid hormones regulate adult bone turnover. Thyrotoxicosis results in high turnover osteoporosis whilst hypothyroidism leads to low bone turnover with increased bone mass and mineralisation. T3-target tissues express thyroid hormone receptor alpha (TRα), thyroid hormone receptor beta (TRβ)or both receptors. TRα1 mediates the actions of T3 in bone and in skeletal cells TRα1 mRNA expression is 12-fold higher than TRβ1. Accordingl...

Introduction: Hyperprolactinaemia may occur in 30% of adults with chronic kidney disease (CKD), although rare in paediatrics. The pathophysiology might be further complicated by pre-existing pituitary abnormalities.Case: Symptomatic hyperprolactinaemia developed in this adolescent girl with CKD and hypopituitarism. History involved neonatal hypoxic ischaemic encephalopathy (HIE) and renal cortical necrosis. CKD Stage 3 ensued. Growth declined by 2.3 year...

Local regulation of T3 action in bone and cartilage is a novel mechanism underlying the pathogenesis of osteoarthritis (OA). Accelerated chondrocyte differentiation is a hallmark of OA and T3 regulates this process. The type 1 and 2 deiodinases (D1, D2) convert the pro-hormone T4 to the active hormone T3 whilst D3 inactivates both T3 and T4. D1 contributes to circulating T3 levels and local T3</s...

Childhood hypothyroidism results in delayed skeletal maturation and impaired growth. Thyroid hormones act via thyroid hormone receptors α (TRα) and TRβ which are tempo-spatially regulated. In the skeleton, TRα is the predominant receptor, thus we hypothesise that the skeletal effects of hypothyroidism are mediated by TRα. To investigate this we assessed the response of wild type (wt), TRα knockout (TRα0/0) and TRβ knockout (TR...

Hypoglycemia is an uncommon clinical problem in patients without diabetes mellitus. Potential aetiologies include drugs, critical illness, hormone deficiencies, and non islet cell tumors. In the absence of these causes, the possibility of accidental, surreptitious, or even malicious hypoglycemia should be considered. We present three cases of severe, prolonged hypoglycemia occurring spontaneously in healthy young men without a history of diabetes mellitus or chronic illness. A...

A 77 year old man with a background of Crohns disease requiring ileostomy, pernicious anaemia and hypertension, presented with a 4month history of dysphagia to solids, hoarseness of voice, anorexia and marked weight loss of 30 kg. He was initially referred to gastroenterology, who performed an endoscopy which was normal. Subsequently he was referred to the ENT and speech and language therapy departments. A video fluoroscopy confirmed severe oropharyngeal dysphagia with effortf...

A decrease in insulin sensitivity (IS) is associated with increasing visceral adiposity. An inverse correlation has been demonstrated between Intramyo-(IMTG) and intrahepatocellular triglyceride (HCTG) concentrations and IS. Patients with AA have reduced IS but IMTG and HCTG content has not been studied.Eight patients with AA (IGF-I >ULN, median 1.83×ULN (range1.16–4.38) ((6 M), median age 39.5 (range 23–66) years, median BMI 30.6(23.5...

Increased hypothalamic–pituitary–thyroid (HPT) axis activity results in high bone turnover. T3 stimulates osteoblast and osteoclast activities, whereas TSH is proposed to inhibit bone turnover directly. Resolving the relative importance of T3 and TSH is complicated by their physiological inverse relationship. We studied 10 controls and 4 patients with resistance to thyroid hormone (RTH), in which mutation of thyroid hormone receptor beta (THR...

Generalised oedema as a rare complication of insulin treatment in the absence of renal, hepatic or cardiovascular disease was first described by Leifer in 1928. The true incidence of insulin oedema in children with type 1 diabetes mellitus is unknown and since it was first reported in 1979, there have been only 12 reported cases worldwide. Insulin oedema has been described both in patients with newly diagnosed diabetes receiving insulin therapy for the first time and also in t...