Endocrine Abstracts

Endocrinopathies are amongst the most common complications of thallasaemia, which is a hereditary disorder of haemoglobin synthesis and excessive iron deposition is thought to be the main reason.Our hospital serves a multiethnic population and consequently we see a substantial number of patients with thallasaemia who are screened for endocrine complications. Those found to have endocrine problems are reviewed in our joint thallasaemia-endocrine clinic. B...

We present two cases where, without measurement of cortisol binding globulin (CBG), interpretation of their 250mcg short synacthen test (SST) would have falsely suggested inadequate pituitary-adrenal reserve.A 62yr old woman was referred with an incidental finding of a pituitary adenoma. Pituitary function tests confirmed gonadotrophin and growth hormone deficiency. Initial and subsequent SSTs were normal (30min cortisol reater than 600nmol/L). Follow up...

IGFs act as amplifiers of gonadotrophin (Gn) action in the ovary, but their activity is modulated by IGFBPs. In addition, we have shown IGF-independent inhibitory effects of IGFBP-4 on ovarian steroidogenesis. The aim of this study was to investigate the possible mechanism of action of IGFBP-4 in ovarian cells.Granulosa cells (GC) and theca were harvested from intact follicles (2.5-14mm) dissected from 8 pairs of ovaries collected with ethics committee a...

The role of prolactin in the regulation of ovarian folliculogenesis and in particular it's relationship to follicular atresia is as yet unclear; although a decline in prolactin concentrations in bovine follicular fluid appears to be related to morphological signs of atresia. In addition to the pituitary and endometrium sources of prolactin, there is also a local ovarian source of prolactin. Hence a potential autocrine mechanism of prolactin action may exist in the ovary. We in...

The IGF/IGFBPs are important in follicle growth and selection, with IGFBP-4 being one of the major players in this system. We have shown potent, IGF-independent, inhibitory effects of IGFBP-4 on steroidogenesis, explaining its' preferential proteolysis in healthy follicles. Two isoforms of IGFBP-4 exist, non-glycosylated and glycosylated, at approximately 24 and 28kDa, with different susceptibility to proteolysis. We therefore investigated the production of IGFBP-4 isoforms by...

IGFs and IGFBPs have an important role in folliculogenesis, with the profile of IGFBPs being different in healthy and atretic follicles. In particular, IGFBP-4, which is a potent inhibitor of steroidogenesis, is preferentially proteolysed in healthy follicles. We therefore investigated the production and activation of IGFBP-4 protease in human follicular cells.Follicles of 3-25mm were dissected from 13 pairs of ovaries collected with ethics committee app...

Background: Type 1 diabetes is a chronic condition with significant implications on the child, the family and the health services. Management of this condition in a refugee child is fraught with further challenges.Methods: In this observational case report, we discuss the challenges in the management of a 10-year-old Somalian boy, with type 1 diabetes for the past few years, who presented with Diabetic ketoacidosis.Table 1 illustra...

Background: Diamond Blackfan anaemia (DBA) is a condition caused by mutations in ribosomal protein genes. After the first year of life, the mainstay of treatment is corticosteroids whilst red blood cell transfusions are used for patients who do not respond.Case: We present a case of a 20-year-old woman with a history of DBA (RPS19 mutation), initially treated with courses of prednisolone, who aged 3 developed steroid-ind...

Sulphonylurea is an oral hypoglycaemic agent which stimulates the release of insulin from the pancreas and may induce raised plasma insulin and c-peptide levels. Sulphonylurea overdose is associated with profound refractory hypoglycaemia and can cause neurological deficit and acute renal failure. We report the case of a 15 year old non-diabetic girl who presented to our emergency department with sudden onset generalised tonic clinic (GTC) seizures secondary to hypoglycaemia of...

A 57 year-old gentleman with uncomplicated Type 2 Diabetes Mellitus and 30 pack year smoking history was assessed in outpatient endocrinology clinic with a 4 month history of non-specific symptoms, including dizziness, lack of energy and intermittent bi-frontal headaches described as ‘pressure behind the eyes’. There was no history of exogenous steroid use. Bloods at 0833 h identified deficiency in testosterone (<1 nmol/l; N= 6–30 nmol/l), thyroxine...