Endocrine Abstracts

Introduction: The early management of atypical genitalia has been highlighted as being of critical importance by the UK-DSD guidance in 2011.Objectives: To estimate the incidence of atypical genitalia requiring early specialist input in neonates and its clinical presentation and management.Method: Prospective audit through the Scottish DSD network and the Scottish Paediatric Endocrine Group, between June 2013 and June 2014. Monthly...

Background: Vertebral Fractures (VF) are recognized as an important aspect of bone health in children and adolescents. The clinical utility of vertebral fracture assessment (VFA) using dual-energy X-ray absorptiometry (DXA) has not been evaluated in the paediatric population.Method: VFA was performed independently by two non-radiologist observers, in 165 patients (77M/88F) as part of their investigation for low bone mineral density. Lateral thoracolumbar...

Background: The optimal management of paediatric craniopharyngiomas has been debated for years. Radical surgery aimed at complete resection (CR) was the approach for several decades, with higher reported rates of tumour control compared with incomplete resection (IR). The shift towards conservative surgery with adjuvant radiotherapy (DXT), aimed at reducing post-operative morbidities, especially hypothalamic and visual, has not been systematically studied.<p class="abstext...

Background: Adult survivors of childhood leukaemia treated with bone marrow transplantation and total body irradiation (BMT/TBI) have an increased risk of diabetes mellitus (DM) disproportionate to their level of adiposity or other recognised risk factors. Post prandial hyperglycaemia due to reduced β-cell reserve after irradiation will be missed by fasting glucose (FG) levels. However, the UK National Institute of Clinical Excellence (NICE) screening guidelines recommend...

Background: High resolution peripheral quantitative computed tomography (HRpQCT) can accurately determine three-dimensional in-vivo skeletal microstructure. However, HRpQCT is limited to the ultradistal radius and tibia (9 mm) imaging. MRI may be an alternative approach to cortical and trabecular bone analysis; to date there is limited information regarding the accurate quantification of trabecular bone.Method: Ninety-three 13–16 years-old ...

Introduction: The short Synacthen test (SST) is a popular diagnostic investigation for adrenal insufficiency (AI). Cannulation and blood sampling are required making it invasive, time-consuming and resource-intensive. Salivary cortisol is a well-established alternative to serum sampling. We have developed a non-invasive alternative to the 1 μg SST, using a novel formulation of Synacthen (with a nasal drug enhancer, chitosan) given nasally and utilising saliva to measure t...

Background: GH deficiency (GHD) has a spectrum of severity as characterised by GH stimulation tests; the cut-off level for GHD has been a long standing contentious issue. An independent biological correlate of severity would be valuable.Objectives: To identify patterns of gene expression (GE) that correlate with severity in GHD.Methods: Pre-pubertal children with GHD (n=72) were enrolled from the PREDICT study (NCT00256126...

Introduction: National Institute of Health and Care Excellence (NICE) has provided guidance for the use of human recombinant GH in the treatment of growth failure in children. An ongoing National GH Audit was established in 2013 by BSPED to maintain a central database and gather information regarding trends in prescribing and facilitate future long-term follow up. This part of the audit looked at the trends of off label prescribing of GH.Method: Data wer...

Introduction: Gynaecomastia (GM) is common in boys with Klinefelter syndrome (KS) during adolescence. It develops due to the relatively higher diurnal oestradiol–testosterone ratio in early to mid puberty. The physiological mid-late pubertal rise in testosterone causes the GM to disappear in chromosomally normal boys, but it persists in boys with KS if this rise in testosterone is blunted.Aim: As a previous longitudinal RCT of testosterone in boys w...