Endocrine Abstracts

Asfotase alfa (AA, STRENSIQ, Alexion Pharmaceuticals, Inc.) is the first FDA-Approved treatment for patients with hypophosphatasia, the result of a mutation in the tissue-nonspecific alkaline phosphatase (ALPL) gene. Because it contains the ALP active site, AA is able to catalyse the substrate as the antibody-conjugated ALP would within an assay. Therefore, AA present in a patient’s sample may generate a false positive or a false negative result. We investigated ...

Type 1 diabetes mellitus (T1D) is an autoimmune disease that results from the destruction of insulin producing β cells, in genetic susceptible individuals. Vitamin D (Vit D) is mostly known for its role in bone and calcium metabolism, however it is also involved in the modulation of the immune response. Serum levels of vitamin D partly depend on diet and sunlight exposure. However, genetic factors are also involved. Patients with T1D have been reported to have a higher pr...

Endogenous Cushing’s syndrome poses considerable diagnostic challenges. It is recommended to use two screening tests to confirm hypercortisolaemia. While late-night salivary cortisol assessment (LNSC) is reported to have good specificity and sensitivity and deemed to be cost-effective, it is the least widely biochemical tool used both nationally and in Europe. We aim to compare the specificity and sensitivity of LNSC against and in combination with other diagnostic tests,...

Introduction: Failure to recognise critically ill patients delays escalation to intensive care units (ICU) and results in increased mortality. Objectively identifying the sickest patients on admission remains challenging for healthcare professionals. This study proposes a novel Metabolic Index as a marker of metabolic disturbance based on a patient’s sodium, potassium and bicarbonate. The Metabolic Index is proposed as a predictor of outcome in patients presenting to A&#3...

Background: Low glucose is a relatively common primary care referral to specialist endocrine services. However the prevalence of endocrine disease causing endogenous hypoglycaemia is extremely rare.Methods: We obtained all plasma glucose results <4 mM originating from primary care within NHS Lothian, in non-diabetic individuals (20 145 people (77.6% female)) aged 18–40 years, between 2002 and 2017. These data were linked to national admission, m...

Background: Post-thyroidectomy hypocalcaemia is a common complication with significant short and long term complications. The aim of this study was to determine the incidence and predictors of post-thyroidectomy hypocalcaemia (corrected calcium <2.1mmol/l).Method: A total of 183patients who underwent total thyroidectomybetween 2012 and 2015 in a national general hospital were included in this retrospective study. Clinical and biochemical data were ob...

A recent audit of the urine steroid profile (USP) service at Glasgow Royal Infirmary (GRI) revealed that up to 25% of requests are made inappropriately, or without any clinical information. In contrast to the majority of biochemical testing, USP analysis is very labour intensive, and interpretation of results requires both quantitative and qualitative assessment of the profile. Adequate clinical information is essential to generate a complete report, as a number of steroids fo...

Introduction: Disorders of plasma sodium are one of the commonest electrolyte abnormalities affecting acutely unwell patients. The North Middlesex is a busy district general hospital with a diverse population. We reviewed our hypernatraemic population to identify possible trends in age, demographics and outcomes.Methods: Through the biochemistry laboratory, we identified all patients with sodium level above 145 mmol/L who were acute inpatients or attende...

GS, Patients have hypokalemia, metabolic alkalosis, hypomagnesemia, and hypocalciuria together with normal blood pressure. Most of the patients are clinically asymptomatic, but some patients experience seizures, muscle weakness, cramps, episodic tetany, and paresthesia. The diagnosis is usually made based on clinical features and laboratory blood test. In this study we present a young patient with persistent hypokalaemia. She feels well in herself. She denies any symptoms of h...

Objectives: Oestrogen analysis using liquid chromatography mass spectrometry is problematic, as oestrogens do not readily ionise. This coupled with low concentrations in men, pre-pubertal and post-menopausal women provides an analytical challenge. We investigated N-Methyl Pyridine-3-sulfonyl chloride (NMPS) derivatisation, as described by Wang et al. (Steroids 2015 Apr;96:140-152) to improve sensitivity of 11 oestrogens; oestrone (E1), oestradiol (E2), 2-hydroxy-oestr...