ESPE Abstracts

Background: Diabetic ketoacidosis (DKA) in children and young adults carries significant morbidity and mortality relating to complications such as cerebral oedema. Acute kidney injury (AKI) is a rare but potentially fatal complication of DKA. We present three cases of DKA complicated by AKI.Case 1: A 9-year-old girl presented with severe DKA at diagnosis. She was treated with intravenous fluids and insulin as per protocol. She had oliguria and haematuria...

Introduction: The role of genetics in obesity is a much under discussed area. Whilst it is undeniable that environmental factors play a major role in obesity in most cases, there is a small proportion of cases where genetic mutations are the main underlying cause. This includes novel monogenic conditions involving mutations in the Melanocortin-4 receptor (MC4R) signalling pathway. In a healthy individual, the post-meal increase in leptin (LEP) stimulates melan...

Introduction: Insulin stress test (IST) to diagnose growth hormone (GH) deficiency is rarely used by paediatric endocrine teams in the United Kingdom, due to concerns over safety. We share our experience of undertaking modified IST in children, with regards to safety and outcomes.Methods: We adapted the protocol for insulin stress test, proposed by Galloway et al to undertake pituitary stimulation test for our c...

Background: Brown adipose tissue metabolism is of remarkable pathophysiological interest, because it could be a target for therapies for obesity and metabolic syndrome. Irisin (Ir), recently identified adipomyokine is essential in a white-to-brown fatty tissue transdifferentiation, and mediates some of the positive influences on metabolic disorders through increase of energy expenditure. The exact regulation of Ir secretion and action is unknown but positive associations of ci...

Growth differentiation factor 5 (GDF5) was reported to regulate brown adipogenesis, however, its effects on insulin sensitivity, full metabolic syndrome spectrum and the thermogenesis in subcutaneous white adipose tissue (sWAT) haven't been elucidated yet. We thus generated fatty acid-binding protein 4 (Fabp4)-GDF5 transgenic mice and showed that GDF5 transgenic mice developed a relative lean phenotype on a high-fat diet (HFD) and showed increased insulin sensitivity. Over...

Background: Accelerated catch-up growth following intrauterine growth restriction increases the risk of developing visceral adiposity and metabolic syndrome. Animal models of growth restriction during gestation have been developed as a powerful tool to provide insight into the underlying molecular mechanisms thereof.Objective: To analyze the patterns of gene expression in the retroperitoneal adipose tissue of rats with i...

Introduction: The presence of ZnT8 (zinc transporter 8) has been described on the surface of beta pancreatic cells in type 1 diabetic patients and the ZnT8 Ab (zinc transporter-8 autoantibody) has been recently established as a new marker of this autoimmune disease. There are studies demonstrating that ZnT8 may be of importance in some other endocrine cell types. In our study we wanted to verify the presence of ZnT8 in thyroid cells of children and adolescents...

We report a case of a child who presented with huge pericardial effusion complicated to cardiac tamponade secondary to primary hypothyroidism. Due to the severity of cardiac tamponade, pericardiocentesis was performed to relieve the compression effect. The child improved with Levothyroxine treatment.Hypothyroidism is a rare cause of pericardial effusion in children. If the pericardial effusion increases in volume, cardiac tamponade with clinical...

Background: The new adipokine/myokine meteorin-like (Metrnl) has been proposed to be of interest for obesity and metabolic disease through its potential role for brown/beige fat thermogenesis and macrophage activation in mice. METRNL was reported to be expressed in white adipose tissue (AT) and upregulated during adipogenesis and by exercise and.Aims: In this study we analysed the expression of METRNL during human adipogenesis and its regulation...

Objective: Remission rates in young people with Graves’ hyperthyroidism are 25% or less after a 2-yr course of thionamide antithyroid drug (ATD). Immunomodulatory agents could potentially improve outcome by facilitating immune tolerance. We wanted to explore whether rituximab, a B lymphocyte depleting agent, would increase remission rates when administered with a short course of ATD.Design: This was an investigator-...