Imperial College London

Professor Karim Meeran

Faculty of MedicineDepartment of Medicine

Professor of Endocrinology
 
 
 
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Contact

 

+44 (0)20 8846 1065k.meeran

 
 
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Location

 

9E05Charing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
to

188 results found

Abbara A, Clarke SA, Nesbitt A, Ali S, Comninos AN, Hatfield E, Martin N, Sam A, Meeran K, Dhillo WSet al., 2018, Interpretation of serum gonadotropin levels in hyperprolactinemia., Neuroendocrinology

<br>Background/Aims: Hyperprolactinemia is a common cause of amenorrhea due to hypogonadotropic hypogonadism. Prolactin is hypothesized to impede the reproductive axis through an inhibitory action at the hypothalamus. However, limited data exists to aid the interpretation of serum gonadotropins in the context of hyperprolactinemia. METHODS: Serum gonadotropin values were reviewed in 243 patients with elevated serum monomeric prolactin due to discrete etiologies at a tertiary reproductive endocrine centre between 2012 and 2015. The cause of hyperprolactinemia was categorized by an experienced endocrinologist / pituitary multidisciplinary team, unless superseded by histology. The most frequently encountered diagnoses were Microprolactinoma (n=88), Macroprolactinoma (n=46), Non-Functioning Pituitary Adenoma (NFPA) (n=72), Drug-Induced Hyperprolactinemia (DIH) (n=22) and Polycystic Ovarian Syndrome (PCOS) (n=15). RESULTS: In patients with prolactinoma and modestly raised serum prolactin levels (<4000 mU/L), increasingly FSH-predominant gonadotropin values were observed with rising prolactin level, consistent with a progressive reduction in hypothalamic GnRH pulsatility. Patients with prolactinoma and higher prolactin values (>4000 mU/L) were more likely to have a reduction in serum levels of both FSH and LH, consistent with direct pituitary gonadotrope dysfunction. Patients with macroadenoma and extremes of serum gonadotropin values (either serum FSH or LH >8 IU/L) were more likely to have NFPA than prolactinoma. Patients with polycystic ovarian syndrome (PCOS) and hyperprolactinemia had LH-predominant secretion in keeping with increased GnRH pulsatility despite a raised prolactin level. CONCLUSION: The pattern of gonadotropin secretion in patients may reflect the etiology of hyperprolactinemia.<br>.

JOURNAL ARTICLE

Choudhury S, Meeran K, 2018, Glucocorticoid replacement in Addison disease., Nat Rev Endocrinol

JOURNAL ARTICLE

Choudhury S, Tan T, Meeran K, 2018, Once-daily, modified-release hydrocortisone in patients with adrenal insufficiency, LANCET DIABETES & ENDOCRINOLOGY, Vol: 6, Pages: 269-270, ISSN: 2213-8587

JOURNAL ARTICLE

Feeney C, Buell KG, Avari P, Buckley A, Meeran K, Rees DAet al., 2018, Addisonian crisis: assessment and management, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 79, Pages: C34-C37, ISSN: 1750-8460

JOURNAL ARTICLE

Khalil AB, Dina R, Meeran K, Bakir AM, Naqvi S, Al Tikritti A, Lessan N, Barakat MTet al., 2018, Indeterminate Thyroid Nodules: A Pragmatic Approach, EUROPEAN THYROID JOURNAL, Vol: 7, Pages: 39-43, ISSN: 2235-0640

JOURNAL ARTICLE

Loh WJ, Tharakan G, Todd J, Chahal H, Dhillo W, Martin N, Toumpanakis C, Caplin M, Spalding D, Meeran K, Tan T, Khoo Bet al., 2018, Sensitivity and Specificity of Insulin, C-Peptide and Nadir Glucose during 72 hr Supervised Fast in Diagnosis of Insulinoma, 15th Annual ENETS Conference for the Diagnosis and Treatment of Neuroendocrine Tumor Disease, Publisher: KARGER, Pages: 297-297, ISSN: 0028-3835

CONFERENCE PAPER

Sam AH, Field SM, Collares CF, van der Vleuten CPM, Wass VJ, Melville C, Harris J, Meeran Ket al., 2018, Very-short-answer questions: reliability, discrimination and acceptability, MEDICAL EDUCATION, Vol: 52, Pages: 447-455, ISSN: 0308-0110

JOURNAL ARTICLE

Zheng SL, Roddick AJ, Aghar-Jaffar R, Shun-Shin MJ, Francis D, Oliver N, Meeran Ket al., 2018, Association Between Use of Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-like Peptide 1 Agonists, and Dipeptidyl Peptidase 4 Inhibitors With All-Cause Mortality in Patients With Type 2 Diabetes A Systematic Review and Meta-analysis, JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, Vol: 319, Pages: 1580-1591, ISSN: 0098-7484

JOURNAL ARTICLE

Khoo B, Boshier PR, Freethy A, Tharakan G, Saeed S, Hill N, Williams EL, Moorthy K, Tolley N, Jiao LR, Spalding D, Palazzo F, Meeran K, Tan Tet al., 2017, Redefining the stress cortisol response to surgery, CLINICAL ENDOCRINOLOGY, Vol: 87, Pages: 451-458, ISSN: 0300-0664

JOURNAL ARTICLE

Meeran K, Choudhury SM, Wass J, 2017, GENERIC DRUG PRICING The scandal of generic drug pricing: drug regulation policies need review, BMJ-BRITISH MEDICAL JOURNAL, Vol: 356, ISSN: 1756-1833

JOURNAL ARTICLE

Smith DJF, Prabhudev H, Choudhury S, Meeran Ket al., 2017, Prednisolone has the same cardiovascular risk profile as hydrocortisone in glucocorticoid replacement, ENDOCRINE CONNECTIONS, Vol: 6, Pages: 766-772, ISSN: 2049-3614

JOURNAL ARTICLE

Vimalesvaran S, Narayanaswamy S, Yang L, Prague JK, Buckley A, Miras AD, Franks S, Meeran K, Dhillo WSet al., 2017, Using kisspeptin to assess GnRH function in an unusual case of primary amenorrhoea., Endocrinol Diabetes Metab Case Rep, Vol: 2017, ISSN: 2052-0573

SUMMARY: Primary amenorrhoea is defined as the failure to commence menstruation by the age of 15 years, in the presence of normal secondary sexual development. The potential causes of primary amenorrhoea extend from structural to chromosomal abnormalities. Polycystic ovarian syndrome (PCOS) is a common cause of secondary amenorrhoea but an uncommon cause of primary amenorrhoea. An early and prompt diagnosis of PCOS is important, as up to 30% of these women are predisposed to glucose intolerance and obesity, with the subgroup of women presenting with primary amenorrhoea and PCOS displaying a higher incidence of metabolic dysfunction. We describe a case of an 18-year-old female presenting with primary amenorrhoea of unknown aetiology. Although initial investigations did not demonstrate clinical or biochemical hyperandrogenism or any radiological evidence of polycystic ovaries, a raised luteinising hormone (LH) suggested a diagnosis of PCOS. If PCOS was the correct diagnosis, then one would expect intact hypothalamic GnRH and pituitary gonadotropin release. We used the novel hormone kisspeptin to confirm intact hypothalamic GnRH release and a GnRH stimulation test to confirm intact pituitary gonadotroph function. This case highlights that kisspeptin is a potential unique tool to test GnRH function in patients presenting with reproductive disorders. LEARNING POINTS: Polycystic ovarian syndrome (PCOS) can present with primary amenorrhoea, and therefore, should be considered in the differential diagnosis.PCOS is a heterogeneous condition that may present in lean women with few or absent signs of hyperandrogenism.GnRH stimulation tests are useful in evaluating pituitary function; however, to date, we do not have a viable test of GnRH function. Kisspeptin has the potential to form a novel diagnostic tool for assessing hypothalamic GnRH function by monitoring gonadotropin response as a surrogate marker of GnRH release.Confirmation of intact GnRH function helps consolidate a

JOURNAL ARTICLE

Sam AH, Hameed S, Harris J, Meeran Ket al., 2016, Validity of very short answer versus single best answer questions for undergraduate assessment, BMC MEDICAL EDUCATION, Vol: 16, ISSN: 1472-6920

JOURNAL ARTICLE

Daniel E, Aylwin S, Mustafa O, Ball S, Munir A, Boelaert K, Chortis V, Cuthbertson DJ, Daousi C, Rajeev SP, Davis J, Cheer K, Drake W, Gunganah K, Grossman A, Gurnell M, Powlson AS, Karavitaki N, Huguet I, Kearney T, Mohit K, Meeran K, Hill N, Rees A, Lansdown AJ, Trainer PJ, Minder A-EH, Newell-Price Jet al., 2015, Effectiveness of Metyrapone in Treating Cushing's Syndrome: A Retrospective Multicenter Study in 195 Patients, JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol: 100, Pages: 4146-4154, ISSN: 0021-972X

JOURNAL ARTICLE

Jayasena CN, Izzi-Engbeaya C, Narayanaswamy S, Modi M, Clarke H, Nijher GMK, Meeran K, Dhillo WSet al., 2015, Associations of coefficient of variation of serum GH with previous radiotherapy, hypopituitarism and cardiac disease in patients with treated acromegaly, CLINICAL ENDOCRINOLOGY, Vol: 82, Pages: 870-875, ISSN: 0300-0664

JOURNAL ARTICLE

Ramachandran R, Bech P, Murphy KG, Caplin ME, Patel M, Vohra S, Khan MS, Dhillo WS, Sharma R, Palazzo FF, Win Z, Tan T, Khoo B, Meeran K, Frilling A, Ghatei MA, Bloom SR, Martin NMet al., 2015, Comparison of the Utility of Cocaine- and Amphetamine-Regulated Transcript (CART), Chromogranin A, and Chromogranin B in Neuroendocrine Tumor Diagnosis and Assessment of Disease Progression, JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol: 100, Pages: 1520-1528, ISSN: 0021-972X

JOURNAL ARTICLE

Sam AH, Shah S, Saleh K, Joshi J, Roncaroli F, Robinson S, Cox J, Martin NM, Mendoza N, Meeran K, Mehta A, Dhillo WSet al., 2015, Clinical outcomes in patients with nonfunctioning pituitary adenomas managed conservatively, CLINICAL ENDOCRINOLOGY, Vol: 83, Pages: 861-865, ISSN: 0300-0664

JOURNAL ARTICLE

Allum M, Barnes S, Jackson J, Tan T, Meeran Ket al., 2014, Repeat Adrenal Vein Sampling Demonstrating Bilateral Aldosterone Secretion after Initial Discordant Results in the Investigation of Conn's Syndrome, a Case Report, ENDOCRINE REVIEWS, Vol: 35, ISSN: 0163-769X

JOURNAL ARTICLE

Amin A, Sam AH, Meeran K, 2014, Glucocorticoid replacement, BMJ-BRITISH MEDICAL JOURNAL, Vol: 349, ISSN: 1756-1833

JOURNAL ARTICLE

Cegla J, Troke RC, Jones B, Tharakan G, Kenkre J, McCullough KA, Lim CT, Parvizi N, Hussein M, Chambers ES, Minnion J, Cuenco J, Ghatei MA, Meeran K, Tan TM, Bloom SRet al., 2014, Coinfusion of Low-Dose GLP-1 and Glucagon in Man Results in a Reduction in Food Intake, DIABETES, Vol: 63, Pages: 3711-3720, ISSN: 0012-1797

JOURNAL ARTICLE

Daniel E, Aylwin SJB, Ball SG, Boelaert K, Cuthbertson D, Daousi C, Davis JR, Drake W, Grossman AB, Gurnell M, Karavitaki N, Kearney T, Meeran K, Rees A, Trainer PJ, Newell-Price JDCet al., 2014, Clinical Effectiveness of Metyrapone Monotherapy in 195 Patients with Cushing's Syndrome, ENDOCRINE REVIEWS, Vol: 35, ISSN: 0163-769X

JOURNAL ARTICLE

Dubb SS, Tafader A, Meeran K, Fletcher Jet al., 2014, Hypertension in a teenager: a family affair., BMJ Case Rep, Vol: 2014

We present a young, lean, female patient following surveillance by the general practitioner for abnormally high blood pressure readings. Her grandmother died at a young age because of hypertension which shows her family has significant history for hypertension. Her symptoms and signs included feeling hot and nauseous following exercise, sweating and palpitations. Her young age and significant family history immediately prioritises secondary causes including phaeochromocytoma and familial syndromes causing hypertension. Urinary results showed significantly elevated norepinephrine, MRI scanning revealed a mass not within but adjacent to the right adrenal gland while CT-based scanning showed no other ectopics. The patient subsequently underwent surgical intervention at Great Ormond Street Hosptial and following a difficult procedure, that initially started laparoscopically and was converted to open, the tumour was excised. Histopathology and genetic analysis ultimately revealed the patient to have suffered from a paraganglioma type 4 syndrome with a missense mutation of the SDHB gene.

JOURNAL ARTICLE

Fikri R, Todd J, Palazzo F, Robinson S, Cox JP, Jackson J, Meeran Ket al., 2014, The Lost Subtype of Conn's Syndrome. Case Series of Aldosterone & Cortisol Co-Secreting Adenomas Complicated By Post Retroperitoneal Adrenalectomy Hypoadrenalism Requiring Glucocorticoid Replacement, ENDOCRINE REVIEWS, Vol: 35, ISSN: 0163-769X

JOURNAL ARTICLE

Hill N, Meeran K, 2014, The dark truth about vitamin D licensing: food or drug?, BMJ, Vol: 348

JOURNAL ARTICLE

Hill N, Meeran K, 2014, VITAMIN D MINEFIELD The dark truth about vitamin D licensing: food or drug?, BMJ-BRITISH MEDICAL JOURNAL, Vol: 348, ISSN: 1756-1833

JOURNAL ARTICLE

Pinato DJ, Tan TM, Toussi STK, Ramachandran R, Martin N, Meeran K, Ngo N, Dina R, Sharma Ret al., 2014, An expression signature of the angiogenic response in gastrointestinal neuroendocrine tumours: correlation with tumour phenotype and survival outcomes, BRITISH JOURNAL OF CANCER, Vol: 110, Pages: 115-122, ISSN: 0007-0920

JOURNAL ARTICLE

Rahman A, Meeran K, 2014, The link between type 2 diabetes and pancreatic adenocarcinoma is yet to be established, ANNALS OF ONCOLOGY, Vol: 25, Pages: 2290-2290, ISSN: 0923-7534

JOURNAL ARTICLE

Stevens JL, Constantinides V, Todd J, Meeran K, Christakis I, Tolley NS, Palazzo FFet al., 2014, Do flow volume loops alter surgical management in patients with a goitre?, CLINICAL ENDOCRINOLOGY, Vol: 81, Pages: 916-920, ISSN: 0300-0664

JOURNAL ARTICLE

Cegla J, Jones B, Seyani L, Papadoulou D, Wynne K, Martin NM, Meeran K, Chapman R, Donaldson M, Goldstone AP, Tan Tet al., 2013, Comparison of the overnight metyrapone and glucagon stimulation tests in the assessment of secondary hypoadrenalism, CLINICAL ENDOCRINOLOGY, Vol: 78, Pages: 738-742, ISSN: 0300-0664

JOURNAL ARTICLE

Constantinides VA, Christakis I, Touska P, Meeran K, Palazzo Fet al., 2013, Retroperitoneoscopic or laparoscopic adrenalectomy? A single-centre UK experience, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 27, Pages: 4147-4152, ISSN: 0930-2794

JOURNAL ARTICLE

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