Endocrine Abstracts

Background: Radioactive iodine (RAI) therapy is well-established in the management of benign thyroid disorders associated with thyrotoxicosis, but the optimal dose remains controversial. Guidelines recommend 500–800 MBq, though it is thought that Graves’ thyrotoxicosis may respond more readily to lower doses (400–600 MBq).Methods: We studied all local cases receiving RAI over four calendar years (2010–2013; n=447). Demographi...

Non-alcoholic fatty liver disease (NAFLD) is characterised by intra-hepatocyte lipid accumulation. Simple steatosis, which is a reversible condition, can progress to non-alcoholic steatohepatitis (NASH), cirrhosis and eventually hepatocellular carcinoma. The aetiology of NAFLD is not fully understood and it is suggested that glucocorticoid reactivation through the activity of the 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) enzyme may promote hepatic lipid accu...

Glucocorticoids (GC), such as prednisolone, are widely prescribed for their anti-inflammatory and immunosuppressive properties. However, they have significant side-effects including insulin resistance and hepatic steatosis. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts 11-dehydrocorticosterone (11DHC) to active corticosterone (CORT) and thus amplifies local GC action. We hypothesise that enhanced local GC regeneration of exogenously administered GCs by ...

Leydig cell tumour (LCT) is a stromal testicular tumour comprising 3% of testicular neoplasms. Metastases are rare, have a poor prognosis and can appear many years after tumour removal. Current therapy for metastatic disease is limited, with no role for radiotherapy and poor efficacy of chemotherapy regimens. About 50–70% of metastatic LCT show associated steroid excess, comprising not only androgens but sometimes steroids physiologically produced in the adrenals. Here we...

Introduction: Testicular leydig cell tumours (LCTs) are rare stromal tumors often associated with androgen excess. Metastatic malignant LCTs typically show resistance to radiotherapy and cytotoxic chemotherapy, calling for alternative management options. Here we describe our experience with treatment of two patients with metastatic LCTs with the adrenolytic drug Mitotane.Patients/methods: Case 1: A 51-year-old patient presented with a 6 month hi...

Background: The inclusion of a youth worker within a transition service can be pivotal to its success.Objective: To assess the impact of a youth worker on diabetes care in adolescents with type 1 diabetes (T1DM) over a 6 month period by measuring HbA1c levels (primary outcome), Personal Development Tool score (PDT), hospital admissions and clinic attendance (secondary outcomes).Method: Prospective cohort study. 20 adolescents (age ...

Background: Childhood tumours of the hypothalamic pituitary axis (HPATs) are very rare and hence any single centre experience is limited. Without evidence-based guidance, treatment is individualised on a case basis. Survival rates are high, but at the expense of significant morbidity. Centralised care or wider multi-professional consultation may improve neuroendocrine and visual outcomes.Objective and hypotheses: 1. To facilitate multi-professional dial...

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. The role of glucocorticoids (GC) in its pathogenesis, is highlighted in patients with GC excess, Cushing’s syndrome, who develop central adiposity, insulin resistance and in 20% of cases, NAFLD. Although circulating cortisol levels are normal in patients with NAFLD, hepatic cortisol availability is controlled by enzymes that regenerate cortisol from inactive cortisone (11&#94...

Cytological evaluation establishes the diagnosis of a benign or malignant nodule in 70–80% of all cases, but the remaining cases lack the features needed for a definitive diagnosis. Molecular tests have been developed to assist in determining if a nodule with indeterminate cytology is benign or malignant. The first studies focused on the analysis of the most common thyroid cancer (TC) mutation, BRAFV600E. However, since many TCs are driven by other mutations, testing for ...

The evaluation of a thyroid nodule is a very common clinical problem and fine needle aspiration biopsy (FNAB) is the only test that can provide a definitive preoperative diagnosis of malignancy. The sensitivity and specificity of FNAB are limited by aspirates that yield insufficient material for definitive diagnosis and those with indeterminate diagnoses, which can account for up to 30–40% of all specimens. The detection of several novel gene mutations in differentiated t...