Endocrine Abstracts

Introduction: IIH is associated with hypo and hyperthyroidism. We report a case of IIH where the likely precipitant was the treatment for hypothyroidism itself, levothyroxine, and the challenges this presents.Case: A 14-year-old girl was diagnosed with primary hypothyroidism following investigations for short stature (height 137 cm < 0.4th centile). Serum assay showed TSH 538 mU/l (0.55–4.78 mU/l), T4 0.68 pmol/l, (1.7–22.7 pmol/...

Introduction: Rates of obesity in children are rising and the cause is multifactorial. Previous studies have shown a higher prevalence of childhood obesity in areas with high socioeconomic deprivation and that the gap is increasing gap between the obesity prevalence in the most and least deprived areas. We report data on the Index of Multiple Deprivation (IMD), specific Domains of Deprivation and E-food desert index (EFDI) data for children and young people (CYP) in the compli...

In September 2021 the pathology department announced it would be going paperless, a change that resulted in endocrine monitoring being added to the trust risk register. To manage this risk several options were considered including the DAWN system used by rheumatology and systems used by other local hospitals. Unfortunately, none of these were viable options. Discussions were started with the IT systems development team about building a database for management of thyroid patien...

Background: The autoimmune thyroid diseases, primary autoimmune hypothyroidism (AH) and Graves’ hyperthyroidism (GD), represent the most prevalent endocrine disorders. Although clinically distinct, they share several genetic susceptibility loci, many of which remain unidentified.TIGIT (T cell immunoreceptor with immunoglobulin and ITIM domains), expressed on the surface of T-cells, interacts with CD-155 on dendritic cells to form an alternative cost...

An endocrine specialist pharmacist has been running an adrenal incidentaloma clinic since September 2020. As of Jun-22 258 patients have been seen in clinic and managed using a local protocol. Adrenal incidentaloma patient referrals are screened as per current guidelines on receipt; those measuring <1 cm are declined, suspected adrenocortical carcinomas are seen by a consultant and referred elsewhere if needed. All others are seen by the endocrine pharmacist within 4 weeks...

Introduction: Increasing evidence is emerging that demonstrates the increased prothrombotic risk associated with DKA.1 We present the case of a child who developed multiple complications which we believe can be explained by his hypercoaguable state.Case history: A 14-month-old male was admitted in DKA at first diabetic presentation, complicated by cardiovascular shock. Initial blood tests showed blood glucose 80 mmol/l, blood ketones 5.9 mmol/...

Burosumab, monoclonal antibody targeting fibroblast growth factor 23, is now available for clinical use in children with X-linked hypophosphatemia (XLH). We explored the effects of this treatment in a clinical setting, considering biochemistry, growth, deformity, functionality, quality of life, pain and fatigue.Methods: Clinical, biochemical, radiological and questionnaire data were reviewed at 6 and 12 months(m) for 8 children with XLH starting burosuma...

Epidemiological studies have suggested that in man low birth weight followed by rapid catch-up growth dramatically increase the risk of adulthood diabetes and metabolic syndrome. This experiment investigated the effect of a high fat, high cholesterol post-weaning diet on blood glucose levels of low (L) and normal (N) birth weight pigs.Low (L: <10thpercentile; n=6) and normal (N: 40th - 60th percentile; n=12) birth weig...

Background: Pituitary metastases are a rare occurrence, accounting for just 0.4% of intracranial metastatic tumours and are most often associated with breast and lung malignancies. The vast majority of lesions are asymptomatic and due to the predilection of metastasis to the posterior lobe of the pituitary gland, clinical presentation with anterior pituitary insufficiency is uncommon and rarely reported in literature.Case summary: A 51-year old male with...

Background: 21-hydroxylase deficiency congenital adrenal hyperplasia (CAH) is characterised by cortisol deficiency, androgen excess, varying degrees of virilisation and salt-wasting. CAH management involves replacement therapy with hydrocortisone, and, often, fludrocortisone. High levels of androgens cause the advancement of bone age (BA) with the potential to increase bone mineralisation. Hydrocortisone therapy on the contrary can contribute to reducing bone mineralisation. P...