Endocrine Abstracts

Background: Type 1 diabetesmellitus (T1DM) isthe most widespread metabolic/endocrine condition among children/adolescents in Georgia. T1DM patients aged 0–18 yrs are treated both in– and outpatiently. In 2015–2019 totally 533 patients were hospitalized, 211 of them had fresh T1DM. Special attention is paid to interactive diabetes education (IDE) of patients/their caregivers, thatis very important for adequate diabetes management. IDE is initiated from the day...

Background: Pembrolizumab is a novel anti-cancer drug that targets programmed cell death protein 1 (PD-1) receptor on lymphocytes resulting in their activation against tumor cells. PD-1 receptors are also distributed in endocrine organs and pembrolizumab use has long-been associated with hypophysitis and thyroiditis. We describe a patient with pembrolizumab-induced thyroiditis who developed an uncommon fulminant Type 1 Diabetes Mellitus (FT1D).Case prese...

Case Presentation: 37-year-old woman of South Asian origin was referred from retinopathy screening to our diabetes clinic for evaluation of an unusual finding during her retinal screen. Her retinal blood vessels appeared white in contrast to normal pink to red colour. She was recently diagnosed with type 2 diabetes and with type 1 hyperlipidaemia (T1 HPLA) confirmed by genotype for more than 10 years for which she had suboptimal control with multiple hospitalisations with recu...

Introduction: Immunoassays are important tools in the diagnosis and management of disease; however, they are not free from interference by cross-reacting substances. Discordant clinical evidence and laboratory results raised suspicion of interference in a patient with persistently raised parathyroid hormone.Case Presentation: Case description: A 56-year-old Caucasian female previously diagnosed with hypothyroidism consistently demonstrated elevated PTH l...

Introduction: Hypothyroidism is a clinical syndrome resulting from a deficiency of thyroid hormones, which in turn results in a generalized slowing down of metabolic processes. There are consistent reports demonstrating that many diseases, including the thyroid gland dysfunction are associated with changes of serum homocysteine (tHcy) level, with its genetic and epigenetic causes.Case report: In 2018 we reported 51 and 52-year-old sisters diagnosed with ...

Introduction: Older age and diabetes are both risk factors for frailty. Functional decline and disability in older, frail adults with diabetes results in an increased susceptibility to falls and hospital admission. Hypoglycaemia is common and more likely to result in hospital admission in older adults with diabetes and frailty. An HbA1c of below 7% (53 mmol/mol) is likely to represent overtreatment of hyperglycaemia. JBDS has recommended a review of HbA1c...

Background: Although pheochromocytoma classically presents with headaches, palpitations and paroxysmal hypertension, uncommon presentations such as cardiomyopathy, stroke and subarachnoid haemorrhage have been documented. We present one such infrequent presentation of myocardial infarction with normal coronary arteries (MINOCA).Case presentation: A 79-year Caucasian female presented with central crushing chest pain radiating to left arm associated with h...

Background: Effective management of diabetic ketoacidosis (DKA) improves clinical outcomes. Regular auditing and performance feedback are key to achieving sustained and significant improvement in the management of DKA. One of the major limitations for maximal impact of an audit is the delay from initiation to results as the latter may not be applicable to the then current practice. In order to overcome this, we created an automated auditing system called Digital Evaluation of ...

Introduction: Methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism results in thermolabile, reduced functioning enzyme and predicts hyperhomocisteinemia and altered DNA methylation. On the other hand, several studies indicated a higher plasma homocysteine (Hcy) levels in patients with primary hypothyroidism than in healthy, euthyroid individuals, including some experimental studies that indicated decreased MTHFR activity in hypothyroid patients. We cond...

IntroductionRecently, apart from its main physiologic role, the active form of vitamin D has also been recognised to have anti-inflammatory and immune-modulating properties. Accumulating evidence suggests that Vitamin D deficiency is associated with increased prevalence of various autoimmune diseases, and in particular, with autoimmune thyroid disease. Despite contradicting evidence, the balance is tipping towards inverse correlation between vitamin D de...