Endocrine Abstracts

Objective: Levothyroxine (LT4) is the gold standard of care for primary hypothyroidism. For most patients, it fully resolves the symptoms of hypothyroidism. However, a small proportion of treated individuals continue to experience symptoms even when euthyroid. The management of such patients has generated significant controversy and public attention throughout the years. This systematic review aims to analyse and evaluate the existing evidence for the benefits...

A 29 year old lady presented to an outside hospital with 1 year’s history of episodes of confusion in the mornings. The patient’s partner had noticed that 2–3 times a week she awoke with episodes of confusion, minimal communication, stereotyped lip smacking and winking lasting up to 20 min. She had one nocturnal tonic-clonic seizure abroad, requiring A+E attendance. She was then seen by a neurologist, had a normal sleep deprived EEG and was diagnosed with focal ...

We present the case of a 19-year old male who presented with a generalized tonic clonic seizure associated with visual loss. Examination revealed severe visual field defects and arrested pubertal development. Laboratory evaluation revealed a very elevated prolactin of 298 410 mU/l, hypogonadotrophic hypogonadism, secondary adrenal insufficiency, and secondary hypothyroidism. He was also found to have thrombocytosis due to JAK 2 essential thrombocythaemia. Pituitary MRI reveale...

We present the case of a 19-year old male who presented with a generalized tonic clonic seizure associated with visual loss. Examination revealed severe visual field defects and arrested pubertal development. Laboratory evaluation revealed a very elevated prolactin of 298 410 mU/l, hypogonadotrophic hypogonadism, secondary adrenal insufficiency, and secondary hypothyroidism. He was also found to have thrombocytosis due to JAK 2 essential thrombocythaemia. Pituitary MRI reveale...

Introduction: Besides medullary thyroid carcinoma and other endocrinopathies, people with MEN 2B have intestinal ganglioneuromatosis. A recent MEN2B cohort study reported high rates of gastrointestinal (GI) symptoms: we hypothesized these might have a major impact on patients’ daily lives.Methods: An online survey was conducted among patients from Association for Multiple Endocrine Neoplasia Disorders (AMEND). This incorporated relevant elements fro...

Background: Thyroid incidentaloma (TI) is an unsuspected, asymptomatic thyroid lesion discovered on an imaging study performed for unrelated purposes. Reported incidence during 2-(18)(F) fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET/CT) varies from 0.2 to 8.9%, with a quoted thyroid malignancy prevalence of 8-64%.Method: We reviewed all 18F-FDG-PET/CT scans performed in our institution over 52 mon...

Background: In May 2010 a dedicated Consultant-delivered Endocrine Telephone Advice Clinic (ETAC) was launched at St Bartholomew’s Hospital as a direct point of access for primary care doctors to obtain endocrine advice about new patients. The proposed benefits of this clinic were to: 1. Reduce unnecessary clinic attendances that could be managed in primary care. 2. Allow for more detailed and less hurried discussions of non-urgent cases than was possible via the on-call ...

Introduction: The investigation and management of large adrenal lesions varies widely. It is appropriate to have a low threshold for surgical removal of large adrenal lesions with the possible exception of stable adrenomyelipomata. 18F-FDG PET is increasingly used as an imaging technique to assess these lesions. We would like to highlight the potential benefits and pitfalls of using 18F-FDG PET as part of the diagnostic pathway.Method: Since 2008, 18F-FD...

Introduction and Objectives: Guidelines are available for the investigation of thyroid nodules. These include a general agreement that patients with abnormal thyroid function tests (TFTs) do not need routine ultrasound (US) assessment. Thyroid US is a common imaging request made by General Practitioners (GPs). This audit was devised to determine the range of clinical indications for GP thyroid US and the frequency with which TFTs are assessed by the GP prior to requesting the ...

Introduction: Successful treatment for childhood-onset Hodgkin lymphoma (HL) has highlighted long-term effects of therapy. We review endocrinopathy in HL survivors attending a hospital follow-up clinic and consider, together with published data, appropriate disease screening and monitoring.Method: Retrospective review of notes and investigations from survivors of childhood HL ≥5 years from diagnosis.Results: Forty-four subjec...