Endocrine Abstracts

Armour thyroid (Armour) is unlicensed in the UK for the treatment of hypothyroidism. It is natural porcine-derived thyroid replacement with 1 grain containing 38 mcg levothyroxine (T4) and 9 mcg L-triiodothyronine (T3), and unspecified amounts of T1, T2 and calcitonin. We have used Armour as a third line agent in selected patients who have not responded adequately to T4 monotherapy, and combination T4/T3 therapy since 2003.Aim: To assess c...

A 64-year-old man presented with mild biochemical hyperthyroidism – TSH <0.01 mU/l (NR 0.35–4.90), FT4 19.4 pmol/l (NR 9–19) in 2005. He was treated by his general practitioner with a 9 months course of carbimazole. Six months later, TSH became suppressed (0.05 mU/l) but with a normal fT4 (17 pmol/l). He was referred to a ‘One-Stop’ Thyroid Clinic and was seen there 3 months later. Thyroid isotope scan showed a toxic multinodular goitre. He was tre...

ObjectiveThe aim of the study was to evaluate the peripartum changes in the level of anterior pituitary hormones, due to iron deficiency anaemia and also to evaluate whether severe iron deficiency anaemia leads to postpartum pituitary changes.MethodThe female albino rats of Wister strain were fed on iron deficient diets (30, 15, 7.2 mgFe/kg of diet) and control diets (50 mgFe/kg of diet). Prior to one month o...

Thyroid dysfunction is not uncommon in pregnancy and is associated with various maternal, foetal and neonatal complications. We report the occurrence of neonatal hyperthyroidism in two successive pregnancies in a post radio-ablation mother with Graves’ disease who is on thyroxine replacement.Mother: A 30-year-old lady, treated for Graves’ thyrotoxicosis with radioiodine 10 years ago, was on thyroxine 100 mcg replacement for hypothyroidism. She ...

Type 2 diabetes mellitus (T2DM) is associated with insulin resistance/ hyperinsulinaemia and chronic sub-clinical inflammation that is considered important in the pathogenesis of macrovascular disease. We propose activation of the innate immune system, a biologically conserved first line immune response, within adipose tissue by endotoxaemia secondary to hyperinsulinaemia as one of the causes of this phenomenon. Hyperinsulinaemia may lead to altered gut permeability and result...

We report 28 patients (21M 7F; 17-86y) with pituitary apoplexy presenting between 1988 and 2004. Presenting features included: headache in 25 patients, 'collapse' in 3, vomiting in 13, complete blindness in 4, decreased visual acuity in 13, visual field loss in 12 and ophthalmoplegia in 16. Only 4 had no initial visual deficit. Predisposing factors included a known pituitary tumour in 4 patients, anticoagulant therapy in 3 patients and ITP in 1 patient. CT was initial imaging ...

Central obesity is strongly associated with insulin resistance and chronic sub-clinical inflammation, which is implicated in the development of type 2 diabetes (T2DM). However, the mechanisms underlying this link remain unclear. Recently JNK, a mitogen activated protein kinase (MAPK), has been implicated in obesity and insulin resistance by interfering with insulin action. Studies in rodent models show that phosphorylated JNK-1 is elevated in obesity, whilst the absence of JNK...

Background: 20% of patients with acromegaly can have visual field defect due to compression of optic chiasm. This patient presented with visual field defect but no evidence of pressure effect on optic chiasm, but later found to have pituitary macroadenoma and acromegaly.Clinical Details: 59 yr old man presented 7 years ago to ophthalmologist with left inferior field defect of 2 months duration. The field defect was confirmed with perimetry. Subsequent CT...

IntroductionRenal disease in type 2 diabetes can be prevented and limited with early detection and management of the condition. We studied the adherence of renal guidelines introduced by national institute of clinical excellence (NICE), in patients who attended the annual review in the last 12 months.MethodsAudit standards were based on guidelines for Prevention and Early Management of Renal disease in Type 2...

The renin-angiotensin system (RAS)is important for the regulation of blood pressure with its blockade shown to reduce the vascular complications of diabetes. Adipose tissue expresses the RAS system and may contribute to obesity associated hypertension. Our previous in vitro studies have demonstrated that in human adipose tissue production of both angiotensinogen (AGT) and the active metabolite angiotensin II are stimulated by insulin. The present study investigated the ...