Endocrine Abstracts

Propylthiouracil (PTU) treatment for thyrotoxicosis in pregnancy is common clinical practice. However maternal ingestion of PTU has been recognised to be associated with the development of foetal hypothyroidism and in rare cases at high doses of PTU, overt foetal goitre. Foetal goitre can be potentially dangerous due to mechanical obstruction and needs to be carefully monitored in utero. We report a case of development of goitre in utero secondary to maternal ingestion of PTU ...

A 38 year old lady presented at 30 weeks gestation with a 3 week history of headaches and 5 day history of blurring of vision, worse in the left eye. Visual field testing revealed a bitemporal hemianopia. MRI scan of the pituitary showed appearances typical of a macroadenoma which was lobulated in appearance with suprasellar extension (max height 13mm) and compression of the optic chiasm. Endocrine tests indicated that thyroxine was low for the 3rd trimester (79nmol/l), with f...

Introduction: Thyroid eye disease affects an estimated 400,000 people in the UK and for a sizeable minority this is an extremely unpleasant condition. Radioactive iodine treatment with I131 for thyrotoxicosis can cause sight-threatening flare-up of dysthyroid eye disease. Patients with dysthyroid eye signs should undergo specialist ophthalmology assessment prior to administration of I131.Case history: A 56 year old gentleman presented with symptoms of th...

IntroductionIsolated TSH (thyroid stimulating hormone) deficiency has been reported in the literature as a rare condition. Only 60 cases have been reported so far since 1960. It has been defined as central hypothyroidism without evidence of any other pituitary hormonal deficiencies or evidence of any structural pituitary abnormality. We report 3 cases of suspected isolated TSH deficiency, 2 of which presented in a year to one endocrine centre.<p clas...

IntroductionRecent studies have confirmed that IGF-I is an important determinant of future glucose homeostasis and cardiovascular risk. Insulin-like growth factor binding protein-3 (IGFBP-3) is the principal carrier protein for IGF-I in the circulation. Therefore we tested the relationship of IGF-I and IGFBP-3 to insulin resistance in an ethnic group with a high incidence of type 2 diabetes and cardiovascular disease.Methods. In a population-based study 100 subjects of...

Adults with brain tumours experience changes in multiple aspects of quality of life and this is associated with their medical condition and its treatment. There is some evidence to suggest that the mode of treatment is also a significant factor in the development of affective symptomatology. The primary aim is to explore within our cohort of patients treated for pituitary tumours, whether there are significant differences in multiple domains of quality of life and the severity...

Macroprolactinaemia, a common phenomenon variably expressed in different assays, influences interpretation of prolactin results, as recognised since 1978. The degree of macroprolactinaemia manifest over time is less well described. We examined how macroprolactin status (based on polyethylene glycol(PEG) precipitation prolactin % recovery) varied over serial measurements in hyperprolactinaemic individuals.Methods: All serum total prolacti...

Introduction: Between 5-10% of patients with hypothyroidism treated with levothyroxine (T4) continue to experience profound symptoms, despite achieving free T4/thyroid stimulating hormone concentrations within reference range. Liothyronine is sometimes added to levothyroxine, but its use is controversial due to uncertainties in clinical/cost effectiveness.Methods: An economic model was developed to estimate the incremental cost per quality-adjusted life ...

Background: It is well known that care must be taken in initiating testosterone replacement in individuals with historically low androgen levels. However less is reported about the influence of restoration of normal endogenous testosterone production on behaviour.Here, we report the how adverse sequelae of successful treatment of secondary hypogonadism were managed through a joint approach.Case report: A 34-year-old Business Accoun...

Background: Hyponatraemia is one of most common electrolyte abnormalities in acutely ill elderly patients. Severe hypothyroidism is often associated with hyponatraemia. The mechanism of hyponatraemia in hypothyroidism is not fully understood. It is suggested that hypothyroidism induces hyponatraemia either by inappropriate release of ADH or by decrease in GFR. Regardless of the mechanism, the net effect is impairment of water excretion. We report a case of severe hypothyroidis...