Endocrine Abstracts

Introduction: The commonest complications post trans-sphenoidal surgery is diabetes insipidus and the development of anterior pituitary hormone deficiencies. Other complications include meningitis, CSF leak, visual deterioration, haemorrhages and transient hyponatremia. We present a case of pituitary abscess 6 months post pituitary surgery who presented with viral meningitis and panhypopituitarism.Case report: A 55-year-old lady presented with a 3 weeks ...

Introduction: Empirical research studies suggest that continuous glucose monitoring systems (CGMS) are safe and could optimize neonatal hypoglycaemia management. However, they need to be tested within resource-limited, time-constrained clinical practice. CGMS was piloted in our Level 3 Neonatal Intensive Care Unit (NICU) in June 2017. Five key barriers to its effective implementation were identified: 1) Lack of NICU staff confidence in device usage 2) Infant discomfort during ...

Introduction: The HPA axis is essential for mammalian life. Glucocorticoids are commonly administered and long-term HPA axis suppression is a major clinical problem. Previous experiments in our lab have shown that long-term treatment with glucocorticoids cause silencing of tpit, a pituitary-specific master regulator of the key player in HPA axis regulation – propiomelanocortin (pomc). Even after withdrawal of treatment tpit expression is silence...

Introduction:: The HPA axis is essential for mammalian life. Proopiomelanocortin (POMC), expressed in corticotroph cells of the pituitary, is the master activator of the axis, and a classical negative feedback loop exists whereby glucocorticoids from the adrenals repress its expression. Glucocorticoids are commonly prescribed medicines (10 million prescriptions in UK per year), but when used long-term, suppression of the HPA axis is a major side effect, with risk of life-threa...

Objectives: Pregnancy and early infancy are periods when increased demand for thyroid hormone can result in subclinical hypothyroidism (SH). SH is frequently a prodrome to autoimmunity, but may be a compensation mechanism for an underlying genetic defect. The W546X mutation of the thyrotropin receptor (TSHR) is present at a frequency of 1 in 180 in a Caucasian population. We aimed to investigate whether W546X was the cause of SH presenting in pregnancy and early infancy.<p...

Kennedy’s Disease (KD) or Spinal and Bulbar Muscle Atrophy is a rare X-linked recessive condition due to CAG repeat in the androgen receptor (AR) gene. KD affects males with unaffected female carriers. Reported prevalence in male populations is highly variable; recent data suggests 2.5 in 100,000 with region specific higher prevalence. KD manifests as androgen insensitivity (AI) with features including gynaecomastia and motor signs such as early tremor, facial an...

Introduction: The COVID-19 pandemic prevented face-to-face school diabetes training in 2020/2021 at Birmingham Women’s and Children’s Hospital. Moving school training online was the only viable option to ensure children with type 1 diabetes could attend school.Objectives: 1. Develop an online school training package with competency assessment for all diabetes devices 2. Audit the number of staff competent and the cost and acceptability of the t...

Introduction: Achieving an HbA1c of less than 48 mmol/mol minimises the risk of complications in children and young people with type one diabetes. Elective admissions to hospital are one option employed to improve glycaemic control in patients with an HbA1c above target. There is however limited evidence to support such admissions. We aimed to retrospectively compare glycaemic control between patients electively admitted to hospital to stabilise their dia...

Introduction: Ongoing structured education for children and young people with type 1 diabetes and their families is considered essential by ISPAD (2014) and NICE (2015), because there is a lot of education and skills that need to be reinforced.In 2016 the majority of the self-management education was provided at our trust by diabetes self-management education (DSME) sessions, which are two hour sessions designed to improve self-management. This format of...

Case report: A 52-year-old woman developed painful anterior neck swelling seven days after receiving the first COVID-19 vaccine AstraZeneca (AZ). Investigations showed TSH 0.14 mIU/l, CRP 34 mg/l and TRAb 0.3 IU/l. A neck Doppler ultrasound scan on day 15 showed features of thyroiditis. On day 21, she was hyperthyroid with TSH <0.02 mIU/l and free T4 70.3 pmol/l. COVID-19 test was negative, and she was advised to start Carbimazole and propranolol but took only the beta-blo...