Endocrine Abstracts

Introduction: We were one of ten paediatric diabetes teams taking part in the pilot RCPCH QI project initiated in Autumn 2017 and the sole representative from the North East of England. The project we chose was to enable and empower children, young people and their families to improve overall diabetes management, long term health and wellbeing through education and knowledge in adjusting insulin to improve blood glucose control.Method: We created a bespo...

Destructive thyroiditis is characterised by hyperthyroidism due to release of pre-formed hormones. The increased concentration of thyroid hormone suppresses serum TSH. Radioactive iodine uptake is close to nil in all cases when hyperthyroidism is present. The duration of hyperthyroidism is generally 2–3 months and limited by the amount of thyroid hormone present. The ratio of serum T3:T4 is lower in destructive thyroiditis than in Graves’ disease. Hypothyroidism is c...

Disorders of salt and water homeostasis are common following traumatic brain injury. Diabetes insipidus is a well-recognized complication of TBI. Polyuria occurs immediately after significant brain injury in up to 22% of cases, nearly always occurring within the first 2–3 days. The great majority of cases resolve spontaneously, and cross-sectional studies of long-term survivors of TBI report low rates of chronic diabetes insipidus. It is likely that in the absence of form...

Acute adrenal insufficiency, also termed adrenal crisis, is a life-threatening endocrine emergency due to a lack of production of the adrenal hormone cortisol (and also aldosterone in primary adrenal insufficiency). Patients with both primary (PAI) and secondary adrenal insufficiency (SAI) are at risk of adrenal crisis. PAI is caused by loss of function of the adrenal gland itself resulting in both glucocorticoid and mineralocorticoid deficiency. SAI is caused by alterations i...

Diarrhoea is a common symptom in patients with neuroendocrine tumours (NETs), especially metastatic small bowel NETs. Diarrhoea substantially impairs quality of life, as increased frequency of bowel moments with associated urgency, cause social embarrassment and constrain diet and the ability to leave the house. Diarrhoea, with associated electrolyte disturbance, was a major cause of premature death in patients with NETs prior to the advent of medical therapies. It is importan...

Sweating in the absence of any physiological precipitant can be extremely distressing and unpleasant. Primary hyperhydrosis, usually affecting the palms of the hands, soles of the feet and the axillae, usually presents in teenage years and is managed by dermatologists. Secondary hyperhydrosis usually develops later in life, is more generalised and may be associated with flushing. The differential diagnosis is very long and includes systemic illness (such as lymphoma and chroni...

Background: Thyrotropinomas (TSHomas) have traditionally been considered a rare, albeit important cause of thyrotoxicosis. However, a recent report suggests their prevalence may be 2–3 times higher than previously suspected. In addition, although early case series described a predominance of invasive macroadenomas, recent findings (including in our own cohort of 40 patients) confirm that microadenomas are being increasingly diagnosed, and the clinical/biochemical phenotyp...

Traumatic Brain Injury (TBI) is a devastating neurological emergency, usually resulting in transient or permanent neurological dysfunction. It is the most common cause of death and disability in young adults in industrialised countries and is a major public health problem. Although anatomical pituitary damage following TBI was first recognised as long ago as 1918, evidence of hormonal dysfunction in both the acute and chronic phases following TBI had only been studied in detai...

Accurate diagnosis of thyroid dysfunction is dependent on understanding hypothalamic–pituitary–thyroid (HPT) axis physiology and the pathophysiology that can affect this classical endocrine feedback loop. Even minor perturbations of thyroid status, which may be imperceptible to the patient and clinician, can significantly alter the relationship between circulating thyroid hormone (TH) levels and pituitary TSH such is the finely-tuned nature of the axis.<p class="...

Cushing’s syndrome (CS), is the prolonged exposure to excess cortisol within the body and has a significant negative prognostic impact if left untreated. There are several screening tests available for CS: urinary free cortisol (UFC), overnight dexamethasone suppression test (oDST), and late night salivary cortisol test (LNSC).This audit evaluated the screening of patients for CS by the Manchester Royal Infirmary (MRI), in 2012 against guidelines pr...