Endocrine Abstracts

As thyroglobulin antibodies (TgAb) are a well recognised cause of interference in thyroglobulin (Tg) immunoassays current guidelines recommend that TgAb should be measured concurrently with Tg when monitoring thyroidectomised thyroid cancer patients. However the concordance between different TgAb assays has been questioned despite the availability of an International TgAb Reference Preparation (MRC 65/93).Four commonly used TgAb assays were tested in 145...

Metyrapone (MT) is used in the medical management of Cushing’s syndrome as it decreases serum cortisol (CT) levels by inhibiting adrenal β-hydroxylation of 11-deoxycortisol, the final step in CT synthesis. CT precursors, in particular 11-deoxycortisol (DOC), increase following MT therapy. Monitoring glucocorticoid replacement in patients taking MT could therefore be confounded as DOC cross-reacts in commonly used immunoassays (IA) for serum CT. Serum CT results from ...

We report five cases of hyperthyroidism with complex management issues, which were successfully treated with iopanoic acid prior to thyroidectomy.Three patients (cases 1–3) had Graves’ disease; two developed agranulocytosis on carbimazole and one had uncontrolled severe thyrotoxicosis and poor compliance with treatment. Radioiodine was either declined or contraindicated due to radio-protection issues. All patients were rendered euthyroid with i...

TRAB antibody is specific for diagnosis of Grave’s disease. We have conducted an audit to on our practice on parameters which TRAB could influence.Method: TRAB (NR 0–1 IU/l) positive patients were identified from biochemistry laboratory form April 2003 to February 2004. Sixty case notes were randomly selected for reviewed. Data were analysed subsequently.Result: 46 cases (77%) were female. Mean age was 42, range 6 to 78 y...

Aim: Focussed parathyroidectomy is an established technique in subjects where imaging has identified a single parathyroid lesion. The aim of this study was to examine the long-term cure rate following this procedure.Method: Of 188 patients undergoing surgery for primary hyperparathyroidism between 2001 and 2006, 150 had a single parathyroid lesion on imaging using sestamibi +/− neck ultrasound. These patients were treated by focused parathyroidecto...

Primary hyperparathyroidism in pregnancy is reported as being rare rare. It can be associated with significant complications. Maternal complications include symptomatic hypercalcaemia, renal calculi, hyperemesis, muscle weakness, and pre-eclampsia. Fetal complications include IUGR, low birth weight, preterm delivery, intrauterine death, neonatal tetany and fits.Patient 1 presented with asthma and was found to have primary hyperparathyroidism, corrected c...

A 44 yr old IT systems analyst, presented in 2003 with a six month history of weight gain, diabetes and hypertension. On examination he was floridly Cushingoid. Investigations showed raised 9AM cortisol (1887 nmol/l) with failure to suppress following low and high dose dexamethasone, together with elevated 24 h urinary free cortisol (3300 nmol) and circulating ACTH (130 ng/l) levels. CT scan demonstrated a complex 11.5×9 cm lesion in the left lobe of liver and biopsy indi...

Background: Primary hyperparathyroidism (PHPT) is a common endocrine disorder. Aim of this audit was to assess clinical, biochemical parameters, localisation modalities and outcome in patients undergoing parathyroidectomy at University College London Hospital (UCLH).Methods: We audited all patients aged 15-years or above, undergoing parathyroidectomy, from 01-02-2018 to 31-12-2021 at UCLH via retrospective data collectio...

Peptide receptor radionuclide therapy (PRRT) is a targeted therapy using synthetic somatostatin analogues attached to a radionuclide, which binds to tumours expressing somatostatin receptors. The aim was to review the role of PRRT in a tertiary referral centre. We retrospectively reviewed a cohort of 25 patients (eight males, 17 females), with a median age of 65, who received Yttrium-90 DOTATATE or Lutetium-177 DOTATATE at Addenbrookes Hospital. The location of the primary tum...

Context: Pancreatic neuroendocrine tumours (NETs) overexpressing glucagon are associated with phenotypic heterogeneity. Objective: To correlate clinical phenotype with detailed analysis of plasma levels of proglucagon-derived peptides (PGDPs) in subjects with proglucagon-expressing tumours using specific immunoassays and gel filtration profiles to elaborate molecular heterogeneity of PGDPs, before and after somatostatin analogues.Case 1: A 57 year old wo...