Endocrine Abstracts

A previously fit 39 year old joiner presented in November 2003 with a 6 month history of intermittent right-sided abdominal pain. There was no associated nausea or vomiting. An abdominal ultrasound requested by his general practitioner revealed a single gallbladder calculus and a 10 cm right-sided cystic mass with some echogenic areas, probably of hepatic or adrenal origin. He was normotensive and clinical examination was normal. CT scan of the abdomen confirmed a 9 cm mass ar...

There are discrepancies between different studies with regards to the association of subclinical hypothyroidism (SCH), dyslipidaemia and cardiovascular (CV) disease. Therefore, we have conducted a systematic search and meta-analysis of population-based studies of CV disease in which thyroid status was examined and randomised controlled trials (RCTs) of treatment.The PubMed and Embase databases were searched for relevant studies published between 1976 and...

Background: Syndrome of Inappropriate Anti-diuretic Hormone (SIADH) secretion is the most common cause of hyponatremia in cancer patients. About 14% of hyponatremia in medical inpatients is due to underlying tumor-related conditions. We performed an audit to evaluate prevalence of lung malignancy in patients newly diagnosed with SIADH and to assess proportion of patients having radiological evidence of lung cancer through chest x ray and/or CT chest imaging six months after es...

Background: Relapse rates in young people with Graves’ disease (GD) are around 75% after 2 years of antithyroid drugs (ATD). However, there is little mechanistic insight into the pathophysiology of relapse and a lack of robust predictive biomarkers. B cell subsets and related cytokines may reflect humoral immune activity, for which T cells have an important supporting role.Aims: The purpose of this study was to evaluate T and B cell subpopulations, ...

Background and Aims: Relapse in Graves’ disease (GD) often occurs after antithyroid drugs (ATD) are withdrawn, however there is a lack of robust predictive biomarkers for relapse and little mechanistic insight into its pathophysiology. B-cell related cytokines and chemokines may reflect humoral immune activity and therefore be predictive of outcome. The purpose of this study was to evaluate serum B-cell activating factor (BAFF), Chemokine ligand 13 (CXCL13), A-proliferati...

Background: HLA-DRB1*04 is one of the MHC alleles which is associated with several autoimmune endocrinopathies, including autoimmune Addison’s disease (AAD). The two versions of the gene which encodes the main target of the autoimmune attack in AAD, steroid 21-hydroxylase, are encoded in a gene cluster, called RCCX module, which is a copy number variation located in the MHC class III locus. Previous data from our group showed that AAD patients are more likely to have no c...

Background: Diagnostic work-up for Cushing Syndrome (CS) can be challenging and is based on clinical and biochemical assessments. Biochemical evidence of endogenous steroid excess is demonstrated through overnight dexamethasone suppression test (ODST), low dose dexamethasone suppression test and/or 24-hour urinary free cortisol estimation (UFC). Once endogenous steroid excess is confirmed, random serum ACTH measurement is key in determining the suspected source of steroid exce...

Objective: The SH2B3 gene encodes the src homology-2B adaptor protein 3, also known as lymphocyte adaptor protein (LNK), and is a negative regulator of T lymphocyte activation and the cytokine signalling pathways involved in inflammation and haematopoiesis. rs3184504, a non-synonymous SNP (R262W) in exon 3 of the SH2B3 gene, has been associated with numerous autoimmune conditions including type 1 diabetes, rheumatoid arthritis and coeliac disease. Th...

Background: Congenital adrenal hyperplasia (CAH) is the commonest genetic endocrine disorder, affecting 1 in 18 000 UK births. The 2010 CaHASE Study identified a myriad of health problems associated with CAH and its treatment, and a lack of consensus on treatment strategies in adults. Endocrine Society guidelines (2010, revised 2018) have since been published to support management. As one of the original CaHASE centres, we have audited our recent practice against these new sta...

Ipilimumab and tremelimumab are monoclonal antibodies directed against the extracellular domain of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and have been used as the immunotherapies against immune checkpoints that suppress T cell activation. These anti-CTLA4 antibody-based therapies are effective in treating various cancers including metastatic melanoma. However, a few immune-related adverse events including hypophysitis and transient thyroiditis have been reported....