Endocrine Abstracts

Thyroid hormone is considered the easiest hormone to replace as it can be taken orally, has a long half-life allowing once daily dosing, and serum levels can be monitored accurately using thyroid function tests. However, in repeated surveys up to 50% of patients on thyroxine do not have thyroid hormone levels in the reference range and the potential long-term consequences in terms of cardiovascular and bone health have recently been re-evaluated in large cohorts. Community sur...

A 67-year-old woman was diagnosed by her GP with hypothyroidism and referred to our department. During the first 2 years after diagnosis, the TSH remained elevated (16–19 mlU/l) with the free T4 ranging 11.1–31.9 pmol/l despite her insistence that compliance with therapy was good and on incremental doses of thyroxine. When seen in the nurse-led thyroid clinic for the first time, concerns were raised to the consultant endocrinologist. Interference with the TSH assay w...

The newborn screening programme for congenital hypothyroidism was introduced in the United Kingdom in 1981 and has virtually abolished cases of untreated congenital hypothyroidism (CH). Congenital hypothyroidism is a common (1 in 3–4000 life births) condition in which the thyroid gland has either failed to develop (agenesis) developed in an abnormal position (ectopic gland) or is present but does not respond to thyroid stimulating hormone (TSH) (dyshormonogenesis). In the...

A 24-year-old lady was diagnosed with thyrotoxicosis following an emergency admission, with a normal laparotomy, for right iliac fosa pain. She was commenced on carbimazole. After self discontinuation of carbimazole she was re-referred, by her GP, with poorly controlled thyrotoxicosis and typical features of weight loss, anxiety, oligomenorrhoea and tremor. Her FT4 on re referral was 60 pmol/l, suppressed TSH and raised TPO antibodies. She then had an unplanned pregnancy which...