Endocrine Abstracts

Background: Insulin tolerance test (ITT) is the gold-standard investigation in children with suspected growth hormone deficiency (GHD). Despite their benefits, ITTs are resource intensive, potentially dangerous and can result in unnecessary treatment due to false positive results in children that are at low risk for GHD.Methods: Retrospective analysis of all paediatric patients undergoing an ITT in two tertiary hospitals in the UK (centre A between 2017-...

Background: Growth hormone stimulation testing (GHST) is used to diagnose growth hormone deficiency (GHD) in children. Given that sex steroids impact on anterior pituitary function, there is concern around the efficacy of GH stimulation testing in pre/peripubertal children, where sex steroid levels are low. Sex steroid priming prior to GH stimulation testing is thought to improve test efficacy in these children, however evidence to support its use in clinical practice is limit...

Background: Childhood obesity is the single most pressing public health emergency of the 21st century. The prevalence has increased at alarming rates and globally over 41 million children under 5 years of age are classified as overweight/obese. Overweight and obese children are likely to stay obese as adults and develop multi-morbidities including type 2 diabetes, cancer, non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease at an earlier age. The ava...

Background: The Short Synacthen Test (SST) is the most popular test of adrenal insufficiency (AI) worldwide. The current SST protocol at Sheffield Children’s Hospital (SCH) recommends measurement of serum cortisol at baseline, then 30- and 60-minutes post stimulation. A peak cortisol of >429nmol/l constitutes a pass. Our practise has evolved to consider results between 350 and 429nmol/l as “borderline” and these patients may be treated with stress dosing ste...

Introduction: The use of long-term oral corticosteroids in DMD leads to secondary adrenal insufficiency. The 2018 international care consensus recognizes this important issue and recommends emergency plans to be in place. Aim: This online UK-wide patient survey aims to determine the advice/education given for emergency stress dose plans and the impact of the COVID-19 pandemic in corticosteroid-treated young people with DMD. Methods...

Over 700 patients with known adrenal insufficiency are treated across the trust. Whilst unwell or fasting for a procedure, these patients potentially risk suffering an adrenal crisis. A flagging system has already been implemented on the electronic patient records (EPR) which identifies patients who are ‘on replacement Hydrocortisone’. Following an inpatient adrenal crisis which could have been more optimally managed, we sought to highlight care of this vulnerable co...