Endocrine Abstracts

Cytological evaluation establishes the diagnosis of a benign or malignant nodule in 70–80% of all cases, but the remaining cases lack the features needed for a definitive diagnosis. Molecular tests have been developed to assist in determining if a nodule with indeterminate cytology is benign or malignant. The first studies focused on the analysis of the most common thyroid cancer (TC) mutation, BRAFV600E. However, since many TCs are driven by other mutations, testing for ...

The evaluation of a thyroid nodule is a very common clinical problem and fine needle aspiration biopsy (FNAB) is the only test that can provide a definitive preoperative diagnosis of malignancy. The sensitivity and specificity of FNAB are limited by aspirates that yield insufficient material for definitive diagnosis and those with indeterminate diagnoses, which can account for up to 30–40% of all specimens. The detection of several novel gene mutations in differentiated t...

A role for glucocorticoids (GCs) in the regulation of carbohydrate metabolism and the development of diabetes was first described over 70 years ago. Whilst there is little doubt that systemic GC excess leads to insulin resistance the tissue specific mechanisms underpinning their effect on insulin sensitivity remain to be understood. We have defined tissue specific effects of GCs on insulin sensitivity and lipid metabolism in vitro and in vivo. In skeletal myotube...

The current model of glucocorticoid receptor (GR) action is well established, whereby GR remains inactive in the cytoplasm until bound by ligand, then rapidly translocates to the nucleus to regulate target genes. However, our recent observations challenge the simplicity of this model and suggest a greater range of GR action.We have identified a novel pathway in which the GR is recruited to the plasma membrane through binding to the lipid raft marker cave...

Feline hyperthyroidism (FH) is the commonest endocrinopathy in cats. The mean age at presentation is 13 to 14 years of age, and the incidence has been estimated at 1 cat per 300 cats examined. Hyperthyroidism due to thyroid stimulating autoantibodies (a feline Graves’ disease) has not been reported in cats. FH is analogous, clinically and pathologically, to human toxic nodular goitre (HTNG), though there is no known sex predisposition in cats, unlike the female predisposi...

Thyroid diseases are common disorders. Globally, hypothyroidism is still frequently caused by iodine deficiency. In iodine sufficient areas, the most common cause of hypothyroidism is thyroid autoimmunity. Subclinical hypothyroidism is defined as elevated thyroid-stimulating hormone (TSH) levels with free thyroxine (fT4) estimates within the reference range. It is a common disorder that increases with age affecting up to 20% of the elderly, with a higher prevalence in women. S...

Section 1: Case history: A 55 year woman presented with a one month history of fatigue, anxiety, tremor and diarrhoea. She was diagnosed with Grave’s thyrotoxicosis and commenced on Carbimazole 30 mg daily. Thyroid hormones normalised, but after three weeks of therapy she developed rapidly progressive ascending numbness and weakness predominantly affecting her legs. Examination revealed distal symmetrical lower motor neurone weakness and widespread loss of light touch sensatio...

Aim: Lipedema is a painful fat disorder that affects ~11% of the female population, characterized by bilateral, disproportionate accumulation of subcutaneous adipose tissue predominantly in the lower body. The initial manifestations of lipedema arise in phases of hormonal change (puberty, pregnancy, menopause). The pathophysiology of lipedema is unclear. The putative causes proposed include altered adipogenesis, microangiopathy, and disturbed lymphatic microcirculation The dis...

A 35 year old Asian man presented to the emergency department on several occasions with episodes of severe muscle weakness, affecting his arms and legs, to the point he was unable to walk or stand. He was found to be hypokalaemic on both occasions, at 2.3mmol/l and 3.0mmol/l respectively, and his weakness gradually improved with potassium replacement. He gave a history of two years of intermittent weakness and stiffness of the limbs which typically occurred at night or after l...

A 66 year old woman was referred to endocrinology in January 2023 with severe hypercalcaemia of 4.7mmol/ladjusted (2.2-2.6mmol/l) and low normal PTH of 1.8 pmol/l(1.6-6.9 pmol/l). She presented with one week of cough, breathlessness and fatigue, and 3-4 days of nausea and vomiting. She had commenced Furosemide 40 mg for bloating symptoms one month prior. She had a history of breast cancer treated with mastectomy and lymph node clearance in 2019, with subsequent Letrozole (ongo...