Endocrine Abstracts

Severe hyponatraemia (SHN, <120 mmol/l) is reported to be associated with mortality as high as 50%; although there are several international guidelines for management of SHN, there are few data on the impact of treatment. We have longitudinally audited our treatment outcomes of SHN. We present the results of three audit periods, of six months each, from 2005, 2010 and 2015. The three periods represented; 2005, prior to hospital policy for SHN, 2010, audit of impact of poli...

Background: RAI is used as definitive treatment for hyperthyroidism, but administered activities vary between institutions. We used a fixed activity of RAI therapy for Grave’s disease (GD) and toxic multinodular goitre (TMNG), and calculated activity for toxic adenoma (TA). We reviewed treatment outcomes at one year.Methods: Thyroid function tests 1 year post RAI were reviewed retrospectively to asess outcome for 79 hyperthyroid patients divided int...

The thyroid telephone clinic (TTC) was established to facilitate rapid decision making on timing of introducion of anti-thyroidals or L-thyroxine replacement therapy post RAI so avoiding unnecessary outpatient appointments or leaving patients with untreated hyperthyroidism or hypothyroidism. The TTC is also used to monitor TFTs during pregnancy and to dose-titrate treatment of unstable hypo- or hyperthyroid patients. This service is provided to patients who speak English fluen...

Background: Radioiodine (RAI) is widely used for the treatment of hyperthyroidism. Most patients respond to RAI therapy with a normalization of TFTs and improvement in clinical symptoms within 4–8 weeks. Hypothyroidism may occur from 4 weeks on, with 40% of patients being hypothyroid by 8 weeks and >80% by 16 weeks. American thyroid association guidelines recommend testing for free T4, total T3, and TSH within the first 1–2 months after RAI. Biochemical monitorin...

A 24 year old man presented with gait instability, myalgia, and cognitive decline, after a holiday in Crete; his alcohol intake exceeded 200 units/week. He had marked facial dysmorphism, with frontal bossing, and global muscle weakness. He had hypernatraemic dehydration (plasma sodium 175 mmol/l urea 16.9 mmol/l), but denied thirst. Urine concentration was 894 mOsm/kg, excluding diabetes insipidus. CK was elevated at 15,540 U/l. CT brain shown marked hydrocephalus. Rhabdomyoly...

Non-thyroidal illness syndrome is the alteration in thyroid function tests (TFTs) that occurs in critically ill patients, including those using thyrotoxic medications. Therefore, it is a challenge to interpret thyroid function tests in a critically ill patient on amiodarone. Case of 66-year-old male with history of heart failure with reduced ejection fraction, atrial fibrillation, and hypertension who presented to the emergency room due to progressive shortness of breath. Phys...

Type 2 Diabetes Mellitus (T2DM) is associated with decreased bone quality and a higher prevalence of fractures. Sclerostin is an inhibitor of bone formation produced by osteocytes and its expression is elevated in serum of diabetic patients. We examined the effect of T2DM on bone architecture and sclerostin levels in a rat model of T2DM and the influence of hyperglycaemia on sclerostin production by bone cells in vitro. Bone architecture was measured by microCT in 14 ...

Background: Given the technically challenging nature of adrenal venous sampling (AVS) there is a drive to centralise services to improve successful outcomes. This has potential implications for patients living in remote and rural areas.Methods: We retrospectively reviewed the case notes of 15 patients who underwent AVS in our hospital, for investigation of primary hyperaldosteronism between 2002 and 2015. We assessed the success rate of cannulation of th...

Background: Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder characterised by impaired cortisol synthesis. In the CaHASE study, a surprisingly low number of cases were identified as attending adult endocrine clinics. It has been suggested that patients with CAH are lost to follow up around the time of transition to adult services.In our service, there is a transition clinic that has a lead paediatric and adult Consultant who attend...

Steroid sulphatase (STS) liberates sulphated oestrogens into their active forms. In the colon, evidence suggests that although initially pro-apoptotic in healthy mucosa, once malignancy occurs, oestrogens may stimulate colorectal cancer (CRC) proliferation. Moreover, greater intratumoural oestrogen synthesis is negatively associated with survival outcomes in CRC patients. However, little is known about oestrogen metabolism pathways in CRC, and whether alterations in local oest...