Endocrine Abstracts

At 39 I was diagnosed with Thyroid Eye Disease (TED) and commenced on Prednisolone by my Endocrinology team. There followed 18 months under my local Eye Hospital. I was started on Azathioprine. The Prednisolone was then gradually decreased to nil and then the Azathioprine decreased to nil. Now that my TED was inactive I transferred to Moorfields Eye Hospital (MEH). In 1 year I had bilateral lateral wall decompressions, bilateral upper lid surgery & bilateral lower lid surg...

A 64-year-old woman who had been on Lithium 600 mg/day for 6 years for affective neurosis, presented in 2005 with acute confusion associated with a serum calcium concentration of 3.02 mmol/ which improved with rehydration. She was followed-up in outpatients and diagnosed with ‘Lithium-associated hypercalcaemia’ likely to be secondary to parathyroid hyperplasia. Results showed a corrected calcium of 2.74 mmol/l (2.1–2.55), phosphate 1.00 mmol/l (0.74–1.52), ...

Case history: An 80-year-old woman, with a background of primary hyperparathyroidism (PHPT), presented to the emergency department with a spontaneous pathological fracture of her left femoral shaft. Blood tests revealed severe hypercalcaemia (corrected calcium 3.26 mmol/l, 2.1 – 2.55) after being lost to follow up for twenty years. She was vitamin D replete after supplementation, had normal renal functions (creatinine 76 umol/L, 50-98), and high parathyroid hormone (PTH 1...

Testosterone deficiency is a common in men with type two diabetes (T2D). We have shown testosterone replacement therapy (TRT) improves insulin resistance and glycaemic control. The mechanisms by which testosterone mediates this action are unknown but may be due to a combination of effects on muscle, liver and adipose tissues. This study investigates the expression of Glut4 and HK2, (two key proteins involved in insulin sensitivity) in muscle tissue of the testicular feminised ...

Introduction: Primary hyperparathyroidism (PHPT) affects 0.3% of the population. It is characterised by hypercalcaemia with an inappropriately high parathyroid hormone level. The majority of patients with primary hyperparathyroidism are asymptomatic and are diagnosed following an incidental finding of hypercalcaemia. Symptomatic disease is related to hypercalcaemia and can present with complications such as renal calculi and osteoporosis. Parathyroidectomy is the treatment of ...

Background: Central hypothyroidism can be difficult to diagnose as TSH values often reside within the normal range. The Endocrine Society clinical guideline for hormone replacement in hypopituitarism suggests levothyroxine is indicated for treatment of secondary hypothyroidism where fT4 levels decrease by ≥20%. To determine the reliability of this biochemical marker of secondary hypothyroidism we evaluated evolution of TFTs over time within a cohort of NFPA.<p class=...

Introduction: There is a strong association between testosterone deficiency and the incidence of type 2 diabetes (T2D) in men. Physiological testosterone replacement (TRT) improves insulin resistance and glycaemic control in hypogonadal men. The mechanism by which testosterone mediates these beneficial actions are unknown but may be due to an effect on major metabolically active tissues such as liver and muscle. This study investigates the expression of key regulatory targets ...

Testosterone deficiency increases risk for cardiovascular disease (CVD) and type 2 diabetes. Testosterone replacement (TRT) improves insulin resistance, glycaemic control and cholesterol in hypogonadal men. Liver X receptor (LXR) is a nuclear receptor which regulates lipid and glucose metabolism. LXR agonists protect against atherosclerosis but cause hepatic steatosis. We have previously shown that TRT protects against hepatic steatosis and atherosclerosis in high-fat diet-fed...

This group has previously audited the effect of a protocol for investigation of primary hyperparathyroidism (PHP); the protocol stating that only patients meeting criteria for parathyroidectomy should have parathyroid imaging carried out. This showed a reduction in the number of radiological investigations (USS, CT, MRI and sestamibi scans) done in patients with primary hyperparathyroidism following introduction of this protocol.The aim of this audit was...

Objective: Determinants of why only a subset of patients with adrenal insufficiency (AI) experience recurrent adrenal crises (AC) and intercurrent illnesses are not well understood. This study aimed to identify whether residual adrenal function (RAF), defined by the peak response to a provocative test undertaken before commencing glucocorticoids, may help explain differences in prevalence.Design and Methods: Patients wit...