Endocrine Abstracts

Introduction: Central hypothyroidism is frequently seen after pituitary surgery, radiation therapy or head injury. We present a case of silent thyroiditis in a patient with secondary hypothyroidism. Case Description A 24 year old woman complained of tiredness during her periodic review in the endocrine clinic. Her endocrine history included surgery for craniopharyngioma at the age of 3 years and subsequent hypopituitarism with growth hormone, ACTH deficiency, diabetes insipidu...

Introduction: Recent trials suggest that using ergot-derived dopamine agonists such as cabergoline in the treatment of Parkinson’s disease is associated with an increased risk of valvular heart disease. However, the dose of cabergoline used to treat hyperprolactinaemia is considerably less than that used in Parkinson’s disease.Study design: A cross-sectional study; forty four patients, who received cabergoline for at least 6 months, underwent t...

Introduction: The short synacthen test (SST) is commonly used to assess the hypothalamic pituitary adrenal (HPA) axis in clinical practice. We evaluated the underlying clinical conditions pre-empting the request for a SST in a general medical ward and the adequacy of clinical follow up of patients with suboptimal responses to the test.Methods: All patients with suboptimal SST results (30 min cortisol level 450–540 nmol/l) performed in the Acute Asse...

A 73 years old female presented in 2005 with 8 year history of face and body hirsutism. Examination confirmed hirsutism but there were no other masculinization features. Her initial investigations revealed a high testosterone of 13 nmol/l, normal androstenedione, DHEA-S and 17 hydroxy progesterone. CT and U/S of pelvis and abdomen, showed normal adrenals, ovaries and a large calcified uterine fibroid. Urinary steroid metabolites ruled out adrenal testosterone source and exogen...

Introduction: Normocalcemic hyperparathyroidism is a less recognised variation of primary hyperparathyroidism (pHPT). Patients present with normal calcium and elevated level of PTH.Case: A 70 years old woman presented to her general practitioner with left sided loin pain. She had no past medical history of note and she was not taking any medications. Ultrasound of the urinary tract showed bilateral nephrocalcinosis. Her blood tests showed raised PTH leve...

Background: Absorption of levothyroxine is significantly reduced in the presence of oral iron if these two medications are ingested simultaneously, possible as a result of the formation of an insoluble complex with these 2 medications. Ideally all hypothyroid pregnant women on thyroid replacement therapy should be advised to avoid simultaneous ingestion of levothyroxine and iron containing medicines.Patients and methods: We conducted a retrospective obse...

Background: Thyroid hormone is essential in foetal neurological development and thyroid hormone deficiency in pregnant women has been linked to lower intelligence quotient and underperformance in their children later in life. Thyroid hormone requirement increases during pregnancy by approximately 50% in the first trimester. We audited our practice of increasing thyroid hormone dose at booking and thereafter in pregnant women attending our combined obstetric medical clinic....

Introduction: Adult growth hormone deficiency (AGHD) is associated with target organ insensitivity to parathyroid hormone (PTH) and abnormal PTH circadian rhythm. In aging women with established osteoporosis, GH and insulin like growth factor -1 (IGF-1) concentrations are low and administration of GH has been shown to increase bone turnover and bone mineral density (BMD), but the mechanisms remain unclear. Consequently we investigated the effects of declining GH and IGF-1 conc...

Background: Postprandial hypertriglyceridaemia is an independent risk factor for cardiovascular diseases. An acute rise of insulin in the fed state suppresses hormone-sensitive lipase to inhibit free fatty acids (FFAs) mobilisation from adipose tissue, and up-regulates lipoprotein lipase to increase FFAs influx to adipose tissue from chylomicrons, that is blunted in insulin resistant states. Polycystic ovary syndrome (PCOS) is associated with insulin resistance and cardiovascu...