Endocrine Abstracts

A 39-year-old female was referred to the emergency department with a sore throat, fever, myalgia and odynophagia. She had presented to her GP three months previously with palpitations, erratic mood and fatigue and had been diagnosed with hyperthyroidism. She had been started on carbimazole 20 mg od and was awaiting review in endocrinology OPD. She had no other past medical history and was a non-smoker. On examination she was tachycardic with a heart rate of 113. She had cervic...

Introduction: Patients with complex health care needs and severely limited communication and mobility may be less likely to participate in research studies, and may find continued participation in such studies challenging. Allan Herndon Dudley syndrome (AHDS), due to defective thyroid hormone transporter (MCT8), causes severe neurological and physical disability. A multicentre trial (the TRIAC trial) studying the efficacy of the thyroid hormone analogue TRIAC in this rare cond...

Pseudohypoparathyroidism type 1b is a disorder of calcium metabolism resulting from renal resistance to PTH, the genetic basis caused by abnormal imprinting and thus expression of the gene encoding the Gs alpha-subunit (GSα) of the stimulatory G protein.For patients with PHP 1b, pregnancy raises issues regarding management of calcium and vitamin D homeostasis as well as more difficult aspects such as genetic counselling.<p class="abst...

Background: Immune checkpoint (CTLA-4, PD-1) inhibitors are increasingly used to treat cancers including advanced melanoma. Although endocrine immune related adverse events (IRAEs) are now well reported, the frequency and type of thyroid and pituitary dysfunction reported varies considerably, with hypophysitis after CTLA-4 inhibitors reported in 2–16%, and thyroid dysfunction after PD-1 inhibitors in 2–39%. In addition, recove...

Background: Immune checkpoint (CTLA-4, PD-1) inhibitors are increasingly used to treat cancers including advanced melanoma. Although endocrine immune related adverse events (IRAEs) are now well reported, the frequency and type of thyroid and pituitary dysfunction reported varies considerably, with hypophysitis after CTLA-4 inhibitors reported in 2–16%, and thyroid dysfunction after PD-1 inhibitors in 2–39%. In addition, recove...

Case history: A clinically euthyroid 7-year-old boy was noted to have a persistently elevated TSH 7.35–14 mU/l (NR 0.27–4.2) and normal FT4 15.0 pmol/l (NR 10-24) with negative anti-thyroid peroxidase antibodies. Thyroid ultrasonography revealed a eutopically-located thyroid gland of normal size. Following commencement of levothyroxine, he developed insomnia, irritability and headaches, resulting in cessation of treatment. Growth and development proceeded ...

Introduction: Familial dysalbuminemic hyperthyroxinemia (FDH) is characterized by artefactual hyperthyroxinemia caused by enhanced binding affinity of thyroxine to the mutant albumin. However little is known about how FDH affects the measurement of thyroid hormones, especially FT3, across many assay platforms.Methods: Forty-eight genetically confirmed FDH patients (R218H mutation) had FT4 and FT3 measured with 1-step (ADVIA CENTAUR®, Siem...

Introduction: Intestinal cholesterol absorption is known to be important in post-prandial lipid levels, and implicated in the development of vascular disease. This study evaluated the effect of intestinal gene expression on markers of early vascular disease in a cohort of diabetic and non-diabetic subjects.Methods: Subjects were identified from routine upper GI lists and enrolled as per local ethics approval. Intestinal gene expression was measured on du...

Overt hypothyroidism (OH) and more controversially subclinical hypothyroidism (SCH) are associated with abnormal lipid metabolism and endothelial dysfunction under fasting conditions. Little data exists regarding the metabolic and vascular effects of OH or SCH under postprandial conditions.We aimed to characterize postprandial metabolism with emphasis on intestinally derived lipoproteins, HDL-cholesterol (HDL-C) and endothelial function in patients with ...

Severe obesity continues to dramatically increase in prevalence and is associated with significant mortality and morbidity. The American Society of Metabolic and Bariatric Surgery recommends that bariatric surgery only be performed on those with severe obesity. Gastric bypass surgery decreases mortality by 40% at 7.5 years.Using photographs of volunteers from a hospital based weight management clinic, we performed a survey of endocrinologists, general pr...