Endocrine Abstracts

Radioiodine is indeed the best first line treatment in all patients with Graves’ disease. Except in those who want to try for pregnancy in the next few months, those with significant child care or work responsibilities that will not allow them to take the necessary radioprotection precautions, those who are breast feeding or who smoke and have ophthalmopathy, and those who have been exposed to stable iodine. Oh, and those who are not very happy to accept the risk of perma...

Amiodarone was first introduced in the 1960s and is now widely used to treat and prevent arrhythmias but it has a number of side effects, which include a perplexing array of thyroid effects. The latter stem from three features of the drug: its high iodine content, its ability to affect deiodination of T4 and its inhibition of T3 receptor binding. Around 3% of amiodarone-treated patients in areas with high iodine intake develop amiodarone-induced thyrotoxicosis (AIT), whereas t...

The debate on the utility of TSH receptor (TSH-R) measurement in the management of Graves’ patients has a long history (see for instance J Clin Endocrinol Metab 1998; 83: 3777–3785), and despite advances in assay techniques, the use of TSH-R antibodies in clinical practice is determined more by local custom and practice than evidence base. The diagnosis of Graves’ disease itself is usually straightforward and surrogates for TSH-R antibody testing, such as thyroi...

Context: Pendrin is a transmembrane protein located at the apical end of the thyrocyte where it mediates the efflux of iodide through the thyroid follicular cell. Recently, pendrin was described as a significant antibody target in Japanese patients with Graves’ disease or autoimmune hypothyroidism using an immunoblotting assay. However, a subsequent study failed to verify this in autoimmune thyroid disease patients of Tunisian origin.Objective: The ...

Context: Autoimmune polyendocrine syndrome type 1 (APS1) is characterised by multiple autoimmune endocrinopathies and results from mutations in the autoimmune regulator (AIRE) gene. Approximately 80% of patients present with hypoparathyroidism which is suggested to result from autoimmune responses against the parathyroid glands. The calcium-sensing receptor (CaSR), which plays a pivotal role in maintaining calcium homeostasis by sensing blood calcium levels and regula...

Rationale and hypothesis: Autoimmune polyendocrine syndrome type 1 (APS1) is a rare autosomal recessive disease which is characterised by chronic mucocutaneous candidiasis and multiple autoimmune endocrinopathies and results from mutations in the autoimmune regulator (AIRE) gene. Approximately 80% of APS1 patients present with hypoparathyroidism which is suggested to result from aberrant immune responses against the parathyroid gland. As patients typically display org...

Autoimmune polyendocrine syndrome type 1 (APS1) is a rare autosomal recessive disorder caused by mutations in the autoimmune regulator gene. Major disease components include mucocutaneous candidiasis, hypoparathyroidism and Addison’s disease. Acquired hypoparathyroidism (AH) occurs in 80% of APS1 patients and is associated with hypocalcaemia, hyperphosphataemia and low serum levels of parathyroid hormone (PTH). Reports suggest that these clinical symptoms are initiated by...

We have studied 20 patients with autoimmune hypothyroidism on large doses of daily thyroxine that were referred to our departments with concerns regarding possible thyroxine malabsorption or compliance issues. Here we describe 3 patients seen in Oxford. One patient had coeliac disease. The other two patients had no history of malaborption and were coeliac antibody negative. None of the 3 patients were on medication which would interfere with thyroxine absorption. All were fema...

Context: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is caused by mutations in the autoimmune regulator (AIRE) gene and is characterised by the presence of chronic mucocutaneous candidiasis, hypoparathyroidism and Addison’s disease. Patients typically display organ-specific autoantibodies which correlate with a particular clinical manifestation. Previous studies have identified the parathyroid-expressed calcium-sensing receptor (CaSR) as an aut...