Endocrine Abstracts

Graves’ disease is an autoimmune condition predominantly affecting middle aged women. It can be difficult to manage and consumes a lot of medical time and resources.In Torbay Hospital, we introduced endocrine nurse specialist (ENS) follow up service to reduce medical burden. This has shifted the work-load of patient care but on the other hand, has resulted in identification of great need for support and increased nurse time.We...

Introduction: The study aim was to compare serial Short Synacthen test (SST) results to diagnose secondary Adrenal Insufficiency (AI) in patients with confirmed pituitary diseases.Methods: Serial SST results of patients, tested between 2006 and 2018 in the department of Diabetes and Endocrinology, at a tertiary centre, were reviewed retrospectively. Patient details were obtained from local dynamic test database, maintained by Endocrine Nurse Specialist. ...

Background: Accurate diagnosis of an underlying cause of thyrotoxicosis is critical for targeted therapy. Thyroid radionuclide uptake scan is a useful second line investigation in patients who lack TSH receptor antibody. The uptake scan patterns identify patients who can be preferentially treated with anti-thyroid drugs (diffuse pattern - Graves’ disease) or radio-iodine treatment (patchy uptake - multinodular or localised uptake – toxic adenoma) or simple monitoring...

Adrenocortical carcinomas are rare malignancies (incidence 1–2/one million). They present in a variety of ways and carry a poor prognosis. Prompt diagnosis and early intervention offers better outcome.We describe 5 cases of adrenocortical carcinoma to help identify and improve delays in their pathway of care. Five patients (four females and one male), age range 38–76 years, presented between September 2011 and April 2013. Three patients referre...

Background: Monogenic familial Partial Lipodystrophy, a rare but clinically important cause of severe insulin resistance, is often underdiagnosed.Case: A 33 years’ lady was referred to the diabetes clinic for sub-optimal glycaemic control. She was diagnosed with diabetes at 22 years of age, insidious in onset, and was managed as Type 2 diabetes for 10 years until presentation. She had a h/o oligomenorrhoea and was diagnosed with PCOS. She also had h...

Introduction: Radiotherapy is an important adjuvant treatment for pituitary and cranial diseases. The aim of the study was to observe response of Radiotherapy (RTX) on Hypothalamic–Pituitary–Adrenal (HPA) axis determined by serial Short Synacthen tests (SSTs). Methods: Patients treated with adjuvant Cranial Radiotherapy between the years 2000 and 2018 in the department of Radiation Oncology and who also underwent serial Short Synacthen tests, i...

Background: Sporadic and familial autosomal dominant non-autoimmune hyperthyroidism (S/FANH) is caused by activating germline mutations in the TSH Receptor (TSHR) gene. These patients lack TSHR-Ab, show diffuse uptake on radionuclide thyroid scan and often lack positive family history due to variable penetrance. Because of these overlapping features, S/FANH is difficult to distinguished from Graves’ disease without autoimmune features. Ther...

Background: Sporadic and familial autosomal dominant non-autoimmune hyperthyroidism (S/FANH) is caused by activating germline mutations in the TSH Receptor (TSHR) gene. These patients lack TSHR-Ab, show diffuse uptake on radionuclide thyroid scan and often lack positive family history due to variable penetrance. Because of these overlapping features, S/FANH is difficult to distinguished from Graves’ disease without autoimmune features. Ther...