Endocrine Abstracts

Acute Treatment-Induced Diabetic Neuropathy (ATDN) is a reversible small nerve fibre neuropathy involving pain and autonomic nerves precipitated by a rapid improvement in glycaemia. It is well described in adults with type 1 and 2 diabetes, but not in children. A 15 year old boy developed ATDN shortly after starting treatment for type 1 diabetes. He presented with polyuria and polydipsia and a blood glucose of 51.4 mmol/L. He was started on a basal bolus regime. Eight weeks la...

Background: Activating mutations in the calcium sensing receptor can result in severe hypoparathyroidism with symptomatic hypocalcaemia. Complications of treatment with calcitriol or alfacacidol include hypercalciuria, nephrocalcinosis and renal failure. The use of synthetic parathyroid hormone (PTH 1–34, teriparatide) provides a more physiological treatment option and reduces the risk of hypercalciuria. Intermittent injections of PTH have been used with some success but ...

Introduction: Patients with diabetes mellitus are known to have increased mortality and morbidity from influenza and pneumococcal disease. The Department of Health recommends that these children, along with other high risk patients, receive yearly influenza vaccination and additional immunisations against invasive pneumococcal disease. We audited the uptake of these additional immunisations in our patients.Method: Retrospective audit of all patients with...

Introduction: We previously used an assay measuring GH levels in microgram per litre. Peak GH levels >20, 10–20 and <10 μ/l representing sufficiency, partial deficiency and deficiency of GH respectively. With a new assay introduced in 2008 peak GH levels >8, 4–8 and <4 μg/l were quoted as normal, partial deficiency and deficiency. Although the patient groups tested were different we would have expected to have approximately similar rates o...

Background: Emergency staff are under pressure to assess and refer within tight targets. Two adolescents presented to A&E with psychiatric symptoms, were referred to Child and Adolescent Mental Health (CAMH), but fortunately came to our attention and were diagnosed with thyroid disorders.Case 1: Fifteen-year-old boy presented with a two week history of disturbing auditory hallucinations and was referred to CAMH. He was commenced on antipsychotic medi...

Background & Objective: Pseudohypoparathyroidism (PHP), a heterogeneous condition, classically causes parathyroid hormone (PTH) resistance. PHP1a is caused by heterozygous inactivating mutations on the maternally derived GNAS allele. PHP1b results from methylation defects at the GNAS imprinted gene cluster, which are either sporadic, or familial, normally associated with maternally inherited intragenic STX16 deletions. We investigated the presentation, phenotype, ...