Endocrine Abstracts

Resistance to thyroid hormone (RTH) is usually due to heterozygous mutations in THRB gene with rare cases being homozygous for receptor defects. We describe an RTH case due to a homozygous TRβ mutation (R243Q).The Proband (male, 8.4 years), was born at term with low birth weight (1.9 kg) to consanguineous parents. He has a prominent nasal bridge, goitre, low body weight (10th centile), recurrent tonsillitis, hyperactivity and has mild hearing impair...

A 42-year-old man with resistance to thyroid hormone (RTH) and a recognised thyroid hormone receptorβ mutation (R383C) mutation, presented with atrial fibrillation (AF) which was resistant to DC cardioversion until initiation of amiodarone therapy.As expected in RTH, his baseline TFTs were abnormal (FT4 34.6 pmol/l, TSH 2.27 mU/l), but rose further (FT4 45 pmol/l, TSH 0.93 mU/l) following commencement of amiodarone. However, sh...

Background: Hyperthyroxinaemia with non-suppressed TSH, due to resistance to thyroid hormone (RTH) or TSH-secreting pituitary tumour (TSHoma), can be difficult to diagnose, particularly with coincident autoimmune thyroid disease (AITD).Methods: To determine presentation patterns of AITD coincident with RTH or TSHoma, we analysed our cohort of cases with dual diagnoses.Results: Nine patients with RTH had AITD. Six had Graves’ d...

The superfamily of ~25 human selenoproteins includes antioxidant and oxidoreductase enzymes together with other proteins of unknown function. We describe a child with a multisystem disorder involving deficiencies of several selenoproteins, identified on the basis of abnormal thyroid function.A 3.6-year-old male was referred with elevated free thyroxine (FT4 – 44.4 pmol/l (N 12–22)), low free triiodothyronine (FT3 &#...

Introduction: Anti-TSH-receptor binding antibodies can cross the placenta and can stimulate or inhibit the fetal thyroid, causing fetal and neonatal thyroid dysfunction. We test for these antibodies in all pregnant women with a history of thyroid disease using a TSH binding inhibitor immunoglobulin (TBII) assay. Our aims were to audit our management of TBII positive pregnancies and to review pregnancy outcomes.Methods: Serum TBII concentration was measur...

Introduction: Adrenocortical carcinoma (ACC) is a rare but devastating malignancy. We performed a review to determine outcome in our patient cohort.Of 20 patients 14 were females, six males. Median overall survival was 27.5 months (range 1–168), nine being deceased. Mean age at presentation 52.3 years (range 18–71). The majority of cancers were large; 5% ≤5 cm, 40% 5–10 cm, 55 >10 cm. 25% had stage IV disease, 10% stage III, 55% ...