Endocrine Abstracts

Maternal thyroid hormones play a critical role in foetal brain development in the first 12 weeks of gestation. Children born to hypothyroid mothers, especially those undertreated, are more likely to suffer lower IQ. Based on BES guidance 2007 and NICE 2011 at confirmation of pregnancy a woman with hypothyroidism should immediately increase the dose of levothyroxine by 25–50 mcg with aim TSH of less than 2.5 mu/l as soon as possible with monitoring of TFT every 4 weeks.</p...

Introduction: Thyrotropin-secreting adenomas are a rare cause of hyperthyroidism. Preferred treatment is pituitary neurosurgery.Case report: A 35 year old lady was first noted to have abnormal thyroid function when presenting with an AV-nodal re-entry tachycardia in 2011. She had tremors, sweating and irritability. FT4 was 35 pmol/l (10-20 pmol/l) with a non-suppressed TSH level of 7.5 U/l (02–6 U/l). Previous meningococcal meninigitis ag...

Introduction: Pituitary dysfunction is a recognised complication of traumatic brain injury; it usually involves multiple hormones and can be transient. We present a case of traumatic pituitary haemorrhage resulting in late onset persistent isolated cortisol insufficiency. Case report: A 40 year old man sustained head injury following a road traffic collision. CT brain scan soon after the event was unremarkable. He then developed drowsiness and confusion. MRI scan of the brain ...

Introduction: Hypothyroidism is usually easily treated with levothyroxine tablets. Patients who show poor response to oral therapy are usually found to have inadequate absorption of levothyroxine, or non-compliance. We report a case where intramuscular thyroxine was used successfully in treating a case of resistant hypothyroidism due to possible malabsorption. Case report: A 47 year old lady with primary hypothyroidism, diagnosed aged 34 years, was referred to the endocrine cl...

57 year old female physiotherapist, diagnosed with osteoporosis following a fibula fracture from a low impact stretch and a wedge vertebral fracture at age 51 with a metatarsal fracture age 54. With associated history of easy bruising, increase abdominal girth although her weight remained stable at 48.5 kg with BMI 19.9 and proximal myopathy. Blood pressure was constantly normal. Investigations: Early morning random Cortisol 564 and ACTH 6.6 (2–11), cort...

Introduction: Glucagonoma syndrome is a rare paraneoplastic phenomenon characterised by necrolytic migratory erythema, diabetes mellitus and symptoms of gastrointestinal upset. It is often diagnosed late leading to a poor prognosis.Case report: A 70 year old lady with type two diabetes mellitus and fibromyalgia presented in late 2011 to Gynaecology with an itchy erythematous vulval rash. Skin biopsy suggested lichen sclerosis and she was discharged with ...

Background: Raised prolactin is a frequent reason for referral to endocrine clinics. Prolactinomas are the most common functioning pituitary tumours. Medical management with dopamine agonists remains the treatment of choice. MHRA advises baseline echocardiograms within 3–6 months and then 6–12 monthly in patients taking dopamine agonists due to a potential risk of cardiac valvular fibrosis though the evidence for fibrosis at endocrine doses remains limited. Aim: The ...