Endocrine Abstracts

Background: Graves disease is the most common cause of hyperthyroidism or thyrotoxicosis in children. The prevalance is 1 in 10 000 among children. It is important to reinforce the awareness amongst clinicians as patients can present with wide range of clinical symptoms. The range of presentations in our study included a child treated for one year for Attention Deficit Hyperactivity Disorder (ADHD) to a child who had diarrhoea and abdominal pain and presented as appendicitis i...

Background: Hypoglycaemia is a common complication of diabetes which causes great anxiety in patients and their families. Asymptomatic hypoglycaemia can be debilitating, especially in young children. All patients who attend Children and Young People (CYP) Diabetes Clinic have their blood glucose tested. If hypoglycaemia is identified (Blood Glucose less than 4 mmol/l), the local hypoglycaemia hospital policy should be followed by staff to provide safe and effective treatment.<...

Background: Diabetic ketoacidosis (DKA) can have significant morbidity and mortality in children and young people (CYP). Its management is very well standardised, based on National Guidance (National Institute of Clinical Excellence – NICE). In the UK, CYP DKA Guidelines have been reviewed in 2015 in order to reduce the risks of cerebral oedema. There have been concerns that the new recommended fluid management has the potential to increase the risk of acute kidney injury...

Introduction: The incidence of type 1 diabetes (T1DM) is increasing, affecting approximately 1 in 500 children and young people (CYP) under 19 years of age. The diagnosis of diabetes, as well as initial investigations and management is standardised, based on national guidance. Initial education and management have huge importance for long-term glycaemic control. We review the practice in our hospital, to establish our compliance and any deviations from the guidelines. We also ...

Aim: Re-analyzing (study starting in 2007) the effect of injectable testosterone undecanoat depot (TUD) in hypogonadic patients.Materials and Methods: A. Patients: at onset 231 men with hypogonadism (median: 62 y). B. Distribution: by decade (starting with 20y); no =4, 14, 24, 61, 63, 49, 17, 1. C. TUD (NebidoR-Bayer) 1000 mg injected one/3 months i.m. D. Prostate volume (PV) appreciated by per-abdominal ultrasound: 3.5–5 MHz probe, ellip...

A 1 month old baby boy presented at a local district general hospital with failure to thrive. He was born to non-consanguineous Eastern European parents, with an 18 month old healthy sister. The term birth was unremarkable, with nil of note from the antenatal history. Initial clinical examination revealed a slightly low but stable blood pressure for age, but was otherwise normal.Investigations: Biochemistry results showed low plasma sodium (125 mmol/l) a...

Aim: To find if testosterone undecanoat 1000 mg injection (Nebido; Bayer-Schering) has a negative effect on prostate.Materials and methods: i) PSA (ng/ml) was registred retrospective (from files) and prospective analysis (onset 2010). ii) From over 175 patients to whom testosterone undecanoate 1000 mg, i.m. was administrated at 3 months, in the last 4 years, and to whom the prostatic volume was quantified (Journal of Sexual Medicine8</st...

Hypothyroidism is a well-known cause of delayed puberty in children. But in rare instances, hypothyroidism can also be related to isolated menarche. The mechanism remains debatable whilst the overall incidence of the condition remains unknown.Case Report: 6-year girl presented to children’s emergency with 2 days history of vaginal bleeding. Mum reported her being intolerant to cold, constipated and faltering growth compared to her twin sister. Her s...

Introduction: Hypercalcaemia secondary to malignancy is rare in childhood. Bisphosphonates have previously been shown to be effective in managing such cases in adults, however caution must be exercised in patients with renal failure or respiratory compromise. Denosumab, a RANKL monoclonal antibody is a very potent inhibitor of osteoclasts and can induce hypocalcaemia. It is not excreted by the kidney. Limited trials in adults have shown denosumab to have greater efficacy compa...

Introduction: Neuropsychiatric manifestations are well recognised in patients with primary hyperparathyroidism (PHP). Abnormal calcium channel physiology has been implicated in several pain disorders. The psychopathology emerges after prolonged subclinical hypercalcemia, but there is poor correlation with symptom severity. We report the complex management of two adolescents with PHP, secondary to parathyroid adenoma (no predisposing germline mutation identified), with persiste...