Endocrine Abstracts

Background: The third generation thyrotropin receptor antibodies (TRAb) assay has high sensitivity and specificity in diagnosing Graves’ disease (GD). Circulating levels of TRAbs predict the disease course of Graves’ orbitopathy (GO) and remission rates in GD. However, the relationship between TRAb and thyroxine (FT4) and the factors affecting their interaction are unclear.Method: A prospective cohort study was conducted to evalua...

Background: The third generation thyrotropin receptor antibodies (TRAb) assay has high sensitivity and specificity in diagnosing Graves’ disease (GD). Circulating levels of TRAbs predict the disease course of Graves’ orbitopathy (GO) and remission rates in GD. However, the relationship between TRAb and thyroxine (FT4) and the factors affecting their interaction are unclear.Method: A prospective cohort study was conducted to evalua...

Ipilimumab and tremelimumab are monoclonal antibodies directed against the extracellular domain of cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) and have been used as the immunotherapies against immune checkpoints that suppress T cell activation. These anti-CTLA4 antibody-based therapies are effective in treating various cancers including metastatic melanoma. However, a few immune-related adverse events including hypophysitis and transient thyroiditis have been reported....

After adrenal insufficiency is confirmed by synacthen testing, lifelong steroid replacement is expected. We report a case of apparent reversal of adrenal insufficiency. Case details: a 66-year-old man was referred for oral pigmentation, and a random cortisol level of 184 nmol/l. He reported a 2-year history of tiredness, nocturia, dry mouth and reduced libido. There was no dizziness, salt-craving, or weight loss. He denied taking any form of steroid or over-the-counter drugs. ...

ACTH is a 39 amino acids polypeptide which stimulates adrenocortical steroid production. The N-terminal segment of ACTH(1–24) is biologically active and the C-terminal is considered to have greater antigenicity. In one previous (‘RoSA’) and one current (‘RADS2’) clinical trial synthetic ACTH (zinc tetracosactide; depot synacthen) was administered to autoimmune Addison’s disease (AAD) patients to stimulate adrenocortical regeneration. 4/13 RoSA pat...

Background: Immune responses to self-peptides should not generally occur. However, four of 12 autoimmune Addison’s disease (AAD) patients developed adverse reactions immediately after synacthen injections, following repeated subcutaneous synacthen injections during a clinical trial (RoSA study). We wondered if these adverse effects were due to the production of anti-synacthen (ACTH1–24) antibodies.Methods: We evaluated the presence o...

In patients with autoimmune Addison’s disease (AAD), exogenous glucocorticoid (GC) therapy is an imperfect substitute for physiological GC secretion; patients on long-term steroid replacement have increased morbidity, reduced life expectancy and poorer quality of life. Recent early-phase studieshave demonstrated that some endogenous steroidogenic function – Residual Adrenal Function (RAF) - is maintained at the point of diagnosis in a proportion of AAD patients; this...

Despite lifelong glucocorticoid and mineralocorticoid replacement, there is excess morbidity and mortality associated with autoimmune Addison’s disease (AAD). Adrenal cortical cells undergo continuous self-renewal from a population of subcapsular progenitor or stem cells, under the influence of ACTH. We aimed to determine if synthetic ACTH analogue could revive adrenal steroidogenic function and ameliorate AAD.We performed an open-label trial of syn...

Due to the rarity of autoimmune Addison’s disease (AAD), it has proved difficult to gather large case cohorts for genetic studies. Linkage analysis offers a powerful means of identifying genetic susceptibility loci but has never been applied to AAD because of the scarcity of families containing ≥2 affected individuals. We collected DNA from 23 such families to perform the first linkage study in AAD.We genotyped 117 samples (50 cases, 67 contro...