Endocrine Abstracts

A recently published meta-analysis has demonstrated a significant beneficial effect on exercise performance of growth hormone (GH) replacement in GH-deficient (GHD) adults. The current meta-analysis was carried out to determine whether GH replacement confers a similar improvement in muscle strength in this patient group. A medline search and examination of reference lists of included studies and relevant review articles identified five studies with utilizable, robust data, inv...

A 31 year-old woman is referred into the Endocrine clinic with a palpable mass in her right anterior neck that was found incidentally by her GP. She had no known past medical history, did not take any medications and had not noticed any dysphagia, neck pain, or compressive symptoms. On clinical exam, there was an enlarged thyroid with a 1.5-cm left-sided thyroid nodule that moved on swallowing. There was no palpable cervical lymphadenopathy. TSH was 2.5 mIU/l (0.29–5.1 mI...

Background: Thyroid carcinoma consists of just 1% of all malignancies but is the commonest malignant endocrine tumour. Papillary thyroid carcinoma is the most common form of thyroid carcinoma consisting of 80% of all cases. There are very few case reports in the literature of papillary thyroid cancers presenting with distant to the pelvic organs. Distant metastases are noted in 1–3% of patients with thyroid cancer at initial diagnosis.Clinical case:...

Atheroma is accelerated in overt hypothyroidism (OH) and possibly in subclinical-hypothyroidism (SCH), and is not completely explained by increased LDL-cholesterol. There is little data available regarding post-prandial metabolic changes in OH or SCH.Subjects with OH (n=21), SCH (n=28) and age, sex and BMI matched controls (n=50) were studied fasting and for up to 8-h following a mixed-meal. Investigations included apolipoprotein(apo...

Macroprolactin has reduced bioactivity and accumulates in the sera of some subjects, resulting in apparent hyperprolactinaemia. Development of the polyethyleneglycol (PEG) precipitation technique has enabled large-scale screening for macroprolactin in hyperprolactinaemic subjects. We have reviewed the experience of routine screening for macroprolactin using PEG precipitation over a 54-month period in a single centre.Plasma levels of prolactin exceeded 50...

Since the thyroid is diffusely active in Graves' disease (GD) but exhibits focal activity in toxic nodular goitre (TNG), we tested the hypothesis that hypothyroidism will occur more frequently following radioactive iodine treatment (RAI), in patients with GD compared to those with TNG. To do this we reviewed the outcome of treatment in 86 patients, age 49.7 plus/minus 1.5 years (mean plus/minus SEM), with GD, and 77 patients, age 62.7 plus/minus 1.3 years, with TNG, followed o...

Chronic kidney disease (CKD) is an important complication of diabetes and determinant of mortality. Albuminuria represents early diabetic nephropathy, and also indicates generalised vascular dysfunction. Understanding the epidemiology of CKD and albuminuria helps inform health planning and identify opportunities to prevent or delay progression of diabetic kidney disease. The last available serum creatinine and urine albumin/creatinine ratio (UACR) in patients with Type 1 (T1DM...

While it is generally acknowledged that hyperthyroidism and Paget's disease are states of increased bone turnover and that treatment reduces this, whether treatment entirely corrects or reverses abnormalities has not been established. A variety of biomarkers for bone formation which include serum levels of bone alkaline phosphatase (BAP), osteocalcin (OC) and amino terminal procollagen type 1N propeptide (PINP) and resorption biomarkers which include urinary excretion of deoxy...

The importance of the differentiation between the apparent benign clinical condition of macroprolactinaemia and that of true hyperprolactinaemia, which requires therapy, is becoming widely recognised. Laboratories routinely rely on prolactin recoveries of less than 40 percent following treatment of sera with polyethylene glycol (PEG) to distinguish between the former and latter conditions. However, the 40 percent threshold employed is arbitrarily defined with little scientific...

Adrenal mineralocorticoid biochemistry differs between people of African and European ancestry. The aldosterone/renin ratio (ARR) is the initial screening test for primary hyperaldosteronism (PHA), but little data exists regarding ethnic variations in this.Following clinical observation of a high prevalence of abnormal ARR in patients of African origin, we retrospectively reviewed all ARR measurements in a single centre over 10 years. Rates of hypokalaem...