Endocrine Abstracts

Introduction: Despite high rates of recurrence after anti-thyroid drug (ATD) withdrawal, ATD (mainly Carbmazole) remain the first line of treatment for Graves’ disease (GD) in the UK. Limited retrospective observational studies have shown that a low TSH post ATD withdrawal had a positive predictive value of 70% and a negative predictive value of 62% (specificity 85%) for relapse of Graves’ disease.Aim: We wished to determine the relationship be...

Case history: A 24-year-old previously healthy male presented to his GP with unilateral “gynaecomastia”, prompting investigations which showed a low FSH of 0.7 (1–12 IU/l). He had normal libido, erectile function, and a normal sense of smell. He had no children. He was subsequently investigated for persistent dysuria but imaging and cystoscopy were entirely normal. He was a non-smoker who took little alcohol and worked as an insurance agent. His past medical his...

Introduction: The commonest metastases to the thyroid are from renal cell carcinomas (RCC) and 23–48% of all thyroid metastases are RCCs. They may occur many years after RCC excision, the longest reported latent period being 20 years. Sunitinib (SUN), a multiple targeted anti-cancer drug, is increasingly used for RCC therapy but may cause thyroid dysfunction in some – usually hypothyroidism. We report a patient who presented with thyroid metastases 21 years after RCC...

Introduction: Short Synacthen tests (SST) are expensive, inconvenient, time consuming and subject to Synacthen availability. Any strategy reducing the need for SSTs will improve its cost effectiveness and also improve patient satisfaction. In this regard indications for SST and assay specific pre-test cortisol levels (not all SSTs are done at 0900 h) may have clinical utility.Methods: We retrospectively examined the indications for, time and place of tes...

Introduction Lithium (Li) is an effective treatment for bipolar and schizo-affective disorders. It has a narrow therapeutic index, and produces common side effects when this is exceeded. Li causes endocrine disruption by predictable and some hitherto unclear mechanisms. We present a subject who developed multiple Li induced endocrinopathies concurrently, and was a therapeutic challenge. Case presentation and investigations Mr. DM had been on Li for 10 years and developed polyu...

Introduction: Following treatment of Graves’ disease (GD), levels of thyrotropin receptor autoantibodies (TRAb) tend to decrease depending on treatment modality and length of follow up. We have assessed TRAb biological activity at follow up, years after GD treatment.Subjects and methods: TRAb concentration and biological activity were measured in 69 GD patients (59 females; 10 males; median age 59 years; TRAb positive at diagnosis), with follow up r...

Introduction: Following treatment of Graves’ disease (GD), levels of thyrotropin receptor autoantibodies (TRAb) tend to decrease depending on treatment modality and length of follow up. We have assessed TRAb biological activity at follow up, years after GD treatment.Subjects and methods: TRAb concentration and biological activity were measured in 69 GD patients (59 females; 10 males; median age 59 years; TRAb positive at diagnosis), with follow up r...