Endocrine Abstracts

Our patient a 39yr old man was referred to endocrinology clinic. He described a history of being diagnosed with congenital adrenal hyperplasia after presenting with a salt wasting state at 6 weeks old. After living in Dublin as a child his family moved to Canada for 14yrs. At presentation he was taking hydrocortisone 10 mg twice daily and fludrocortisone 0.1 mg once daily. His main concern was fertility. He and his wife had been investigated in Canada. Information provided by ...

A 77 year old female was admitted two weeks after an out-patient CT Pulmonary Angiogram showed a subsegmental pulmonary embolism and retrosternal goitre. History was of ten days of confusion, breathlessness, diarrhoea and reduced intake. On admission, she was febrile, tachypnoeic and in new, rate controlled, AF. Burch-Wartofsky Point Scale: 45, this being highly suggestive of a thyroid storm. TFTs were normal one year prior. Thyroid USS showed a multi-nodular goitre. She was c...

An 18 year old male presented with dyspnoea, haemoptysis, weight loss and a large right testicular swelling. On examination he appeared cachectic, diaphoretic and tachycardic. A large firm non-fluctuant right-sided scrotal swelling was present. There were no signs of goitre or dysthyroid eye disease. Thyroid function tests revealed biochemical hyperthyroidism: [fT4 38.6 pmol/L (NR: 9.4–18.6), TSH <0.01 mu/L (NR: 0.3–4.4)]. CT chest demonstrated multiple large pul...

Sub-clinical Cushing’s syndrome has, in recent years, been described among diabetic populations but no consensus has emerged about the value of screening. We enrolled 201 consecutive diabetics attending clinic and 80 controls. Local ethics committee approval was obtained. Patients with at least 2 of the following 3 criteria were offered screening: HbA1c≥7%, BMI≥25 and history of hypertension or BP≥140/90. An 11 pm salivary sample was stored at room tempe...

We describe the presentation of a 65 years old lady with upper gastrointestinal bleed to Altnagelvin Area Hospital in April 2023, eventually diagnosed with Cushing’s syndrome due to ectopic ACTH secretion from a high grade neuroendocrine tumor. Acute presentation was preceded by three months of general decline, weight loss, poor appetite and a history of smoking 20 cigarettes per day for more than 20 years. On examination, she was cachectic and delirious with cutaneous no...

Iodine is a trace element required for thyroid hormone production. Requirements increase in pregnancy, when even mild deficiency may affect offspring neurocognitive development.The gold standard for assessing iodine status is population surveys of urinary iodine concentration (UIC). The WHO also suggests a population prevalence of >3% of TSH values > 5 mIU/L indicates deficiency. A recent UK survey of 700 teenage girls demonstrated ...

Iodine is a trace element required for thyroid hormone production. Requirements increase in pregnancy, when even mild deficiency may affect offspring neurocognitive development.The gold standard for assessing iodine status is population surveys of urinary iodine concentration (UIC). The WHO also suggests a population prevalence of >3% of TSH values > 5 mIU/L indicates deficiency. A recent UK survey of 700 teenage girls demonstrated ...

Selenium (Se) supplementation is recommended by the European Group (EUGOGO) for mildly active TED (200 mg/day for six-months) based on a seminal RCT which reported slowing of disease progression vs placebo. Treatment in Se deficient geographical areas may be particularly important. We recently reported Se deficiency in a cohort of 240 pregnant women in NI. The TEAMeD-NI group was set up in 2019 as part of the UK-wide quality improvement program to take a proactive approach to ...