Endocrine Abstracts

Background: Recent evidence suggests that detection of fetal goitre (defined as fetal thyroid circumference >95th percentile) may be a useful way of detecting over and under activity of the fetal thyroid in maternal Graves’ disease. Clinical translation is made difficult by the large differences in normative data from different populations. We examined fetal thyroid circumference in our population against normative data based on at least 150 examinations. Normative da...

Background: Thyroid disease in pregnancy can have a profound impact on both mother and fetus. Guidelines on diagnosis and management are lacking in the UK and there is significant variation between European and US guidelines. This survey aimed to gather data on current management by endocrinologists in Scotland.Methods: An online survey was created using Google Forms and emailed to endocrinology trainees and consultants in Scotland (April 2019). The surv...

Phaeochromocytomas (PHAEOs) and extra-adrenal paragangliomas (PGLs) are rare neuroendocrine tumours. As many as 35% may have an identifiable germline mutation, most commonly in the genes encoding RET, VHL or subunits of succinate dehydrogenase (SDHx).[123I]-labelled metaiodobenzylguanidine (123I-MIBG) scintigraphy is used to localise PHAEOs/PGLs, while 131I-MIBG is used as therapy in malignant disease. Uptake of radioisot...

Bilateral adrenal haemorrhage (BAH) is uncommon in pregnancy; most cases are thought to be secondary to trauma, anti-coagulation, pre-eclampsia, tumour or sepsis, rather than spontaneous. Management is usually conservative, but adrenalectomy may be required in uncontrolled haemorrhage. We discuss two cases of spontaneous BAH presenting in the third trimester.Case 1: A 23-year-old female with BMI 33kg/m 2 presented at 37 weeks’ gestation w...

Case history: Pre pregnancy: A 31-year-old female with no family history of thyroid disease presented with clinical hyperthyroidism and large goitre with bruit. Graves’ Disease was confirmed: TSH <0.01 (0.35–5.0 mU/l), free T4 53.4 (9.0–21.0 pmol/l), TSH Receptor Antibodies (TRAB) >40 (0–1.9 U/l), TPO 32.2 (<6 U/ml). She started on carbimazole (CBZ: 20 mg BD) and propranolol. She then switched to propylthiouracil (PTU: 150 mg BD) at 2 months due...

Background: Acromegaly is rarely encountered in pregnancy and the lack of data for clinical outcomes limits the development of evidence-based guidelines. We present the case of a pregnancy in a 31-year-old woman with acromegaly due to a pituitary microadenoma.Clinical case: The patient underwent trans-sphenoidal hypophysectomy in 2015 at the age of 28, which was non-curative: post-operative IGF-1 was 533 mcg/l (72–259 mcg/l) (down from 894 mcg/l pre...

Introduction: Patients with mutations in the Succinate Dehydrogenase Complex Subunit B (SDHB) gene are predisposed to neuroendocrine tumours such as parangangliomas, phaeochromocytomas and gastrointestinal stromal tumours. Individuals who are carriers but have no manifestation of disease require regular surveillance. Our tertiary endocrine service provides follow up/surveillance for these patients and we cover a wide geographical area throughout the West of Scotland.<p cla...

Background: Guidelines from ATA and the Endocrine society suggest the use of fetal thyroid monitoring in maternal Graves’ disease to detect fetal thyrotoxicosis or hypothyroidism in response to maternal thyroid receptor antibodies (TRAb) or thionamide therapy respectively. The literature examining how effective this policy is remains sparse, since these remain unusual clinical situations for most centres. Here we review our experience of scanning for fetal goitre.<p c...

Phaeochromocytomas (PHAEO)/paragangliomas (PGL) are neuro-endocrine tumours. They may present sporadically or as the primary abnormality in a number of familial syndromes. Advances in molecular genetics have led to the identification of several PHAEO/PGL predisposing genes including VHL, NF1 and RET. Mutations in the genes encoding the subunits of Succinate Dehydrogenase (SDH) have also been reported. We describe the phenotype of a cohort of patients with a Succinate Dehydroge...