Endocrine Abstracts

Introduction: A standard oral glucose tolerance test (OGTT) measures samples at 0, 30, 60, 90, 120 min. Insulin and c-peptide are taken along with blood glucose (BG). Whether samples between baseline and 120 min provide any additional value in detecting children at high risk in clinical practice is not well documented. This audit is looking at the value of doing insulin and c-peptide within 2 h post glucose ingestion in otherwise healthy children seen in Oxford Children’s...

Introduction: Drug-based therapy is usually the initial treatment for thyrotoxicosis in children, but there is some debate about treatment duration. Our objective was to assess the effect of long-term Carbimazole therapy by block and replacement regime on thyrotoxicosis remission in children.Methods: 15 children with thyrotoxicosis seen in endocrine clinic between January 2006 and January 2010 were included in the audit. Data was collected retrospectivel...

Background: For patients on hydrocortisone (HC) steroid therapy, educating families on ‘Steroid Sick Day Rules’ (SSDR) is key in preventing adrenal crises.Aim: To audit education provided to patients and their families in emergency management of known adrenal insufficiency against published standards.Method: A questionnaire assessing information provision and confidence with SSDR was given to 49 caregivers of children on ...

Presentation and investigation: A 10-month-old girl presented with a bluish lump on the left side of her abdomen which was increasing in size. An abdominal mass was palpable on examination. An ultrasound showed a large, partly calcified mass measuring 9×6×9 cm arising from the left adrenal gland. There were also calcified lesions in her liver and lungs suggesting metastsis. MRI confirmed the ultrasound finding plus detected an intraspinal deposit with some cord compr...

Approximately 30% of children aged 2–15 years old in the UK are now either overweight or obese. There is some guidance on appropriate management within the UK for paediatricians, including a consensus statement by the Obesity Services for Children and Adolescents (OSCA) network. Obese patients referred to a tertiary paediatric endocrine clinic between January 2010 and December 2011 were audited retrospectively, with follow-up until the end of December 2012 included. Child...

Objectives: Secondary Adrenal Insufficiency is diagnosed using an ACTH stimulation test. There is no clear evidence that either a Low dose Synacthen Test (LDST) or a Short Synacthen Test is more superior in diagnosis. In our service, we routinely use LDST to investigate adrenal function. There is a lack of standardisation regarding timing, dose and frequency whilst undertaking a LDST leading to diagnostic inconsistencies. We routinely measure baseline cortisol levels, then at ...

Background: Insulin tolerance test (ITT) is the gold-standard investigation in children with suspected growth hormone deficiency (GHD). Despite their benefits, ITTs are resource intensive, potentially dangerous and can result in unnecessary treatment due to false positive results in children that are at low risk for GHD.Methods: Retrospective analysis of all paediatric patients undergoing an ITT in two tertiary hospitals in the UK (centre A between 2017-...

Introduction: Thyrotroph adenomas are extremely rare accounting for only 0.5–2.8% of paediatric pituitary adenomas. Almost 90% of thyrotropinomas are macroadenomas.Case report: A 9-year-old boy presented with acute onset of a right divergent squint on a background of 6 months of visual disturbance. Opthalmological assessment confirmed reduced visual acuity and visual field defects.MRI revealed a large macroadenoma invading the...

Background: A 5-month-old girl presented with a history of acute abdominal distension over several weeks. Three weeks previously she had developed pubic hair, and some early breast development. The GP had reassured parents on two occasions that this was normal. On examination she had Tanner breast stage 3 bilaterally, pubic hair stage 3, mild cliteromegaly, and gross abdominal distension.Investigations: An ultrasound scan revealed a massively enlarged ri...

Poor transitional care leads to increased loss to follow up, non-adherence to treatment, high morbidity and mortality. The paediatric and adult endocrinology teams in our Trust have been running a joint transition service since 10/2000. A review of this service was undertaken, in order to examine its effectiveness and to aid its improvement.The details of all 81 patients, who had been through transitional care between 10/00-09/09 were acquired. Their rec...