Endocrine Abstracts

Current strategies for prevention of vitamin D deficiency are primarily aimed at infants and young children to prevent rickets. In most countries this is based on recommendations to take a daily multivitamin supplement containing vitamin D often in a dose of 350–400 IU. There is variation in recommendations as to at risk groups who should receive supplementation and at what age these commence. In the UK this is currently delivered through the Healthy Start scheme with a r...

Childhood and adolescence represents an important period for accrual of bone mass and therefore changes during this time have a potential influence on adult bone mass and risk of osteoporosis. It is known that between 33 and 46% of adult bone mineral content is accrued over a 4-year period of adolescent growth surrounding peak height velocity. Although genetic factors are the most significant influence, environmental factors such as nutrition, exercise including mechanical loa...

Rickets is a disorder in which defective mineralisation of the growth plate occurs in growing children. The aetiology is due to deficiency of calcium and/or phosphate with hypophosphataemia being pivotal in the pathogenesis of all forms of rickets. It is convenient to classify rickets as calcipenic or phosphopenic depending on whether there is predominantly a deficiency of calcium or phosphate.Although nutritional rickets is the most well known and preva...

Introduction: Nutritional rickets due to vitamin D and dietary calcium deficiency is common in the UK. However, nutritional rickets secondary to hypophosphataemia is rare. We present a rare case of hypophosphataemic rickets secondary to use of hydrolysed infant formula.Case description: A 4 month old infant presented to ED with breathing difficulty. He was diagnosed to have bronchiolitis and admitted for further management.He was b...

Case report: A 7-year-old girl presented with short stature following removal to the UK from China, where she had been diagnosed with GH deficiency on blood testing, for which GH treatment had been recommended. She had reportedly not grown well over the previous 2 years, and though the oldest in her class, she was the smallest. She had a poor appetite but otherwise was well. She had no constipation, normal activity levels, and was doing well in school. She was born at term wei...

Introduction: National Institute of Health and Care Excellence (NICE) has provided guidance for the use of human recombinant GH in the treatment of growth failure in children. An ongoing National GH Audit was established in 2013 by BSPED to maintain a central database and gather information regarding trends in prescribing and facilitate future long-term follow up. This part of the audit looked at the trends of off label prescribing of GH.Method: Data wer...

Introduction: GH therapy is prescribed to UK children for a variety of indications. However, no central record exists, making follow-up studies difficult.Aim: To establish an ongoing audit of UK children and adolescents newly-prescribed GH in order to i) monitor trends in prescribing practice and ii) facilitate future long-term follow-up.Patient population: UK children aged ≤16.0 years newly starting GH therapy.<p class="...

Brown tumours are benign osteolytic lesions of bone caused by high levels of serum parathyroid hormone (PTH). They are now rarely seen as a feature of primary hyperparathyroidism. We report two cases of brown tumour in adolescent girls caused by secondary hyperparathyroidism due to severe vitamin D and dietary calcium deficiency.Case 1: 14.5-year-old South Asian girl referred with a 1 year history of right hip pain. She had presented to the orthopaedic t...

Introduction: The diagnosis of Turner Syndrome (TS) must be included in the differential diagnosis of all girls with short stature. Despite overall earlier diagnosisand treatment there remain patients with TS who present late with delayed puberty.Although growth hormone (GH) is known to increase final height (FH) in girls with TS, little evidence exists on treatment in late-presenting girls.Objective and hypothesis: To assess the effect of late GH treatm...

Introduction: Central precocious puberty (CPP) is rarer in boys than girls, therefore evidence is limited for interpreting LHRH testing in boys. Current recommendations also suggest use of basal LH.Objectives: i) Test efficacy of using basal LH and testosterone for predicting CPP in boys. ii) Establish diagnostic cut-offs for LHRH testing in boys.Method: Retrospective data collection of LHRH test results in 67 boys aged 2–10 y...