Endocrine Abstracts

42-year-old female with relapsing Graves’ disease treated with propylthiouracil (PTU) presented to the Emergency Department with a two-week history of fevers, night sweats, transient rash, arthralgia and fatigue. Five years previously she presented with Graves’ disease, TSH <0.02 mIU/l, FT4 of 39.8 pmol/l (9–16 pmol/l) and TSH receptor antibody positive with a titre of 11.3 IU/l. Initially treated with carbimazole therapy but developed an urticarial rash, lo...

Idiopathic ketotic hypoglycaemia is cited as the most frequent cause of hypoglycaemia in childhood but is a rare phenomenon in adults. We present the case of a 72 year man without diabetes presenting to the emergency department with spontaneous symptomatic hypoglycaemia with a glucose of 2.2 mmol/l. On admission he had a normal pituitary profile, negative insulin antibodies, a normal short synacthen test, a negative urine and serum sulphonylurea screen and a normal IGF-II and ...

Pseudohypoparathyroidism (PHPT) is a very rare disorder characterised by a lack of response to parathyroid hormone at the level of the proximal tubule. In the absence of the classical features of Albright Osteodystrophy, the diagnosis can be missed. We present two cases of type 1B PHPT. The first case was of a 39 year old man presenting with non-specific abdominal symptoms and was found to have a corrected calcium of 1.89 mmol/ (2.21-2.52 mmol/l) with a paired PTH of 734pg/ml ...

Introduction: Accumulating evidence suggests that one of the most significant contributors to endothelial dysfunction is increased oxidative stress. Excessive reactive oxygen species (ROS) generation can have injurious effects within the vasculature including elevated expression of adhesion molecules, stimulation of vascular smooth muscle cell proliferation, and promotion of endothelial cell apoptosis; events which culminate in the formation and progression of atherosclerotic ...

Introduction: Increased oxidative stress is associated with endothelial dysfunction in atherosclerosis and cardiovascular diseases (CVD). Evidence suggests that tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), a member of the tumour necrosis factor (TNF) superfamily, may also be involved in the pathogenesis of CVD. Observational studies have demonstrated that serum levels of TRAIL are inversely correlated with severity of coronary artery disease. This concurs ...

Reproductive morbidity is increased in women with diabetes, including a higher prevalence of polycystic ovary syndrome, hypothalamic amenorrhoea and premature ovarian failure. Routine discussion of reproductive and menstrual dysfunction for women with diabetes remains a peripheral feature of clinical consultations. Here we aimed to determine women’s own reproductive care experience. We surveyed women of all ages attending routine diabetes care using a detailed clinical qu...

Idiopathic Isolated ATCH deficiency (IIAD) is a rare cause of secondary adrenal insufficiency characterised by ACTH deficiency with otherwise intact pituitary function. Our objective was to describe the presentation, the autoimmune associations and diagnostic findings observed in IIAD. We present a case series of 19 cases of idiopathic Isolated ACTH deficiency which were identified from the National Pituitary Register in Ireland. A chart and biochemical review was performed to...

Background: Dose adjustment for normal eating (DAFNE) structured education programme is an effective tool in improving glycaemic control in patients with type 1 diabetes while reducing the frequency of hypoglycemic episodes. DAFNE however, does not solve all glucose related problems and patients often request or are recommended continuous subcutaneous insulin infusion (CSII) therapy post DAFNE.Objective: Out of our 370 DAFNE graduates, 46 have subsequent...

Background: There are very few studies comparing glycaemic control in patients with different basal rates on Continuous Subcutaneous Insulin Infusion therapy (CSII), so the ideal number of basal rates for a patient is not clear.Objective: To compare the glycaemic control between patients with different basal rates.Methods: Data were collected from hospital’s database and by contacting patients via phone....

Increased life expectancy in patients with CF has brought about novel challenges in their care. Osteoporosis in CF is associated with significant morbidity and is an exclusion criterion for lung transplantation. Recent evidence suggests an association between dysglycaemia and low bone mineral density (BMD). We aimed to determine predictors of bone loss in a cohort of CF patients attending a tertiary referral centre and, in particular, if dysglycaemia is linked with low BMD.</p...