Endocrine Abstracts

Introduction: Normocalcaemic hyperparathyroidism (nHPT) is a persistently elevated parathyroid hormone (PTH) with normal ionised calcium levels in the absence of secondary hyperparathyroidism. nHPT is proposed to be an earlier phase of hypercalcaemic primary hyperparathyroidism (PHPT). nHPT patients can present with progressive complications such as osteoporosis and nephrolithiasis. Currently, there is no diagnostic test to confirm primary hyperparathyroidism in nHPT patients,...

Introduction: Primary hyperparathyroidism (PHPT) is an endocrine condition in which autonomous excessive secretion of parathyroid hormone (PTH) results in hypercalcaemia. In approximately 80% of cases the aetiology is due to a single parathyroid adenoma, the remainder are due to hyperplasia of more than one gland. Familial Hypocalciuric Hypercalcaemia (FHH) is an autosomal dominant, inactivating mutation of the calcium-sensing receptor, causing a right-shift in the concentrati...

MEN2B is the most aggressive form of MEN2. Consequently, the new American Thyroid Association guidelines recommend prophylactic thyroidectomy early in the first year of life. Ninety-seven percentage of MEN2B cases result from a germline methionine to threonine mutation at codon 918 (M918T) of the RET proto-oncogene. In addition, an exceedingly rare alanine to phenylalanine mutation at codon 883 (A883F) has been reported in 4 unrelated adults. In each case metastatic MTC and th...

BackgroundThyrotoxicosis with Graves’ Disease is treated with thionamide, radio-iodine treatment and thyroidectomy. Surgery is an important choice, especially when Graves’ Disease is complicated by thyroid orbitopathy. Pre- and post-operative protocols for thyroidectomy are imperative.Aims1) To assess pre-operative preparation of patients, with potassium iodide, vitamin D, beta blockade, and the pre...

Introduction: Phosphatase and tensin homolog gene (PTEN) gene encodes a lipid phosphatase that plays a central role in cell-cycle processes. PTEN hamartoma tumour syndrome (PHTS), caused by the mutation of the PTEN gene, is a diverse multi-system disorder. PHTS is characterised by the hamartomatous growths, increased risk of breast, thyroid, and renal cancers. In terms of thyroid presentation of PHTS, there is up to 75% risk of multinodular goitre and the life...

Background: The incidence of thyroid cancer is increasing globally mainly due to increased detection of papillary microcarcinoma. The British Thyroid Association (BTA) guideline (2014) recommends the use of U1-U5 classification on ultrasound to assess thyroid cancer risk. U3 nodules have low, but indeterminate risk and therefore need FNAC. This retrospective review analyses the outcome of U3 nodules in an outer London hospital.Methods: Thyroid ultrasound...

Background: Temporary hypocalcaemia occurs in up to 40% of patients following a total thyroidectomy. Serum calcium and parathyroid hormone (PTH) measurements are currently used to predict post-thyroidectomy hypocalcaemia. However, immediate access to PTH measurement is expensive and not widely available. Serum phosphate responds rapidly to changes in circulating PTH levels and its measurement is readily available in all hospitals. We evaluated the use of serum phosphate to pre...

A 25 year old Afghan male presented with a 4 day history of worsening left-sided loin pain. He had a past history of deafness since birth, speech problems and development delay. Bilateral renal calculi and widespread multiple well defined lytic lesions (likely brown tumours) were seen on CT-KUB. The corrected calcium was 3.21 mmols/l, PTH 80 pmol/l, Vitamin D 25 nmol/l, phosphate 0.49 mmols/l, ALP 960 IU/l and fractional calcium excretion was 0.16. His skull X Ray/OPG, done du...

Background: Absence of effective clinical indicators for thyroid cancer, which has an excellent prognosis, means community ultrasounds (US) can be important in identifying risk. Where cytology is definitive it should be reviewed by appropriate MDT specialists. This study aimed to examine the outcomes from two-week-wait (2WW) referrals.Methods: To achieve these aims, we retrospectively reviewed 293 patients referred on th...