Endocrine Abstracts

Very early in the Covid-19 pandemic it became clear that diabetes was a highly significant comorbidity with an increased risk of mortality in adults of up to 3.5 fold. At the same time, anecdotes started to circulate of an apparent unseasonal increase in incidence and severity of DKA in children and young people presenting with type 1 diabetes [T1DM]. In order to examine this further, the characteristics of children presenting with T1DM from January to July 2020 in North East ...

Introduction: Obese adults of South Asian origin in the UK are considered to be obese at a BMI of 27.5 kg/M2 compared with 30 kg/m2 for other groups and are at increased risk of obesity related disorders such as type 2 diabetes. From July 2021, GPs have been offered financial incentives for referral of adults to weight management services. However no provision or adjustments have been made for children and young people especially those of South Asian orig...

Background: Pseudo precocious puberty in young children usually arises from adrenal or less commonly testicular causes. Though rare, the possibility of an exogenous source should also be considered.Case Report: A 2 year 2 month old male child presented with apparent overgrowth since about 1 year of age. His height was 108 cms [+6.29 SDs], weight 21 kgs [+4.54 SDs] and head circumference 52.2 cms [2.76 SDs]. He looked very mature for his age but had no dy...

Thyroid hormone resistance is a rare condition, caused by mutations of the thyroid hormone receptor beta (THRB) gene, inherited in an autosomal dominant manner. This results in decreased tissue sensitivity to thyroid hormone action, the hall mark is high FT4 levels with normal TSH levels. The clinical presentation is variable. We discuss 2 cases of thyroid hormone resistance who received Carbimazole treatment. Case 1 is an 8 year old girl, who was initially misdiagnosed as hyp...

Introduction: The long term remission rate of Grave’s disease in children after anti-thyroid drug (ATD) therapy is around 30% as opposed to 40-60% in adults. There still exists a controversy regarding the duration of medical treatment and the markers of long term medical remission that support cessation of therapy. Normalization of TSH Receptor Antibody (TRAb) level is considered to be a favourable marker for remission prior to stopping therapy. We report two patients who...

Introduction: Abnormalities of the Internal Carotid Artery (ICA) are rare and agenesis has an estimated incidence of 0.01% in the general population. We here report a probable association with congenital hypopituitarism.Case report: A baby girl presented with respiratory distress after the birth and 1 month later, because of prolonged jaundice, was found to have low FT3, FT4, and TSH (FT3 was <2.3 pmol/l FT4 was <3.5 pmol/l, TSH which was <0....

Background: Type A insulin resistance syndrome (TAIRS) is rare (prevalence 1/100 000) and is caused by pathological mutations in the insulin receptor (INSR) gene. The clinical features tend to affect females more severely. Patients can present with severe hyperinsulinemia, hyperandrogenism and acanthosis nigricans. We report a case of a girl with symptoms initially suggestive of polycystic ovarian syndrome (PCOS) but also with asymptomatic diabetes mellitus.<p class="abste...

Introduction: Multiple endocrine neoplasia type 2B (MEN2B) is a rare autosomal dominant neuroendocrine neoplasia syndrome characterised by early onset medullary thyroid carcinoma (MTC) in all patients, phaeochromocytoma and multiple extra-endocrine features. We present a case of late diagnosis of MEN2B illustrating the challenge of early diagnosis.Case report: A 12 year old boy presented after lifetime of investigation. There was no relevant family histo...

Aims: The use of glucose meter downloads provides statistics (mean blood glucose level, S.D.) which may have a role in outpatient Diabetes monitoring. We aimed to compare these measures with the current gold standard, HbA1c.Methods: Thirty-eight patients had blood glucose readings downloaded from their monitoring device (Accuchek) at clinic visits over 25 months. Statistical analysis from the Accuchek Software package was per...

Aims: The use of glucose meter downloads in outpatients enables clinicians to monitor how frequently children with type 1 diabetes mellitus are testing their blood glucose level on a daily basis. We tested the hypothesis that increased frequency of blood glucose testing improves HbA1c value, the current gold standard in monitoring diabetic control.Methods: Thirty-eight patients had their glucose meter (Accuchek) downloaded at outpatient clinic vis...