Endocrine Abstracts

Introduction: Radioiodine (Iodine-131) is a widely used treatment for thyrotoxicosis. Fluctuation in thyroid hormone levels following radioiodine treatment is common. Hypothyroidism occurs in approximately 5.5% of patients per month in the first 6 months, with onset time hard to predict. In contrast, some patients remain hyperthyroid either due to persistent pre-radioiodine thyrotoxicosis or transient exacerbation following radioiodine. We examined whether the block & repl...

Pretibial myxoedema (thyroid-associated dermopathy), an extrathyroidal manifestation of Graves disease, is a localized thickening of the skin due to accumulation of acid mucopolysacharides (glycosaminoglycans). Almost invariably, pretibial myxoedema occurs in the presence of ophthalmopathy.We report the case of a 57-year-old man of North African origin, who presented with pretibial myxoedema as the first manifestation of Graves disease. He was admitted w...

Background: Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder characterised by various combinations of tumours of the parathyroid, enteropancreatic and anterior pituitary glands. With the identification of the MEN1 gene, the genetic diagnosis of this condition is now possible. In this study, we have examined whether different clinical presentations of MEN1 are more likely to yield positive mutation result.Methods: We analysed t...

Background: Multiple Endocrine Neoplasia (MEN1) is an autosomal dominant disorder characterised by tumours of the parathyroids, pancreas and pituitary. Recent consensus guidelines have recommended screening of MEN1 gene mutations in patients who have at least two of the parathyroid hyperplasia, pancreatic endocrine tumour or pituitary adenoma, or are suspicious of having MEN1 (multiple parathyroid tumours before age 30, recurrent hyperparathyroidism, gastrinoma or multiple isl...

Graves' disease, which is characterised by thyrotoxicosis and a diffuse goitre, is an autoimmune disease caused by thyroid-stimulating antibodies. The onset of Graves' disease whilst a patient is on immunosuppressive treatment is unexpected and remains a rarity.A 37-year-old Caucasian female presented to the thyroid clinic with a two week history of sweating, nausea, tremor, heat intolerance and palpitations. She was known to suffer from severe pustular ...

Introduction: Thyroid eye disease (TED) is a chronic disorder with a potential to cause facial disfigurement and visual impairment. Recent surveys of clinicians have shown variability and deficits in the management of TED. The European Group on Graves’ Orbitopathy (EUGOGO) recently published guidelines on the management of TED, recommending that all patients with TED should be referred to specialist multi-disciplinary TED clinics. We aimed to study the patients’ expe...

Background: Multiple endocrine neoplasia (MEN) type 2B is an autosomal dominant condition characterised by aggressive medullary C cell tumours, phaeochromocytoma and a discrete physical appearance. A specific point mutation in the RET proto-oncogene is present in 95% cases; prophylactic thyroidectomy is recommended in the mutation carriers. Occasionally cases present with the characteristic physical appearance of MEN2B but no identifiable germline mutation or endocrinop...

Background and Aims: Recent studies have suggested that maternal thyroid dysfunction, particularly in early pregnancy, may have a detrimental effect on the neuropsychological development of offspring. In the light of these studies a local guideline was drawn which recommended screening thyroid function at booking in all pregnant women with a personal or family history of thyroid disease. The aims of this study were to assess adherence to this guideline, and to test its efficac...

Introduction: There remains considerable debate over combination T4/T3 therapy for thyroid hormone replacement. Whilst large randomised-controlled studies have failed to show benefit over T4 only, there remain patients who feel better on the combination. Animal studies suggest that up to 80% of intracellular T3 in the brain is derived from circulating T4 by local deiodination. We hypothesized that in patients on thyroxine ...

Aim: To audit the management and treatment outcomes of patients with acromegaly at Royal Devon and Exeter Hospital.Patients and methods: Hospital case records of 43 patients (21 male), presenting between 1982 and 2004 were reviewed retrospectively. Age at presentation ranged from 21 years to 77 years, with average follow-up being 11.2 years.Results: 9 (29 percent) of 31 patients had microadenomas at presentation while 22 (71 percen...