Endocrine Abstracts

We report the management of 16 predominately elderly patients (12 female: 2 male; mean age at presentation 73.8 years, range 48 to 85 years) presenting with massive goitres. Seventy-five percent had significant co-morbidities. Fifteen had multinodular goitres and 1 Reidel’s thyroiditis. Four goitres were confined to the neck; 6 were intra-thoracic and 6 had both neck and intra-thoracic goitres. Five had symptoms of compression; 9 were thyrotoxic and 2 hypothyroid. Mean fo...

Aims.To quantify the reasons for undertaking TRH testing and whether it changed management.Methods.A standard protocol was utilised-normal TSH response is peak 5-20 mUper litre at 20 mins with 60-minute level falling by third off peak. Hospital notes of 53-pts undergoing their first TRH test between October 2000 and May 2004 were reviewed.Results.44 (83%) pts had ...

A 27-year-old woman presented with severely symptomatic Graves and ophthalmopathy (FT4 49.1; TSI 53). Despite 60 mg carbimazole and 240 mg propranolol she required admission to control her symptoms and thyroid function, changing to propylthiouracil 800 mg daily with propranolol (FT4 19.9). Whilst considering thyroidectomy a 6-week pregnancy was confirmed. She relapsed (? compliance) and was admitted at 14 weeks with hyperemesis gravidarum (FT4 >77.2), which responded to an...

An 18-year old male presented with galactorrhoaea and obesity. PRL measured 16,630 mU/l, FSH 6.0 U/l, LH 5.0 U/l, testosterone 8.6 nmol/l, SHBG 15.0 nmol/l, IGF-1 22.0 nmol/l and TSH 1.39 mU/l. Several 24-hour urinary free cortisol estimations excluded hypercortisolism. Short synacthen test confirmed an intact HPA axis. Visual fields were full. Pituitary-MRI revealed a large adenoma extending into the right cavernous sinus without suprasellar extension. PRL started declining u...

The foetus of a mother with previous or current Graves disease is at risk of developing thyrotoxicosis. The mother can act as a bioassay to diagnose foetal thyrotoxicosis. We describe the difficulties in managing foetal thyrotoxicosis in a mother who could not act as a bioassay because of previous Graves disease treated by total thyroidectomy.A 35year old woman fell pregnant 3 months after a total thyroidectomy for relapsed Graves disease and concomitant...

We conducted a retrospective notes analysis to determine the incidence, prevalence and predictive factors of idiopathic postprandial hypoglycaemia (IPH) in a population of 230 000 served by our Hospital.Using the Biochemistry Database all patients who had a 5-hour oral glucose tolerance test (OGTT) from 1995 to 2001 were identified, and their notes were reviewed. Demographic, clinical and biochemical data were recorded for each patient. The latter includ...