Endocrine Abstracts

IntroductionAntithyroid drugs are widely used in the therapy of hyperthyroidism. This review (update of Cochrane review: Antithyroid drug regimen for treating Graves' hyperthyroidism. In: The Cochrane Library, Issue 4, 2003; with 4 additional trials) assesses the effects of dose, regimen and duration of antithyroid drug therapy for Graves' hyperthyroidism.MethodsThe Cochrane Controlled Trials Register, MEDLIN...

While iodine deficiency goitre is common worldwide, it is rarely described in the U.K. Vegan diet is the only real way for this deficiency to occur in the U.K. A MEDLINE search from 1966 revealed 1 reported case (Shaikh et al. Transient neonatal hypothyroidism due to a maternal vegan diet; Journal of Pediatric Endocrinology & Metabolism Jan 2003). We have identified 3 cases, which we will describe here.Case 1A 21-year-ol...

Background: True cyclical Cushing's syndrome is rare and usually due to an ACTH-secreting corticotrophinoma. We describe a man with cyclical Cushing's syndrome of 15 years duration who had unexpected pituitary immunohistopathology.Clinical details: A 22-year-old man presented in 1986 with clinical features of Cushing's syndrome & urinary free cortisols up to 1800 nmol/24h, but normal low-dose DXM suppression, & normal pituitary and adrenals on CT. He was then lost ...

Efficacy and Safety of High Dose Testosterone Therapy in Partial Androgen InsensitivityS. Bandyopadhyay, W.A.Watson, C. M.Park, P. Abraham, S. Philip, S. Acharya , J.S. Bevan. Department of Endocrinology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN.INTRODUCTION: There have been few reports of the efficacy and safety of high dose androgen therapy in men with partial androgen insensitivity (PAI). We report on the responses of a p...

The high survival rate for patients with differentiated thyroid carcinoma (DTC) declines markedly in those with bony metastases. We compare the management of two patients with large dominant pelvic metastases.Case 1 63 year old man with R hip pain. Investigation revealed a 10cm lesion in the R hemi pelvis and subsequent imaging and biopsy revealed a 9th rib lesion and metastatic follicular DTC. He underwent 131 I ablation of the normal thyroi...

Thymic carcinoma is a rare but aggressive cause of ectopic ACTH secretion, with fewer than 100 reported cases.Hypokalaemic alkalosis was found in a 38 year old woman who presented with a 2-week history of leg swelling, fatigue and dyspnoea. She was not obviously Cushingoid.ACTH-dependent Cushing's Syndrome was confirmed biochemically: urinary free cortisol (UFC) >8500nmol/day and serum cortisol 4060nmol/l, (no suppression on 8...

Objective: To establish the efficacy of CAB as primary and exclusive therapy in the management of macroprolactinomasMethod: Retrospective case note review of all patients with macroprolactinomas treated with CAB since the drug received a UK licence in 1994. Patients: Sixteen patients (8males, 8 females) with mean age at presentation of 42.3yrs (range 22-72 years) were treated with initial CAB doses ranging from 0.5-1mg/week (median 1mg/week). Results: T...

Phaeochromocytoma in association with hypercortisolism is thought to be rare. However we have observed 4 cases in 3 years and question the rarity of this link. In each case there was a dominant adrenal mass (3.6-7.7cm) with contralateral adrenal hyperplasia. Three of the 4 tumours showed increased 123-I-mIBG uptake. Urinary catecholamines ranged from 872-22752nmol/24h (N < 600). Hypercortisolism was present in all 4 patients; sustained in 2 and cyclical in 2. Case 1 (JCEM ...