Endocrine Abstracts

85 yo presenting with collapse, found to be hypothermic, bradycardic, hypotensive and hypoglycaemic, decreased GCS, on admission. TSH 135, T4 unrecordable. Prescribed IV liothyronine and hydrocortisone as per guidelines. Managed in Medical HDU. Careful management of hypothermia to avoid vasodilation and hypotension- blankets rather than active warming. Close management of blood sugars for hypoglycaemia. Pt responded well to therapy. Oral levothyroxine started once pt alert and...

Steroid-dependence is a life-long condition with a risk of premature mortality from undertreated adrenal crisis or omission of steroids. Previous studies identified rates of adrenal crisis around 8.3/100 patient years (Hahner 2015). We invited members of Addison’s Disease Self-Help Group to complete an online questionnaire about any experiences of adrenal crisis. Respondents(N=628) were asked to provide demographic information and details of their most recent adr...

There is clear evidence from epidemiological studies that adverse conditions during pregnancy can programme changes in offspring which lead to increased risk of developing type two diabetes and obesity, two diseases associated with metabolic syndrome. Whilst earlier investigations focused on undernutrition in relation to famine, it is also relevant in the developed world to consider how dieting may programme lasting changes in the offspring.In models of ...

In 1996, in Monte Carlo’s famous Loewes Hotel, I went from sudden crippling gastric pain to continuous flushing in the space of <24 h, on my return to the UK, I was diagnosed with Carcinoid syndrome. Based on freely available information on the Web at that time, in my mind my life expectancy was going to be 6 years from the point of diagnosis.This session will discuss the impact of a ‘skewed’ sample on the following 6 years of my life ...

The advent of high throughput techniques and genome sequencing has brought about a new era in the availability of biological data. This has created a need for new approached for data integration and to interpret complex biological data sets. A cell cannot be considered as using a set of independent signalling pathways. Instead, it is now clear that signalling proteins are integrated into a complex network. The human brain cannot handle this complexity. At the same time, we nee...

The decision to undertake a PhD launches you on a path of discovery, but not necessarily scientific discovery!You discover a lot about yourself. Can you survive the failed experiments, the confusion about your goals and the uncertainty about a future career?You discover a lot about working in research groups. Sometimes there is stress with your supervisor, sometimes with other members of the team.The problem ...

Addison’s disease (AD) has an estimated prevalence of 126–144 per million among Northern European populations. Average age at diagnosis is 39, but AD may be diagnosed from pre-teens to 80 year olds.AD may occur in isolation or as part of autoimmune polyendocrine syndromes. Previous studies identified significant associations with autoimmune thyroid disease (predominantly hypothyroidism), type 1 diabetes mellitis, vitiligo, vitamin B12 deficienc...

Addison’s disease (AD) has an estimated prevalence of 126–144 per million among Northern European populations. Average age at diagnosis is 39, but AD may be diagnosed from pre-teens to 80 year olds.AD may occur in isolation or as part of autoimmune polyendocrine syndromes. Previous studies identified significant associations with autoimmune thyroid disease (predominantly hypothyroidism), type 1 diabetes mellitis, vitiligo, vitamin B12 deficienc...

Good clinical practice encourages patients to minimise long-term glucocorticoid overexposure to preserve bone density and prevent the development of glucose intolerance or hyperlipidaemia. However, the absence of a protective “cushion” of excess cortisol implies an increased risk of adrenal crisis. (White & Arlt 2010) This assumption has been challenged by a leading adrenal specialist, who suggested instead that chronic over-replacement may increase the susceptib...

Steroid-dependent patients have a lifelong dependency on replacement therapy and a lifelong vulnerability to sudden death from under treated adrenal crisis. Yet evidence about the adequacy of medical response to adrenal crisis within the UK is largely anecdotal.We invited members of the main UK support groups representing steroid-dependent patients to complete an online questionnaire identifying the frequency, causes and location of their adrenal crises ...