Endocrine Abstracts

Thyroid storm is rare and life threatening manifestation of thyroid hormone excess. It has high mortality rate with delayed treatment. As early intervention is associated with improved patient outcome, prompt diagnosis based on clinical grounds is of paramount importance. We present a case of thyroid storm which was different in terms of absence of fever on presentation, presence of thrombocytopenia and deranged cholestatic LFTs which resolved after treatment of thyroid storm....

Vitamin D deficiency is associated with the development of some cancers and in vitro 1,25-dihydroxyvitamin D (1,25D) reduces cell proliferation. We suggest that modification of tissue specific immune responses, as a consequence of local synthesis of 1,25D, may be key. To assess the impact of serum 25D on the risk of bladder cancer we conducted a systematic review. To test our hypothesis, expression of vitamin D signalling components and the synthesis of 1,25D were exa...

High grade pancreatic NETs are usually non-functional. Here, we report a case of a patient with a high grade pancreatic NET, which was initially non-functional but became functional after chemotherapy. He was initiated on a flash glucose monitoring device (FreeStyle Libre®) avoiding the need for frequent capillary blood glucose monitoring. Using this novel approach, we demonstrated an improvement in his disabling hypoglycaemia with medical treatment. A 45-year-old profess...

A 58-year-old gentlemen presented with severe neckache, sweating, feeling hot, and cold. PMH included hypertension and MI. On examination, he was clammy, with blood pressure (BP) 205/107 mmHg. Laboratory results showed leucocytosis 28.5 and TroponinT 2002 ng/l (reference range <14.0). ECG showed inferolateral ST depression. CT angiogram showed a normal aorta and a 6 cm right adrenal mass. An echocardiogram showed severe LV impairment and normal valves.<p class="abstext...

Male hypogonadism is usually considered in the presence of classical symptoms like reduced libido, erectile dysfunction and reduced bone mineral density.We present the case history of a 43-year-old man with learning difficulties who presented with long-standing lethargy. Clinical examination revealed bilateral ptosis, muscle weakness and slow relaxation of handgrip. He had abdominal obesity, pseudo-gynaecomastia, frontal balding, reduced facial, chest, a...

Objective: Hypothyroidism is common and predominantly managed in primary care. Symptoms are non-specific, with thyroid function tests (TFT) required for diagnosis. We sought to investigate current practice in levothyroxine prescribing in primary care.Methods: We studied the initiation of levothyroxine using the General Practice Research Database (GPRD), the world’s largest database of anonymised medical records. Individuals with i) thyroid cancer ii...

Objective: The hypothalamus–pituitary–thyroid axis profoundly influences skeletal development. Whilst the adverse effects of thyroid dysfunction on bone are well established; the effects of variation within the normal range is less clear.Design: In a subset of the Avon Longitudinal Study of Parents and Children we performed full thyroid function tests from stored samples taken at age 7. 668 children had thyroid hormone parameters within the ref...

Background: Single-nucleotide polymorphisms (SNPs) allow us to study effects of genetic variation on thyroid hormone levels. Phosphodiesterase 8B (PDE8B) is a protein responsible for cAMP generation, found in thyroid and brain tissue, but not normal pituitary tissue. Variation at this locus has been reported to influence TSH levels, but its effect on T3 and T4 had not been studied in the general population. Deiodinase 1 (DIO1) is known to influence T...

BackgroundInappropriate footwear is a major cause of ulceration in diabetes while good footwear prevents ulceration and recurrence.AimTo analyse the benefits of orthotic interventions in foot ulcers in our high risk diabetic patients.Design and methodsWe present preliminary data of a prospective analysis of 18 diabetic patients from our foot clinic to evaluate res...

Behavioural restrictions observed following Radioiodine therapy(RAI) administered for management of hyperthyroidism are becoming more stringent. Over the last two years we have administered a fixed 400 MBq RAI dose after performing a 24-hour RAI uptake test with a view to reducing post RAI restrictions e.g. for patients with a 50% uptake, restrictions applicable to 200 MBq were advised. The aim or our study was to compare the restrictions as advised by this method with what wo...