Endocrine Abstracts

Background: The term “neuro-cardio-facial-cutaneous (NCFC) syndrome” describes a group of phenotypically overlapping syndromes that result from germline mutations in genes of the RAS-MAPKinase pathway. This pathway plays a role in growth factor signalling and short stature is a consistent feature of NCFC syndromes. This diagnostic group includes Noonan syndrome (NS) and cardio-facio-cutaneous (CFC) syndrome. Growth hormone (GH) has been used with good effect in NS. T...

Introduction: Recent reports suggest that thyroid hormones are independently associated with components of metabolic syndrome. We studied the association between thyroid hormones, insulin resistance and components of metabolic syndrome in euthyroid overweight or obese individuals.Methods: A total of 45 overweight or obese women with no past history of thyroid disease or diabetes mellitus were studied. Body fat was estimated by bio-impedance method and wa...

Case: In April 2008, a 68-year-old male was referred to the endocrine clinic with symptoms of hyperthyroidism and was prescribed carbimazole 20 mg daily. A week later, he developed sudden onset dizziness, together with reduced hearing in his left ear and associated tinnitus. Similar symptoms developed in his right ear shortly thereafter. Seven weeks after starting carbimazole, he attended the ENT outpatient clinic with severe vertigo, tinnitus and bilateral hearing loss. Otosc...

In boys with constitutional delay of growth and puberty (CDGP), puberty may be induced with a short course of testosterone, either as esters or enantate injections. While both types of testosterone are known to be effective in inducing puberty, there are no studies comparing their efficacies. We have compared height gain, a quantitative marker of puberty, between boys treated with a short course of testosterone esters and enantate injections in a retrospective, observational s...

A 24-year-old women (wt 63 kg, BMI 23) presented with history of secondary amenorrhea. Menarche occurred at age 16 years and was followed by a regular cycle (7/35). She started the combined oral contraceptive pill (OCP) at 18 years of age for menorrhagia and stopped this 16 months before her presentation, before undergoing elective surgery. Four months after discontinuing the OCP she experienced a single episode of PV bleeding, but otherwise remained amenorrhoeic. Past history...

We report a case of a 20-year-old male with a clinical profile of Gorlin-Goltz syndrome with delayed puberty. This 20-year-old man had learning disablitiy, macrocephaly and multiple jaw cysts. His other clinical features included agenesis of the carpus callosum, obesity and multiple cutaneous lesions suggestive of angiolipomata. His pubertal development was delayed although a LHRH test done at the age of 16 showed a normal response. Radiological features included macrocephaly,...

This 55-year-old gentleman presented to endocrine clinic following an episode of septicaemic shock complicating benign prostatic surgery one year previously. He subsequently developed symptoms of lethargy, palpitations, lightheadedness, peripheral weakness and loss of libido, which had developed after this episode. Routine biochemistry and ambulatory electrocardiography measurements were normal.Endocrine testing revealed:: - Undetectable gonadotrophins (...

There is a relative lack of data regarding the timing and in particular the severity of hypothyroidism post Radioiodine (RI). We retrospectively examined the timing and severity of hypothyroidism following RI in 213 patients, in relation to ‘target’ and actual follow up appointments, and the introduction of a nurse-led follow-up clinic. Hypothyroidism was defined as persistent elevation of TSH – mild (TSH 6.1–10 mU/l), moderate (TSH 10.1–50 mU/l) and s...

Armour thyroid (Armour) is unlicensed in the UK for the treatment of hypothyroidism. It is natural porcine-derived thyroid replacement with 1 grain containing 38 mcg levothyroxine (T4) and 9 mcg L-triiodothyronine (T3), and unspecified amounts of T1, T2 and calcitonin. We have used Armour as a third line agent in selected patients who have not responded adequately to T4 monotherapy, and combination T4/T3 therapy since 2003.Aim: To assess c...

A 64-year-old man presented with mild biochemical hyperthyroidism – TSH <0.01 mU/l (NR 0.35–4.90), FT4 19.4 pmol/l (NR 9–19) in 2005. He was treated by his general practitioner with a 9 months course of carbimazole. Six months later, TSH became suppressed (0.05 mU/l) but with a normal fT4 (17 pmol/l). He was referred to a ‘One-Stop’ Thyroid Clinic and was seen there 3 months later. Thyroid isotope scan showed a toxic multinodular goitre. He was tre...