Endocrine Abstracts

Introduction: Subactue thyroiditis (SAT) is a self-limiting inflammatory condition caused by follicular destruction of the thyroid gland, commonly precipitated by viral upper respiratory tract infection 2 weeks preceding the onset of thyroid symptoms. However, SAT following COVID-19 vaccination is rare. Herein, we report two cases of subacute thyroiditis which presented after administration of COVID-19 vaccine. Case series: The first patient was a 42 yea...

Background: Adrenal Insufficiency (AI) presents a diagnostic and clinical challenge. While short Synacthen Tests (SSTs) are most commonly utilised to diagnose AI, the value of a baseline cortisol is being explored. We aimed to review indications for performing an SST and to determine the baseline cortisol that predicted a preserved cortisol response to Synacthen.Methods: Eight hundred and sixty SSTs performed in 621 individuals at a tertiary endocrinolog...

Autosomal dominant hypoparathyroidism (ADH) is caused by gain-of-function mutations in the calcium-sensing receptor (CaSR), increasing its sensitivity to extracellular calcium, suppressing PTH and resulting in hypocalcaemia. In contrast to idiopathic hypoparathyroidism, treatment to correct serum calcium results in high urine calcium excretion, causing nephrocalcinosis, stones and renal impairment. Unlike surgical hypoparathyroidism where calcium should be maintained, patients...

Monogenic diabetes is estimated to account for 1-2% of all diabetes cases diagnosed before the age of 45. It is caused by mutations in genes encoding for beta cell development, function and regulation. We present three cases of monogenic diabetes in pregnancy.Case 1: Age 30, Para 3, White ethnicity. This individual was screened for a GCK mutation at 18 weeks gestation (third pregnancy) on the basis of family history. She required metformin and insulin to...

We present the case of a 53-year-old lady who was recently diagnosed with Type 2 Diabetes, Hypertension and Dyslipidaemia. She was referred by the lipid clinic with a 3-month history of progressive facial swelling, hyperpigmentation and proximal myopathy. Clinical history and examination were highly suspicious of endogenous hypercortisolaemia. An initial overnight dexamethasone suppression test yielded an elevated morning cortisol (752 nmol/l, normal <50nmol/l). Two 24-hou...

TSH-secreting pituitary adenomas (TSHomas) are rare. Previously, the reported prevalence was one case per million populations although this is probably an underestimate. A recently published study reported a prevalence of TSHomas in Sweden of 2.8/million inhabitants.Methods/design: Observational study conducted in four tertiary referral centres in Ireland. We retrospectively collected data on the prevalence, demographics, hormonal profile, tumour charact...

Pituitary patients with different aetiologies of hypopituitarism exhibit differing phenotypes despite optimal replacement therapy. We hypothesised that differential regulation of the isoenzyme 11β-hydroxysteroid dehydrogenase 1 (11β-HSD1), which mediates the autocrine conversion of cortisone to cortisol in adipose tissues and liver may play a role.We prospectively studied 11β-HSD1 activity through analysis of 24 h urine cortisol/cortisone ...

Besides total body irradiation and immunosuppressive drugs, massive iodine supply and stress might participate in thyroid dysfunction, described in 50% of allo-HSCT. We report on a rare case of hypothyroidism related to blocking TRAb. A 55-year-old man was admitted for asthenia, dyspnea, myalgia, 8 kg-weight gain, constipation, dry skin, hoarse voice, recent deafness. He had moon face without any goiter. He had received, 1 year before, an unrelated 9/10 human leukocyte antigen...

IgG4 related hypophysitis is a recently described entity belonging to the IgG4 related diseases. It is characterised by markedly elevated serum IGG4 levels and tissue infiltration by IgG4 positive plasma cells. To date, 34 cases of IgG4 related hypophysitis have been described but only a handful were in women or biopsy proven. We describe a case of a 58 year old woman who presented with transient headache. She also complained of polyuria and nocturia. She had a thyroidectomy f...

Neck ultrasound (US) can facilitate minimally invasive parathyroidectomy by providing fine anatomical detail of enlarged parathyroid adenomas in patients with primary hyperparathyroidism (PHPT). The role of neck MRI in US negative/equivocal cases remains unclear. We aimed to evaluate the performance of neck MRI in parathyroid tumour localisation in the setting of negative or equivocal neck US.We performed a retrospective review of a consecutive series of...