Endocrine Abstracts

Introduction: The chondrodysplasias are a heterogeneous group of genetic conditions affecting growth and form of the skeleton. As genetic knowledge has improved and genetic testing has become increasingly available, we hypothesize that over the past 10 years there has been an increase in the number of children where a genetic diagnosis is reached.Aims: To ascertain if there had been an increase in the number of chondrodysplasias confirmed by genetic test...

A 37-years-old man was referred to rheumatology with a 3 month history of widespread joint pains, worse on rising in the mornings with early morning stiffness lasting about 15 min. Hands were affected first followed by knees and hips. On further questioning, he also complained of generalised fatigue, loss of libido and thinning of the hair on his chest, as well as 15 kg weight loss over 6 months. He recalled a febrile illness with headache prior to the onset of his symptoms, b...

Obesity is almost invariably present in Cushing, but is of little diagnostic value because of its high incidence in the population as a whole , particularly in women between the age of 20 and 50 years who are the most likely to be suffering from Cushing’s Syndrome. Clinical acumen, however, is insufficient to establish the diagnosis, and confirmation depends on showing that cortisol production is in excess of normal. Because obesity is increasing at an alarming rate throu...

In a retrospective study, we studied the medical notes of 35 patients with adrenal insufficiency; aged 61±15 (mean ±S.D.) years. Their average age at diagnosis was 45±18 years, and duration of the disease was 17±15 years.Most patients were on hydrocortisone replacement (32 patients); taking 23±4 mg daily in divided doses, and only 3 (9%) patients were on single dose of prednisone 7.5±05 mg daily in a single do...

Introduction: Prolonged use of topical corticosteroids causes systemic adverse effects including Cushing’s syndrome and hypothalamic–pituitary–adrenal (HPA) axis suppression, which is less common than that of the oral or parenteral route.History: A 31-year-old female patient was referred from the dermatology clinic with symptoms and signs consistent with Cushing’s syndrome. She has been treated for psoriasis with a prolonged course of...

Background: Bone densitometry by DXA is now considered routine part of clinical management of children at risk of osteoporosis. Data on activity of a paediatric DXA service would be helpful for service planning but are currently lacking.Aim: A survey of referrals to the service and size-adjusted total body (TB) and lumbar spine (LS) bone mineral content for bone-area standard deviation scores (BMC for BA SDS) were obtained from the local database.<p ...

Introduction: Hypocalcaemia secondary to post-operative hypoparathyroidism is a recognised complication of thyroid surgery with reported rates of up to 75%. Little guidance exists on the appropriate management of post-operative hypocalcaemia and individual clinicians may develop their own preferred management strategies based on past experience. However, delay in restoring normocalcaemia may increase length of hospital stay and patient morbidity.Aims: i)...

Background: Radionuclide thyroid scanning using technetium pertechnetate (Tc99m) is a useful aid in the differential diagnosis of benign thyroid disease. It is particularly useful in the differentiation of the causes of a thyrotoxic biochemical picture, e.g. viral thyroiditis, toxic nodular disease or Grave’s disease. This has implications for long-term management plans. However, its cost and exposure to radiation necessitate the need to justify its use in the ...

The aim of this retrospective study was to assess hydrocortisone replacement therapy in patients with adrenal insufficiency, by correlating hydrocortisone regimens and doses to that of serum and urine cortisol levels.Method: We studied the case notes of 83 patients, whose records contained the results of at least one valid hydrocortisone day curve and 24 h urine free cortisol level. Twenty-seven patients were on twice daily, and 56 were on thrice daily r...

Controversy about the optimal dose of 131I in thyrotoxicosis is ongoing. High doses result in higher cure rates, but are associated with elevated risk of hypothyroidism and irradiation exposure. There is no consensus as to the optimum period of thionamide discontinuation prior to treatment, nor to its impact on the success of RAI.We retrospectively analysed 151 clinical records of patients with thyrotoxicosis due to Grave’s disease or tox...