Endocrine Abstracts

Introduction: 3-β-hydroxysteroid dehydrogenase (3BHSD) deficiency is a rare genetic disorder of steroid biosynthesis that results in decreased production of all three groups of adrenal steroids, which include mineralocorticoids, glucocorticoids, and sex steroids.Case presentation: An infant was born with ambiguous genitalia in 1975 to a conservative Muslim family and was registered as male. The child was hospitalised with addisonian crisis on the el...

Background: Struma ovarii, defined as containing 50% or more thyroid tissue is rare and accounts for 1% of ovarian tumours. Presentation is non-specific, relating to mass effect. Although the tumour predominantly consists of thyroidal tissue, features of hyperthyroidism occur in <5% of cases. Majority are benign, histological features of thyroid cancer are found in about 5–10%. Seventy per cent of these are papillary thyroid cancer (PTC). We present a case of struma o...

A 55-year female from low economic background was referred from the local dental hospital where she had presented with a swelling near her left lower 3rd molar which caused her significant difficulty in eating. On further questioning she conceded to having progressive difficulty in walking and bony pains over the past 6 months with increasing dependency for daily activities. She was frail with proximal muscle weakness and widespread bony tenderness but no other significant neu...

Background: Testosterone deficiency (TD) affects 5–6% of men aged 30–79 years and it can be a presenting feature of a serious underlying condition like a pituitary tumour. Clinical practice guidelines have recommended thorough investigative workup of such patients to delineate the underlying pathology in patients with secondary TD. We have undertaken a retrospective study to assess the need for expensive investigations in patients with relatively mild TD suspected to...

Background and objective: Addison’s disease occurs more frequently in patients with type 1 diabetes mellitus (T1DM) as part of the autoimmune polyendocrine syndromes. There is, however, no such association between adrenal failure and type 2 diabetes mellitus (T2DM). We, therefore, retrospectively audited referrals for short synacthen tests (SST) on patients with T2DM.Methodology: Seven years retrospective study of indications for and results of SST ...

Case: An 81-year-old man with type 2 diabetes, cerebrovascular disease and hypertension presented with a sudden onset of headache. CT scan and MRI scan of the head did not show any significant abnormality. Headache improved spontaneously and he was discharged with no cause for his headache being identified. Four months later he was diagnosed to have pan-anterior hypopituitarism at another hospital and was commenced on appropriate replacement therapy. Serum prolactin was not el...

Objectives: Transient thyroid hypofunction during the initial 3 months following radioiodine (RAI) therapy is well recognised with a reported incidence of 10–15%. There are no clear diagnostic criteria, often leading to management uncertainty, inappropriate diagnosis of ‘cure’ and institution of life-long thyroxine therapy. The aim of our audit was to assess the incidence and identify predictors for transient euthyroidism or hypothyroidism following administrati...

Aim: The aim of our study was to explore the possibility of using a district-wide laboratory database as a governance tool to ensure the optimum management of patients with biochemical hyperthyroidism.Patients and methods: A complete list of patients on whom TFT were requested over a 3-month period was obtained and patients with unequivocal hyperthyroidism were identified. General practitioners (GP) of patients not referred to the specialist endocrine te...

Background and Aim: RAIT is successful in achieving cure of thyrotoxicosis. However, 10-15% patients require further doses, usually administered at 4-6 months after the initial dose. We assessed the role of TRAB values in predicting the need for redosing, which could have useful implications.Patients and Methods: We measured TRAB at diagnosis and at the time of 550MBq RAIT in 54 patients with Graves’ disease. We rec...

Background: Short Synacthen Test (SST) is widely used to assess hypothalamic-pituitary-adrenal (HPA) axis in patients on corticosteroids. This requires significant material and human resources especially as patients often require multiple tests. We performed a retrospective cohort study, followed by the implementation of QIP methodology to reduce the number of SST in this cohort of patients.Methodology: We reviewed 167 patients who had a SST and derived ...