Endocrine Abstracts

Case History: We present a 3-week-old baby who presented to a District General Hospital with prolonged unconjugated hyperbilirubinaemia and evolving developmental delay.Investigations: Initial thyroid function demonstrated a TSH at 2.41 mIU/l (0.8-5.4), free T3 at 7.39 pmol/l (3.40–7.60) and free T4 at 9.9 pmol/l (11.0–23.6). The TFT was repeated using an alternative assay with FT4 at 11.8 pmol/l (11.5–28.3), FT3 at 9.20 pmol/l (3.00–...

Background: Acute hypercalcaemia of biochemical and symptomatic nature is a relatively common emergency medical presentation. Its management has tended to vary significantly and this can affect patient’s outcomes and length of hospital stay.Aim: To assess the acute management of hypercalcaemia in relation to the new Society for Endocrinology guidance.Method: A retrospective audit of all cases of hypercalcaemia admitted to Oxfo...

The term subclinical Cushing syndrome arose at the turn of the millennium with the description of large Italian study of adrenal incidentalomas. Of 1096 patients from 26 centres, 9.2% had ‘subclinical Cushing’s’ (JCEM, 2000; 85:637-644). Since then over 300 publications have detailed this newly discovered endocrine diagnosis, and herein lies the main issue. The definition of Cushing’s syndrome is not in doubt – a ‘constellation of symptoms and sig...

Changes in hormone output to regulate physiological processes is a feature of all endocrine systems, with the added complication that for many systems, the pattern as well as level of output, determines the response of target tissues. Periodic patterns of hormone secretion can occur over multiple time scales, from ultradian to circadian, infradian, and circannual and may be dependent on physiological status. The activity and output of lactotroph and somatotroph cells of the pi...

Introduction: Iodine deficiency in Western countries is considered a historic disease. In 1924 up to 30% of school aged children in the UK had a goitre. The UK however remains one of the most iodine deplete countries in the world. Those following restricted diets are also at particular risk of iodine deficiency.Case Report: A nine year old female on a significantly restricted diet due to multiple food allergies presented with a goitre. Ultrasound scan co...

MEN2a is a rare genetic endocrine disorder associated with mutation of RET oncogene on chromosome 10. It involves lesions in thyroid, parathyroid and adrenal glands. Medullary thyroid carcinoma is the pathological hallmark and usually the first presentation of this syndrome.Clinical case: A 64-year-old lady with previous history of hypertension, IHD, and hypercholesterolemia was referred to Endocrine clinic after she was incidentally found to have high c...

Introduction: Early thyrotoxicosis is associated reduced bone density. The aim of this study is to determine any difference between bone mineral density (BMD) in those presenting with overt or subclinical thyrotoxicosis.Methods: Retrospective observational study of BMD in individuals presenting with thyrotoxicosis from 2008 to 2013. BMD was assessed by bone densiometry using T, Z, and total BMD within 1 year of first abnormal thyroid fu...

There are traditionally two major methods of treating autoimmune biochemical hyperthyroidism (Grave's disease) with anti-thyroid medication employed by Endocrinologist's in the UK today. The first is ‘dose titration’ and the second is ‘block and replace’, each treatment regime has it's own advantages and disadvantages and there is sometimes controversy over which is the best approach. A Cochrane review in 2005, undertook a systematic evaluation of all the g...

Loss of normal blood-brain barrier (BBB) function is an integral feature of the neuroinflammatory process in the human demyelinating disease multiple sclerosis (MS). Our previous studies using EAE as the experimental model of MS have demonstrated that restoration of BBB function is associated with an improved clinical status. The vasoactive peptide ADM works in an autocrine manner on endothelial cells of the vasculature and is produced at particularly high levels within the ne...

Introduction: Dyshormonogenesis accounts for approximately 10–15% of cases of congenital hypothyroidism. Although relatively uncommon, the presence of a neonatal goitre should raise suspicion of thyroid dyshormonogenesis. Advances in genomic sequencing have identified errors at all stages of the thyroid hormone synthesis pathway. We present a case of a fetal goitre with the infant subsequently being diagnosed with dyhormonogenesis secondary to two separate thyroglobulin g...