Endocrine Abstracts

Case History: A 68-year-old gentleman with hypertension and diet-controlled type 2 diabetes presented in September 2015 with weight loss, fatigue, low libido and cold intolerance.Investigations: Blood results demonstrated secondary hypothyroidism (TSH 0.59 mU/l (reference range 0.35–5.00), free T4 8.3 pmol/l (ref 9.0–21.0)), hypogonadotrophic hypogonadism (testosterone 1.0 nmol/l (ref 10.0–36.0), FSH 1.5, LH 1.1) and a modestly elevated pr...

The circadian clock is a key regulator of immune responses. Both circulating and resident immune cells possess intrinsic timers, which act to impart time-of-day variation in their function. It is now becoming evident that the circadian clock is also critically involved in regulating the function of endogenous anti-inflammatory glucocorticoid hormones. Consequently, we see variation in an animal’s inflammatory responses dependent on the time the stimulus was delivered. Thi...

Thyroid dysfunction is associated with well-recognised maternal and fetal complications. There is an increase in thyroxine requirement during pregnancy by 25–50% hence close monitoring of thyroid function and dose augmentation is vital in attaining euthyroid status. In our combined antenatal-endocrine clinic we aim to test thyroid function tests (TFTs) at booking, in the second and third trimesters. In order to reduce the need for patients to re-attend the clinic purely f...

Background: Primary hyperparathyroidism is an endocrine disorder characterized by autonomous production of parathyroid hormone (PTH) results in the derangement of calcium metabolism. Imaging modalities used to localize includes technetium-99m sestamibi, sestamibi-single photon emission computed tomography (SPECT), SPECT-CT fusion, ultrasound Neck and Four dimensional computed tomography (4D-CT). Sestamibi scintigraphy combined with sestamibi single photon emission computed tom...

Background: Thyroid carcinoma consists of just 1% of all malignancies but is the commonest malignant endocrine tumour. Papillary thyroid carcinoma is the most common form of thyroid carcinoma consisting of 80% of all cases. There are very few case reports in the literature of papillary thyroid cancers presenting with distant to the pelvic organs. Distant metastases are noted in 1–3% of patients with thyroid cancer at initial diagnosis.Clinical case:...

Primary adrenal lymphoma is rare and accounts for <1% of extra-nodal non-Hodgkin’s lymphoma cases. It presents with B symptoms, bilateral adrenal masses and hypoadrenalism; and thought to have a poor prognosis. We describe a patient that was diagnosed with and successfully treated for primary adrenal diffuse large B cell lymphoma (DLBCL).Case: A 62-year-old gentleman with longstanding hypertension presented with a 5-month history of weight loss,...

Introduction: Langerhans cell histiocytosis (LCH) is a rare multisystem disease. Pituitary manifestations include failure of the anterior and/or posterior pituitary, with diabetes insipidus and gonadotrophine deficiency being most prevalent. We present a case of a female who had pituitary failure yet conceived naturally following chemotherapy.Case description: A 24-year-old female presented with polydipsia, polyuria, and lethargy. A water deprivation tes...

Until 12th week of gestation foetus is entirely dependent on maternal thyroxine. Inadequate thyroxine replacement may lead to lower IQ of offspring and also an increased miscarriage rate.We audited 68 hypothyroid pregnant females to assess whether management of their thyroid status had met current standards. In the first trimester TSH is not an optimal monitoring marker as it is supressed by rising HCG level. According to established clinical guidelines ...

Introduction: Parathyroidectomy is the treatment of choice for patients with primary hyperparathyroidism who have significant hypercalcemia and/or end-organ damage. The incidence of postoperative hypocalcaemia is 25–90% in patients with evidence of radiological evidence of parathyroid disease, 0–6% without. In most patients it is mild, but in some, it can cause significant morbidity. It has been attributed as ‘hungry-bone syndrome’ and attempts have been ma...

The human foetal adrenal gland (HFA) comprises of two distinct zones; the foetal zone (FZ) and the definitive zone (DZ). The subcapsular DZ has been proposed to contain a population of adrenocortical progenitors that migrate centripetally to populate the FZ. Rodent studies have identified sonic hedgehog (SHH) signalling in a subcapsular non-steroidogenic progenitor population and its disruption during development causes adrenal hypoplasia. The involvement of SHH in the human f...