Endocrine Abstracts

A 76 year old female presented in 2000 with thyrotoxicosis secondary to Grave’s disease. She was treated successfully with propylthiouracil (PTU) for 2 years then opted for and received a standard therapeutic dose of radioactive iodine (131I) in September 2003. Her thyroid function tests (TFTs) normalised in the first 6 months after treatment (FT4 <14 pmol/l) and she was started on replacement thyroxine 50 mcg od for 8 weeks. She presented in March 2004 wit...

It is now well established that unilateral autonomous aldosterone secreting tumour (AST) in contrast to bilateral adrenal hyperplasia (BAH) - are corrected by surgery. The optimal method of pre-operatively defining a unilateral autonomous AST still remains controversial. There is agreement that adrenal scanning techniques are often unreliable or misleading. The aim of the current study was to analyse if a random aldosterone:renin (AR) ratio (after stopping anti-hypertensive me...

Anti-thyroperoxidase autoantibodies (TPOAb) are one of the major secondary autoantibodies associated with AITD. Many endocrine hospital referrals are received for patients with elevated TPOAb levels without other disordered thyroid function tests.This study aimed to investigate the use of TPOAb testing in hospital practice, to determine whether the presence or absence of TPOAb indicates the existence of thyroid disease and the effect of the TPOAb result ...

A 65 year old lady presented to her GP in 1997 with an extensive rash. She was referred to a dermatologist but the rash which failed to settle with topical treatments. A plasma glucagon level was elevated at 275 pmol/l (NR 0-50). CTscan revealed a mass in the pancreatic tail and hepatic metastases consistent with malignant glucagonoma. She was commenced on octreotide and the rash resolved. She underwent a distal pancreatectomy, partial left hepatic lobectomy and intraoperative...

ObjectiveTo assess the results of bilateral adrenalectomy and further assess the relevance of Nelson's syndrome as a complication of bilateral adrenalectomy.Patients33 patients treated by bilateral adrenalectomy at the Hammersmith Hospital were identified (earliest operation performed in 1958). Although all bilateral adrenalectomies in recent years were included, it was not possible to confirm that all bilate...

A 40-year-old female presented with a 6 week history of right-sided headaches and nausea. She was found to have an Arnold-Chiari malformation and an unusual C3 syrinx on MRI brain scanning. She underwent a foramen magnum decompression and C1 laminectomy. Three weeks later, she was admitted with headaches, nausea and vomiting, and blurring of her vision on left lateral gaze. Whilst in the emergency unit, the patient had a tonic-clonic seizure.Following th...

Background: Radioiodine (RAI) is highly effective in the treatment of hyperthyroidism. Lithium reduces thyroidal release of organic iodide and thyroid hormones, thus increasing thyroid retention of RAI and subsequently, the delivered dose of radiation. Controversy surrounds whether lithium increases the efficacy of RAI.Aims: To assess whether lithium improved outcome after radioiodine treatment and analyse fT4 and eye disease changes in lithium treatment...

Background: Close follow up of patients treated with radioiodine (RAI) for hyperthyroidism is imperative to ensure that resultant hypothyroidism or ensuing hyperthyroidism is detected promptly and treated. Protocols of follow up vary between hospitals. In our centre, a telephone clinic is used and patients are called after thyroid function tests at 1, 3, 6, 9 and 12 weeks post radioiodine.Aims: To audit patient follow up in the telephone clinic, comparin...

A 37-year old gentleman with MEN 1 was referred to our Centre for further assessment. MEN 1 had manifested as recurrent primary hyperparathyroidism and multiple pancreatic gastrinomas. He complained of reduced libido, with absent early morning erections for the preceding 18 months. Biochemistry confirmed hyperprolactinaemia (prolactin 1494, NR 0–625 mU/l, testosterone 12 NR 10–28 nmol/l, LH 2.6 NR 2–12 IU/l, FSH 3.7 NR 1.7–8 IU/l). During investigation of h...

IntroductionPatients treated with radioiodine (RAI) for thyrotoxicosis, secondary to Graves or a toxic nodule, require close follow up to determine whether they have become hypothyroid or have a recurrence. National guidelines state that patients should have their first blood test at about six weeks post RAI. Telephoning patients with their results, rather than reviewing them at outpatient appointments, can be a more convenient and efficient method of fo...