Endocrine Abstracts

A para 2+0 female, 11 weeks gestation presented with vaginal bleeding and hyper-emesis. An ultrasound scan showed a dichorionic pregnancy with one viable foetus and a hydatiform mole. β-human chorionic gonadotrophin (β-hCG) level was elevated at 159845 U/L and subsequent thyroid biochemistry revealed hyperthyroidism. Serum thyrotrophin (TSH) was suppressed at <0.05 mU/L (NR 0.2–4.5), with a FT4 37 pmol/L (NR 9–24), and Free T3 of 17.8 nmol/L (NR 2.6&#15...

Case History: We report the case of a 59-year-old lady with a persistently elevated serum thyroglobulin following a total thyroidectomy for multifocal papillary thyroid carcinoma. She subsequently underwent radioiodine therapy following which her serum thyroglobulin remained elevated. However, it was later found to be almost undetectable at 0.3 μg/l after a change in laboratory method. This discrepancy prompted further investigation, and repeat analysis using the original assa...

Background: Thyroid stimulating receptor hormone receptor antibodies (TRAb) markers are useful in confirming diagnosis of Graves’ disease, but also recognised as a predictor of relapse. Good practice dictates that a TRAb is measured at the commencement of treatment, to confirm a diagnosis of graves’ disease. Repeating the TRAb before discontinuation of treatment can assist in guiding treatment. If TRAb remains elevated, the chances of relapse are inc...

Background: During Covid-19 pandemic, we recognised the importance of optimising adrenal insufficient patients’ ability to manage adrenal crisis and seek medical intervention thereby reducing the need for more intensive support. Evidence suggests omission of steroids during an adrenal crisis is a medical emergency and can be fatal. Research by National Reporting Learning System (2020) identified 4 deaths, 4 admissions to critical care, 320 incidents relating to steroid re...

Case history: We present a 76-year-old woman with cyclical ACTH-dependent Cushing’s syndrome since 2002. She has two-yearly relapses with proximal myopathy, candidiasis, facial swelling and hypokalaemia that have been biochemically confirmed with Overnight and Low Dose Dexamethasone Suppression tests. Although her initial cycles were brief and uncomplicated, her most recent episodes led to prolonged hospital admissions. During her last admission, she became septic complic...

Introduction: Childhood obesity remains a major health concern and there are a number of serious complications associated with it. These include type 2 diabetes mellitus (T2DM), obstructive sleep apnoea (OSA), idiopathic intracranial hypertension (IIH) and non-alcoholic fatty liver disease (NAFLD). Glucagon-like peptide 1 (GLP-1) therapy has shown promising results for weight loss in adults and has recently been approved for the use in the treatment of childhood obesity for ad...

Introduction: There is a clinical need to develop novel and better biomarkers to monitor patients with neuroendocrine neoplasms (NENs). Our aim was to identify and track plasma circulating cell free tumour derived DNA (ctDNA) in a cohort of patients using a personalised, patient specific approach.Materials and methods: 35 serial plasma samples were collected from 9 patients with metastatic NENs (6 small intestinal and 1 each of lung, ovarian, and pelvic;...

Serum total cortisol has been linked to increased mortality in patients with Covid-19, but its reliability in critically ill patients is limited. We examined the association between serum free cortisol (SFC) levels and clinical outcomes in patients hospitalized with Covid-19 between 5/5/2020 and 1/3/2021 in our institution. Methods: SFC was measured in blood samples collected at patient’s admission, prior to any medical treatment. Patients’ fil...

Background: Among the various ethnicities in the Israeli mosaic, the Ethiopian community is the most recently settled, with an immigration that started less than 40 years ago. Largely young, this 160,000-member community comprises nonetheless about 25,000 persons 50 years or older, virtually all born in Ethiopia. Despite this growing aging population, there is no knowledge regarding osteoporotic fractures in this unique East African ethnic group, not even from data originating...

Androgen excess in women is most commonly caused by polycystic ovary syndrome (PCOS), but sinister ovarian and adrenal pathology requiring immediate action needs to be excluded. Here we examined whether the severity of androgen excess indicates the likely underlying pathology in women evaluated for androgen excess.We included all women undergoing assessment of serum DHEAS, androstenedione (D4) and testosterone (T) by liquid chromatogra...