Endocrine Abstracts

Overt hyperthyroidism occurs in about 0.1–0.4% of all pregnancies. Propylthiouracil (PTU) is recommended in first trimester due to risk of teratogenicity with Carbimazole (CBZ). CBZ is preferable in rest of the pregnancy and postpartum period due to risk of serious liver disease with PTU. We reviewed our management of hyperthyroidism in pregnancy from 2009 to 2014. Total number of pregnancies =34, mean maternal age 32.6 years. Except one all (33/34) were diagnosed pre- pr...

Hypoparathyroidism post-thyroidectomy is a recognised complication and treated with calcium supplements, vitamin D, and rather recently with recombinant human parathyroid hormone therapy (teriparatide). We report a case of a 68-year-old female who developed refractory hypocalcaemia and hypomagnesaemia following thyroidectomy for a multinodular goitre. Her management was complicated by inflammatory bowel disease, surgically treated with an ileostomy in situ. Post-opera...

Background: The glands most commonly affected in MEN1 are parathyroid, pituitary and pancreas. Pancreatic neuroendocrine tumours (pNETs) are of foregut origin, but a number of other so-called ’foregut carcinoid tumours’ may also occur in MEN1, including tumours of bronchial, thymic, and gastrointestinal origin. Reported rates of prevalence of these latter tumours vary from 2% for thymic and bronchial carcinoids, to 10% for gastric carcinoids. Thymic carcinoids have b...

Introduction: Adrenal incidentalomas (AI) are mostly benign and non secretory, but some are malignant. Current diagnostic and management algorithms are not fail safe when assessing malignant potential, although functional status is much easier to assess. We present a subject with multiple comorbidities whose AI was a very rare adrenal leiomyosarcoma (AL)Case presentation: A 40-year-old woman with SLE and the antiphospholid syndrome on lifelong warfarin t...

Introduction: The incidence of adrenal insufficiency in cases of unexplained death in young children is unclear. It is also unclear whether there is a relationship between adrenal size and plasma cortisol concentration.Methods: All post-mortem (PM) reports of sudden deaths in children in the West of Scotland between 2010 and 2012 were retrospectively analysed. Combined adrenal weight (g) was recorded and expressed as the percentage of total body weight (...

Introduction: Measurement of the anterior pituitary hormone prolactin is often performed in patients with pituitary pathology. Mild hyperprolactinemia occurs in subjects with hypothalamic disorders and/or pituitary stalk dysfunction, and is also described in patients with isolated optic nerve hypoplasia (ONH), this is proposed to be due to decreased dopaminergic tone.Objective: To assess prolactin levels in patients with septo-optic dysplasia (SOD) (with...

Cardiovascular risk factors are more prevalent in south Asian (SA) adults compared to White Europeans (WE), although the reasons for this are not fully known. Vascular growth factors (VGFs) are increasingly recognised to have various roles in arterial development, function and remodelling. We hypothesised that ethnic differences in VGFs in early life contribute to the later differences in CV risk. We further hypothesised that arterial stiffness, as a measure of large artery st...

The Royal College of Physicians guidelines (2007) on follow-up post radioiodine therapy for hyperthyroidism recommend thyroid function monitoring around weeks 6, 12, 26, 39, 52 and yearly thereafter in stable patients. We retrospectively analyzed data from 91 patients given radioiodine in 2005 who were followed-up locally comparing our practice with these standards. Fifteen percent of patients were lost to follow-up before year one with 40% of these not having their thyroid fu...

3-M syndrome is an autosomal recessive disorder characterised by severe pre- and post-natal growth failure, a characteristic facial appearance (triangular shaped face, fleshy tipped nose) and radiological features (slender long bones and tall vertebrae). 3-M syndrome is known to be caused by mutations throughout the Cullin 7 gene, identified in a range of ethnic groups including Brazilian, European, Moroccan, Yakutskian and Indian.We have now identified ...

Background: Virilising congenital adrenal hyperplasia (CAH) is the most common cause of genital ambiguity, and 90–95% of CAH cases are caused by 21-hydroxylase deficiency. Associated inefficient cortisol synthesis results in increased CRH and ACTH levels, leading to production of excess sex hormone precursors. These are further metabolized to active androgens and to a lesser extent oestrogens. We recently reported that one of these androgens, DHEA-S or its metabolites sig...