Endocrine Abstracts

Background: Radioactive iodine (RAI) therapy is well-established in the management of benign thyroid disorders associated with thyrotoxicosis, but the optimal dose remains controversial. Guidelines recommend 500–800 MBq, though it is thought that Graves’ thyrotoxicosis may respond more readily to lower doses (400–600 MBq).Methods: We studied all local cases receiving RAI over four calendar years (2010–2013; n=447). Demographi...

The myokine irisin is secreted after cleavage of the transmembrane protein Fibronectin type III domain-containing protein five and was shown to induce a thermogenic program in white adipose tissue. This cleavage can be induced by exercise, thus linking exercise with browning of adipose tissue. We investigated the response of Fndc5/irisin as well as its inducer Peroxisome proliferator-activated receptor gamma co-activator 1α (Ppargc1a) in mice long-term selected for high t...

Background: The diagnosis of neuroendocrine tumor disease has been tardy due to a lack of sensitive, noninvasive technology to facilitate identification. In the 1960’s, diagnosis required tumor tissue attained by surgery or biopsy. Identification was by histopathology and immunohistochemistry (1975). Acquisition of information was limited by the morbidity of invasive strategies, inability to reassess and interpretation was user-dependent with low kappa values. The introdu...

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 insufficiency (primary/secondary) is a rare and potentially life-threatening condition which can be easily overlooked. Patient awareness and management of problems is critical and central to effective treatment. The NICE Clinical Knowledge Summaries for patients identifies and recommends critical areas that require attention in adrenal insufficiency. In particular, patients should:i) Realize the need for lifelong glucocorticoid repl...

Atrazine (ATR) is a widely used herbicide, with known effects as an endocrine disrupting chemical. Several studies have implicated ATR in causing disorders of sex development in reptiles, and chronic exposure can cause an increase incidence of intersex in fish, suggesting that the hypothalamo-pituitary–gonadal axis is a major site of ATR action. In this study, we investigated whether acute exposure (hours to days) to ATR could cause abnormalities in the development of Zeb...

This is a case of a 49 year old obese Caucasian female who was referred to an endocrinology clinic for investigation of Cushing’s syndrome, based on raised blood pressure and cushingnoid facies. The patient had underlying schizophrenia and was stable on clozapine. Her blood pressure was 150/99 mmHg on bendrofluoriomethiazide and candesartan. Her 24 hour urinary free cortisol was normal but 24 hour urinary free noradrenaline was elevated at 835 nmol (76–561) with norm...

20% of cases of FIPA have AIP gene mutations. These adenomas are often large and invasive. Our index case presented aged 13 with pituitary apoplexy. Histology showed necrotic tissue. He continued to grow and was 195 cm 4 y later. GH excess was confirmed. After treatment with octreotide and radiotherapy remission was achieved. His first cousin had also been successfully treated for acromegaly. This led to the original familial diagnosis. Subsequently, the c.910C>T, p.R304X ...

Introduction: In our institution the post high-dose RAI whole body scan (WBS) report includes a measurement of quantitative percentage uptake of the dose of RAI administered although this may not be standard practice elsewhere. We aimed to ascertain whether this was associated with the extent of unresected thyroid tissue or residual thyroid cancer following total thyroidectomy and neck dissection represented by the post-surgery TSH-stimulated thyroglobulin concentrations. Meth...

Introduction: Thyrotropinomas are rare pituitary tumour accounting for 0.5–1.0% of all pituitary tumours. There are only seven reported cases of mixed TSH/LH/FSH producing adenoma. We report a patient with secondary hyperthyroidism due to TSH producing adenoma co-secreting FSH and LH.Case report: A 75-year-old Caucasian male was seen with 2-year history of tiredness, anxiety and palpitations along with 7-month history of weight loss. He also complai...