Endocrine Abstracts

Introduction: Polyendocrine autoimmune syndrome is a group of disorder involving endocrine glands as a consequence of autoimmunity. Non-endocrine organs also may be affected. An association between autoimmunity and immunodeficiency has also been recognized. We report a case of polyglandular autoimmune disease associated with common variable immunodeficiency.Case report: A 26-year-old was diagnosed with Addison disease at the age of 4 following recurrent ...

Introduction: Children with Down syndrome (trisomy-21/T21) are at risk of developing congenital and early (diagnosed ≤1 year) hypothyroidism. Our current monitoring follows the Down Syndrome Medical Interest Group (DSMIG) guidance: performing thyroid function tests (TFT) at birth and 12 months.Aims/objectives: 1) Determine the incidence of congenital/early hypothyroidism in babies with T21 and determine long-term thyroid function outcomes (by age 4...

Introduction: Aldosterone is a potent adrenal steroid hormone which regulates renal sodium reabsorption and potassium secretion. Clinically, measurement of aldosterone is important to identify patients with primary hyperaldosteronism, and has traditionally been performed by immunoassay. The specificity of immunoassays is often poor due to antibody cross reactivity to other structurally related steroid hormones, resulting in falsely elevated concentrations. To overcome these li...

A 48-year-old female received radioiodine ablation therapy for thyrotoxicosis secondary to a solitary toxic nodule. The subsequent unexpected requirement for replacement thyroxine was explained by Hashimoto’s thyroiditis with an anti-thyroid peroxidase antibody level of 692.3 IU/ml. Thirty months later she presented with debilitating left facial pain and painful sensory symptoms of her left arm and leg. She was euthyroid taking thyroxine 75 μg daily with a fT4</...

Clinical guidance recommends titrating the dose of metyrapone against serum cortisol concentrations. These serum samples are usually measured by immunoassays; however it has been well documented that there are interferences in these assays in patients with altered steroid metabolism due to a pathological process or drug treatment. The increasing availability of mass spectrometry (MS) assays for steroid hormones may circumvent this issue and assays that measure multiple steroid...

Testosterone, androstenedione and DHEAS are commonly measured by immunoassays. Variations in antibody specificity and calibration of assays results in non-commutability of measurements. Even more specific mass spectrometry (LC–MS/MS) assays still exhibit differences in calibration. As the use of mass spectrometry for measuring steroids is becoming more common in the clinical laboratory, the development of LC–MS/MS reference ranges for these analytes is essential to h...

Salivary cortisol is an increasingly popular tool in endocrine, psychological and sports studies. Immunoassays used for its measurement are limited by cross-reactivity from related steroids, mainly cortisone, which is abundant in saliva.A method was developed for the simultaneous measurement of cortisol and cortisone (SalF and SalE respectively) in saliva using LC-MS/MS. 40 μl of extract was injected onto a C8 4×2 mm guard cartridge attached to...

Salivary cortisol (SalC) potentially has advantages over serum cortisol (SerC) as it is easier to collect and possibly reflects unbound (free) cortisol. SalC levels are approximately 10 times lower than SerC and require high measurement precision best addressed by liquid chromatography–tandem mass spectrometry (LC-MS/MS), which in contrast to previously used radioimmunoassays eliminates cross-reactivity by other steroids. We describe the use of LC-MS/MS to evaluate the po...

The link between thyrotoxicosis and coronary artery disease is complex with associations between therapy and vasculitis, as well as thyroid hormone excess and coronary artery spasm described. We present a 37-year-old female with a one-year history of Graves thyrotoxicosis treated with Propylthiouracil, who presented acutely with chest pain and a left hemiparesis. Typical electrocardiography changes and elevation of Troponin T confirmed a recent myocardial infarction, and CT sc...

We report 2 patients with Graves’ thyrotoxicosis complicated by jaundice.Case 1 - A 36 year old referred to the gastroenterologists with a 3-month history of general malaise, myalgia, jaundice, 4 stone weight loss and diarrhoea. A hepatitis and autoimmune liver screen were negative, bilirubin elevated at 200 umol/l, coagulation screen and ultrasound scan were normal and a liver biopsy showed cholestasis. Thyroid function tests (TFT’s) demonstra...