Endocrine Abstracts

Objectives: Recently updated NICE guidelines (2015) on coeliac screening for children with Type 1 diabetes mellitus (T1DM) recommend just one initial screen for coeliac disease (CD) at the time of T1DM diagnosis and thereafter only if symptomatic. This is in contrast to the recommendation for on-going annual screening for autoimmune thyroid disease (ATD). Our unit has historically performed annual screening for both ATD and CD. Our study aimed to establish whe...

Objectives: Secondary Adrenal Insufficiency is diagnosed using an ACTH stimulation test. There is no clear evidence that either a Low dose Synacthen Test (LDST) or a Short Synacthen Test is more superior in diagnosis. In our service, we routinely use LDST to investigate adrenal function. There is a lack of standardisation regarding timing, dose and frequency whilst undertaking a LDST leading to diagnostic inconsistencies. We routinely measure baseline cortisol levels, then at ...

Background: Refractory hypothyroidism poses a clinical dilemma, with great difficulty to treat. Novel cases have targeted intramuscular (IM) levothyroxine (LT4) as a potential treatment for cases resistant to oral LT4. We discuss a patient who became intolerant of IM LT4 after 18 years of treatment, thus SC LT4 was initiated as alternative management.Case Presentation: 35-year-old female with diagnosed Schmidt’s Syn...

Genitalia appear larger and swollen in all neonates due to the circulating maternal hormones and this subsides spontaneously over few weeks or months. Additionally, general growth of the rest of the body outpaces any growth of the genitalia during childhood, resulting in apparent reduction in the size of the genitalia comparatively. There are high levels of circulating androgens in children with CAH until the commencement of medical replacement therapy (MRT). It is universally...

Background: Excess adipose tissue accumulation and obesity are characterised by a chronic, low-grade, systemic inflammation that contributes to obesity-related cardio-metabolic disease. Nestfatin-1 is a neuropeptide derived from the precursor protein nucleobindin-2 (NUCB2), which was initially reported to exert anorexigenic effects. We have previously shown that NUCB2/Nesfatin-1 is highly expressed in human and mouse subcutaneous white adipose tissue (Sc-WAT) and that circulat...

Introduction: Iatrogenic Cushing’s syndrome (ICS) can be caused by virtually all forms of steroid treatment with or without suppression of hypothalamic–pituitary–adrenal (HPA) axis. Here we report betamethasone nasal drops used as treatment post septorhinoplasty as a cause of iatrogenic Cushing’s syndrome.Case: A 36 years old female with background history of depression presented to endocrinology clinic for evaluation of progressive w...

Empty sella is an incidental finding characterised by the herniation of subarachnoid space into the sella turcica with resultant flattening of pituitary gland to varying extent. It was considered benign. But recent reviews have shown its association with some neuroendocrinopathies.Aims and Objectives: To determine if patients with radiological diagnosis of PESS were;1. Referred to Endocrinology team?2. What p...

Introduction: Hypoglycaemia is a common paediatric medical emergency, hence prompt treatment with appropriate investigations of causes is essential.Aims: 1) Re-audit investigations sent for children with hypoglycaemia after introduction of “Hypo-packs” from previous audit; (2) To improve awareness of local guidelines to unify clinical practice; (3) Review “Hypo-packs” and consider other improvements.Methods: A r...

Introduction: Resistance to thyroid hormone (RTH) is a rare inherited syndrome characterised by refractoriness of target tissue to thyroid hormone. Over 80% of cases are due to mutations in the thyroid hormone receptor beta (THR β) gene with over 100 mutations identified to date. The clinical manifestations vary from common feature as goitre to less common sinus tachycardia, learning disabilities, growth and developmental delay. Aim: We rep...

Chronic hypoparathyroidism (HypoPT) is a rare endocrine condition characterised by hypocalcaemia and deficient or absent parathyroid hormone. The recent European Society of Endocrinology Guidelines outline recommendations for treatment and monitoring of chronic HypoPT in adults. A Delphi panel was conducted to agree upon the characteristics that define ‘not adequately controlled on standard therapy’ where this relates to patients with chronic H...