Endocrine Abstracts

Background: Vitamin D deficiency in pregnancy is a growing public concern amongst ethnic minority groups in the UK. This is related to both skin colour and clothing.Aim: To investigate vitamin D status in four ethnic groups in an inner city obstetric practice. This was part of an ongoing study of vitamin D deficiency and supplementation in pregnancy.Subjects: Women from St Mary’s Hospital, London were recruited at 28 weeks ges...

A 23-year-old Rwandan lady was 27 weeks pregnant and reported feeling non-specifically unwell for 3 days followed by 24 h of diarrhoea and vomiting. She denied fever, rash, polyuria, polydipsia, weight loss or foreign travel. She has sickle cell trait with no other past medical history. Laboratory glucose at 16 weeks gestation was 5.1 mmol/l.On admission she looked unwell and was tachycardic and dehydrated. Her capillary blood glucose was 17.9 mmol/l and...

Aims: Within Imperial College Healthcare Trust, St Mary’s Hospital has a large one-stop shop thyroid service. On average, 700 encounters have been recorded per annum in the St Mary’s thyroid nurse-led service since its inception in June 2017. We aimed to critically evaluate the role of the specialist nurse within safe and robust monitoring clinical parameters, to determine the conditions managed in the nurse-led service and assess attendance rate.<p class="abstex...

Background: Increased cardiovascular mortality and evidence of atherosclerosis have been reported in patients with pituitary disorders, irrespective of type of pituitary hormone deficiency. However, there are few data on cardiovascular events in patients with secondary adrenal failure due to pituitary disease compared with those who have primary adrenal failure.Subjects: 2052 patients with primary adrenal failure were compared with 20 366 matched control...

A 60-year-old Caucasian lady was referred to the metabolic bone clinic for assessment of osteoporosis. Her risk factors for osteoporosis included gender, postmenopausal status, childhood immobility due to illness, previous severe vitamin D deficiency, COPD, as well as an extensive smoking and alcohol history. She had multiple previous fragility fractures involving her ribs and both radii. A DEXA scan revealed lumbar osteoporosis (T -4.0) and femoral osteopenia (T -2.0). Thorac...

Grave’s orbitopathy typically presents with symptoms of proptosis and diplopia. It is an autoimmune condition of retro-orbital tissues. We present a case in which the management of orbitopathy has been complex and required escalation to immunosuppression and consideration of biological agents. A 34-year-old female presented with 2 weeks of diplopia. She had normal visual acuity with no past medical or family history. She never smoked. Thyroid eye disease was diagnosed, sh...

MEN2B is the most aggressive form of MEN2. Consequently, the new American Thyroid Association guidelines recommend prophylactic thyroidectomy early in the first year of life. Ninety-seven percentage of MEN2B cases result from a germline methionine to threonine mutation at codon 918 (M918T) of the RET proto-oncogene. In addition, an exceedingly rare alanine to phenylalanine mutation at codon 883 (A883F) has been reported in 4 unrelated adults. In each case metastatic MTC and th...

BackgroundWhilst hydrocortisone is standard glucocorticoid replacement therapy in patients with adrenal insufficiency, some have considered prednisolone an alternative. Some data have shown diabetes and osteoporosis risk. Mortality of patients using prednisolone in relation with those using hydrocortisone is not known. We compared all-cause mortality risk compared to matched controls in patients with primary or secondary adrenal insufficiency using predn...

BackgroundIncreased mortality risk of patients with adrenal insufficiency has been inconsistently reported. This might have resulted from the disparity of time and place of clinical care between the study patients and reference population. Also, data of patients with secondary adrenal insufficiency was limited as majority focused on other types of pituitary disorders. Therefore, we compared all-cause mortality of patients with primary and secondary adren...

BackgroundThyrotoxicosis with Graves’ Disease is treated with thionamide, radio-iodine treatment and thyroidectomy. Surgery is an important choice, especially when Graves’ Disease is complicated by thyroid orbitopathy. Pre- and post-operative protocols for thyroidectomy are imperative.Aims1) To assess pre-operative preparation of patients, with potassium iodide, vitamin D, beta blockade, and the pre...