Endocrine Abstracts

Background: Management of adrenal insufficiency (AI) with glucocorticoid replacement is associated with increased mortality and morbidity. There is growing evidence that this is because of excess, non-physiological steroid exposure. Low dose prednisolone (2-4 mg) is a once-daily alternative to standard hydrocortisone regimens that more closely mimics the circadian rhythm and may translate to better outcomes. There is however a paucity of studies comparing the two treatments.</...

Introduction: Eligibility for bariatric surgery in the Unighted Kingdom is based on specific body mass index (BMI) thresholds and the presence of obesity-associated complications. Patients with partial lipodystrophy (LD) often have an abundance of metabolic and cardiovascular complications, but their abdominal adiposity does not always substantially increase BMI. The consequence is that patients with LD may be inappropriately excluded from obesity treatments when judged by BMI...

Case history: This 33-year old Scottish female presented in February 2017 with a 3-month history of vomiting, erythematous vesicular pruritic rash and three stone weight loss. The rash started 1 day postpartum in January 2015 and migrated from dorsum of feet to both lower legs, upper thigh and torso. A negative biopsy for pemphigus led the team to suspect necrolytic migratory erythema (NME) in November 2016. Her past medical history includes gestational diabetes with her third...

Background: The presence of liver metastases is a poor prognostic factor in patients with Neuroendocrine tumours (NET). Resection of NET liver metastases (NET mets) has been reported to be associated with good long-term outcomes but must be balanced against the risks of major surgery. Thermal ablation or arterial embolisation offers an alternative to surgery.Objective: To review the outcomes of radical treatment of NET mets.Materia...

Background: Adrenal insufficiency (AI) is a life-threatening condition if left unmanaged. Despite treatment patients can expect a life expectancy that is shortened by 12 years secondary to probable inherent over-replacement associated with oral glucocorticoid regimens. Thrice-daily hydrocortisone is the most common regimen used. Very low-dose prednisolone (2-4 mg) is an alternative with lower uptake due to the absence of evidence for its use. This study fills this literature g...

Objective: Propensity score matching (PSM) was used to study whether male patients with differentiated thyroid cancer (DTC) were the risk factors for prognosis after 131I treatment.Methods: 1677 patients with DTC who underwent total thyroidectomy and received 131I treatment were divided into male group (n= 546) and female group (n= 1131). The PSM method was adopted to process all the data to reduce the influence of...

A 46-year-old lady was referred to endocrinology with thyrotoxicosis. She was diagnosed with Graves’ disease by her GP in October 2016 when presenting with classical symptoms and investigations [TSH<0.01 mIU/L (NR 0.3–4.2), fT4=34.3 pmol/L (NR 9–23), TSHrAb>30 u/mL (NR<0.4), and increased iodine uptake]. She was therefore started on carbimazole 15 mg/day. She returned to her GP in December 2016 reporting resolved symptoms, however, she ...

A 46-year-old lady was referred to endocrinology with thyrotoxicosis. She was diagnosed with Graves’ disease by her GP in October 2016 when presenting with classical symptoms and investigations [TSH<0.01 mIU/L (NR 0.3–4.2), fT4=34.3 pmol/L (NR 9–23), TSHrAb>30 u/mL (NR<0.4), and increased iodine uptake]. She was therefore started on carbimazole 15 mg/day. She returned to her GP in December 2016 reporting resolved symptoms, however, she ...

A 53 year old female weighing 117 kg was thought to be slightly cushingoid by her GP who checked a morning cortisol. This was surprisingly undetectable (<28nM) on 13th June 2022. The patient was urgently referred for a medical opinion. A repeat cortisol in A&E was 29nM with an undetectable ACTH. Given the lack of clinical features of adrenal failure, further history was obtained. The patient appeared well on examination, and denied any inhaled, oral/ topical steroid us...

Aim: The current focus for the treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) is lifestyle intervention with the aim of significant weight loss. NAFLD is tightly associated with type 2 diabetes (T2D) and obesity. In patients with T2D, glucose lowering agents that promote weight loss have shown a beneficial impact on NAFLD. However, it remains unclear as to whether glucose lowering can improve NALFD in patients with T2D, independent of weight loss.<p class="abstext"...