Endocrine Abstracts

Neonatal thyrotoxicosis (NT) is a rare condition caused by the transplacental passage of maternal thyroid-stimulating antibodies from mothers with active Graves’ disease or a past history of the condition. We suspected that there were wide differences in the way that babies at risk of NT were managed in our locality and undertook a survey to establish the local approach to this clinical problem.Method: The lead clinician who was considered most like...

Energy homeostasis in mammals is controlled by the actions of circulating hormones, which coordinate fuel production and utilization between metabolically active tissues. Mounting evidence implicates the osteoblast as an important player in the coordination of global energy utilization through its hormonal interactions with other tissues. Leptin produced by adipocytes controls postnatal bone acquisition by activating sympathetic nerves whose efferent outputs target β...

Hyperinsulinaemic-hypoglycaemia has been described following Roux-en-Y gastric bypass for obesity and is thought to be due to hyperfunction of pancreatic β cells. It has been questioned whether the β cell hyperfunction may have preceded the bariatric surgery and contributed to the obesity. We report a case of hyperinsulinaemic-hypoglycaemia in a non-diabetic, lean patient (BMI 26 kg/m2) who underwent distal gastrectomy and Roux-en-Y bypass for a benign gas...

Acute and long-term complications attributable to diabetes are regrettably still common. To monitor for the development of such complications NICE recommend regular measurement of certain criteria to enable early intervention. A previous audit performed in our hospital looked at the adherence of paediatric diabetic reviews to NICE guidelines. As a consequence of this audit a detailed pro-forma to be used at all paediatric diabetic reviews was introduced....

A 20-year-old man presented to his general practitioner in 1990 with 4-months history of general malaise. He was clinically and biochemically thyrotoxic. Carbimazole was started but the patient stopped treatment on his own after 2 months. Two years later he was referred to our department with severe thyrotoxicosis marked by lethargy, shaking, palpitations and weight loss (FT4 116.6 pmol/l (reference range 10–24.5 pmol/l) TT3 8.8 nmol/l (1.0–2.5 ...

Sunitinib and sorafenib are orally active tyrosine kinase inhibitors which have recently been developed as therapy for renal cell cancer and gastro-intestinal stromal tumours. Changes in thyroid function are frequently found during sunitinib therapy, typically occurring 7–24 months into therapy; the mechanism is not clear, though inhibition of iodine uptake, thyroid follicular cell apoptosis and thyroiditis have all been proposed. In contrast, thyroid dysfunction is repor...

The pro-inflammatory cytokine interleukin-1 is selectively cytotoxic to rodent and human beta-cells in vitro, and anti-IL-1 therapies reduce diabetes incidence in animal prevention models: (1) IL-1 alone or in combination with other inflammatory cytokines causes beta-cell destruction in rodent and human islets and in perfused pancreas via MAPK and NFkB signaling, (2) IL-1 given i.p. to non-diabetes prone animals causes transient insulinopenic diabetes (3) IL-1 is expres...

A 43 year old hypertensive lady was referred to a surgical team at a tertiary oncology centre for consideration of completion thyroidectomy following removal of a nodule the histology of which had shown medullary thyroid carcinoma. She was reviewed in the cancer Multi-Disciplinary Team meeting; surgery was deferred until she had been reviewed in the endocrine clinic.There was no known family history of MTC or other endocrine abnormality; however the pati...

Type 1 diabetes mellitus is usually believed to present acutely and it is assumed that metabolic decompensation is sudden.We present 3 cases of asymptomatic type 1 diabetesCase1A 28 year old asymptomatic gentleman moved to a new surgery and glycosuria was noted as part of routine screening , no ketonuria., body mass index 21, no past medical illness or any family history of diabetes. His fasting blood glucose...

Background: TIRADS scoring is used to assess the thyroid nodules using USG, commonest used is ACR-TIRADS; another is K-TIRADS scoring. Nodule stiffness is assessed by elastography strain Rago scoring & FNA nodule gives lower (benign) or higher Bethesda (possible malignant) category report. The combined use of TIRADS & Rago scorings with Bethesda as final output can assess whether addition of elastography improves the correlation between thyroid nodule TIRADS scoring an...