Endocrine Abstracts

The National Diabetes Paediatric Audit Report (NDPAR) 2009–10 was published earlier this year. A total of 155 units submitted data to the report, representing an overall increase of 31 units since the 2008–9 audit. Whilst non-participation has been largely attributed to lack of resources and technical infrastructure, there are some concerns over the method of data collection and interpretation.Our unit entered the data by using the automatic ex...

Aim of the current glucocorticoid treatment strategies in patients with classic types of CAH due to 21 hydroxylase deficiency is to replace the lack of cortisol (substitution) and, secondly, to suppress excess adrenal androgen production by restoring the negative feedback on ACTH release (suppression).In adolescence, besides adequate substitution, achieving normal puberty and menstrual cycle, preventing hyperandrogenism (hirsutism) and prevention of the ...

Introduction: Micronodular adrenocortical disease is a very rare cause of Cushing syndrome in children. This adrenocorticotropic hormone (ACTH)-independent form of Cushing syndrome is mostly a part of the Carney Complex, which is caused by mutations in the PRKAR1A gene (1). A young female with endogenous ACTH independent hypercorticism without the classical gene mutations in the pigmented and the non-pigmented form of micronodular adrenal disease is presented.<p c...

Background: SGLT2i have shown promising results as an adjunct therapy in T1DM, resulting in better glucose control, weight loss and lower blood pressure. No increase in hypoglycemia risk, in particular severe hypoglycemia, was observed, but, an mild increased risk of (euglycemic) diabetic DKA was reported (Van den Mooter L. et al. Exp Opinion Pharm 2018).Case report: A 49-year-old Caucasian female nurse with underlying type 1 diabetes was admitt...

The treatment of papillary thyroid cancer consist of surgery and if indicated post-surgical administration of radioiodine with the initiation of thyroid hormone substitution. Whether or not a patient receives a post-operative radioiodine treatment largely depends on the pathological staging (TNM).Through observational data, the benefit of additional radioiodine treatment was only significant in patients with thyroid cancer classified as high risk accordi...

BackgroundLong-term glucocorticoids, as measured in scalp hair (HairGC), are associated with obesity and the metabolic syndrome (MetS). It is not known whether this represents a state of obesity or whether chronic hypercortisolism may influence the course or reversibility of obesity. In this study we longitudinally examine the relation between HairGC concentrations and metabolic syndrome parameters in patients with obesity who participate in a 1.5 year i...

IntroductionMeasurements of thyroglobulin (Tg) and Tg antibodies play a crucial role in the follow-up of treated differentiated thyroid cancer (DTC) patients, for instance to determine the response to therapy and the use of additional investigations and therapies. The aim of this study was to explore, from a laboratory perspective, the practical implications of the substantial clinical role of these measurements being imposed by national and internationa...

Based on insights obtained during the last decade, the classical concept of an activated hypothalamus-pituitary-adrenocortical (HPA) axis in response to critical illness is in need of revision. After a brief central HPA axis activation, the vital maintenance of increased systemic cortisol availability and action in response to critical illness is predominantly driven by peripheral adaptations rather than by an ongoing centrally-activated several-fold increased production and s...

Introduction: Adequate hormone replacement therapy in adrenal insufficiency is essential. Patients should have basic knowledge about their condition and what to do in situations which could trigger an adrenal crisis. Education on how and when hydrocortisone replacement therapy should be adjusted as well as instruction and practice an emergency injection are considered important measures to prevent an adrenal crisis. A standardized nurse-led group-based education programme (GEP...

Background: Medullary thyroid carcinoma (MTC) is a rare disease accounting for 1-3% of all thyroid carcinomas. Unfortunately, most patients present with metastasized disease: 70% with cervical lymph node metastasis and 5-10% with distant metastasis. Survival strongly correlates with stage of disease at diagnosis, illustrating the need for early diagnosis. Calcitonin is a well-established tumour marker for MTC, but its use in the screening phase is limited by a high rate of fal...