Endocrine Abstracts

Introduction: Women with premature ovarian insufficiency (POI) may complain of various symptoms and consequently be seen by clinicians in a range of settings. Management is multifactorial and may vary depending on the awareness of practitioners within each specialty/subspecialty. In 2015, the European Society for Human Reproduction and Embryology (ESHRE) published guidelines on the management of POI. These state that women should have the following investigations: karyotype; s...

Background: Hyperthyroidism affects 1.3% of the population. The antithyroid drugs (ATD), carbimazole and propylthiouracil, can induce agranulocytosis, a rare but potentially life threatening side-effect with a prevalence of 0.10–0.15%. We assessed the adequacy of our patient’s knowledge of this side-effect.Methods: Patients on ATD completed a questionnaire before attending clinic. The questionnaire consisted of nine questions detailing informat...

Diagnosis of primary hyperparathyroidism is often made incidentally following routine biochemical screening. Parathyroidectomy is usually carried out in patients at risk of disease progression or with clinical features that may improve and that is in line with NIH guidance. Current recommendations suggest that Minimally Invasive Parathyroidectomy (MIP) should take place only if sestamibi and ultrasound findings are concordant. We studied the medical notes of 53 patients, aged ...

We present a 20-year-old lady who was known to have MEN-1 and had previously been treated for hyperparathyroidism at a different hospital in 2003 with excision of right upper and lower and left lower parathyroid glands and left thyroid lobectomy, resulting in normalisation of adjusted calcium (adjCa) levels.She presented to our department with persistently elevated adjusted calcium levels (adjCa 2.69 mmol/l) along with raised parathyroid hormone (PTH 16 ...

Background: Current UK guidelines for the Use of Thyroid Function Tests provide specific recommendations for the use of thyroid function tests in inpatients. Isolated alterations in TSH occur in 15% of inpatients and <2% will have underlying thyroid disorder. Thyroid function should be repeated every 4–6 weeks when changing thyroxine replacement dose or when commencing thionamides.Aim: To identify the indications and frequency of thyroid tests i...

A 25 year old man, with no significant past medical history and on no medication, presented to Accident and Emergency with collapse. He was anuric, hypotensive, with a sodium of 107 and a potassium of 8.8. Electrocardiographic changes showed widening of the QRS complex and tall tented T waves. He was in prerenal renal failure with a creatinine of 377 and urea of 36.9.This presentation came after a week of feeling non-specifically unwell, progressive fati...

Adult survivors of haematological malignancies are subject to a number of putative insults to the skeleton. Adverse impacts on bone mass include sex-hormone deficiency, radiotherapy, chemotherapy, inadequate nutrition and a generalised catabolic state. We assessed BMD using DXA at the lumbar spine (LS) and femoral neck (FN) in 34 women with POF, defined by secondary amenorrhoea, elevated gonadotropins, and low oestradiol levels. Mean age at diagnosis was 29.7 (range 14–45...

The optimal oestrogen dose required to maintain bone mass in young women who develop POF is contentious. We reviewed longitudinal BMD data in 21 women with POF resulting from multi-modality cancer therapy for haematological malignancies. The 21 women were of mean age 30.6 (range 17–45) years at onset of amenorrhoea and weight 64.1+/−11.2 kg. Primary diagnoses were acute myeloid leukaemia (n=12), chronic myeloid leukaemia (n=5), acute lymphocytic leukae...

Prenatal manipulations in animal models result in lifelong alterations in the stress responsivity of the hypothalamic-pituitary-adrenal axis (HPAA). While several human studies have found raised 0900h cortisol concentrations in low birthweight individuals, twenty-four hour cortisol profiles do not vary according to birthweight (a marker of adverse antenatal exposures). One explanation for this dichotomy is that 0900h cortisol concentration measured in a novel clinic setting ma...

Adeno-associated virus (AAV) has been used to express GFP in a variety of tissues. AAV has a tropism for neurones and we have been using AAV-GFP to determine the anatomical localisation of gene transfer after injection into the hypothalami of Wistar rats. The long term aim is to use this viral vector as a tool for investigating the hypothalamic control of appetite, energy expenditure and pituitary function.Male Wistar rats were anaesthetised and injecte...