Endocrine Abstracts

With the right balance of daily medication, individuals with adrenal insufficiency can expect to have a normal life span and to lead busy and rewarding lives. Despite this, research finds that people with adrenal insufficiency often feel below par compared to healthy individuals.(1)(2) One recent study found that the rate of hospital admission for adrenal crisis is almost three times higher for women with autoimmune adrenalitis than it is for patients with secondary adrenal in...

The majority of patients with Cushing’s syndrome are ACTH-dependent, but the diagnosis of ACTH-dependence, and then the differential diagnosis between Cushing’s disease and the ectopic ACTH syndrome, is dependent on the measurement of ACTH. In the mammalian adult anterior pituitary, POMC is cleaved into a variety of products including the ‘normal’ ACTH(1-39). In the pars intermedia (present in the human fetus and most mammals), ACTH is cleaved further by th...

The majority of patients with Cushing’s syndrome are ACTH-dependent, but the diagnosis of ACTH-dependence, and then the differential diagnosis between Cushing’s disease and the ectopic ACTH syndrome, is dependent on the measurement of ACTH. In the mammalian adult anterior pituitary, POMC is cleaved into a variety of products including the ‘normal’ ACTH(1-39). In the pars intermedia (present in the human fetus and most mammals), ACTH is cleaved further by th...

Recent epidemiological studies of primary adrenal insufficiency (Addison's disease) in Scandinavia have identified an average age at diagnosis of less than 40 (Bergthorsdottir 2006 n=1675, Erichsen 2009 n=426). They also found a broader range of ages than earlier UK studies, which had suggested that the majority of diagnoses occur in the third to fifth decades of life (Kong 1994, n=86). We analysed all membership records for the UK Addison’s Disease S...

Introduction: Hypothyroidism in pregnancy may be associated with neurodevelopmental delay of the unborn baby. Timely management of abnormal thyroid function tests (TFTs) in pregnancy is important. In our centre, some patients attend an Endocrinology-led dedicated antenatal thyroid clinic, whilst others attend an Obstetrician-led general antenatal clinic.Objectives: The management of hypothyroid pregnant patients attending our centre was audited against T...

Patients with chronic adrenal insufficiency (Addison’s) have mildly but significantly increased mortality from cardiovascular, malignant, and infectious diseases, predominantly pneumonia (Bergthorsdottir et al. 2006). Death from adrenal crisis is rare and largely preventable, but life-threatening adrenal crisis is a regular event in treated Addison’s with a previously reported annual incidence of 8% in the UK.We analysed the frequency of...

Pituitary apoplexy (characterised by sudden onset headache, meningism and cranial nerve defects) is an unusual but serious complication of pituitary macroadenoma. Less than 2 percent of patients with pituitary macroadenoma present initially with apoplexy. Pituitary adenoma is the presenting feature in 10–25% of cases with multiple endocrine neoplasia (MEN) type 1, with microadenomas accounting for 2/3 of MEN-related pituitary adenomas.A 35-year-old ...

Adrenal crisis is a life-threatening emergency requiring immediate treatment with high glucocorticoid doses. In diagnosed Addison’s disease between 3.8% and 29% of patients are estimated to need emergency hospital treatment per annum (Arlt & Allolio, 2003; Fleming & Ostergaard Kristensen, 1999).In 2003 we conducted the largest international survey of diagnosed Addison’s patients to date (N=868), enquiring about the causes and fre...

Autoimmune hypoadrenalism (Addison’s disease) is a rare condition with a European prevalence of up to 140 per million1. It frequently occurs in association with other organ-specific autoimmune diseases, both endocrine and non-endocrine. These conditions are recognised to occur in the extended family, but their prevalence has been hard to determine, because of the rarity of the disease.In 2003 we conducted the largest international survey ...

Factitious thyrotoxicosis secondary to Levo-thyroxine accounts for approximately 0.3% of all cases of hyperthyroidism. Although recognised as a cause of thyrotoxicosis, there are no peer-reviewed published cases of thyrotoxicosis secondary to ingestion of Tri-iodothyronine.A 23-year old lady presented to endocrine clinic with a 6-month history of palpitations, heat intolerance and tremor. She had a history of PCOS and reported difficulties with weight co...