Endocrine Abstracts

Background: While few hypothyroid patients require more than the expected weight related dose of levothyroxine, the underlying causes of larger-than-expected dosing requirements have not been studied in a single cohort. Our aim was to determine and quantify the multiple factors contributing to high dose levothyroxine requirements in a cohort of patients with hypothyroidism.Methods: The Grampian Automated Follow-Up Register (GAFUR) monitors around 17 500 ...

Vitamin D deficiency with secondary hyperparathyroidism is common in South-east Asia. In contrast, primary hyperparathyroidism is relatively rare. We present a case of severe proximal myopathy with significant diagnostic delay.A 23-year-old lady presented with a 2 years history of lower back pain, radiating to both groins and upper thighs associated with recurrent falls. Her pain and weakness progressed insidiously leading to difficulty standing or walki...

Introduction: In our institution the post high-dose RAI whole body scan (WBS) report includes a measurement of quantitative percentage uptake of the dose of RAI administered although this may not be standard practice elsewhere. We aimed to ascertain whether this was associated with the extent of unresected thyroid tissue or residual thyroid cancer following total thyroidectomy and neck dissection represented by the post-surgery TSH-stimulated thyroglobulin concentrations. Meth...

Unwanted late effects of cranial irradiation frequently include endocrine and psychosocial impairment, which may be overlooked in routine follow-up. The aim of the present study was to obtain systematic data on the long-term, psychosocial impairments of patients treated with cranial irradiation as compared to a non-irradiated control group. Both groups were fully hormone replaced including growth hormone (GH) substitution.A compilation of questionnaires ...

Case report: A 33-year-old pregnant Nigerian woman presented at 37 wks gestation with a 2-week history of frequent headaches and visual disturbance. She had persistent galactorrhoea following previous pregnancy in 1998, which settled after a short course of bromocriptine. On examination, she had classical bitemporal hemianopia. Her prolactin was raised at 19,220 mU/L (higher than expected in a normal pregnancy), random cortisol 553 nmol/L and thyroid function tests satisfactor...

Background: Generalised Resistance to Thyroid Hormone (GRTH) is an autosomal dominant condition with impaired tissue responsiveness to thyroid hormones. The majority of patients are asymptomatic and compensate adequately by elevated thyroid hormone production.Index case: A 47-year-old woman was referred to the thyroid clinic in 2000 when routine thyroid function tests (TFT) showed elevated TSH at 4.9 mU/l and fT4 36 pmol/l. A TSH-oma was excluded by norm...

Background: True cyclical Cushing's syndrome is rare and usually due to an ACTH-secreting corticotrophinoma. We describe a man with cyclical Cushing's syndrome of 15 years duration who had unexpected pituitary immunohistopathology.Clinical details: A 22-year-old man presented in 1986 with clinical features of Cushing's syndrome & urinary free cortisols up to 1800 nmol/24h, but normal low-dose DXM suppression, & normal pituitary and adrenals on CT. He was then lost ...

Background: Since receiving its UK licence in 1994, cabergoline [CAB] has become the dopamine agonist of choice for the management of hyperprolactinaemia in most UK endocrine units. Aim: To review the outcomes for the mother and neonate when CAB is taken during conception and into early gestation. Method: Retrospective review of Aberdeen casenotes from all hyperprolactinaemic women of childbearing age on CAB therapy and those of their live born infants. Results: Twenty women w...

The high survival rate for patients with differentiated thyroid carcinoma (DTC) declines markedly in those with bony metastases. We compare the management of two patients with large dominant pelvic metastases.Case 1 63 year old man with R hip pain. Investigation revealed a 10cm lesion in the R hemi pelvis and subsequent imaging and biopsy revealed a 9th rib lesion and metastatic follicular DTC. He underwent 131 I ablation of the normal thyroi...

Background/methodsPatients with uncontrolled acromegaly or receiving high cost medical therapy despite initial treatment, usually transsphenoidal surgery (TSS), were considered for a ¹¹C-methionine PET-CT scan (11C-Met PET-CT). This imaging technique may identify a target for TSS or radiotherapy when MRI appearances are inconclusive1. In preparation, four patients on long-term SSA were taken off treatment 3 months prior to the scan. ...