Endocrine Abstracts

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Introduction: Hyponatraemia is a common cause of morbidity and mortality affecting 15–28% of inpatients. Tolvaptan is a competitive vasopressin 2 antagonist licensed to treat hyponatraemia secondary to the syndrome of inappropriate anti-diuretic hormone secretion (SIADH). There has been concern that tolvaptan treatment may lead to rapid overcorrection of sodium in a minority of patients, thus potentially leading to osmotic demyelination syndrome.Met...

Background: Community based surveys have revealed that approximately 20% of patients taking thyroxine have low serum TSH concentrations. Likewise, a high proportion of patients (27%) have been found to have high TSH concentrations. Suboptimal thyroxine treatment, in particular overtreatment, is associated with significant potential health risks including atrial fibrillation and osteoporosis. In Sheffield, thyroxine treated patients are routinely enrolled on a computerised thyr...

Graves' disease (GD) is an autoimmune disorder of the thyroid gland, of which the aetiology is unknown, but susceptibility to disease is thought to result from both genetic and environmental factors. Familial clustering data suggests that GD is a polygenic disorder, with laboratory studies identifying the HLA gene region and the CTLA-4 gene region as susceptibility loci. However, together the HLA region and the CTLA-4 gene regions only contribute about 50% towards the genetic ...

Aim: To evaluate the outcomes of radioactive iodine therapy (RAI) in benign thyroid disease following implementation of 2007 Royal College of Physicians (RCP) guidelines in a large NHS foundation trust.Method: The medical records of patients referred for RAI therapy at Sheffield Teaching Hospitals (UK) between 2013 and 2015 were retrospectively reviewed. Patient data was collected from patients’ notes and electronic documents system. The data record...

Background: Graves’ disease is the commonest cause of hyperthyroidism. Although first line and definitive treatment options are clearly defined, management practices and the natural history in terms of outcomes of treatment in a large consecutive cohort of Graves’ disease has not been well characterised.Aims: To describe incidence, presentation, diagnosis, management strategies and medium term outcomes following anti-thyroid drug treatment, rad...

We have studied 20 patients with autoimmune hypothyroidism on large doses of daily thyroxine that were referred to our departments with concerns regarding possible thyroxine malabsorption or compliance issues. Here we describe 3 patients seen in Oxford. One patient had coeliac disease. The other two patients had no history of malaborption and were coeliac antibody negative. None of the 3 patients were on medication which would interfere with thyroxine absorption. All were fema...

BackgroundPropylthiouracil treatment of Graves' disease has been postulated to provoke anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis, particularly myeloperoxidase (MPO)-ANCA, however it is unclear whether the abnormal immune environment of autoimmine thyroid disease influences the development of ANCA.MethodsThe occurrence of ANCA and the relationship to thionamide treatment was investigated in 407 patients' with Graves' disease, 200 with Hashimo...

A number of candidate genes have been investigated as susceptibility loci for the development of Graves' disease. Those which appear to be consistently associated with disease include the HLA and the CTLA-4 gene regions. Polymorphisms of the VDR gene have been shown to increase susceptibility to autoimmune diseases including type 1 diabetes, multiple sclerosis, and Crohn's disease. Recently, an association has also been reported between the VDR gene and autoimmune thyroid dise...

Systemic lupus erythematosus (SLE) is characterised by the activation of autoreactive T and B cells and the production of autoantibodies. Concordance rates in monozygotic and dizygotic twins, along with familial clustering, suggest that SLE has a strong genetic component. Moreover, the co-existence of SLE and other autoimmune diseases within individuals, including autoimmune thyroid disease (ATD), suggests a sharing of general autoimmune susceptibility loci. Case control studi...