Endocrine Abstracts

Addison’s disease rarely newly presents during pregnancy. We highlight two cases diagnosed within 3 months. A 41-year-old with mild depression on Sertraline, presented at 11-weeks’ gestation with an 8-week history of fatigue, weight loss, dizziness and vomiting. Persistent hyponatraemia was noted (Na 122–127 mmol/l). Random cortisols were 298–428 nmol/l. Sertraline withdrawal and fluid restriction at another centre did not improve her hyponatraemia, the use...

Introduction: Primary hyperaldosteronism (PHA) accounts for 5–13% of all hypertension and up to 20% of resistant hypertension. Aldosterone producing adenomas (APA) account for 60% of PHA and surgical resection in these patients can be curative. There is no consensus on the need for and duration of follow-up after adrenalectomy. This study assessed the immediate effect of unilateral adrenalectomy for APA on the serum potassium, renin and aldosterone levels. Acute effects o...

Case history: A 42-year-old female presented to the emergency department with dizziness, vomiting, abdominal pain and thirst. While investigating a 3-month history of lethargy, menstrual irregularity and weight loss, her GP had found a raised TSH, FSH and LH and had prescribed levothyroxine and, 1 week prior to admission, Adcal-D3 supplements. On examination, she was hypotensive and hyperpigmented.Investigations: Na+130 mmol/l (132–144), ...

Introduction: Antiphospholipid syndrome (APS) is the association of anti-cardiolipin antibodies and venous & arterial thrombosis. APS accounts for <0.5% of cases of hypoadrenalism. We present a series of 5 such cases occurring at our institution plus a further patient identified with unilateral adrenal haemorrhage. Case 1 presented with nausea, vomiting and weight loss. Lupus anticoagulant positive. Commenced aspirin 300 mg. 6-weeks later represented with dehydration, ...

Hyperthyroidism due to Graves’ disease (GD) is traditionally managed in the secondary care ambulatory setting. Conventionally patients are required to attend for regular review at 4–12 weekly intervals, presenting practical difficulties for many adults. Nurse-led Telephone Consultations are gaining momentum in the care of long-term conditions. This Service Development Project (SDP) addressed whether or not a specialist nurse delivered telephone consultation could be ...

GnRH is released from the hypothalamus in a pulsatile manner and binds to specific receptors (GnRHR) in the anterior pituitary gland to stimulate follicle-stimulating hormone (FSH) and luteinizing hormone (LH) subunit gene expression and subsequent FSHβ and LHsecretion. The FSH and LH subunits are preferentially stimulated by pulsatile GnRH at low and high pulse frequencies, respectively. The transcription factors, cAMP response element binding protein (CREB) and inducibl...

Background: Testosterone replacement therapy has been shown to produce a wide range of benefits for men with hypogonadism with studies showing improvement in libido, bone density, muscle mass, body composition, mood, cognition, and erythopoiesis. The risks associated with testosterone replacement therapy are less well characterised and there is a lack of larger randomised trials. One recognised risk is polycythaemia. The aim of this study is to assess the frequency of polycyth...

Background: A variety of thyroid antibody assays are used in the diagnosis of auto-immune thyroid disease (AITD). Commonly both thyroid peroxidase (TPOab) and thyroglobulin antibodies (TGab) are measured but the added value of testing two markers has not been established.Method: We retrospectively collected clinical and laboratory data on 500 consecutive patients who had thyroid autoantibodies requested from a specialist endocrine department of a tertiar...

Topical testosterone gels are now a widely used method of testosterone replacement therapy and have been shown to be convenient and effective. The unintentional transfer of testosterone gel to children or partners by skin contact with the application site causing hyperandrogenism has been described.A 3-year-old well girl was referred for assessment of precocious puberty. Pubic hair had been first noted by her mother 9 months earlier. There was no history...

Introduction: Congenital hypothyroidism (CHT) has a reported incidence of 1:3500 in Caucasian populations. Early detection by newborn screening and appropriate L-thyroxine treatment leads to normal or near-normal neurocognitive outcome.The National Newborn screening programme (NNP) was established in Children’s University Hospital, Temple St. in 1979. This study aimed to ascertain the incidence of congenital hypothyroidism in the Republic of Ireland...